Cross-cultural adaptations of the oral health impact profile - An assessment of global availability of 4-dimensional oral health impact characterization

OBJECTIVE

The 4-dimensional (4D) structure of oral health-related quality of life (OHRQoL), comprising of the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, is clinically plausible and psychometrically solid. The original Oral Health Impact Profile (OHIP) instrument and its short-form versions have been proven to lend themselves well to the assessment of these 4 OHRQoL dimensions. However, whether this 4-dimensional approach to oral health impact characterization can be performed on a global scale, that is, for most of the world's population, is not known. The purpose of this study was perform a systematic review to identify all cross-cultural adaptations of OHIP versions with 49, 20/19, 14, and 5 items. The global availability of 4D oral health impact characterization was investigated.

METHODS

We performed searches of electronic databases- Scopus, Pubmed, Web of Science, along with hand searching in June 2022 to identify all cross-cultural language adaptations of the different OHIP versions available in the literature. Whether the 4D oral health impact assessment can be considered a global approach was judged based on the criteria whether 4D psychometric information was available for at least 75% of the most widely spoken languages with an OHIP version.

RESULTS

We identified 82 studies with a total of 90 individual OHIP language versions for 45 languages. Among the top 20 languages with most first-language (native) speakers, 16 (80%) had OHIP versions. Among the top 20 languages with the most first- and second-language speakers, also 16 (80%) had OHIP versions. Of these 16 OHIP versions, across both language categories, 13 versions (81%) allowed for 4D oral health impact characterization.

CONCLUSION

Four-dimensional oral health impact assessment using the dimensions Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact can be considered a globally available approach given that OHIP versions with 4D information are readily available for most widely spoken languages. Thus, psychometrically sound, practical, and internationally comparable oral health impact characterization can be easily performed to study population oral health and determine oral disease impact and treatment efficacy for dental patients.

Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version of the Satisfaction and Recovery Index (SRI): Structural Validity, Construct Validity, Internal Consistency, and Test-retest Reliability

Background

The Satisfaction and Recovery Index (SRI) is a generic importance-weighted health satisfaction tool to measure the process and state of recovery following musculoskeletal injuries. The objectives of this study are (1) to translate and cross-culturally adapt the SRI to Persian and (2) evaluate its psychometric properties.

Methods

The forward-backward translation technique was used for translation, and two rounds of cognitive interviews were conducted to assess cultural appropriateness. Participants (n=100, mean age=32.5, 82%male) had acute (i.e., <30 days) musculoskeletal injuries of any etiology. Structural validity, construct validity, internal consistency, and test-retest reliability were evaluated.

Results

Participants identified issues in 3/6 areas of a coding system during the cognitive interviews: comprehension/clarity, relevance, and inadequate response definition. These issues informed subsequent changes to arrive at the final version of the SRI-P. The SRI-P had adequate construct validity (P<0.001), the confirmatory factor analysis demonstrated a two-factor structure, the internal consistency was acceptable (Cronbach's α=0.83), and it was deemed reliable (ICC_{2, 1}=0.72).

Conclusion

The psychometric evaluation revealed that the SRI-P has adequate construct validity, internal consistency, and test-retest reliability. Unlike the original English version, the SRI-P has a two-factor structure, which appears to be related to cultural differences in interpreting some of the items. The clinical importance of this study is that the SRI (which captures the state of recovery and how important the various items of the tool are to each patient and how satisfied they are with their recovery) can now be available to surgeons and therapists in the orthopedic and rehabilitation realms in Persian populations.

Cross-cultural adaptation and validation of the geriatric 8 screening tool in Chinese hospitalized older adults with cancer

OBJECTIVES

To translate, cross-culturally adapt, and validate the Geriatric 8 (G8) questionnaire in Chinese hospitalized older adults with cancer.

METHODS

The Chinese version of the G8 (C-G8) was produced following Brislin's guidelines. The psychometric properties of the C-G8 were evaluated among 296 eligible patients.

RESULTS

The content validity index of the C-G8 was 0.8∼1 at the item level and 0.975 at the scale level. The C-G8 identified more frail individuals among these older (>75 years) participants compared to their younger (65∼75 years) counterparts (frailty prevalence: 87.1% vs. 70.9%, P=0.010). The convergent validity of the C-G8 was tested by correlating it with the FRAIL scale (r=-0.592, P<0.001). The C-G8 had a lower internal consistency (Cronbach's α coefficient=0.501) but higher test-retest reliability and inter-rater reliability (intraclass correlation coefficient=0.913 and 0.993, respectively, P<0.001).

CONCLUSIONS

The C-G8 questionnaire presented acceptable validity and reliability and could be used in Chinese hospitalized older adults with cancer.

Cross-cultural adaptation and validation of the Spanish version of the Client-Centred Rehabilitation Questionnaire (CCRQ)

PURPOSE

The aim of the study is to present the process of translation, adaptation and validation of the Client-Centred Rehabilitation Questionnaire (CCRQ) in the Spanish context.

METHODS

The process integrates two sequential phases. Phase 1 consists of a questionnaire translation and back-translation process conducted by a panel of experts, and a pilot study. In phase 2, CCRQ-e (Spanish version) was administered to 305 rehabilitation inpatients to collect evidence on the reliability and validity of the instrument.

