Factor structure of the German version of the pain attitudes and beliefs scale for physiotherapists

The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a questionnaire that is frequently used to measure the treatment orientation of physiotherapists and other healthcare providers toward low back pain (LBP). Previous validation studies of the PABS-PT have reported consistently that exploratory factor analysis (EFA) yielded a two-factor model with the factors "biomedical" and "biopsychosocial." However, there remain concerns regarding the composition of these two factors and the internal consistency of the "biopsychosocial" factor. The objective of this study was to replicate the previous validation study on the German PABS-PT. EFA was implemented to reexamine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to test the fit of the hypothesized two-factor model. Results of the initial validation study were not replicated. EFA indicated that a two-factor solution is an inadequate representation of the PABS-PT data, and CFA showed insufficient fit of the hypothesized two-factor model to the PABS-PT data. Our results indicate a need for caution when using the PABS-PT to measure physiotherapists' orientation toward LBP, particularly in measuring the magnitude of a biopsychosocial orientation.