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Garavito JA, Rodarte P, Navarro RA. Readability Analysis of Spanish-Language Patient-Reported Outcome Measures in Orthopaedic Surgery. J Bone Joint Surg Am 2024:00004623-990000000-01108. [PMID: 38781322 DOI: 10.2106/jbjs.23.01367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are increasingly used to quantify patient symptomatology when assessing intervention effectiveness as well as to guide patient-centered health-care management and research. Previous studies have analyzed the readability of PROMs used in orthopaedics in the English language; however, the readability of PROMs used in orthopaedics in the Spanish language has not been evaluated. Given the increasing number of Spanish-speaking individuals seeking orthopaedic care in the United States, it is imperative that PROMs are at an adequate reading level for patients to answer appropriately in their native language. This study aimed to assess the readability of publicly available Spanish-language PROMs used in orthopaedics. METHODS Searches of the PubMed, Google Scholar, and Embase databases were conducted to identify publicly available Spanish-language versions of PROMs used in orthopaedics. Additionally, the PROMIS Health Organization was contacted to obtain Spanish-language versions of the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires. A total of 42 Spanish-language PROMs were identified and included in this study. The text of each PROM was inserted into multilingual readability software (legible.es), which analyzed the readability of each PROM using the Fernández Huerta and Índice de Legibilidad de Flesch-Szigriszt (INFLESZ) readability formulas. The mean and standard deviation (SD) of the raw readability scores were calculated for the PROMs. The percentage of PROMs at or below the 6th-grade reading level was also calculated. RESULTS The mean readability of PROMs using the INFLESZ formula was at a 7th to 10th-grade reading level (mean = 63, SD = 16), and the mean readability using the Fernández Huerta formula was 68 (SD = 15). On average, 57% of the PROMs used in orthopaedics were at or below the INFLESZ 6th-grade readability level. CONCLUSIONS Approximately half of Spanish-language PROMs used in orthopaedics are written at a reading level that does not meet the National Institutes of Health and the American Medical Association recommendations at or below the 6th-grade level. PROM developers and translators should consider the importance of readability when translating PROMs, to maximize their use and efficacy among orthopaedic patients speaking that language.
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Affiliation(s)
- Jorge A Garavito
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Patricia Rodarte
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Ronald A Navarro
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Suarez ML, Angulo R, Suarez AJ, Fullwood D, Allen J, Stern MC, Flores-Rozas H, Wilkie DJ. Cognitive Testing of PAIN Report It-Spanish in Monolingual Hispanic Adults. Cancer Nurs 2023; 46:364-374. [PMID: 37607372 PMCID: PMC10232677 DOI: 10.1097/ncc.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A Spanish language computerized tool would facilitate cancer pain assessment and management for the underserved population of native Spanish speakers who do not speak or lack command of the English language. OBJECTIVE Our aim was to identify Spanish-speaking adults' understanding and interpretation of the PAIN Report It-Spanish items and instructions as well as translation and technical issues. METHODS In a cross-sectional study, 20 mostly monolingual Spanish-speaking adults engaged in 1.5- to 2-hour, audio-recorded cognitive interviews as they completed the multidimensional PAIN Report It-Spanish. Three bilingual researchers conducted content data analysis. RESULTS Sixteen women and 4 men generally understood the translated text, but some had interpretation issues regarding the 0 to 10 number scale and understanding of the pain quality descriptors. Many participants found the program easy to complete, even when they had problems in some areas. Most participants welcomed the opportunity to report pain in their native language and appreciated research to help Hispanics with the management of their pain. CONCLUSION PAIN Report It-Spanish is a valid tool to assess pain in a Spanish-speaking population. Improved orientation to the pain reporting tasks and alternate translations for several problematic/confusing Spanish words require additional study, especially among underrepresented black Hispanics and males. IMPLICATION FOR PRACTICE Findings indicate that Spanish-speaking adults (1) easily use a body outline to report their pain location, (2) may use a 0 to 10 scale differently than other individuals, and (3) may have a limited repertoire of pain quality and pattern descriptors.
