The musculoskeletal pain literacy questionnaire (MSK-PLq) - Part 1: Development of a preliminary version through a systematic review and Delphi consensus.

Pablo Bellosta-L&#xf3;pez; Francesco Langella; Julia Blasco-Abad&#xed;a; Alice Baroncini; Kieran O'Sullivan; Lara Coyne; Thorvaldur Skuli Palsson; Steffan Wittrup McPhee Christensen; Morten Hoegh; Mary O'Keeffe; Nathan Skidmore; Zs&#xf3;fia Nagy; Pedro Berjano; Domenico Compagnone; Joanne O'Brien Kelly; Nathan Hutting; S&#xf8;ren T Skou; V&#xed;ctor Dom&#xe9;nech-Garc&#xed;a

doi:10.1016/j.msksp.2026.103601

PubMed · 42341408

The musculoskeletal pain literacy questionnaire (MSK-PLq) - Part 1: Development of a preliminary version through a systematic review and Delphi consensus.

Pablo Bellosta-López·Francesco Langella·Julia Blasco-Abadía·Alice Baroncini·Kieran O'Sullivan·Lara Coyne·Thorvaldur Skuli Palsson·Steffan Wittrup McPhee Christensen·Morten Hoegh·Mary O'Keeffe·Nathan Skidmore·Zsófia Nagy·Pedro Berjano·Domenico Compagnone·Joanne O'Brien Kelly·Nathan Hutting·Søren T Skou·Víctor Doménech-García

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Abstract

OBJECTIVE: Chronic musculoskeletal (MSK) pain is a leading cause of disability worldwide, and self-management is a first-line approach recommended by international clinical guidelines. Access to evidence-based information that enhances health literacy may support patients' engagement in their self-management and treatment decision-making, potentially reducing disease burden and pain. However, no tool currently exists to assess health literacy specifically in MSK pain. This study aimed to develop and describe the preliminary version of a knowledge-based questionnaire to evaluate MSK pain literacy, the Musculoskeletal Pain-Literacy questionnaire (MSK-PLq). METHODS: A systematic literature review identified existing health literacy instruments and generated a preliminary list of domains. A two-round Delphi study with 22 panellists (19 experts and three people living with chronic MSK pain), followed by consensus meetings, was used to refine domains and items (≥70% agreement). Readability was assessed using the Flesch Reading Ease (FRE) score and three stakeholders were consulted to review the questionnaire for comprehensibility, clarity, and face validity. RESULTS: Six domains were retained (Understand, Access, Appraise, Apply, Digital, Beliefs), comprising 20 items in the preliminary version of MSK-PLq. Readability was acceptable (mean FRE 74, indicating fairly easy reading), and subject feedback supported the questionnaire's clarity and face validity. CONCLUSIONS: The preliminary version of the MSK-PLq is proposed as the first knowledge-based tool to assess functional, interactive, and critical aspects of MSK pain literacy. It may have applications in clinical practice, research, education, and digital health, by informing tailored patient education and supporting self-management strategies, although further psychometric validation is required.

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Humans Delphi Technique Health Literacy Musculoskeletal Pain Surveys and Questionnaires Female Male Consensus Middle Aged Adult Reproducibility of Results Chronic pain Delphi technique Health literacy Musculoskeletal diseases Patient reported outcome measures Self care Journal Article Systematic Review

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Pablo Bellosta-López, Francesco Langella, Julia Blasco-Abadía, Alice Baroncini, Kieran O'Sullivan, Lara Coyne, Thorvaldur Skuli Palsson, Steffan Wittrup McPhee Christensen, Morten Hoegh, Mary O'Keeffe, Nathan Skidmore, Zsófia Nagy, Pedro Berjano, Domenico Compagnone, Joanne O'Brien Kelly, Nathan Hutting, Søren T Skou, Víctor Doménech-García. 2026-06-16. The musculoskeletal pain literacy questionnaire (MSK-PLq) - Part 1: Development of a preliminary version through a systematic review and Delphi consensus.. https://doi.org/10.1016/j.msksp.2026.103601

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