A new biopsychosocial questionnaire (BETY-BQ) for patients with ankylosing spondylitis

VEREP U., ÜNAL E., Oksüz S., Soy M., ÖNEN F., KİRAZ S.

European Journal of Integrative Medicine, vol.61, 2023 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 61
  • Publication Date: 2023
  • Doi Number: 10.1016/j.eujim.2023.102267
  • Journal Name: European Journal of Integrative Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Keywords: Biopsychosocial, Chronic pain, Holistic evaluation, Patient-reported outcomes, Quality of life, Rheumatic diseases
  • Hacettepe University Affiliated: Yes


Introduction: Scales for biopsychosocial evaluation of patients are limited. This study assessed the validity, reliability, and responsiveness of a Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (Bilişsel Egzersiz Terapi Yaklaşımı-Biopsychosocial Questionnaire; BETY-BQ) in patients with ankylosing spondylitis (AS). Methods: Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL), Hospital Anxiety and Depression Scale (HADS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Bath Ankylosing Spondylitis Functional Index (BASFI), were selected to investigate the validity of the BETY-BQ. Spearman's correlation coefficient was used as the data were not normally distributed. For scale reliability, the test-retest method was performed, Intraclass Correlation Coefficient (ICC) was calculated and Cronbach's alpha (α) coefficient was checked for internal consistency. The same scales were applied to patients under medical treatment at 3-month intervals for the determination of responsiveness. Results: A total of 157 individuals took part, including 106 (67.5%) male participants and 51 (32.5%) female participants, with a mean age of 43.86±11.60 years. The correlations of BETY-BQ with the HAQ-S, ASQoL, HADS, BASDAI, and BASFI were very high to moderate (r = 0.819 to r = 0.583, p<0.001). The test-retest method was used for reliability, and the correlation between the responses was very high (r = 0.846, p<0.001). The ICC (r = 0.944, p<0.001) and the Cronbach's α value (0.936) were checked and were found to be excellent. In the correlation analysis of time-dependent changes, a weak to high correlation was found between BETY-BQ and the other scales (r = 0.672 to r = 0.285, p<0.001). As a result of the confirmatory factor analysis, it was determined that all goodness-of-fit indices of BETY-BQ except GFI were suitable and the construct validity of the scale was ensured. Conclusion: A valid, reliable and responsive biopsychosocial questionnaire BETY- BQ was added to the literature. This scale is easy-to-understand and practical, and can be used both in the clinic and in research for the biopsychosocial assessment of individuals.