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Affiliation(s)
- Marie L Suarez
- Author Affiliations: College of Nursing, University of Illinois Chicago (Dr Suarez, Mr Angulo, and Mr Suarez); Institute on Aging, University of Florida (Dr Fullwood), Gainesville; College of Pharmacy, University of Florida (Dr Allen), Gainesville; Department of Population and Public Health Sciences and Department of Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center (Dr Stern), Los Angeles, CA; College of Pharmacy, Florida Agricultural and Mechanical University (Dr Flores-Rozas), Tallahassee; and College of Nursing, University of Florida (Dr Wilkie), Gainesville
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Durán AM, Salto LM, Câmara J, Basu A, Paquien I, Beeson WL, Firek A, Cordero-MacIntyre Z, De León M. Effects of omega-3 polyunsaturated fatty-acid supplementation on neuropathic pain symptoms and sphingosine levels in Mexican-Americans with type 2 diabetes. Diabetes Metab Syndr Obes 2019; 12:109-120. [PMID: 30662277 PMCID: PMC6329345 DOI: 10.2147/dmso.s187268] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To determine whether dietary supplementation with omega-3 polyunsaturated fatty acids (PUFAs) reduces neuropathic pain symptoms in Mexican-Americans with type 2 diabetes. METHODS Forty volunteers with type 2 diabetes enrolled in the "En Balance-PLUS" program, which provided weekly nutrition-diabetes education and daily supplementation with 1,000 mg docosahexaenoic acid (DHA)-200 mg eicosapentaenoic acid over 3 months. The study assessed self-reported neuropathic pain symptoms pre/postintervention using the short-form McGill Pain Questionnaire (SF-MPQ), monitored clinical laboratory values at baseline and 3 months, and performed baseline and 3-month metabolomic analysis of plasma samples. RESULTS A total of 26 participants self-reported neuropathic pain symptoms at baseline. After 3 months of omega-3 PUFA supplementation, participants reported significant improvement in SF-MPQ scores (sensory, affective, and visual analogue scale; P<0.001, P=0.012, and P<0.001, respectively). Untargeted metabolomic analysis revealed that participants in the moderate-high SF-MPQ group had the highest relative plasma sphingosine levels at baseline compared to the low SF-MPQ group (P=0.0127) and the nonpain group (P=0.0444). Omega-3 PUFA supplementation increased plasma DHA and reduced plasma sphingosine levels in participants reporting neuropathic pain symptoms (P<0.001 and P<0.001, respectively). Increased plasma DHA levels significantly correlated with improved SF-MPQ sensory scores (r=0.425, P=0.030). Improved SF-MPQ scores, however, did not correlate with clinical/laboratory parameters. CONCLUSION The data suggest that omega-3 PUFAs dietary supplementation may reduce neuropathic pain symptoms in individuals with type 2 diabetes and correlates with sphingosine levels in the plasma.
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Affiliation(s)
- Alfonso M Durán
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
| | - Lorena M Salto
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
| | - Justin Câmara
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
| | - Anamika Basu
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
| | - Ivette Paquien
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
| | - W Lawrence Beeson
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Anthony Firek
- Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, Moreno Valley, CA, USA
| | - Zaida Cordero-MacIntyre
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Marino De León
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA,
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Rodríguez Medina DA, Domínguez Trejo B, Cortés Esteban P, Cruz Albarrán IA, Morales Hernández LA, Leija Alva G. Biopsychosocial Assessment of Pain with Thermal Imaging of Emotional Facial Expression in Breast Cancer Survivors. MEDICINES 2018; 5:medicines5020030. [PMID: 29601485 PMCID: PMC6023480 DOI: 10.3390/medicines5020030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 12/20/2022]
Abstract
Background: Recent research has evaluated psychological and biological characteristics associated with pain in survivors of breast cancer (BC). Few studies consider their relationship with inflammatory activity. Voluntary facial expressions modify the autonomic activity and this may be useful in the hospital environment for clinical biopsychosocial assessment of pain. Methods: This research compared a BC survivors group under integral treatment (Oncology, Psychology, Nutrition) with a control group to assess the intensity of pain, behavioral interference, anxiety, depression, temperament-expression, anger control, social isolation, emotional regulation, and alexithymia and inflammatory activity, with salivary interleukin 6 (IL-6). Then, a psychophysiological evaluation through repeated measures of facial infrared thermal imaging (IRT) and hands in baseline—positive facial expression (joy)—negative facial expression (pain)—relaxation (diaphragmatic breathing). Results: The results showed changes in the IRT (p < 0.05) during the execution of facial expressions in the chin, perinasal, periorbital, frontal, nose, and fingers areas in both groups. No differences were found in the IL-6 level among the aforementioned groups, but an association with baseline nasal temperature (p < 0.001) was observable. The BC group had higher alexithymia score (p < 0.01) but lower social isolation (p < 0.05), in comparison to the control group. Conclusions: In the low- and medium-concentration groups of IL-6, the psychophysiological intervention proposed in this study has a greater effect than on the high concentration group of IL-6. This will be considered in the design of psychological and psychosocial interventions for the treatment of pain.
