Translation and psychometric properties of the Hebrew version of Patient Enablement Instrument for Back Pain (PEI-BP)

Background: Low back pain (LBP) is a widespread cause of disability worldwide. Self-management is a significant factor impacting an individual's ability to cope with LBP. The Patient Enablement Instrument for Back Pain (PEI-BP) assesses the ability of people with LBP to self-manage their illness. Objective: This study aimed to translate and culturally adapt the PEI-BP into Hebrew and evaluate the reliability, validity, and responsiveness. Design: Cross-sectional study with a nested prospective sub‐sample. Methods: The PEI-BP was translated and culturally adapted into Hebrew using recommended guidelines. We included 188 LBP patients. The psychometric properties of the PEI-BP were evaluated according to the COSMIN methodology. For construct validity, the Ronald Morris disability questionnaire, the Brief Illness Perception Questionnaire, the Fear-Avoidance Beliefs Questionnaire-physical activity, the 12-item Short‐Form Health Survey mental health, and the Numerical pain rating scale were included. To assess reliability, a sub-sample of participants (n = 50) completed the PEI-BP again after one week and after six weeks (n = 50) to evaluate responsiveness. Results: The PEI-BP demonstrated good internal consistency (Cronbach's α = 0.821) and test-retest reliability (ICC = 0.77). For construct validity, four out of the five hypothesized correlations were confirmed. Responsiveness showed a Receiver Operating Characteristic curve area of 0.81 (95% CI 0.67–0.93); the minimal detectable change was 14.5. A potential significant ceiling but no floor effects were observed (17.5% and 6.4%, respectively). Conclusions: The translation and validation of the PEI-BP suggest that it is a feasible, reliable, valid, and responsive instrument for evaluating 'patient enablement' with LBP in the Hebrew-speaking population.