Validation of the portuguese version of the tampa scale for kinesiophobia heart (TSK-SV heart)

Ghisi, Gabriela Lima de Melo; Santos, Rafaella Zulianello dos; Felipe, Thiago Renee; Bonin, Christiani Decker Batista; Pinto, Edson Fonseca; Guerra, Felipe Eduardo Fernandes; Knackfuss, Maria Irany; Oh, Paul; Benetti, Magnus

doi:10.1590/1517-869220172303159416

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Revista Brasileira de Medicina do Esporte

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ARTIGO ORIGINAL • Rev Bras Med Esporte 23 (03) • May-Jun 2017 • https://doi.org/10.1590/1517-869220172303159416 copy

Validation of the portuguese version of the tampa scale for kinesiophobia heart (TSK-SV heart)

Validação da versão em português da escala de tampa para cinesiofobia cardíaca (TSK-SV cardíaca)

Validación de la versión en portugués de la escala de tampa para kinesiofobia cardiaca (TSK-SV cardiaca)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

It has been shown that kinesiophobia has a negative influence on the outcomes of cardiac rehabilitation and consequently is important for the clinical setting.

Objective:

The objective of this study was to translate, culturally adapt, and psychometrically validate the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) to Brazilian Portuguese.

Methods:

The Portuguese version was tested in 300 patients in cardiac rehabilitation. Test-retest reliability was assessed by intraclass correlation coefficient, internal consistency by Cronbach’s alpha, and criterion validity was assessed with respect to patients’ education, income, duration of cardiac rehabilitation, and sex.

Results:

After intraclass correlation coefficient analysis, one item was excluded. All four areas were considered internally consistent (α >0.7). Significant differences between mean total scores and income (p<0.01) supported the criterion validity. Two hundred sixty-nine (89.6%) patients had a high level of kinesiophobia (scores > 37).

Conclusions:

The Brazilian Portuguese version of TSK-SV Heart demonstrated sufficient reliability, consistency and validity, supporting its use in future studies.

Keywords:
coronary artery disease; rehabilitation; surveys and questionnaires; fear; movement; validation studies

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E-mail: atharbme@uol.com.br

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[1] Correspondence: Rafaella Zulianello dos Santos Universidade do Estado de Santa Catarina, Centro de Ciências e Desportos em Saúde, 358, Coqueiros, Florianopolis, SC, Brazil. 88080350. rafaella.zulianello@gmail.com

Characteristic		n (%)		Total score	p
Characteristic		n (%)		(mean±SD)	p
				(mean±SD)
Sociodemographic*
Gender	Male	207 (69%)		43.81±4.77	0.317
Gender	Female	93 (31%)		44.39±4.20
	Female	93 (31%)		44.39±4.20
	Never went to school	5	(1.6%)	43.60±5.13	<.001
	Primary school incomplete	32	(10.7%)	43.68±3.43
	Primary school complete	29 (9.6%)		42.79±3.97
	Secondary school	8	(2.7%)	44.50±3.51
	incomplete	8	(2.7%)	44.50±3.51
	incomplete
Educational Level	Secondary School	46	(15.4%)	41.96±4.58
Educational Level	complete	46	(15.4%)	41.96±4.58
	complete
	University degree	7	(2.4%)	37.00±4.00
	incomplete	7	(2.4%)	37.00±4.00
	incomplete
	University degree	93	(31.0%)	44.37±5.16
	complete	93	(31.0%)	44.37±5.16
	complete
	Postgraduate	79 (2.7%)		45.86±3.51
Monthly family
	Less than 1	17 (5.6%)		43.53±4.56	<.001
	minimum salary	17 (5.6%)		43.53±4.56	<.001
	minimum salary
	1-5 minimum salaries	139 (46.4%)		44.24±4.04
Income	5-10 minimum salaries	114 (38%)		45.48±3.52
	10-20 minimum salaries	16 (5.4%)		38.06±3.53
	Above 20 minimum	13 (4.3%)		35.85±6.20
	salaries	13 (4.3%)		35.85±6.20
	salaries
Clinical†
	Hypertension	247 (82.3%)		44.06±4.62	0.589
	Dyslipidemia	131 (43.6%)		43.07±4.90	<.001
	Diabetes Mellitus	103 (34.3%)		44.85±4.70	0.018
	type I or II	103 (34.3%)		44.85±4.70	0.018
	type I or II
Comorbidities	Obesity	59	(19.6%)	44.00±4.91	0.985
Comorbidities	Smoking	3 (1%)		42.67±2.08	0.618
and risk factors	Smoking	3 (1%)		42.67±2.08	0.618
and risk factors	Peripheral Vascular Disease	33	(11.0%)	43.48±4.12	0.392
	Peripheral Vascular Disease	33	(11.0%)	43.48±4.12	0.392
	Chronic Obstructive	3	(1.0%)	46.24±2.49	0.003
	Pulmonary Disease	3	(1.0%)	46.24±2.49	0.003
	Pulmonary Disease
	Heart Failure	29 (9.7%)		45.07±3.14	0.185
	Stroke	2	(0.7%)	44.29±4.24	0.761
Acute event
	Acute Myocardial Infarction	66	(22.0%)	43.53±4.21	0.125
Revascularization
	Coronary Bypass	92	(30.6%)	43.90±4.23	0.826
Procedures
	Angioplasty	190 (63.3%)		43.95±4.83	0.833
Participation in CR
	1-6 months	91	(30.4%)	42.66±4.43	0.013
	6-12 months	36	(12.0%)	45.14±3.66
	12-24 months	44	(14.6%)	44.05±5.33
	More than 24 months	126 (42.0%)		44.63±4.53