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Affiliation(s)
- David Alberto Rodríguez Medina
- Division of Research and Postgraduate Studies, Faculty of Psychology, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
| | - Benjamín Domínguez Trejo
- Division of Research and Postgraduate Studies, Faculty of Psychology, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
| | - Patricia Cortés Esteban
- National Medical Center 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03229, Mexico.
| | - Irving Armando Cruz Albarrán
- CA Mechatronics, Faculty of Engineering, Universidad Autónoma de Querétaro, San Juan del Río City 76807, México.
| | | | - Gerardo Leija Alva
- Interdisciplinary Center of Health Sciences, Instituto Politécnico Nacional, Unidad Santo Tomás, Mexico City 11340, Mexico.
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Aguerrevere LE, Castillo YA, Nicks RC, Juan R, Curtis KL. Pain-Related Symptom Reporting Among Hispanics: Implications for Forensic Psychological Evaluations. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-016-9271-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arimura T, Hosoi M, Tsukiyama Y, Yoshida T, Fujiwara D, Tanaka M, Tamura R, Nakashima Y, Sudo N, Kubo C. Pain questionnaire development focusing on cross-cultural equivalence to the original questionnaire: the Japanese version of the Short-Form McGill Pain Questionnaire. PAIN MEDICINE 2012; 13:541-51. [PMID: 22360795 DOI: 10.1111/j.1526-4637.2012.01333.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The present study aimed to develop a Japanese version of the Short-Form McGill Pain Questionnaire (SF-MPQ-J) that focuses on cross-culturally equivalence to the original English version and to test its reliability and validity. DESIGN Cross-sectional design. METHOD In study 1, SF-MPQ was translated and adapted into Japanese. It included construction of response scales equivalent to the original using a variation of the Thurstone method of equal-appearing intervals. A total of 147 undergraduate students and 44 pain patients participated in the development of the Japanese response scales. To measure the equivalence of pain descriptors, 62 pain patients in four diagnostic groups were asked to choose pain descriptors that described their pain. In study 2, chronic pain patients (N=126) completed the SF-MPQ-J, the Long-Form McGill Pain Questionnaire Japanese version (LF-MPQ-J), and the 11-point numerical rating scale of pain intensity. Correlation analysis examined the construct validity of the SF-MPQ-J. RESULTS The results from study 1 were used to develop SF-MPQ-J, which is linguistically equivalent to the original questionnaire. Response scales from SF-MPQ-J represented the original scale values. All pain descriptors, except one, were used by >33% in at least one of the four diagnostic groups. Study 2 exhibited adequate internal consistency and test-retest reliability, with the construct validity of SF-MPQ-J comparable to the original. CONCLUSION These findings suggested that SF-MPQ-J is reliable, valid, and cross-culturally equivalent to the original questionnaire. Researchers might consider using this scale in multicenter, multi-ethnical trials or cross-cultural studies that include Japanese-speaking patients.
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Affiliation(s)
- Tatsuyuki Arimura
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Wong JPH, Poon MKL. Bringing translation out of the shadows: translation as an issue of methodological significance in cross-cultural qualitative research. J Transcult Nurs 2011; 21:151-8. [PMID: 20220035 DOI: 10.1177/1043659609357637] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Translation is an integral component of cross-cultural research that has remained invisible. It is commonly assumed that translation is an objective and neutral process, in which the translators are "technicians" in producing texts in different languages. Drawing from the field of translation studies and the findings of a translation exercise conducted with three bilingual Cantonese-English translators, the authors highlight some of the methodological issues about translation in cross-cultural qualitative research. They argue that only by making translation visible and through open dialogue can researchers uncover the richness embedded in the research data and facilitate multiple ways of knowing.