RESULTS

The exploratory and confirmatory analysis confirmed seven original domains, eliminating four items from the original scale. CCRQ-e has a good internal consistency. Discriminative construct validity distinguished significant differences based on age, educational level, and severity of diagnosis. Criterion validity of the CCRQ and EQ-5D showed negative significant correlations between CCRQ-e and the general perception of health EQ-VAS, and a positive correlation between CCRQ-e and EQ pain and EQ anxiety (higher scores in CCRQ-e mean lower client-centered practice perceived).

CONCLUSIONS

The Spanish version of the CCRQ is suitable for evaluating person-centered rehabilitation from the person's perspective. It includes aspects related to the comfort, decision-making, and participation of the client, as well as questions about the provision of service and the environment.Implications for rehabilitationThe original seven domains of the CCRQ could be replicated in the sample of patients from Spanish rehabilitation services.By eliminating four items from the original scale, the validated scale, known as the CCRQ-e (Spanish version), was obtained.The CCRQ-e allows a reliable and valid evaluation of the perception of the person-centeredness of the Spanish rehabilitation services.The CCRQ-e is the first self-reported measure in Spanish of an individual's experience during the rehabilitation service.

Cross-cultural adaptation and validation into Spanish of the deprescription questionnaire in the elderly patient

BACKGROUND AND OBJECTIVE

In 2017, a questionnaire was developed in Italian with the aim of determining clinicians' perceptions of deprescription in the elderly population. The objective was to translate and cross-culturally adapt this deprescription questionnaire to Spanish.

METHODS

Forward and blind-back translations, followed by a synthesis and adaptation by a third translator. Development of an expert panel to evaluate the adequacy of the translation, the understandability of the translated question and the usefulness of each question. A comprehensibility analysis was carried out on physicians familiar with deprescription.

RESULTS

The Spanish version of the questionnaire was obtained, where the average degree of difficulty in the direct and the back-translation was low/moderate. In the first phase of the panel of experts, 4 questions had sections considered "indeterminate" and one question was "doubtful". After the second phase, all the questions were considered "adequate" except for one.

CONCLUSIONS

This is the first cross-cultural adaptation to Spanish of this questionnaire, which will provide a tool to assess clinicians' perception of this practice and establish improvements to carry out this activity.

Cultural Adaptation and Validation of the General Self-Efficacy Scale in Ugandan Community Health Workers

Self-efficacy is central to community health workers' capacity and motivation to deliver evidence-based care; thus, validated measures of self-efficacy are needed to assess the effectiveness of community health worker programs. In this study, we culturally adapted and evaluated the General Self-Efficacy Scale among community health workers in Uganda using multiple methods. We adapted the ten-item General Self-Efficacy Scale through cross-cultural discussions within our multidisciplinary research team, translation from English into Luganda and back-translation into English, and six cognitive interviews with community health workers. We administered the adapted scale in a staged, two-part cross-sectional study, including a total of 147 community health workers. Exploratory factor analysis yielded three factors, which we labeled problem-solving, persistence, and resourcefulness. This three-factor solution had good model fit (standardized root mean square residual = 0.07) and explained 53.4% of the variance. We found evidence of convergent validity, as scores for the total scale were positively correlated with years of experience (r = 0.48; p < .001) and perceived social support (r = 0.39, p < .001). Scores were also higher among those with higher educational attainment in one-way analysis of variance and Bonferroni-corrected post hoc tests [F (2,72) = 9.16, p < .001]. We also found evidence of discriminant validity, as scores for the total scale were not correlated with age (r = - 0.07, p = .55), in agreement with literature showing that general self-efficacy is an age-independent construct. The internal consistency of the adapted scale was within the acceptable range for a pilot study (Cronbach's α = 0.61). This evaluation of a Uganda-adapted General Self-Efficacy Scale demonstrated promising psychometric properties; however, larger studies with repeated measures are warranted to further assess the adapted scale's factor structure, validity, reliability, and stability over time.

Chinese cross-culturally adapted patient-reported outcome measures (PROMs) for knee disorders: a systematic review and assessment using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) instrument

BACKGROUND

Knee patient-reported outcome measures (PROMs) are widely used in research in China, but there is limited evidence on the quality of cross-culturally adapted and original Chinese PROMs. We investigated Chinese language knee PROMs to provide evidence for clinicians on their quality and to guide PROM choices.

METHOD

A systematic literature search of databases: PUBMED, CINAHL, EMBASE, and CNKI, using adequate search strings and a three-step screen process identified relevant studies. An independent standardized assessment of the selected studies based on the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool was performed. Inter-rater reliability was assessed using intraclass coefficients (ICC).

RESULTS

Thirty-three articles corresponding to 23 knee PROMs were evaluated with EMPRO global scores (100) ranging from 11.11 to 55.42. The attributes 'reliability,' 'validity,' and 'cultural and language adaptation' were significantly better evaluated compared to the attributes 'responsiveness,' 'interpretability,' and 'burden' (for all comparisons p < 0.0001). Moderate-to-excellent inter-rater agreement was observed with ICC values ranging from 0.538 to 0.934.

CONCLUSION

We identified six PROMs with a minimum acceptable threshold (> 50/100). The osteoarthritis of knee and hip quality of life, the lower extremity function scale, and the Western Ontario Meniscal Evaluation tool ranked highest. Nevertheless, no single PROM had evidence encompassing all EMPRO attributes, necessitating further studies, especially on responsiveness, interpretability, and burden. We identified duplication of effort as shown by repeated translations of the same PROM; this inefficiency could be ameliorated by rapid approval of Chinese language PROMs documented on original PROM developers' platforms.

