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Bad Sobernheim Stress Questionnaire - Deformity

Bad Sobernheim Stress Questionnaire - Deformity

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Purpose

To measure the effect of spine deformity on mood, acceptance, and interactions with environment, and as a result, the effect of experienced stress.

Acronym BSSQ-Deformity

Area of Assessment

Quality of Life
Life Participation
Stress & Coping

Assessment Type

Patient Reported Outcomes

Cost

Free

Key Descriptions

  • 8 questions answered by patient
  • Each question is marked on a four-point scale and scored 0-3
  • Minimum score = 0; maximum score = 24
  • Scores are summed together to yield:
    0–8 = strong stress
    9–16 = moderate stress
    17–24 = little stress
  • Created in Germany; no English adaptation or validation

Number of Items

8

Equipment Required

  • Questionnaire form
  • Pen/Pencil

Time to Administer

2 minutes

Required Training

No Training

Age Ranges

Child

6 - 12

years

Adolescent

13 - 17

years

Adult

18 - 64

years

Instrument Reviewers

Initially reviewed by University of Illinois at Chicago Master of Science in Occupational Therapy students Kate Jordan, Brandi Preston, and Agela Rahman.

ICF Domain

Participation

Measurement Domain

Emotion

Considerations

  • Quick and easy to administer

  • Patient self-report

  • Studies indicate many patients normally do not feel stress due to their scoliosis deformity. There is a higher likelihood of feeling stress due to treatment for their deformity, such as wearing a brace.

Musculoskeletal Conditions

back to Populations

Standard Error of Measurement (SEM)

Adolescent Idiopathic Scoliosis: (Xu et al., 2015; n = 86; mean age = 13.5 (1.5) years; wearing a brace > 12 h/d for 3 months; mean Cobb angle = 30.5 degrees; Chinese sample)

  • SEM for entire group (n = 86): 1.01 (calculated from RMD Statistics Calculator)

Minimal Detectable Change (MDC)

Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

  • MDC for entire group (n = 86): 2.79 (calculated from RMD Statistics Calculator)

Test/Retest Reliability

Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

  • Excellent test-retest reliability: (ICC = 0.85)

Adolescent Idiopathic Scoliosis: (Misterska, Głowacki, & Harasymczuk, 2009; n = 35; median age = 14.8 (1.5) years; wearing a brace 14.9 h/d for 16.1 mos; median Cobb's angle = 27.8 degrees; Polish sample)

  • Excellent test-retest reliability: (ICC = 0.88)

Internal Consistency

Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

  • Excellent: Cronbach's alpha = 0.85

Adolescent Idiopathic Scoliosis: (Misterska et al., 2009)

  • Excellent: Cronbach’s alpha = 0.87

*Scores higher than .9 may indicate redundancy in the scale questions.

Construct Validity

Convergent validity:

Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

  • Adequate convergent validity of the BSSQ-Deformity with SRS-22 (r = 0.48*)

  • Excellent convergent validity of the BSSQ-Deformity with BSSQ-Brace (r = 0.79*)

  • Poor convergent validity of the BSSQ-Deformity with Pain (r = 0.29*)

  • Adequate convergent validity of the BSSQ-Deformity with Mental Health (r = 0.32*)

  • Adequate convergent validity of the BSSQ - Deformity with Self Image (r = 0.37*)

  • Adequate convergent validity of the BSSQ - Deformity with Function Activity Level (r = 0.33*)

  • Adequate convergent validity of the BSSQ - Deformity with Treatment Satisfaction (r = 0.34*)

*p < 0.01

BSSQ-Brace

Z-Skewness

Corrected Item-Total Correlation

Standard for Clinical Use

Item 1

0.05

0.53

Adequate

Item 2

-0.39

0.48

Adequate

Item 3

-0.39

0.79

Excellent

Item 4

-0.48

0.82

Excellent

Item 5

-0.38

0.60

Excellent

Item 6

-0.51

0.50

Adequate

Item 7

-0.53

0.72

Excellent

Item 8

-0.43

0.67

Excellent

 

BSSQ-Deformity

Z-Skewness

Corrected Item-Total Correlation

Standard for Clinical Use

Item 1

-0.26

0.62

Excellent

Item 2

0.03

0.66

Excellent

Item 3

-0.22

0.59

Adequate

Item 4

-0.34

0.21

Poor

Item 5

-0.24

0.66

Excellent

Item 6

0.40

0.37

Adequate

Item 7

0.18

0.50

Adequate

Item 8

0.01

0.63

Excellent

Adolescent Idiopathic Scoliosis: (Misterska et al., 2009)

  • Poor convergent validity of the BSSQ-Deformity with Cobb's angle (r = -.10)

  • Poor convergent validity of the BSSQ-Deformity with angle of trunk rotation (r = -.06)

  • Adequate convergent validity of the BSSQ-Deformity with distance from CSVL (r = -.33)

  • Poor convergent validity of the BSSQ-Deformity with no. of hours a day of brace wearing (r = .03)

  • Poor convergent validity of the BSSQ-Deformity with duration of brace wearing in months (r = .20)

Adolescent Idiopathic Scoliosis: (Kotwicki, Kinel, Stryla, & Szulc, 2007; n = 111; mean age = 14.2 (2.2) years; mean Cobb's angle = 42.8 (17) degrees; mean Bunnell angle = 11.4 (4.5) degrees; Polish sample)

  • Adequate convergent validity of the BSSQ-Deformity with Cobb angle (r = -0.34)

  • Adequate convergent validity of the BSSQ-Deformity with Bunnell primary curve rotation (r = -0.34)

  • Adequate convergent validity of the BSSQ-Deformity with Bunnell sum of rotation (r = -0.33)

Floor/Ceiling Effects

Adolescent Idiopathic Scoliosis: (Misterska et al., 2009)

  • Adequate ceiling effect of 17.1% found for the first administration of the BSSQ-Deformity

  • Adequate ceiling effect of 11.4% found for the second administration of the BSSQ-Deformity

Bibliography

Kotwicki, T., Kinel, E., Stryla, W., & Szulc, A. (2007). Estimation of the stress related to conservative scoliosis therapy: An analysis based on BSSQ questionnaires. Scoliosis Journal, 2(1). Find it on PubMed

Misterska, E., Głowacki, M., & Harasymczuk, J. (2009). Polish adaptation of Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity. European Spine Journal, 18(12), 1911. Find it on PubMed

Xu, X., Wang, F., Yang, M., Huang, Q., Chang, Y., Wei, X., … Li, M. (2015). Chinese Adaptation of the Bad Sobernheim Stress Questionnaire for patients with adolescent idiopathic scoliosis under brace treatment. Medicine, 94(31). Find it on PubMed

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