#69 Validation of the Visayan Translation of the End Stage Renal Disease—Adherence Questionnaire (VESRD-AQ)

Abstract

Abstract Background and aims End-stage renal disease (ESRD) is one of the chronic diseases that rely heavily on patient's adherence to treatment. Measuring the factors related to adherence have been done but are difficult to compare due to non-uniformity of the tools used. The 46-item End-Stage Renal Disease—Adherence Questionnaire (ESRD-AQ) by Kim, et.al (2010) is a validated tool used to measure treatment adherence to the whole of ESRD management: hemodialysis, medications, fluid restrictions, and diet prescription. About 2000 ESRD patients have been registered in the Central Visayas, Philippines in 2022. The availability of a standardized and validated tool in the Visayan native language will help in assessing adherence and its related factors which can lead to interventions that could improve outcomes in ESRD patients. This study was done to translate the End-stage renal disease (ESRD-AQ) into the Visayan dialect (Visayan ESRD-AQ) and test its validity. Method The ESRD-AQ underwent forward translation into a Visayan version. This translation was evaluated for content validity using the Content Validity Index (CVI) rated by 5 experts, and face validity with a group of 5 ESRD patients. Blind backward translation was done and compared to the original ESRD-AQ. Construct validity was tested via a Known-Group Analysis. Test-retest reliability was done using the Intraclass Correlation Coefficient (ICC) to establish the questionnaire's stability overtime. Results The Visayan ESRD-AQ had adequate Content Validity Index of 1.0 which shows that each item on the questionnaire was relevant to its aim. Construct validity showed that the known adherers had higher scores than the known non-adherers. This means that the questionnaire was able to differentiate between the two groups. The responses of two patients were evaluated through the Intraclass Correlation Coefficient (ICC) and had the scores of 0.52 and 0.69, meaning that the questionnaire can be reliably used over time. Conclusion The Visayan ESRD-AQ is a valid and reliable tool for measuring adherence behaviors in a sample of Visayan-speaking dialysis patients as supported by the results of the Content Validity Index and known-group analysis. The can also be used reliably over time as it showed moderate test- retest reliability score. The validated VESRD-AQ may be valuable to researchers in studies of advanced chronic kidney disease. It could be used for studying adherence behaviors of ESRD patients across the Visayan region of the Philippines and the factors that contribute to adherence or non-adherence. Results of these studies can be used to improve services in dialysis units and can even be a tool in policy making with regards to hemodialysis in the Philippines. Further translations into other dialects or languages can also be done to be able to reach a broader population.