Cross-cultural Adaptation Research Articles

Factor structure of the HIV-SM LMIC self-management questionnaire for people living with HIV in low- and middle-income countries

IntroductionDespite the need for reliable questionnaires to monitor self-management in chronic disease patients, such tools are lacking in developing countries. This study aims to pilot and assess the construct validity of the HIV-SM LMIC questionnaire.MethodThe validation of the HIV-SM LMIC questionnaire involved two cross-sectional studies in Ethiopia. The first round, for exploratory factor analysis (EFA), included 261 patients, while the second round, for confirmatory factor analysis (CFA), included 300 patients. Data was collected using the Kobo Collect electronic data entry template.ResultThe sample adequacy test showed a good value of 0.82. In the first round, 6 of the 32 items were not loaded, forming three factors in the EFA. Four of these items were dropped, but two (PSMB2 and PSMB12) were retained for their content. In the second round, CFA on the remaining 28 items led to dropping 8 more items due to conceptual overlap, resulting in a 20-item questionnaire. The final items were structured into three dimensions: awareness and well-being (4 items), self-regulation (6 items), and self-management practices (10 items).ConclusionThe study refined the original 32-item HIV-SM LMIC questionnaire to a validated 20-item, three-dimensional tool with an acceptable goodness of fit. The authors recommend further cross-cultural and predictive validation and adaptation for newly diagnosed HIV patients, those with poor treatment outcomes.

Cross-Cultural Validation of the HIV Adolescent Readiness for Transition Scale (HARTS) in China.

For adolescents infected with the Human Immunodeficiency Virus (HIV), transitioning from pediatric to adult healthcare requires thorough preparation to maintain care continuity and optimal health outcomes. In China, a dedicated scale for assessing their transition readiness is lacking. The HIV Adolescent Readiness for Transition Scale (HARTS) addresses this by evaluating transition readiness across vital domains, with its 15-item design predicting post-transition viral suppression-a key indicator of a successful transition. With no equivalent tool in China, the HARTS's cross-cultural adaptation holds significant potential for enhancing personalized transition strategies and health management.To validate the HIV Adolescent Readiness for Transition Scale (HARTS) among adolescents with HIV in China,the validation was conducted from October 2023 to February 2024, following a five-step process: translation and back-translation; content validity examination by 13 experts; pre-survey with 30 adolescents with HIV; test-retest reliability assessment with 40 adolescents with HIV over a 10-day interval; and structural validation using exploratory factor analysis, including principal component analysis and varimax orthogonal rotation, among 170 adolescents with HIV.The average content validity index of the scale was 0.99. The Cronbach's alpha value for the pre-survey was 0.767, and for test-retest reliability, the intra-class correlation coefficient (ICC) was 0.901. With a total of 15 items, the four factors that made up the scale-"Disclosure," "Health Navigation," "Self-Advocacy," and "Health Literacy"-explained 81.73% of the variation. With alpha values of 0.940, 0.917, 0.929, and 0.888 for each of the four domains, the scale's overall Cronbach's alpha value was 0.943.The Chinese version of HARTS demonstrates good reliability and validity, serving as a tool for assessing the medical transition readiness level of adolescents with HIV in China.

Headache Disability Questionnaire: cross-cultural adaptation and validation of the Turkish version

BackgroundThe Headache Disability Questionnaire (HDQ) evaluates pain intensity, daily activities, work/school disruptions, and the impact on recreational activities. It was aimed to translate the HDQ into Turkish and evaluate its reliability and validity.MethodsThis study included 130 participants, consisting of 105 females and 25 males. The original HDQ was translated into Turkish language using Beaton guidelines. Reliability was assessed using internal consistency and Intraclass Correlation Coefficient. Exploratory (EFA) and Confirmatory Factor Analysis (CFA) were conducted to evaluate the structural validity. For convergent validity, the Turkish version of the HDQ, along with the Headache Impact Test-6 (HIT-6) and Migraine Disability Assessment Scale (MIDAS), was administered to individuals with headaches. The HDQ was retested one week later to assess its reliability.ResultsThe Turkish version of the HDQ demonstrated good reliability, with ICC and Cronbach’s α values of 0.842 and 0.914, respectively. Standard error measurement (SEM) and Minimal Detectable Change (MDC) values were 5.89 and 16.33 units. Bland-Altman plots confirmed a high level of agreement between initial and retest scores EFA revealed a two-factor structure, clustering items into Factor 1 (items 1, 2, 5, 7, and 9) and Factor 2 (items 3, 4, 6, and 8), which was subsequently confirmed by CFA. Convergent validity was confirmed through good correlations with HIT-6, and MIDAS. No ceiling or floor effects were observed.ConclusionsThe study demonstrates that the Turkish version of the HDQ is a valid and reliable instrument for evaluating the effect of headaches on daily living, exhibiting strong internal consistency and test-retest reliability, making it suitable for both clinical practice and research purposes.Trial registrationTrial registration date is January 30, 2021 (NCT04736654).Clinical trials registration numberNCT04736654.