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Mystakidou K, Katsouda E, Parpa E, Tsilika E, Vlahos L. Use of the Greek McGill Pain Questionnaire in cancer patients. Expert Rev Pharmacoecon Outcomes Res 2010; 4:227-33. [PMID: 19807527 DOI: 10.1586/14737167.4.2.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cancer directly causes pain and raises a significant clinical problem. Pain is the most dominant cause of suffering in cancer patients. The accurate assessment of pain is a prerequisite for its effective relief, and therefore, a universal methodology for the assessment of the pain status of a patient is required. There are many different methods and various instruments for the measurement of pain. The McGill Pain Questionnaire is a multidimensional instrument for the assessment of pain intensity and the multiple dimensions of the pain experience. Several translations and version of the McGill Pain Questionnaire exist. The Greek version was developed in Athens and has been tested for its use in cancer patients receiving palliative care. The Greek McGill Pain Questionnaire validation study provided preliminary evidence of the validity and reliability of the questionnaire. Future studies are needed to confirm the validity of the instrument in order to render it fully utilizable for the assessment of pain caused by the diverse conditions experienced by Greek patients.
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Affiliation(s)
- Kyriaki Mystakidou
- University of Athens, Pain Relief and Palliative Care Unit, Department of Radiology, University of Athens, School of Medicine, 27 Korinthias Street, 115 26 Athens, Greece.
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Menezes Costa LDC, Maher CG, McAuley JH, Costa LOP. Systematic review of cross-cultural adaptations of McGill Pain Questionnaire reveals a paucity of clinimetric testing. J Clin Epidemiol 2009; 62:934-43. [DOI: 10.1016/j.jclinepi.2009.03.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 03/09/2009] [Accepted: 03/24/2009] [Indexed: 10/20/2022]
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Abstract
PURPOSE To inform nurse practitioners (NPs) about the influence of culture on patients' responses to pain using the example of acute chest pain. DATA SOURCES Selected clinical and research articles on pain and culture and the authors' clinical experiences providing care across a variety of cultures. CONCLUSIONS There is very little written and even fewer studies on the connection of culture and the response to acute chest pain. This topic needs more attention by nurse researchers. Implications for practice If NPs are not aware that some patients may not demonstrate behavior typically expected in acute myocardial infarction, they may miss the diagnosis and fail to treat or refer these patients for immediate treatment.
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Castillo PR, Brott TG, Alvarez S, Meschia JF. Creation of a Bilingual Spanish-English Version of the Questionnaire for Verifying Stroke-Free Status. Neuroepidemiology 2004; 23:236-9. [PMID: 15316250 DOI: 10.1159/000079949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Spanish-language versions of standardized questionnaires are important for facilitating inclusion of Hispanic populations in epidemiologic, genetic, and clinical studies. We aimed at producing a culturally adapted Spanish translation of the Questionnaire for Verifying Stroke-free Status (QVSS), an instrument used to screen for cerebrovascular end points and to ensure that subjects serving as controls in studies on stroke are indeed stroke free. Five professional translators and ten bilingual physicians independently translated the English-language version of the QVSS into Spanish. Blinded back-translation confirmed conceptual equivalence of the original English-language and final Spanish-language versions.
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Affiliation(s)
- Pablo R Castillo
- Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL 32224, USA
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Mystakidou K, Parpa E, Tsilika E, Kalaidopoulou O, Georgaki S, Galanos A, Vlahos L. Greek McGill Pain Questionnaire: validation and utility in cancer patients. J Pain Symptom Manage 2002; 24:379-87. [PMID: 12505206 DOI: 10.1016/s0885-3924(02)00495-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In 1968, Melzack and Casey suggested that there are three major psychological dimensions of pain: sensory, affect, evaluative. These categories interact with one another to provide quantitative and qualitative information on the components of pain. In 1975, Melzack developed the McGill Pain Questionnaire, which is composed of four major parts and evaluates the qualities of pain. The aim of this study was to assess the applicability, reliability, and validity of the McGill Pain Questionnaire on a sample of Greek cancer patients receiving palliative treatment. It was administered to 114 cancer patients before the initiation of the palliative treatment, and then to 80 cancer patients during the treatment 7 days later. The results indicated that scale reliability was very good (0.95-0.97). During the pretreatment period, correlations between Present Rating Index (PRI), Present Pain Intensity (PPI), and Number of Words Chosen (NWC) ranged between 0.42 and 0.92. During the post-treatment time, the correlations ranged between 0.28 and 0.91. Only 21.8% of the words met a criterion of 30% for representativeness on the first administration of the questionnaire, and 9% met this criterion on the second. Validity was satisfactory (P < 0.005) according to "responsiveness to changes in time", as there was a statistical difference between the pretreatment and post-treatment time. Patients presented a desirable level of convergent construct validity (P < 0.05) concerning their performance status. Exploratory factor analysis was examined and two factors with eigenvalue over 1 were extracted, and they accounted for 95.2% of the variance. These results support the Greek-MPQ as a reliable and valid measure for evaluating the qualities of cancer pain in patients receiving palliative care.
