Low back pain (LBP) is a condition widely experienced by the global population and is one of the leading causes of disability in individuals. The persistence of this condition for three months or more characterizes its chronicity, referred to as chronic low back pain (CLBP). Current evidence suggests that managing CLBP should combine active movement interventions with psychosocial strategies, such as educational approaches, aimed at transforming dysfunctional beliefs into those more aligned with the biopsychosocial model. One way to assess the effectiveness of educational interventions is through instruments that evaluate beliefs and knowledge about pain, such as the Pain Concepts Questionnaire (PCQ). However, this instrument has not yet been validated or cross-culturally adapted for Brazilian Portuguese.

To translate and cross-culturally adapt the Pain Concepts Questionnaire into Brazilian Portuguese.

The PCQ consists of 25 items assessing core pain concepts, which included items related to beliefs about the causes of pain and pain flare-up, pain processing in the brain, and treatment options that reflect a biomedical approach and biopsychosocial approach to pain management. Responses are rated on a 5-point Likert scale: 1) strongly disagree, 2) somewhat disagree, 3) not sure, 4) somewhat agree, and 5) strongly agree. The cross-cultural adaptation process was carried out in five stages: forward translation, translation synthesis, back-translation, expert committee meeting, and pre-final version testing. Thirty participants answered the pre-final version of the PCQ and completed the cognitive interview in which comprehension, comprehensiveness and relevance were assessed. Suggestions to improve the instruments were considered when at least 20% of the participants reported issues with the item.

Two translators fluent in English and native Portuguese speakers translated the PCQ into Brazilian Portuguese. Another two translators, fluent in Portuguese and native English speakers, back-translated it into English. All translators worked independently and were unaware of the original version. A specialist committee, including translators, physiotherapists, and experts in rehabilitation and pain, resolved disagreements to create the pre-final version of PCQ-Brazil. The sample had a mean age of 41.80 years (DP = 11.65), with 60% (n = 18) female and 40% (n = 12) male. Most participants (53.33%, n = 16) had completed high school. Participants answered the pre-final version and reported no issues with comprehension, relevance, or comprehensiveness. Therefore, no modifications were needed for the final version.

The PCQ questionnaire demonstrated good comprehensibility, comprehensiveness, and relevance to the topic. However, it is still necessary to test its measurement properties to ensure that the instrument is suitable for implementation in clinical practice.

The PCQ-Brazil was translated and cross-cultural adapted, making available a new instrument to assess beliefs and knowledge about pain in Portuguese. The PCQ-Brazil should be tested regarding its measurement properties before being used in clinical practice and research to assess changes in beliefs and knowledge about pain in CLBP following educational interventions.