Knee osteoarthritis pre-screening questionnaire (KOPS): cross-cultural adaptation and measurement properties of the brazilian version-KOPS Brazilian version

BACKGROUND

Despite the criteria already established for the classification of knee osteoarthritis (OA), a radiographic and/or clinical knee OA diagnosis usually occurs in cases of fully manifest or more advanced disease, which can make health promotion, prevention, and functional rehabilitation in more advanced stages of the disease less effective. In addition, radiographic knee OA can generate more financial costs for health services. Therefore, developing and validating screening instruments to assess the probability of development and progression of knee OA would be of great value for both clinical practice and science.

OBJECTIVE

To cross-culturally adapt and investigate the measurement properties of the Knee OA Pre-screening Questionnaire Brazilian version.

METHODS

A total of 250 individuals of both sexes aged between 35 and 92 years [(mean (standard deviation): 63 (11) years old; 74.1 (15.1) kg; 1.59 (0.09) m; 29.38 (5.44) kg/m²] participated in this study. The cross-cultural adaptation and analyses of the measurement properties of the KOPS Brazilian version included: (1) assessment of conceptual and item equivalence; (2) assessment of semantic equivalence; (3) assessment of operational equivalence; and (4) assessment of measurement equivalence, reliability, and validity.

RESULTS

Cronbach's alpha for the internal consistency among the six components of the KOPS Brazilian version was 0.71. The test-retest 72 h apart for each component resulted in a coefficient correlation intraclass ranging from 0.74 to 1.00. The probability of an individual randomly chosen from the population having KL ≥ 1 and KOPS Brazilian version ≥ 21 points was 0.74 (area under the curve of the Receiver Operating Characteristic - AUC of ROC); furthermore, the AUC for KL ≥ 2 and the KOPS Brazilian version ≥ 23 points was 0.77.

CONCLUSION

The KOPS Brazilian version is a reliable and valid instrument for early screening of knee OA in individuals aged 35 years and over in the Brazilian context.

Cross-cultural French-Canadian adaptation and psychometric assessment of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire

BACKGROUND CONTEXT

Idiopathic scoliosis (IS) can significantly alter the quality of life of adolescents. Some of the available questionnaires in French measuring the quality of life in this population show weak psychometric properties. The newly developed Italian Spine Youth Quality of Life (ISYQOL) questionnaire promises better properties.

PURPOSE

To provide a French-Canadian version of the ISYQOL and to verify its psychometric characteristics.

STUDY DESIGN

Prospective validation of a cross-cultural adaptation of the ISYQOL questionnaire.

PATIENT SAMPLE

A total of 111 participants with idiopathic scoliosis (77.5% female, 10-18 years old, mean Cobb angle=28°) were included in the study.

OUTCOME MEASURE

The French-Canadian version of the Italian Spine Youth Quality of Life (ISYQOL-F) questionnaire.

MATERIALS AND METHODS

The ISYQOL was translated into French using a forward-backward approach. We then verified the understanding of the translated items with two scoliosis experts and 10 adolescents. Afterward, 111 adolescents with IS were recruited by convenience at the scoliosis clinic and they completed the ISYQOL on three occasions (before seeing the specialist, 1 week, and 2 weeks after). Cronbach's alpha, intra-class (ICC), and Pearson correlation coefficients were used to respectively determine internal consistency, test-retest reliability, and concurrent validity with the SRS-22r and SF-12. The standard error of measurement (SEM) and 95% confidence minimal detectable change (MDC₉₅) were also calculated. The ceiling effect was quantified as the percentage of participants who scored the maximum on ISYQOL-F.

RESULTS

The ISYQOL-F showed good internal consistency with a Cronbach alpha of 0.81 and 0.85 respectively for items 1-13 (n=55; ISYQOL-F mean score ± SD = 63.9±13.5) and 1-20 (n=56; ISYQOL-F mean score ± SD=60.7±10.3). Test-retest reliability was excellent (ICC_3,1=0.94). The SEM is 3.1 and the MDC₉₅ is 8.6. Correlations between ISYQOL-F and SRS-22r and between ISYQOL-F and SF-12 were moderate for total scores (r=0.56 and 0.50 respectively, p<.001), but low for each domain (between 0.20 and 0.48, p<.05). No significant ceiling effects were observed for ISYQOL-F (≤2.5%). In contrast, ceiling effects ranged from 3.6% to 30.6% for SRS-22r and 0%-68.5% for SF-12.

CONCLUSIONS

The internal consistency and reliability of ISYQOL-F are good. The total score correlates moderately with the SRS-22r and SF-12. Unlike SRS-22r, the ISYQOL-F does not appear to have a ceiling effect. The ISYQOL-F may thus be suitable to assess quality of life in a population of French-Canadian adolescents with IS.

Quality of the adaptation procedures and psychometric properties of the scale of oral health outcomes for 5-year-old children (SOHO-5): a systematic review

PURPOSE

The aim of this study was to assess the quality of the cross-cultural adaptations and psychometric properties of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5).

METHODS

A systematic search was performed in three databases, PubMed, SCOPUS, and Dentistry and Oral Science Source (EBSCO). Studies relating to the cross-cultural adaptation and psychometric properties of SOHO-5 were included. The quality of cross-cultural adaptation was assessed in five aspects including translation, synthesis, back-translation, expert committee review, and pretesting. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to assess the psychometric properties in seven domains including responsiveness, internal consistency, reliability, measurement error, and structural, construct, and cross-cultural validity.