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Affiliation(s)
- Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, University of Athens, Vas Sofias 76, Athens 11528, Greece
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Lázaro C, Caseras X, Whizar-Lugo VM, Wenk R, Baldioceda F, Bernal R, Ovalle A, Torrubia R, Baños JE. Psychometric properties of a Spanish version of the McGill Pain Questionnaire in several Spanish-speaking countries. Clin J Pain 2001; 17:365-74. [PMID: 11783818 DOI: 10.1097/00002508-200112000-00012] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Versions of the McGill Pain Questionnaire are available in a several languages and are used in clinical studies and sociocultural or ethnic comparisons of pain issues. However, there is a lack of studies that compare the validity and reliability of the instrument in the countries where it is used. The current study investigates the psychometric properties of a Spanish version of the McGill Pain Questionnaire in five Spanish-speaking countries. DESIGN The authors conducted a multicenter and transnational study with one investigator in each center. Patients were evaluated once with a Spanish version of the McGill Pain Questionnaire, a visual analog scale, and a verbal rating scale. SETTING The study was performed in pain clinics and acute pain units of four Latin American countries (Argentina, Costa Rica, Mexico, and Panama) and Spain. PATIENTS The study included 205 patients (84 with acute pain, 121 with chronic pain) from Latin America. Their data were compared with those of 282 Spanish patients. INTERVENTIONS The McGill Pain Questionnaire, visual analog scale, and verbal rating scale were administered once to all patients. The McGill Pain Questionnaire was administered again to patients from Latin America countries to ascertain descriptor comprehension. OUTCOME MEASURES Demographic data, McGill Pain Questionnaire parameters, and visual analog scale and a verbal rating scale scores were obtained from patients with chronic and acute pain. Psychometric properties of the Spanish version of the McGill Pain Questionnaire were established for each country by calculating the ordinal consistency by means of rank-scale correlation (Spearman test), intercategory correlation, and interparameter correlation (Pearson test). Concurrent validity was also calculated by comparing scores from the visual analog scale (Pearson test) and verbal rating scale (Spearman test) with questionnaire parameters (qualitative-to-quantitative comparisons). RESULTS The Spanish version of the McGill Pain Questionnaire maintained a high internal validity when tested in different countries. Ordinal consistency, intercategory, interparameter, and qualitative-to-quantitative parameter correlations were similar in all countries. Few descriptors were considered to be inappropriate or difficult to understand. CONCLUSIONS The psychometric properties of the Spanish version of the McGill Pain Questionnaire assessed in different Latin-American countries suggest that the questionnaire may be used to evaluate Spanish-speaking patients. The validity of this test should be extended with reliability studies to further establish its usefulness in the evaluation of pain.
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Affiliation(s)
- C Lázaro
- Department of Farmacologia, de Terapéutica i de Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Esposito N. From meaning to meaning: the influence of translation techniques on non-English focus group research. QUALITATIVE HEALTH RESEARCH 2001; 11:568-79. [PMID: 11521612 DOI: 10.1177/104973201129119217] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Language translation techniques are at the core of many cross-cultural qualitative research projects. The purpose of this article is to examine the impact of translation techniques on the collection and interpretation of non-English to English qualitative data and, in particular, on focus-group data collection and analysis. The goal is to offer suggestions that will minimize potential threats to validity. This article includes a working definition of translation, a discussion of issues related to translation in quantitative research, a discussion of how translation issues differ in focus group research, evaluation criteria for translators and interpreters, and an example of translation techniques used in a research study of perimenopausal Hispanic women.