Area	Item	Mean score‡	Item completion	ICC	Cronbach’s alpha	Mean score
		Mean±SD	rates (%)		per area	per area
Danger	3. My body is telling me that I have something seriously wrong.	3.04±0.82	100%	0.79	0.87	9.91±1.14

	8. Just because something causes discomfort in my chest does not mean	1.90±0.73	100%	0.76
	that it is dangerous.	1.90±0.73	100%	0.76
	that it is dangerous.

	11. I would not have my heart problems if there was not something	3.07±0.71	100%	0.88
	dangerous going on in my body.	3.07±0.71	100%	0.88
	dangerous going on in my body.

	16. Even though something causes me a lot of heart problems,	1.91±0.66	100%	0.80
	I do not think that it is actually dangerous.	1.91±0.66	100%	0.80
	I do not think that it is actually dangerous.

Fear	1. I am afraid that I might injure myself during physical activity/exercising.	2.58±0.96	100%	0.91	0.72	11.03±2.37

	7. In general, heart problem is always due to body injury.	2.34±0.65	100%	0.91

	9. I am afraid that I might injure myself accidentally.	2.95±0.85	100%	0.76

	13. My heart problem tells me when I should stop being physically	3.16±0.71	100%	0.75
	active/exercising, so that I do not injure myself.	3.16±0.71	100%	0.75
	active/exercising, so that I do not injure myself.

Avoidance	2. If I tried to be physically active/exercise my heart problem would increase.	2.40±0.99	100%	0.96	0.79	9.53±1.53

	4. My heart problem would probably be relieved if I was physically	2.65±0.79	100%	0.83
	active/exercised.	2.65±0.79	100%	0.83
	active/exercised.

	12. Even if I have a heart problem I would manage better if I was physically	2.64±0.96	100%	0.89
	active/exercised.	2.64±0.96	100%	0.89
	active/exercised.

	14. It is really not safe for a person in my condition to be physically	2.47±0.91	100%	0.67†
	active/exercise.	2.47±0.91	100%	0.67†
	active/exercise.

	17. No one should have to be physically active/exercise when he/she	1.84±0.72	100%	0.77
	has heart problems.	1.84±0.72	100%	0.77
	has heart problems.

Dysfunction	5. People are not taking my medical condition seriously enough.	2.09±0.76	100%	0.90	0.77	11.05±1.73

	6. My heart problem has weakened me physically for the rest of my life.	2.99±0.85	100%	0.86

	10. By being careful with unnecessary movements I can prevent my heart	2.93±0.75	100%	0.72
	problems from worsening.	2.93±0.75	100%	0.72
	problems from worsening.

	15. I cannot do the same things as others because there is a too big risk	3.04±0.79	100%	0.90
	that I will get heart problems.	3.04±0.79	100%	0.90
	that I will get heart problems.

Total		43.99±4.60	100%	0.84	0.83	-