RESULTS

The search identified 162 papers for screening; from these, 107 articles and 9 systematic reviews were excluded. 21 full papers were retrieved and 6 studies that met the inclusion criteria were included. Out of six, two reported all five aspects of cross-cultural adaptation procedures. Regarding the psychometric properties, none of the studies evaluated all aspects of psychometric properties. Almost all of the studies reported internal consistency (Cronbach's alpha ranging from 0.71 to 0.90), test-retest reliability (Intraclass Correlation Coefficient 0.46-0.98), and construct validity. None reported the cross-cultural validity and responsiveness of the measures.

CONCLUSION

While these studies provided satisfactory results regarding the validity and reliability of SOHO-5, the majority of the included studies did not report all domains of the cross-cultural adaptations and psychometric properties. Overall, the quality of the cross-cultural adaptations and psychometric properties of the included studies is doubtful. Future research should follow the guidelines to assess all aspects of psychometric properties and adaptation procedures in cross-cultural settings.

Psychometric evaluation of the Chinese version of advance care planning self-efficacy scale among clinical nurses

Background

Nurses are one of the most critical members of advance care planning (ACP) discussion. The evaluation of ACP self-efficacy is of great significance for developing targeted ACP interventions among clinical nurses and update their professional roles. However, there are few instruments to evaluate their ACP self-efficacy in mainland China. The purpose of this study was to translate the ACP self-efficacy scale into Chinese and evaluate its psychometric properties among clinical nurses.

Methods

A methodological study of the translation and validation of the ACP self-efficacy scale was conducted from January to March 2022. It involved three phases: (1) the translation and revision of the scale; (2) the exploration and evaluation of the item (n = 436); (3) the psychometric evaluation of the scale (n = 674).

Results

After a rigorous translation and revision, the ACP self-efficacy scale with three dimensions and 16 items was finally formed. In this study, the critical ratios of the item ranged from 8.226 to 17.499, and the item-total correlation coefficients ranged from 0.437 to 0.732, and the factor loadings of the item ranged from 0.638 to 0.882. The content validity index of the scale was 0.946. Supported by the eigenvalues, the three-factor structure explained the cumulative 61.131% of the overall variance. As the results of confirmatory factor analysis, all the recommended fitting indexes were appropriate. The average variance extracted values ranged from 0.570 to 0.756, and the composite reliability values ranged from 0.858 to 0.925. The total Cronbach's α coefficient, split-half reliability coefficient and test–retest reliability coefficient of the scale were 0.896, 0.767 and 0.939, respectively.

Conclusion

The Chinese version of ACP self-efficacy scale was successfully introduced into China, showing good psychometric properties among clinical nurses, and can effectively assess the ACP self-efficacy. Also, the scale can provide nursing educators with a significant strategy to develop ACP educational procedure and post-intervention measures for clinical nurses to improve nurse-led ACP practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-01064-6.

Translation, cross-cultural adaptation and validation of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire to Portuguese: Older adults version

BACKGROUND

Deprescribing is a patient-centered approach to managing inappropriate polypharmacy that faces several barriers, including patients' attitudes and beliefs about medications that need to be considered. For this purpose, the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a helpful instrument, but until now, there is no Portuguese version.

OBJECTIVES

To translate and validate the rPATD questionnaire (older adults version) to Portuguese.

METHODS

The rPATD questionnaire was translated and cross-culturally adapted using forward-backward translation and pre-testing. A cross-sectional study with 192 older adults aged ≥65 years taking at least 1 regular medication was conducted for validity assessment. Participants were recruited by convenience sampling in 3 Portuguese outpatient rehabilitation medicine clinics. Psychometric properties were evaluated through face and content validity; construct validity, by assessing structural validity through exploratory factor analysis, hypotheses testing, including concurrent validity and cross cultural validity; reliability with internal consistency; and item-total correlation. Floor and ceiling effects were examined.

RESULTS

The exploratory factor analysis (EFA) revealed a 4-factor structure that explains 51.08% of the total variance, as in the original rPATD. These 4 factors are related to the level of involvement in medication management, beliefs in the appropriateness of medication, perceived burden of medication, and concerns about stopping medications. Factor loadings ranged from 0.226 to 0.800; 2 items scored <0.3, and no cross-loading was found. The exclusion of the 2 items loading <0.3 in the EFA showed no significant improvement in factor loading or internal consistency, so the item structure was maintained. In hypothesis testing, 78% of the correlations were correctly predicted. The 4 factors internal consistency was generally acceptable, with Cronbach's alpha ranging from 0.638 to 0.830. The item-total correlation ranged between 0.223 and 0.7.

CONCLUSION

The Portuguese rPATD questionnaire for older adults presents globally good or acceptable psychometric properties.

Cross-cultural adaptation and validation of the STOP-bang Questionnaire from English to Spanish as a tool for the early detection of sleep apnea syndrome in the surgical patient and in the general population

INTRODUCTION

Obstructive Sleep Apnea Syndrome (OSAS) or Apnea-Hypoapnea Syndrome (SAHS) is one of the most prevalent sleep disorders in the general population. It is associated with an increase in the prevalence of difficult orotracheal intubation and postoperative complications. The application of validated early detection tests, such the STOPbang test in English (STBC), is recommended; a test of high methodological quality, sensitivity and specificity in the early detection of SAHS in both surgical and general populations.

OBJECTIVE

The validation, translation, cross-cultural adaptation of the STBC to the Spanish population.

