ORIGINAL ARTICLE Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire: a cross-cultural adaptation and validation to the Turkish language Okan Küçükakkaş 1 & Aylin Rezvani 2 & Ozan Volkan Yurdakul 1 & Sena Tolu 2 & Mehmet Serkan Kılıçoğlu 1 & Teoman Aydın 1 Received: 14 June 2018 /Revised: 19 July 2018 /Accepted: 23 July 2018 /Published online: 28 July 2018 # International League of Associations for Rheumatology (ILAR) 2018 Abstract In chronic inflammatory rheumatic diseases (CIRD), it is important to understand patients’ fears towards their disease in order to improve patient-physician dialog, to raise the quality of care offered, and to optimize treatment adherence. In this study, we aimed to translate the Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire into Turkish and evaluate its psychometric properties in patients with CIRD. One hundred fifteen patients filled the provided socio-demographic information form, FAIR-Tr questionnaire, Hospital Anxiety and Depression Scale (HADS), and Beck’ s Hopelessness Scale (BHS). For the analysis of short-term reliability, 50 patients re-filled the FAIR-Tr questionnaire 1 week later. Internal consistency was evaluated with Cronbach’ s α coefficient and test-retest reliability was evaluated with intraclass correlation coefficients (ICC). Construct validity analysis was investigated based on the correlation with HADS and BHS. All patients found FAIR-Tr easily understand- able and acceptable. FAIR-Tr internal consistency (Cronbach’ s α = 0.93) and test-retest reliability (ICC = 0.91) were excellent. Psychometric validation was proved upon observing high correlation with HADS (Anxiety, r = 0.77; Depression, r = 0.70) and moderate correlation with BHS (r = 0.65). FAIR-Tr is a questionnaire that has excellent internal consistency and test-retest reliability. The successful correlation with HADS and BHS supported its psychometric validity in terms of evaluating the fear in CIRD cases. We think that FAIR-Tr is a specific scale that can help to evaluate the disease- and treatment-related fears of the Turkish patients with CIRD and may be useful in both routine practice and clinical studies. Keywords Chronic inflammatory rheumatic diseases . Cross-cultural adaptation . Fears . Psychometric properties . Reliability . Turkish language . Validity Introduction Chronic inflammatory rheumatic diseases (CIRD) such as rheu- matoid arthritis (RA) and ankylosing spondylitis (AS) lead to chronic pain, fatigue, muscle weakness, joint stiffness, and swelling. Despite new therapies targeting disease-specific path- ways, the limitations that come with rheumatic diseases are not totally prevented [1]. These damages and limitations that come with chronic inflammation can affect every area of life, such as the family life, social relations, and the work life [2]. These problems are quite common; however, they are frequently overlooked by the patient’ s relatives or the physicians [3]. These diseases are closely related to psychological conditions due to the association between physical deformities and disabil- ities, and their relation to self-image and self-respect [4]. Approximately one third of the patients with rheumatolog- ical disorders develop psychiatric disorders, especially depres- sion and anxiety. These psychiatric disorders can decrease quality of life, independent from the other factors. They can also lead to loss of the labor. The depression and anxiety may root from several causes in the case of CIRD. These include the uncertainty of the prognosis of the disease, pain, and the social isolation that comes together with the disease [5]. It is argued that the social isolation and conflicts that accompany CIRD may be a precursor of the depression [6]. It is observed * Okan Küçükakkaş okan4494@yahoo.com 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmialem Vakıf University, 34093 Istanbul, Turkey 2 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Medipol University, Istanbul, Turkey Clinical Rheumatology (2018) 37:3247–3254 https://doi.org/10.1007/s10067-018-4239-3