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Affiliation(s)
- N Esposito
- Columbia University School of Nursing, USA
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Escalante A, Lichtenstein MJ, Hazuda HP. Walking velocity in aged persons: its association with lower extremity joint range of motion. ARTHRITIS AND RHEUMATISM 2001; 45:287-94. [PMID: 11409671 DOI: 10.1002/1529-0131(200106)45:3<287::aid-art262>3.0.co;2-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To measure the association between walking velocity and hip and knee flexion range, ethnic background, anthropometrics, comorbid pathologies, and coimpairments, in a sample of community-dwelling aged persons. METHODS To reach our objective, we used data from the San Antonio Longitudinal Study of Aging (SALSA), a population-based cohort of Mexican American and European American persons aged 64 to 79. By fitting hierarchical regression models, we measured the variance in the walking velocity over 50 feet explained by hip and knee flexion range, adjusting for the combined influence of demographic and anthropometric variables, coexistent pathologic conditions, impairments, and the examiners who conducted the assessments. RESULTS The average walking velocity among the 702 subjects for whom data were available was 73.6 meters per minute (range 20 to 121). Bivariate analyses revealed significant associations between walking velocity and age, sex, ethnic background, height, weight, presence of arthritis, diabetes mellitus, stroke, upper leg pain, peripheral vascular disease, left ventricular hypertrophy, and forced expiratory volume at 1 second. The correlation (r) between walking velocity and flexion range of the hip and knee were 0.40 and 0.35, respectively (P < or = 0.001 for each). Multivariate hierarchical models adjusting for demographic and anthropometric characteristics of the subjects, and examiner variation, revealed that hip and knee flexion range explained 6% of the variance in walking velocity. Adjusting for the presence of comorbid conditions and coimpairments reduced the variance attributable to hip and knee flexion range only slightly, to 5%. CONCLUSION Hip and knee flexion range contribute significantly to walking velocity in the SALSA cohort of community-dwelling aged persons.
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Affiliation(s)
- A Escalante
- Department of Medicine, The University of Texas Health Science Center at San Antonio, USA
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Escalante A, del Rincón I. Epidemiology and impact of rheumatic disorders in the United States Hispanic population. Curr Opin Rheumatol 2001; 13:104-10. [PMID: 11224734 DOI: 10.1097/00002281-200103000-00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The emergence of a sizable Hispanic population in the US is a relatively recent historical phenomenon, and thus much is still unknown about this group of North Americans. Data from national surveys suggest small differences between Hispanic and non-Hispanic white populations in the age-adjusted prevalence of self-reported arthritic conditions. However, the rate of activity-limitation attributable to arthritis is higher among Hispanic patients. This likely reflects the poorer socioeconomic conditions and lack of health insurance that prevail among Hispanic populations, which may limit their access to rheumatologic care. Osteoporotic vertebral and hip fractures are less frequent, and proximal femoral mineral density is higher, in Hispanic individuals than in non-Hispanic white individuals. The mechanisms for these observations are currently under investigation. There have been no studies of the prevalence of osteoarthritis, rheumatoid arthritis, or systemic lupus erythematosus among Hispanic populations. However, important immunogenetic, clinical, and psychosocial differences between Hispanic and non-Hispanic patients in regard to rheumatoid arthritis and systemic lupus erythematosus have been reported. There is no published information on the prevalence or characteristics of other rheumatic diseases in the US Hispanic population. Emerging evidence suggests considerable underuse of certain health services for arthritis among Hispanic patients, likely due in part to socioeconomic factors. Further research is needed to determine whether biologic, cultural or psychosocial factors contribute to underuse as well. There is clearly a need for data on the prevalence and characteristics of arthritis and other rheumatic and musculoskeletal diseases in this emerging US population.
