Measuring Avoidance in Medical Rehabilitation

Objective: To establish psychometric properties of the Acceptance and Action Questionnaire (AAQ), a measure of avoidance, in medical rehabilitation populations. Study Design: Cross-sectional and longitudinal. Setting: Three acute, inpatient rehabilitation units. Participants: One hundred thirty-nine adults with spinal cord dysfunction, stroke, amputation, or orthopedic surgery. Measures: AAQ, Hope Scale, Spiritual Well-Being Scale, Positive and Negative Affect Scale, Brief Symptom Inventory, Hopkins Rehabilitation Engagement Rating Scale, Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Satisfaction with Life Scale. Results: The AAQ has adequate internal consistency (α = .70), is best understood with a two-factor solution, is positively correlated with depression ( r = .36, p < .01) and negative affect ( r = .41, p < .001), and is negatively correlated with hope ( r = -.51, p < .001), positive affect ( r = -.33, p < .001), and spiritual well-being ( r = -.32, p < .001). Predictive relationships with life satisfaction (β = -.40, p < .001) and level of handicap (β = -.20, p < .014) were found at 3-month follow-up. Conclusions: Findings provide preliminary support that the AAQ is reliable and valid in medical populations and that avoidance plays an important role in rehabilitation outcomes.