Development and Validation of the EXPECT Questionnaire: Assessing Patient Expectations of Outcomes of Complementary and Alternative Medicine Treatments for Chronic Pain

doi:10.1089/acm.2016.0242

I am now going to ask you a series of questions about the effects that [INSERT TREATMENT MODALITY] may have on your back pain and on how back pain impacts your life. In each case, the question is asking about the results at the end of the treatment period.

Back Pain Questions:
1.	How much change do you hope for in your back pain? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “complete relief.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Complete Relief
2.	How much change do you realistically expect in your back pain? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “complete relief.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Complete Relief

Impact of back pain on life questions:
3.	How much change do you hope for in the impact of back pain on your life? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “pain no longer impacts my life.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Impacts My Life
4.	How much change do you realistically expect in the impact of back pain on your life? Please answer on a scale of 0 to 10, where 0 is “no change or worse”, and 10 is “pain no longer impacts my life.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Impacts My Life

Sleep/Mood/Energy:
The next set of questions asks about areas of your life such as sleep, mood, and energy. If any of these questions are not relevant for you because back pain does not impact that area of your life, please answer Not Applicable.
5.	How much change do you realistically expect in your back-related sleep problems? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer affects my sleep.” If back pain does not impact your sleep, please choose “not applicable.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Affects My Sleep
	□ Not Applicable
6.	How much change do you realistically expect in your mood or irritability? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer affects my mood.” Or you may choose “not applicable.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Affects My Mood or Irritability
	□ Not Applicable
7.	How much change do you realistically expect in your energy? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer affects my energy.” Or you may choose “not applicable.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Affects My Energy
	□ Not Applicable

Coping Question: The next question is about your expectations about coping with back pain.
8.	How much improvement in your ability to cope with back pain do you realistically expect as a result of [INSERT TREATMENT MODALITY]? Please answer on a scale of 0 to 10, where 0 is “no improvement” and 10 is “extreme improvement.”
	0 1 2 3 4 5 6 7 8 9 10
	No Improvement Extreme Improvement

Limitations due to back pain questions:
The following questions are about effects that [INSERT TREATMENT MODALITY] may have on your physical limitations due to back pain. In each case, the question is asking about the results at the end of the treatment period. If these questions are not relevant for you because you do not have any physical limitations due to back pain, please choose “not applicable.”
9.	How much change do you hope you will have in your back pain–related physical limitations? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “limitations completely resolved.” Or you may choose “not applicable.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Limitations Completely Resolved
	□ Not Applicable
10.	How much change do you realistically expect in your back pain-related physical limitations? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “limitations completely resolved.” Or you may choose “not applicable.”
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Limitations Completely Resolved
	□ Not Applicable

Impact of back pain on specific areas of life questions:
The next questions to ask about the effects that [INSERT TREATMENT MODALITY] may have on the impact of back pain on specific areas of your life. In each case, the question is asking about the results at the end of the treatment period. If any of these questions are not relevant for you because back pain does not impact that area of your life, please choose “not applicable.”
11.	How much change do you realistically expect in the impact of back pain on yourwork, includinghousework? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer impacts my work,” including housework. Or you may choose “not applicable” if back pain does not impact your work/housework now.
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Impacts my Work
	□ Not Applicable
12.	How much change do you realistically expect in the impact of back pain on your social and recreational activities? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer impacts my social and recreational activities.” Or you may choose “not applicable” if back pain does not impact your social and recreational activities now.
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Impacts my Social and Recreational Activities
	□ Not Applicable
13.	How much change do you realistically expect in the impact of back pain on your daily activities? Please answer on a scale of 0 to 10, where 0 is “no change or worse” and 10 is “back pain no longer impacts my daily activities.” Or you may choose “not applicable” if back pain does not impact your daily activities now.
	0 1 2 3 4 5 6 7 8 9 10
	No Change/Worse Back Pain No Longer Impacts My Daily Activities
	□ Not Applicable