Abstract
BackgroundNon-specific low back pain (NSLBP) is one of the most prevalent conditions in the world. Identifying patients at risk for developing chronic NSLBP is key to effective treatment. The STarT back screening tool is a validated, prognostic screening tool identifying subgroups of NSLBP patients, and the risk factors associated with each subgroup, guiding treatment in the primary care of NSLBP.ObjectivesTo translate the English version of the STarT back screening tool into isiZulu and determine the content validity and reliability of the translated tool.MethodTranslation was completed in four phases - forward translation and synthesis, backward translation and expert review. Validation included expert review for content validity and testing of the translated tool on 30 patients, determining test-retest reliability, internal consistency and usability.ResultsMinor linguistic differences were addressed during the translation phase. Item content validity was excellent for relevance (1.00), satisfactory (0.94) for clarity, simplicity and ambiguity, with scale-content validity acceptable (0.955). Spearman’s correlation coefficient for test-retest reliability was acceptable (0.73). Cronbach’s alpha for internal consistency for the total score for test 1 and test 2 was 0.68 and 0.77, and for the psychosocial scale 0.62 and 0.77 respectively. Overall, 33% found the tool very easy to understand and 40% found it very easy to complete.ConclusionThe isiZulu STarT back screening tool showed excellent content validity, acceptable reliability and acceptable internal consistency.Clinical implicationsUse of the isiZulu tool in local clinics and private practices can improve clinical decision-making and treatment outcomes for isiZulu-speaking patients with NSLBP.
Highlights
Non-specific low back pain (NSLBP) is one of the most prevalent conditions in the world (Bruyere et al 2012) and was the leading cause of disability worldwide in 2015 (Global Burden of Disease (GBD) Study 2015)
It was decided that engikhatazayo which means ‘bothering me’ was the closest translation, as worry and stressful are understood as the same concept in isiZulu
The word ‘bothersome’ in question 9 is not a word often used in Africa, and does not exist in isiZulu, so the expert committee agreed that the most common translation kukuhluphe kangakanani will be used, meaning ‘to bother or trouble’
Summary
Non-specific low back pain (NSLBP) is one of the most prevalent conditions in the world (Bruyere et al 2012) and was the leading cause of disability worldwide in 2015 (Global Burden of Disease (GBD) Study 2015). Predicting the development of chronicity in NSLBP through the early identification of risk factors (Van Tulder et al 2006) has been shown to lead to more effective treatment interventions (Melloh et al 2009). Hill et al (2008) developed and validated a back pain prognostic screening tool, the STarT (subgroups for targeted treatment) Back Screening Tool, which could be used to identify subgroups of patients with NSLBP and their associated risk factors (Keele University 2017), grouping these patients into low-, medium- and high-risk groups. The STarT back screening tool is a validated, prognostic screening tool identifying subgroups of NSLBP patients, and the risk factors associated with each subgroup, guiding treatment in the primary care of NSLBP
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