Spanish cultural adaptation of the avoidance questionnaire for adolescents (AQA) in undergraduate nursing students

• Questionnaires assessing psychological inflexibility exist, but Spanish versions are lacking. • Validation of the AQA in Spanish shows good consistency, reliability, and sensitivity to change. • The Spanish AQA is useful in training, detecting changes after educational interventions. The need for a validated Spanish questionnaire for nursing students focusing on psychological inflexibility, problem-solving, and reflective thinking prompted the adaptation of the Avoidance Questionnaire for Adolescents (AQA). To develop and culturally validate a Spanish version of the AQA for use with undergraduate nursing students. The AQA was culturally adapted and its psychometric properties evaluated through an online survey involving 350 first- and second-year nursing students from the University of Granada and the University of Malaga (Spain). To assess sensitivity to change, a seminar was conducted with 116 students. The highest-scoring factors were "Postponement/strengthening up" and "Mulling," indicating greater reflection on problems. In contrast, "Negative self-efficacy/insolvability" and "Neglecting" scored lowest, suggesting adequate problem-solving skills. An exploratory factor analysis showed a Cronbach's alpha of 0.766 and an intraclass correlation coefficient of 0.874, with a good fit in the confirmatory factor analysis. The Spanish adaptation of the AQA demonstrated good internal consistency, reliability, and sensitivity to change. It is a suitable tool for educational activities in nursing students.