MATERIAL AND METHODS

The transcultural adaptation of the STBC to Spanish was carried out and a subsequent validation study with 77 consecutive patients was carried out. The statistical analysis evaluated the reliability, validity and feasibility of the translated and culturally adapted version.

RESULTS

44% of women and 56% of men were included, with a mean age of 53.58 ± 12.88 years. The reliability results were: a Cronbach's Alpha Coefficient of 0.767, a Pearson correlation r = 0.777 (P < .001) and a Sperman correlation rho = 0.455 (P = .044). The feasibility of the study was 100%. Criterion validity was evaluated using the Kappa coefficient, which was 0.444. For a score >3 of the questionnaire adapted to Spanish, the results of sensitivity, specificity according to the different cut-off levels of the apnea hypopnea index (AHI) >5, >15, >30) were: Sensitivity 87%, 91% and 100% respectively and Specificity of 50%, 31% and 22%.

CONCLUSIONS

The STBC questionnaire translated, adapted and validated into Spanish, evaluated in the present study, is reliable and valid with respect to the original design of the questionnaire. It is a useful tool that is easy to understand and implement, which can be used rigorously to stratify surgical risk and carry out adequate perioperative planning of those patients at risk of SAHS.

Cross-cultural adaptation of four instruments to measure stigma towards people with mental illness and substance use problems among primary care professionals in Chile

Stigma toward people with mental illness and substance use problems is a significant global concern, and prevents people with these conditions from accessing treatment, particularly in primary health care (PHC) settings. Stigma is a cultural phenomenon that is influenced by particular contexts and can differ by country and region. The majority of stigma research focuses on Europe or North America leading to a lack of culturally relevant stigma research instruments for the Latin American context. The present study describes and discusses the methodology for cross-culturally adapting four stigma measurement scales to the Chilean context. The cross-cultural adaptation process included nine phases: (1) preparation; (2) independent translations; (3) synthesis 1 with expert committee; (4) focus groups and interviews with researchers, PHC professionals, and PHC users; (5) synthesis 2 with expert committee; (6) independent back translations; (7) synthesis 3 with expert committee; (8) pilot with PHC professionals; and (9) final revisions. The adaptation process included an array of diverse voices from the PHC context, and met three adaptation objectives defined prior to beginning the process (Understandability, Relevance, and Acceptability and Answer Options). The resulting, culturally adapted questionnaire is being validated and implemented within PHC settings across Chile to provide in-depth insight into stigma among PHC professionals in the country. The authors hope it will be useful for future research on mental illness and substance use stigma in similar settings across Latin America.

Simplified Chinese Version of the Spinal Instability Neoplastic Score in Evaluating Patients with Metastatic Spinal Tumor: A Cross-Cultural Adaptation and Validation

Objective

To translate the original English version of the Spinal Instability Neoplastic Score (SINS) into simplified Chinese, adapt it cross‐culturally, validate its psychometric properties in measuring spinal instability in patients with metastatic spinal tumors in the Chinese mainland, examine the reliability and validity to demonstrate its accuracy and applicability in clinical practice.

Methods

Patients diagnosed with metastatic spinal disease between January 2016 and January 2020 were recruited. The number of participants was advised to be at least 50 for appropriate analysis of reliability, construct validity, as well as ceiling or floor effects, and recruitment of 100 patients was advised for internal consistency analysis. The study was conducted in two phases: first, the SINS was translated into simplified Chinese; second, the factor structure, internal consistency, test–retest reliability, validity, and floor and ceiling effects of the SC‐SINS were assessed. The internationally recognized cross‐cultural adaptation guidelines were followed. Internal consistency was evaluated with Cronbach's alpha. Test–retest reliability was examined among the patients with a 4‐week interval. The validity of the Chinese version of SINS (SC‐SINS) was assessed by examining its relationship with Kostuik classification. Principal component analysis was conducted to confirm the factor structure of each subscale.

Results

A total of 160 participants (88 males and 72 females) were enrolled. No major difficulties occurred in the forward and backward translations of SINS. The internal consistency of SC‐SINS was excellent (Cronbach's α =0.857, ranging from 0.68 to 0.85). Test–retest reliability was also excellent with a value of 0.89, ranging from 0.86 to 0.95. Validity analyses indicated that the SC‐SINS was positively and significantly correlated with Kostuik classification. The correlation between “Posterolateral Involvement of Spinal Elements” and “1‐2 Partial Damage” was the highest with a correlation value of 0.792. The correlation between “Pain” and “1–2 Partial Damage” was the lowest with a value of 0.341. All items showed principal component coefficients greater than 0.4. The values of Factor 1 ranged from 0.523 to 0.681; Factor 2 ranged from 0.591 to 0.731; Factor 3 ranged from 0.613 to 0.754; Factor 4 ranged from 0.461 to 0.711; Factor 5 ranged from 0.513 to 0.701; and Factor 6 ranged from 0.501 to 0.668. In addition, neither floor nor ceiling effects were seen in the SC‐SINS.

Conclusion

The SC‐SINS demonstrated high internal consistency and test–retest reliability, which has been proven valid and reliable to measure spinal stability in patients from the Chinese mainland with metastatic spinal tumor.

Cross-cultural adaptation and psychometric assessment of the Portuguese language version of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire in Brazilian adults

PURPOSES

To develop a Brazilian Portuguese version of the Eating and Appraisal due to Emotions and Stress (EADES) Questionnaire and estimate the psychometric properties of the EADES factorial model for young Brazilian adults and also to assess the association between EADES factors and age, body mass index (BMI), and economic level.

