The validity and reliability of the Arabic version of the short form of neurogenic bladder symptoms score in patients with spinal cord injury

BACKGROUND

The Neurogenic Bladder Symptom Score-Short Form (NBSS-SF) evaluates the impact of disease-specific symptoms on the quality of life in individuals with neurogenic bladder (NB). There is no data on the validity and reliability of the NBSS-SF questionnaire in the Arabic language, so this study aimed to examine the psychometric characteristics of the Arabic NBSS-SF in patients with spinal cord injury (SCI).

METHODS

International standards were followed when culturally adapting the questionnaire. The Arabic version was conducted in patients with neurogenic bladder caused by SCI twice within a 14 day period. Psychometric properties such as content validity, construct validity, internal consistency, and test-retest reliability were tested. Internal consistency and test-retest reliability was evaluated using Cronbach's alpha, and the Intraclass Correlation Coefficient (ICC), respectively. Construct validity was assessed by comparing the NBSS-SF with the Short Form (SF-12) and the Qualiveen questionnaire.

RESULTS

One hundred and one patients with SCI participated in the study. The internal consistency for the overall NBSS-SF score (Cronbach's α of 0.82) and for each subdomain was variable (urinary incontinence 0.84; storage/voiding 0.72; consequences 0.57). ICC was 0.91 for the overall score and 0.94 for the urinary incontinence subdomain, 0.72 for storage/voiding, and 0.90 for consequences. The correlation analysis showed that the Arabic version of NBSS-SF has good construct validity.

CONCLUSION

Our results showed that the Arabic version of NBSS-SF is a valid and reliable instrument for evaluating NB symptoms in the Arabic population suffering from SCI.

Cross-cultural adaptation, translation, and validation of the Arabic version of the short form of Neurogenic Bladder Symptoms Score

BACKGROUND

The Neurogenic Bladder Symptom Score-Short Form (NBSS-SF) evaluates the impact of disease-specific symptoms on the quality of life (QoL) in individuals with neurogenic bladder (NB). There is no data on the validity and reliability of the NBSS-SF questionnaire in the Arabic language, so this study aimed at providing the translation, cultural adaptation, and validation of the Arabic NBSS-SF in patients with multiple sclerosis (MS) and spinal cord injury (SCI).

METHODS

The original English language version of the NBSS-SF was translated into Arabic according to the cultural and linguistic adaptation algorithm. People with SCI and MS completed the NBSS-SF, demographic and clinical information, and Qualiveen QoL questionnaire. Responses were recorded twice within a 14-day period. Psychometric properties such as content validity, construct validity, internal consistency, and test-retest reliability were tested. Internal consistency and test-retest reliability was evaluated using Cronbach's alpha, and the intraclass correlation coefficient (ICC), respectively. Construct validity was assessed by comparing the NBSS-SF with the Qualiveen questionnaire.

RESULTS

Thirty-nine patients with MS and 97 with SCI participated in the study. The internal consistency for the overall NBSS-SF score (Cronbach's α of 0.82) and for each subdomain was variable (urinary incontinence 0.82; storage/voiding 0.73; consequences 0.53). ICC was 0.93 for the overall score and 0.96 for the urinary incontinence subdomain, 0.74 for storage/voiding, and 0.91 for consequences. The correlation analysis showed a significantly strong correlation between the QoL item of NBSS-SF and the Qualiveen total score (r = 0.72, p < 0.000). There was a significant moderate positive correlation between the total scores on the Arabic version of the NBSS-SF and the subdomains of the Qualiveen, including limitations (r = 0.51, p = 0.04), fears (r = 0.57, p = 0.04), feelings (r = 0.46, p = 0.01), and constraints (r = 0.59, p = 0.03).

CONCLUSIONS

Our results showed that the Arabic version of NBSS-SF is a valid and reliable instrument for evaluating neurogenic lower urinary tract dysfunction symptoms in the Arabic population suffering from SCI and MS.

Arabic translation and validation of pediatric lower urinary tract symptom score (PLUTSS)

Objectives

To develop and validate an Arabic version of the pediatric lower urinary tract symptom score (PLUTSS).

