The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation

A systematic review on cross-cultural validations and psychometric solidity of the orthotics and prosthetics user survey

Research is essential to reflect patients' satisfaction with their devices in the field of Prosthetics and Orthotics, record their performance and health-related quality of life. This requires culturally adapted questionnaires for each country. Periodic assessment of validity and test fit are essential elements for the long-term utility and effectiveness of psychometric tests. This article reviews the psychometric properties of the Orthotics and Prosthetics Users Survey (OPUS). The purpose, in addition to its adaptation to the Spanish-speaking population, involves a review/update of content, statistical analyses, and validity studies, until a larger number of studies are conducted. Study design: a Systematic review. A systematic literature search was carried out in specialized search engines: Alcorze (University of Zaragoza), MEDLINE (PubMed), and EMBASE of original articles published since 2000. Eleven items belonging to the OPUS were obtained, according to the language of the country where they were validated, and promising psychometric properties were confirmed (reflecting reliability values between 0.62 and 0.95; Cronbach's α scores between 0.73 and 0.98) with sample sizes between 10 and 321. The study concluded by stating that the OPUS was validated in different languages, reporting good psychometric robustness so far. Further deployment, refinement, and validation of this survey by country is warranted in view of its promising use.

Validity and reliability of the Dutch translation of the OPUS' client satisfaction with device module in chronic users of hand orthoses

BACKGROUND

Orthosis satisfaction is an important outcome in assessing quality of care. However, no measurement specifically assessing orthosis satisfaction is available in the Dutch language. Therefore, the aim of this study was to translate the Client Satisfaction with Device (CSD) module of the Orthotics and Prosthetics Users' Survey (OPUS) into Dutch, and to assess its content validity, structural validity and reliability in persons with chronic hand conditions.

METHODS

The CSD was translated and cross-cultural adapted according to respective guidelines. To determine content validity, 10 chronic hand orthotic users and two professionals judged the relevance, comprehensibility, and comprehensiveness of the Dutch CSD (D-CSD). Thereafter, in a cross-sectional study, 76 persons were asked to complete the D-CSD twice, with a 2-week interval. Dimensionality of the D-CSD was examined by principal component analysis (PCA), and factor model fit was assessed by confirmatory factor analysis (CFA). Reliability was assessed as internal consistency and test-retest reliability, including the 95% limits of agreement (LoA), the standard error of measurement (SEM) and smallest detectable change (SDC).

RESULTS

The D-CSD items and response options were deemed relevant and comprehensible. After adding an item on cleaning the orthosis, content validity was judged sufficient. PCA indicated a one-factor model, which was confirmed by CFA. We found good internal consistency (Cronbach's alpha = 0.82; 95%CI 0.75-0.87), and moderate to good test-retest reliability (ICC = 0.81; 95%CI 0.71-0.87). There was no difference between the mean D-CSD score at test (26.8 points) and retest (25.9 points) (mean (SD) difference: 0.86 points (4.00); 95%CI -0.06-1.79; p = 0.07). The 95% LoA were -6.99 to 8.71, and the SEM and SDC were 2.88 and 7.98 points, respectively.

CONCLUSIONS

Based on sufficient content and structural validity, and good reliability, we consider the D-CSD a useful tool to evaluate orthosis satisfaction in persons with chronic hand conditions on group level. Because of a relatively high SDC, sensitivity to detect changes over time on individual level is limited.

STUDY REGISTRATION NUMBER

NCT05320211.

Satisfaction of individuals with partial-hand amputations after they were fitted with cosmetic silicone prostheses

BACKGROUND

Partial-hand amputations are the most common level of upper-limb amputations which can lead to cosmetic and functional problems. Partial-hand amputations can be acquired or congenital. Cosmetic silicone prostheses are used in the management of partial-hand amputation; however, a literature review shows that most of the studies are on the fabrication of prosthesis, and data remain deficient on the satisfaction of users with silicone prostheses.

OBJECTIVES

To assess the satisfaction of individuals after they were fitted with cosmetic silicone prostheses for partial-hand amputations.

STUDY DESIGN

Cross-sectional study.

METHODS

Fifty-four participants with partial-hand amputations and who received cosmetic silicone prostheses participated in the survey using the validated Arabic version of the Client Satisfaction with Device (CSD-Ar).

RESULTS

Nearly half of the participants were using their silicone prosthesis daily. Most of the patients reported satisfaction with durability and donning, whereas most of the patients were dissatisfied with comfort. The mean of CSD-Ar total score was 16.8 ± 4.7 of 32. The CSD-Ar total score was significantly associated with the side of amputation ( p -value = 0.014) and usage of prosthesis ( p -value < 0.001).

CONCLUSION

The satisfaction of individuals with partial-hand amputations can be enhanced by fitting them with cosmetic silicone prostheses. However, these prostheses should meet certain criteria including fitting, weight, comfort, donning, appearance, durability, skin abrasion and irritation, and pain. Individuals' expectations and concerns should be considered as well.

Psychometric properties of the Client Satisfaction with Device module of the Orthotics and Prosthetics Users' Survey (OPUS): a scoping review

Patient's satisfaction with device is an important clinical outcome in prosthetics and orthotics. The Client Satisfaction with Device (CSD) - one of the five modules of the Orthotics and Prosthetics Users' Survey (OPUS) - has been defined as the only outcome measure specifically developed to measure user satisfaction with a prosthesis or an orthosis. The aim of this study was to provide a comprehensive review of the psychometric properties of the CSD, summarizing the present evidence on this measure, and verifying if the scoring system is consistent in the literature. A systematic literature search was conducted utilizing PRISMA guidelines. Articles were searched in PubMed and Scopus databases using search terms relating to the psychometric properties of the CSD. Thirteen articles assessing the psychometric properties of the CSD met the inclusion criteria for this review. The CSD has been translated and validated in several languages. However, these versions are not consistent across the studies since they include different number of items, with different number of response options, and scoring systems. The CSD - where used in its eight-item version, rated with a four-point rating scale - can be judged as a tool with acceptable psychometric properties for assessing satisfaction with devices in prosthesis and orthosis users. This CSD version seems the best one for optimizing coverage and psychometric quality with the fewest number of items. Further studies are warranted to assess the degree of suitability of this scale in specific populations of users of prostheses or orthoses and to analyze its psychometric properties in further cultural contexts.