METHODS

The cross-cultural adaptation was performed using a standardized protocol. The psychometric properties were assessed separately for each sex. A structural model for each sex was developed to investigate the influence of age, economic level, and BMI on the EADES factors.

RESULTS

A total of 1240 participants completed the study [65.8% female, mean age 23.91 (SD = 5.03) years]. The EADES original factorial model did not present good psychometric properties. Then, a factorial model proposed for a Mexican sample was tested and a different model was fitted for each sex. The results showed that younger women have lower self-efficacy and self-confidence and poorer assessment of resources and coping skills. Women with a higher economic level have lower self-efficacy. Higher BMI was associated with lower self-efficacy and self-confidence in both sexes. Younger men have lower self-efficacy and poorer assessment of resources and coping skills.

CONCLUSIONS

The Brazilian Portuguese version of the EADES provided valid and reliable data after refinement, and a different model was fitted for each sex. Sex, age, BMI, and economic level were significantly associated with the EADES factors.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Translation, cross-cultural adaptation and validation of the Computer Vision Syndrome Questionnaire into Persian (CVS-Q FA©)

Purpose

To translate, cross-culturally adapt and validate the Computer Vision Syndrome Questionnaire (CVS-Q^©) into Persian.

Methods

This study was carried out in 2 phases: (1) the CVS-Q^© was translated and cross-culturally adapted into Persian and (2) the validity and reliability of CVS-Q FA^© were assessed in a cross-sectional validation study. An expert committee composed of 15 optometrists evaluated content validity (item-level (I-CVI) and scale-level (S-CVI) content validity index were calculated). A pretest was performed (n = 20 participants) to verify the comprehensibility of the questionnaire. A total of 102 computer users completed the final questionnaire. Criterion validity and diagnostic performance of the CVS-Q FA^© were assessed by calculating sensitivity, specificity and receiver characteristic operator curve. Cronbach's alpha was calculated for the assessment of internal consistency and 46 participants refilled the questionnaire for the second time and the interclass correlation coefficient (ICC) and Cohen's kappa (κ) were evaluated for test–retest reliability.

Results

The translation and cross-cultural adaptation process was performed successfully according to accepted scientific recommendations without any major difficulties. The I-CVI was above 0.80 for all items (symptoms) except item 15 (feeling that sight is worsening) and the S-CVI was 0.92. The CVS-Q FA^© showed good sensitivity (81.1%) and acceptable specificity (69.2%). Also, it achieved good internal consistency (Cronbach's alpha = 0.80) and test–retest reliability (ICC = 0.81 and κ = 0.65).

Conclusion

The CVS-Q FA^© was successfully translated, cross-culturally adapted, and validated into Persian. This study provides a valid and reliable tool for the assessment of computer vision syndrome among the Iranian working population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10792-022-02340-3.

Cross-cultural adaptation into Spanish of the MULTIPleS scale in elderly patients with multimorbidity

BACKGROUND AND OBJECTIVE

The Multimorbidity Illness Perceptions Scale (MULTIPleS) analyzes whether suffering from two or more chronic diseases affects the quality of life, cost and clinical results of patients. The objective was to translate and cross-culturally adapt the MULTIPleS scale into Spanish.

METHODS

Direct translation and back translation followed by synthesis and adaptation by a third translator and a panel of experts to guarantee the conceptual, semantic and content equivalence between both versions. Subsequently, a comprehensibility analysis was performed on a sample of patients.

RESULTS

The Spanish version of the MULTIPleS scale was obtained. The medium degree of difficulty in the direct translation and the back translation of the title and the questions showed a low difficulty. In the synthesis and adaptation phase, 6 discrepancies were resolved. The comprehensibility analysis was performed in 10 patients, achieving the established requirement (> 80%) for all items.

CONCLUSIONS

This is the first cross-cultural adaptation to Spanish of the MULTIPleS scale. Having this back-translated scale will make it possible to analyze patients' perception of the disease and thus apply improvements in their healthcare.

The German version of the High-Activity Arthroplasty Score is valid and reliable for patients after total knee arthroplasty

PURPOSE

The indications for a total knee arthroplasty (TKA) broadened to younger and more active patients. The High-Activity Arthroplasty Score (HAAS) is a self-administered instrument focussing on the wider range of functional abilities of more active patients. The HAAS was developed in English and is not available in German yet. This study aims to translate, cross-cultural adapt and assess the psychometric properties of the German HAAS in patients 12 months after primary TKA.

METHODS

After forward and backward translation, we examined the final version regarding its psychometric properties in patients 12 months after primary TKA. The HAAS was sent out to 70 patients together with routine questionnaires comprising the Knee injury and Osteoarthritis Outcome Score (KOOS), the Forgotten Joint Score (FJS-12), the EuroQol (EQ-5D-3L) and 2 numerical pain rating scales. Acceptability, reliability, responsiveness, content and construct validity as well as floor and ceiling effects were evaluated.

RESULTS

Fifty-two patients were recruited. The HAAS was well accepted with a mean time to completion of 2.4 min. Cronbach's alpha for internal consistency was 0.749, test-retest reliability was excellent with an Intraclass Correlation Coefficient (ICC) of 0.961. The smallest detectable change was 1.5. Good content validity was confirmed. A strong correlation was found between the HAAS and KOOS sport (r = 0.661) and a medium correlation for all other KOOS subscales (r = 0.324 to 0.453), the FJS-12 (r = 0.425), the EQ-5D-3L (r = 0.427) and pain (r = - 0.439 to - 0.308). The HAAS showed no floor and ceiling effects.

