What factor induces stress in patients with AIS under brace treatment? Analysis of a specific factor using exploratory factor analysis

Background Stress from brace treatment in patients with adolescent idiopathic scoliosis (AIS) can deteriorate their quality of life. A Japanese version of the Bad Sobernheim Stress Questionnaire–Brace (JBSSQ–brace) was developed to assess the stress from brace treatment for Japanese patients with AIS. However, the specific factors causing stress under brace treatment have remained unknown. Method We enrolled 69 consecutive Japanese patients with AIS. Stress from brace treatment was assessed by JBSSQ–brace and Scoliosis Research Society–22 (SRS–22) instruments. The correlations of JBSSQ–brace with SRS–22 score, patient demographics and Cobb angle were analyzed by Spearman's rank correlation. Exploratory factor analysis was used to determine the psychological factor causing stress from brace treatment. Results JBSSQ–brace score was correlated with total score of SRS–22, self-image and mental health domain, but not age, degree of curvature, or other domains of the SRS–22. Factor analysis detected one underlying factor, which was more related to Questions 4 or 5 with the factor loadings of 0.8 than Questions 1 or 6 with loadings of 0.65. Conclusion Stress from brace treatment was not associated with age, spinal curve severity, pain, or satisfaction of treatment. Exploratory factor analysis suggested “anxious feeling about how we are perceived by others” induces the stress from brace treatment in Japanese patients with AIS.