507: Translation, cross-cultural adaptation and validation of the FrePAQ-PL

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary visceral / pelvic pain, Developing methodology/technology, Assessment and Measurement of Pain/Nociception, Pain in Special Populations

Background and Aims: Body perception disturbance is observed in people with chronic pain and is a potential target for treatment [1-3]. The Fremantle Pelvic Awareness Questionnaire (FrePAQ) adapted from the Fremantle Back Awareness Questionnaire, is a tool designed to identify disrupted body perception specific to chronic pain [4]. However, its psychometric properties have not yet been tested. This study aimed to develop and assess the psychometric properties of a Polish version of the questionnaire (FrePAQ-PL).

Methods: Following the translation process, the assessment of content validity was carried out among individuals with pelvic pain and experts working with them. Next, psychometric properties were assessed in 137 people with pelvic pain and 110 pain-free individuals. Those with pelvic pain repeated the FrePAQ-PL assessment within 14-days. The measurement properties assessed in this study were content validity, internal consistency, frequency of responses, known-groups validity, convergent validity, test­–retest reliability and confirmatory factor analysis.

Results: Known-groups validity was confirmed by significant differences in FrePAQ-PL scores between pelvic pain and pain-free individuals (p<0.05). Convergent validity was established by moderate correlations between FrePAQ-PL scores and mean 7-day pain (ρ=0.24, p’s<0.01), pain vigilance (ρ=0.29, p’s<0.001), depression, anxiety and stress (ρ=0.56-0.57, p<0.001), and body image appreciation (ρ = -0.32, p<0.001). The scale exhibited good internal consistency (Cronbach’s α 0.82). The two factor model showed better fit: Δχ²(1)=15.28, p<.001; ΔCFI≈.03 (Factor 1: items 1-6 Cronbach’s α 0.83, Factor 2: Items: 8-9 Cronbach’s α 0.57). Test–retest reliability was poor (ICC2,1 = 0.44).

Conclusions: FrePAQ-PL is an internally consistent and valid measure with a two-dimensional structure that can be used in clinical and research settings. However, item 7 ('Without looking at or touching it, I can’t sense where my perineal area is') was found to be irrelevant to the construct. The data also provides new insight into the strong link between visceral pelvic pain and both affective states and body imagebut indicates relatively low temporal stability.

References: [1] Budzisz, A., Jung, A., Adamczyk, W. M., Szikszay, T. M., Carvalho, G. F., Bąbel, P., & Luedtke, K. (2024). Body Image Measured via the Fremantle Awareness Questionnaire in Individuals With and Without Pain: A Systematic Review and Meta-Analysis. The Journal of Pain, 104530. https://doi.org/10.1016/j.jpain.2024.104530
[2] Wand, B. M., Cashin, A. G., McAuley, J. H., Bagg, M. K., Orange, G. M., & Moseley, G. L. (2023). The Fit-for-Purpose Model: Conceptualizing and Managing Chronic Nonspecific Low Back Pain as an Information Problem. Physical Therapy, 103(2), pzac151. https://doi.org/10.1093/ptj/pzac151
[3] Wand, B. M., Catley, M. J., Rabey, M. I., O’Sullivan, P. B., O’Connell, N. E., & Smith, A. J. (2016). Disrupted Self-Perception in People With Chronic Low Back Pain. Further Evaluation of the Fremantle Back Awareness Questionnaire. The Journal of Pain, 17(9), 1001–1012. https://doi.org/10.1016/j.jpain.2016.06.003
[4] Hardy, A., Campbell, L., Jones, C., Vandyken, C., Bond, J., Moss, P., Smith, A., Wand, B., Thompson, J. The Development and Content Validity of the Fremantle Perineal Awareness Questionnaire (FrePAQ) for Use in People With Persistent Perineal Pain. Journal of Women’s & Pelvic Health Physical Therapy 48(3):p 202-213, July/September 2024. | DOI: 10.1097/JWH.0000000000000307

Presenting Author: Aleksandra Budzisz
Submitting Author: Aleksandra Budzisz

Senior Author: Małgorzata Starzec-Proserpio

IASP 2026 Global Year theme of Neuropathic Pain: No

• Aleksandra Budzisz: PhD - Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland, Academy of Physical Education, Katowice, Poland
• Joanna Kłosowska: PhD - Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
• Jilly Bond: Doctoral Researcher - College of Health, Medicine and Life Sciences, Brunel University of London, UK
• Małgorzata Starzec-Proserpio: PhD - Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland, Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.