CONCLUSIONS

The German version of the HAAS provides good validity and reliability. It can be easily self-administered and is recommended to capture high-intensity activities in patients after TKA.

LEVEL OF EVIDENCE

Diagnostic study, Level I.

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Perceptions of Dating Infidelity Scale in Brazilian Portuguese

The Perceptions of Dating Infidelity Scale (PDIS) assesses how people perceive infidelity through specific behaviors. Originally developed by Wilson et al. (2011), it contains 12 items distributed into three factors: (1) ambiguous, (2) deceptive, and (3) explicit behaviors. In the present research, translation, cross-cultural adaptation, and validation of the PDIS in Brazilian Portuguese were performed. First, qualitative analyses took place: translation, translation synthesis, content validation, pre-test, and reverse translation. Then, quantitative analyses were conducted: psychometric parameter tests with confirmatory factor analysis and reliability. A total of 252 participants were recruited, 160 of whom were female (63.5%). The results indicated consistent PDIS adequacy (conceptual and idiomatic equivalences); satisfactory content validity coefficients regarding language clarity, practical pertinence, and theoretical relevance; and an almost perfect level of consensus regarding the theoretical dimension. The application of the pre-test was proven to be a good parameter for estimating the comprehension of the instrument in the culture for which it was intended. Confirmatory factor analysis showed good indices of adjustment quality of the tested trifactorial model (three factors being identified with ambiguous, deceptive, and explicit behaviors). Therefore, the structure indicated in the original version was corroborated and the instrument's reliability confirmed. The Brazilian Portuguese PDIS is a useful tool for evaluating infidelity perceptions in the Brazilian culture.

Supportive and palliative care indicators tool (SPICT™) in a Danish healthcare context: translation, cross-cultural adaptation, and content validation

BACKGROUND

Early identification of patients who require palliative and supportive care at the general palliative care level is challenging. The Supportive & Palliative Care Indicators Tool (SPICT™) might provide a helpful framework for this process.

AIM

To translate, culturally adapt and content validate SPICT™-DK in hospital, primary care, and general practice and within the broader Danish health care context.

METHODS

SPICT™-DK was translated and cross-culturally validated by using the TRAPD-model (Translation, Review, adjudication, pretesting, and documentation) as well as the EORTC- translation guide (European Organisation for Research and Treatment of Cancer). In the pre-(pilot) testing phase, six focus group interviews and five individual interviews were conducted involving n = 29 health care professionals from general practice, primary care, and hospital. The qualitative data were analyzed through thematic analysis and the SPICT™-DK was then revised and published.

RESULTS

The interviews revealed that SPICT™-DK can be used to identify people with palliative care needs. Three themes were derived from the analysis and showed SPICT™-DK provides a linguistic framework but must be used as an interdisciplinary tool as that SPICT™-DK requires competencies and collaboration.

CONCLUSION

SPICT™-DK is now translated and culturally validated in a Danish healthcare setting. The tool is useful to identify people with palliative care needs but must be implemented as an interdisciplinary collaborative intervention. SPICT™ -DK cannot be used by all healthcare professionals as it requires disease-specific competencies. However, it provides a common language for early palliative care interventions which can form the basis for interdisciplinary planning of future treatment and care.

Cross-cultural validation of the Oxford Elbow Score and Mayo Elbow Performance Score in Greek

BACKGROUND

Oxford Elbow Score (OES) and Mayo Elbow Performance Score (MEPS) are two of the most commonly used instruments for the functional assessment of elbow joint. The aim of this study was to cross-culturally validate the OES and MEPS into Greek language and examine their convergent validity, internal consistency, test-retest reliability and floor and ceiling effects.

METHODS

The two instruments were translated into Greek with the back translation method. Their final Greek versions (OES-GR and MEPS-GR) were completed by 40 patients with elbow disorders. The patients completed also the Greek version of the Disabilities of the Arm Shoulder and Hand (DASH-GR). The patients re-completed the OES-GR after 24 h.

RESULTS

The OES-GR was found to have good internal consistency (Cronbach's α = 0.85, 95%CI = 0.74-0.92), in contrast to the MEPS-GR (Cronbach's α = 0.47, 95%CI = 0.15-0.70). Both instruments were found to have good convergent validity with the DASH-GR (for MEPS-GR r_s = -0.64, 95% CI -0.79 to -0.41; for OES-GR r_s = -0.84, 95%CI = -0.91 to -0.72). Good was also the convergent validity of the OES-GR with the MEPS-GR (r_s = 0.71, 95%CI = 0.51 to 0.84). The test-retest reliability for each domain of the OES-GR was found good to excellent (total score ICC = 0.91, 95%CI = 0.83-0.95; pain ICC = 0.90, 95%CI = 0.81-0.95; function ICC = 0.81, 95%CI = 0.68-0.90; social-psychological ICC = 0.91, 95%CI = 0.84-0.95).

CONCLUSION

The findings about the internal consistency, test-retest reliability, convergent validity and ceiling/floor effects of the OES-GR suggest that it is a quite valid and reliable instrument which can be used with confidence in Greek patients with elbow disorders.

LEVEL OF EVIDENCE

N/A.

Cross-cultural translation, validity, and reliability of the Turkish version of the Back Pain Attitudes Questionnaire

BACKGROUND

As the Back Pain Attitudes Questionnaire (Back-PAQ), a validated instrument, could be performed to evaluate biopsychosocial dimensions of back pain, it has not been translated and adapted for Turkish population.

