Quality of life in South East Asian patients who consult for dyspepsia: Validation of the short form Nepean Dyspepsia Index

Sanjiv Mahadeva,Julian Thumboo,Hwee-Lin Wee,Khean-Lee Goh

doi:10.1186/1477-7525-7-45

Abstract

BackgroundTreatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics.ObjectivesTo validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI) in Malaysian patients who consult for dyspepsia.MethodsThe English version of the SF-NDI was culturally adapted locally and a Malay translation was developed using standard procedures. English and Malay versions of the SF-NDI were assessed against the SF-36 and the Leeds Dyspepsia Questionnaire (LDQ), examining internal consistency, test-retest reliability and construct validity.ResultsPilot testing of the translated Malay and original English versions of the SF-NDI in twenty subjects did not identify any cross-cultural adaptation problems. 143 patients (86 English-speaking and 57 Malay speaking) with dyspepsia were interviewed and the overall response rate was 100% with nil missing data. The median total SF-NDI score for both languages were 72.5 and 60.0 respectively. Test-retest reliability was good with intraclass correlation coefficients of 0.90 (English) and 0.83 (Malay), while internal consistency of SF-NDI subscales revealed α values ranging from 0.83 – 0.88 (English) and 0.83 – 0.90 (Malay). In both languages, SF-NDI sub-scales and total score demonstrated lower values in patients with more severe symptoms and in patients with functional vs organic dyspepsia (known groups validity), although these were less marked in the Malay language version. There was moderate to good correlation (r = 0.3 – 0.6) between all SF-NDI sub-scales and various domains of the SF-36 (convergent validity).ConclusionThis study demonstrates that both English and Malay versions of the SF-NDI are reliable and probably valid instruments for measuring HRQoL in Malaysian patients with dyspepsia.

Highlights

Dyspepsia refers to a collection of recurrent upper gastrointestinal symptoms that is common world-wide [1]
Cross-cultural adaptation of the English ShortForm Nepean Dyspepsia Index (SF-NDI) Cognitive debriefing of the original English version of the Short Form (SF)-NDI was conducted on 10 English-speaking healthy subjects – five were aged below 50 years and six had had tertiary education
No difficulties were encountered by all ten subjects with regards to understanding phrasing of the Malay SF-NDI items and no further changes were made prior to use in the validation study

Summary

Introduction

Dyspepsia refers to a collection of recurrent upper gastrointestinal symptoms that is common world-wide [1]. As most patients with dyspepsia have functional disease, the treatment of which remains unsatisfactory at present [4], health related quality of life (HRQoL) measurement has become an important clinical objective in the assessment of new therapies for this condition [5]. Several HRQoL instruments for dyspepsia currently exist [7,8,9], their applicability has been limited by insufficient specificity for dyspepsia alone or lack of brevity [10]. It has been shown to be a responsive and sensitive instrument for the measurement of dyspepsia-related HRQoL in several different Englishspeaking populations around the world [10]. Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics

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