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 (alpha = .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 (beta = -.40, p < .001) and level of handicap (beta = -.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.