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Affiliation(s)
- A Escalante
- Division of Clinical Immunology and Rheumatology, Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
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Lichtenstein MJ, Dhanda R, Cornell JE, Escalante A, Hazuda HP. Modeling impairment: using the disablement process as a framework to evaluate determinants of hip and knee flexion. AGING (MILAN, ITALY) 2000; 12:208-20. [PMID: 10965379 DOI: 10.1007/bf03339838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Elders often present to health care providers with multiple inter-related conditions that determine an individual's ability to function. The disablement process provides a generalized sociomedical framework for investigating the complex pathways from chronic disease to disability. At each stage of the main pathway, associations may exist among primary physical factors and modifying variables that ultimately have downstream effects on the progression toward disability. The purpose of the present analysis is to examine the inter-relationships between a cohesive set of variables primarily at the level of impairment that may affect hip and knee flexion range of motion (ROM). The San Antonio Longitudinal Study of Aging enrolled 833 community dwelling Mexican (MA) and European American (EA) elders aged 64-78 years between 1992 and 1996. Of these, 647 had complete data from both a home-based and performance-based battery of assessments for these analyses. Concerning impairments, hip ROM was measured using an inclinometer, and knee ROM using a goniometer. Pain location and intensity were assessed using the McGill Pain Questionnaire. Peripheral vascular disease was assessed using doppler brachial and ankle systolic blood pressures. Ankle and knee reflexes, and vibratory sensation were assessed by a standardized neurological examination. As to diseases, diabetes was assessed using a combination of blood glucose levels and self-report, and arthritis by self-report. Concerning modifying variables, height and weight were directly measured and used to calculate BMI. Activity level was assessed with the Minnesota Leisure Time Questionnaire. Analgesic use was assessed by direct observation of medications taken within the past two weeks. We used structural equation modeling to test associations between the variables that were specified a priori. These analyses demonstrate the central role of BMI as a determinant of hip and knee flexion ROM. For an increase in level of BMI, the coefficients [SEM] for changes in levels of hip and knee ROM were -0.38 [0.05] and -0.26 [0.05], respectively. A higher BMI resulted in lower hip and knee ROM. BMI was also directly associated with prevalent diabetes (0.10 [0.05]) and arthritis (0.17 [0.05]). However, after adjustment for BMI, diabetes and arthritis did not have direct independent associations with either hip or knee ROM. BMI was also indirectly associated with knee, but not hip, ROM through paths including lower-leg pain, pain intensity, and neurosensory impairments. Diabetes had an indirect association with hip, but not knee ROM, through a path including peripheral vascular disease. In conclusion, BMI is a primary direct determinant of hip and knee ROM. The paths by which diabetes and arthritis lead to physical disability may be mediated, in part, at the level of impairment by BMI's association with joint range of motion. Interventions designed to decrease the impact of diabetes and arthritis on disability should track changes in BMI and joint ROM to measure the paths that account for the intervention's success. The observed associations suggest that interventions targeted to decrease BMI itself may lead to improved function in part through improved joint ROM.
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Affiliation(s)
- M J Lichtenstein
- Division of Geriatrics and Gerontology, University of Texas Health Science Center at San Antonio 78284, USA.
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Escalante A, Lichtenstein MJ, Hazuda HP. Determinants of shoulder and elbow flexion range: Results from the San Antonio longitudinal study of aging. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/1529-0131(199908)12:4<277::aid-art6>3.0.co;2-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Escalante A, Lichtenstein MJ, Dhanda R, Cornell JE, Hazuda HP. Determinants of hip and knee flexion range: results from the San Antonio Longitudinal Study of Aging. ARTHRITIS CARE AND RESEARCH : THE OFFICIAL JOURNAL OF THE ARTHRITIS HEALTH PROFESSIONS ASSOCIATION 1999; 12:8-18. [PMID: 10513485 DOI: 10.1002/1529-0131(199902)12:1<8::aid-art3>3.0.co;2-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We analyzed data from the San Antonio Longitudinal Study of Aging, a neighborhood-based study of community-dwelling elderly people, to identify factors that determine the flexion range (FR) of hips and knees. METHODS The FR of hips and knees was measured in a cohort of 687 subjects aged 65 to 79 years. We used multivariate models to examine the associations among the FR of hips and knees, and between these and age, gender, ethnicity, body mass index (BMI), pain and its location, self-reported arthritis, and diabetes mellitus. The functional relevance of hip and knee FR was tested by measuring its association with 50-foot walking velocity. RESULTS More than 90 degrees of flexion in both hips and both knees was observed in 619 subjects (90.1%). Correlations among the FR of hips and knees ranged from 0.54 to 0.80 (P < 0.001 for Spearman r values). Multivariate analysis revealed a pattern of significant associations between each of the joints and its contralateral mate and ipsilateral partner joints that was consistent for both hips and both knees. Using each individual joint as the unit of analysis, the following variables were independently associated with hip or knee FR in multivariate models: rising BMI and female sex with reduced FR of both hips and knees, a Mexican American ethnic background with decreased hip FR, and knee pain with decreased knee FR. The functional importance of the FR of these two important joints was supported by its significant association with walking velocity in a model that adjusted for age, gender, ethnic background, BMI, and hip or knee pain. CONCLUSIONS Most community-dwelling elderly people have a FR of hips and knees that can be considered functional. The ipsilateral and contralateral hip or knee are significant independent determinants of the FR of each of these joints. Obesity, a health problem potentially amenable to preventive and therapeutic interventions, is a factor significantly associated with decreased FR of hips and knees.
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Affiliation(s)
- A Escalante
- Department of Medicine, University of Texas Health Science Center, San Antonio, USA
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