Methods

The linguistic translation of the PLUTSS into Arabic was carried out by following the guidelines that have been set out for cross-cultural adaptation of health-related QoL measures (Translation, Reconciliation, Retranslation, Review of retranslation, Debriefing and final review). The questionnaires were applied to 80 patients, 40 patients seeking urology clinic for lower urinary tract symptoms (LUTS) and 40 patients visiting a pediatric clinic without urological compliant. The discrimination validity and strength of association were tested using Mann-Whitney and chi-square tests. Reliability of translation was tested for internal consistency using the Cronbach's α and ROC Curve was used to evaluate the ability of the questionnaire to discriminate between cases and controls.

Results

Patients with LUTS had a higher PLUTSS score and QoL score than controls (P < 0.001). The value of Cronbach's alpha of the 13 items (excluding Qol) evaluated on the scale was 0.717 (95% CI: 0.616-0.800). The ROC curve determined the ability of the questionnaire to discriminate between cases and controls where the area under the curve was 0.901 (95% CI: 0.830-0.972).

Conclusion

The Arabic translated version of the PLUTSS is an acceptable and reliable tool for assessing and evaluating pediatric patients with LUTS in Arabic-speaking countries.

Validation of the Arabic linguistic version of the Overactive Bladder Symptoms Score questionnaire

Objective: To validate an Arabic version of the Overactive Bladder Symptom Score (OABSS) questionnaire.

Patients and methods: In all, 301 patients were evaluated using the Arabic-translated OABSS. They were divided into four groups: 112 patients with OAB symptoms, 115 healthy individuals with no OAB symptoms, 38 with bladder outlet obstruction (BOO) associated with storage lower urinary tract symptoms (LUTS), and 36 with BOO without storage LUTS. The reliability of the Arabic version was evaluated for internal consistency using Cronbach’s α test. Interdomain associations were examined using Spearman’s correlation coefficient (r). The discrimination validity was evaluated using the Mann–Whitney test.

Results: Higher internal consistency was found for all OABSS domains in the OAB and BOO groups. There were strong correlations between all domains in the OAB group (P < 0.001). Similarly, there were strong correlations between all domains in the BOO group. For discrimination validity, scores were statistically significant higher for all OABSS domains and overall total scores in the OAB and BOO groups compared with their control groups (P < 0.001).

Conclusion: The Arabic version of OABSS is a reliable and valid instrument that can be used to evaluate symptoms and health-related quality of life in Arabic patients with OAB.

Clinical trial no. (clinicaltrials.gov NCT03533062)

Abbreviations : BOO: bladder outlet obstruction; OAB: overactive bladder; OABSS: Overactive Bladder Symptom Score questionnaire; (U)UI: (urgency) urinary incontinence

The use of the NDDI-E in Arabic to identify symptoms of depression of moderate or greater severity in people with epilepsy

AIM

The aims of the current study were to translate and to validate the NDDI-E to the Arabic language to be used as a screening instrument to identify moderately severe symptoms of depression in people with epilepsy.

METHODS

The English version of the NDDI-E was translated to Arabic and back translated to English by two independent translators. A total of 51 patients, aged 18-56years old, with a diagnosis of epilepsy, completed the Arabic versions of the Beck Depression Inventory (BDI-II) and the NDDI-E. Patients with BDI scores >20 were considered to be suffering from moderately severe depressive symptoms. Cutoff scores, sensitivity, specificity, and positive and negative predictive values of the NDDI-E to identify symptomatic patients on the BDI were calculated.

RESULTS

A sensitivity of 93.33% and a specificity of 94.44% were found with NDDI-E total scores >15. The positive predictive value was 87.5%, and the negative predictive value was 97.14%. Spearman's rank correlation between the BDI and the NDDI-E was high (r=.78, p=0.000, N=51). Internal consistency was at 0.926 (Cronbach's alpha).

CONCLUSION

The Arabic version of the NDDI-E appears to be a reliable and sensitive instrument in the identification of moderately severe or severe depressive symptoms in people with epilepsy, and it can be used with all Arabic-speaking patients.