OBJECTIVES

It was aimed to translate and cross-culturally adapt the Back-PAQ (versions of 34-item, 20-item, and 10-item) into Turkish language and analyse the validity and reliability of the Back-PAQ-Turkish version (Back-PAQ-Tr).

STUDY DESIGN

Study of diagnostic accuracy/assessment scale.

METHODS

The translation and cross-cultural adaptation process were carried out in several steps according to international best-practice guidelines. 173 participants with back pain were recruited. Turkish version of the Tampa Scale of Kinesiophobia (TSK-Tr) and Fear Avoidance Beliefs Questionnaire (FABQ-Tr) were used to investigate the convergent validity.

RESULTS

Internal consistency of the Back-PAQ-Tr, Back-PAQ-Tr-20, and Back-PAQ-Tr-10 were 0.82, 0.78 and 0.68, respectively. Test-retest reliability was excellent for Back-PAQ-Tr (ICC = 0.95) and Back-PAQ-Tr-20 (ICC = 0.95), but weak for Back-PAQ-Tr-10 (ICC = 0.50). A weak correlation was found between all versions of Back-PAQ-Tr and TSK-Tr & FABQ-Tr, except for the moderate correlation between Back-PAQ-Tr-10 and TSK-Tr (r = -0.51) & the physical activity score of FABQ-Tr (r = -0.51). Back-PAQ-Tr, Back-PAQ-Tr-20, and Back-PAQ-Tr-10 accounted for 66.2%, 60.5%, and 78.2% of the variance in the data set, respectively.

CONCLUSION

The versions of 34-item and 20-item Back-PAQ-Tr are reliable and valid questionnaire to assess Turkish populations' attitudes and beliefs regarding back pain. Since the reliability of the 10-item version was determined to be quite low, we particularly recommend the use of the versions of Back-PAQ-Tr and Back-PAQ-Tr-20.

Job requirements and physical demands (JRPD) questionnaire: cross-cultural adaptation and psychometric evaluation in Iranian Army personnel with chronic low back pain

BACKGROUND

Biomechanical risk factors have been identified as the main predisposing factor of chronic low back pain (CLBP), especially in Army personnel. The Job Requirements and Physical Demands (JRPD) questionnaire has been developed to assess the biomechanical exposures related to CLBP. Examining the biomechanical risk factors could prevent CLBP. This study aimed to translate and cross-culturally adapt the JRPD into Persian and assess its psychometric properties among Iranian male Army personnel with CLBP.

METHODS

In this cross-sectional study, the content validation of the JRPD was assessed after translating to Persian. The Persian JRPD was administered to 198 male Army personnel with CLBP, with an interval of 7 days, to assess test-retest reliability, including Cronbach's α, intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change at 95% confidence interval (MDC_95%). Scores of the Persian JRPD were correlated with the scores of visual analog scale (VAS), Borg's category-ratio (CR10) scale, general health questionnaire-28 (GHQ-28), and physical functioning (PF₁ and PF₂) subscale of the 12-item short-form health survey (SF-12) to assess convergent validity using Spearman correlation for a priori hypotheses.

RESULTS

The Persian JRPD had good content validity evidenced by the higher content validity index (> 0.70). The questionnaire had a significant positive negligible to weak correlation with the VAS (rho = 0.27; p < 0.001), Borg's CR10 scale (rho = 0.19; p = 0.009), and the total score of GHQ-28 and its domains (rho ≤0.34; p < 0.05); and significant negative weak correlation with PF₂ (rho = - 0.27; p < 0.001) and significant negative moderate correlation with PF₁ (rho = - 0.35; p < 0.001), thus confirming the priori hypotheses (89%, 8/9). The internal consistency and ICC (α = 0.91; ICC = 0.80) were highly adequate, with SEM and MDC_95% of 7.91 and 21.3 respectively.

CONCLUSIONS

The JRPD was successfully adapted into Persian and had adequate psychometric properties in terms of content and convergent validity, internal consistency, and test-retest reliability. The questionnaire is found useable to assess the CLBP-related biomechanical exposures in Iranian male Army personnel.

Italian translation and cross-cultural adaptation of the Progressive Aphasia Severity Scale

Primary progressive aphasia (PPA) is a neurodegenerative disease characterised by a progressive decline in language and speech as the first clinical manifestation, which mostly spares other cognitive functions. However, the linguistic impairment of PPA shows different features than that resulting from cerebrovascular diseases. The major difference between the linguistic manifestations of PPA and the traditional classification of aphasias has led to the development of new, more specific methods of language assessment. Among the currently available tools, there has been great interest in the Progressive Aphasia Severity Scale (PASS). This quick and easy-to-use clinical tool allows to collect significant information from caregivers about the communicative, linguistic, and functional difficulties of patients affected by PPA. In addition to monitoring the severity and progression of deficits in 13 different language domains, this scale integrates the classic "clinically reported" assessment with a "caregiver-reported" analysis of the daily experience of the patient, which provides a better understanding of how the disease affects the quality of life of both the patient and the caregiver. In the present contribution, the PASS was translated and adapted into Italian according to the international guidelines for the cross-cultural adaptation of self-report measures. This version of the PASS can help clinicians and researchers in the diagnosis of PPA in Italian clinical populations. Furthermore, it could be particularly useful for the long-term evaluation of the disease, in order to monitor its evolution, and might represent an optimal means to verify the efficacy of speech/language therapy in delaying the progression of the disease.