Translation and validation of the Chinese version of the Attitudes Related to Trauma-Informed Care (ARTIC-C) scale in nursing inters: a psychometric analysis

BackgroundNursing interns, the future nurses, often find it challenging to interact with trauma survivors due to their lack of experience and training. Assessing their attitudes and knowledge in trauma-informed care can improve their clinical performance.ObjectiveTo culturally adapt and assess the reliability and validity of the Attitudes Related to Trauma-Informed Care Scale in Chinese nursing interns.DesignQuantitative cross-sectional design.MethodsThe translation of Attitudes Related to the Trauma-Informed Care (ARTIC) Scale followed guidelines for the cross-cultural adaptation process. A survey was conducted with 490 nursing interns from two colleges in China in February and May 2024, and seven experts evaluated the content equivalence of each item. Reliability and validity were assessed using item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability, and test–retest reliability.ResultsThe Chinese version of the ARTIC-C retained 35 items and demonstrated high content validity. Exploratory factor analysis revealed a 6-factor structure, explaining 61.887% of the total variance. Confirmatory factor analysis indicated that the 6-factor model adequately represented the scale structure: chi-square/degree of freedom (CMIN/DF) = 1.544, root mean square error of approximation (RMSEA) = 0.045, comparative fit index (CFI) = 0.969, incremental fit index (IFI) = 0.969, Tucker Lewis index (TLI) = 0.966, and standardized root mean square residual (SRMR) = 0.046. The scale had a Cronbach's alpha of 0.916 and test–retest reliability of 0.876.ConclusionsThe Chinese version of the ARTIC-C scale has demonstrated strong reliability and validity, making it an effective tool for measuring Chinese nursing interns' attitudes and knowledge regarding trauma-informed care.

Adaptação transcultural de instrumentos em Medicina e na área de Saúde do Trabalhador

Introduction: The cross-cultural adaptation (CCA) of instruments is a crucial research procedurewidely used to ensure cross-cultural equivalence and validity in languages different from the onein which a specific instrument, test, or scale was originally developed. Objective: The aim of thisstudy is to present a structured protocol for the cross-cultural adaptation of health instruments,intended for physicians and academic researchers in the field of occupational health. Methods: The proposed protocol for cross-cultural adaptation in this study was developed based on the main international guidelines and recommendations. The essential steps for the CCA process were grouped and systematized to provide a solid and guiding framework for physicians and researchers in the field of occupational health who wish to conduct CCA studies. Results: The outcome of this study is a detailed CCA protocol that compiles the main international recommendations for the process of adapting health instruments. The protocol, consisting of eight structured stages, aims to guide medical and academic professionals in the appropriate conduct of CCA, promoting the dissemination and standardization of this method. Conclusion: The application of this protocol will enable reliable and valid use of instruments that have been previously validated in other cultures and countries in research related to Medicine and Occupational Health in Brazil.

Cross-cultural Adaption of the Indonesian Version of the Withdrawal Assessment Tool Version-1

Background Sedative and analgesic medications are commonly administered in the Pediatric Intensive Care Unit (PICU) but can cause complications, such as Iatrogenic Withdrawal Syndrome (IWS). The Withdrawal Assessment Tool Version-1 (WAT-1) questionnaire is a validated and reliable diagnostic tool for IWS, but it is not yet available in the Indonesian language. Methods This observational cross-sectional study was conducted in two phases at Ciptomangukusumo Hospital, Jakarta, Indonesia. The initial phase involved translating the WAT-1 and State Behavioral Scale (SBS) instrument into Indonesian. Subsequently, the validity and reliability of the Indonesian version of WAT-1 were tested on 30 patients who received sedative and analgesic medications for at least five consecutive days in the PICU. Evaluations were performed by two groups of nurses: PICU nurses and training nurses. Results The Indonesian version of WAT-1 was found to be valid and reliable. The validity showed correlations ranging from good to very strong (r = 0.490 to 0.836) among PICU nurses and strong correlations (r = 0.634 to 0.808) among trained nurses. The WAT-1 questionnaire demonstrated reliability with Cronbach's alpha values of 0.791 for PICU nurses and 0.785 for trained nurses. The Intraclass Correlation Coefficient (ICC) for WAT-1 indicated very good to excellent consistency in assessments, and the ICC for SBS indicated excellent consistency. Conclusion The Indonesian version of WAT-1 and SBS is a valid and reliable diagnostic tool for detecting Iatrogenic Withdrawal Syndrome in Children.

Cross-cultural adaptation and validation of the Arabic version of the Stay Independent Brochure as part of the CDC’s STEADI initiative among community-dwelling older adults

BackgroundThe Stay Independent Brochure (SIB) is part of the CDC’s STEADI initiative and is a fall risk screening self-report tool. This study aimed to translate and cross-culturally adapt the Arabic version of the SIB (AR-SIB) and evaluate its psychometric properties among community-dwelling older adults.MethodsThe translation and cross-cultural adaptation process followed standard guidelines, including forward and backward translation, expert committee review, and pretesting to ensure semantic and conceptual equivalence, clarity, and cultural relevance of the Arabic version of the SIB. Internal consistency was assessed using the Kuder-Richardson formula (KR-20), and test–retest reliability was evaluated with the intraclass correlation coefficient (ICC2,1). Convergent validity of the AR-SIB was evaluated using Spearman’s rank correlation coefficients (rs) with the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS) and point-biserial correlation coefficients (rpb) with the three key questions. Floor and ceiling effects and the operating characteristic (ROC) curve were also calculated.ResultsA total of 104 community-dwelling older adults participated in the study. The majority of participants were female (52.9%) and had a mean age of 63.77 ± 4.74 years. The AR-SIB demonstrated good internal consistency with an overall KR-20 of 0.73 and excellent test–retest reliability (ICC2,1 = 0.96). The AR-SIB showed moderate correlations with the TUG (rs = 0.51, 95% CI: 0.35 to 0.64) and the BBS (rs = -0.56, 95% CI: -0.69 to -0.41), and a high correlation with the three key questions (rpb = 0.75, 95% CI: 0.65 to 0.82). No floor or ceiling effects were observed. The cutoff point of the AR-SIB was determined to be 4.5.ConclusionsThe AR-SIB is a reliable and valid tool to discriminate falls and screen for fall risk among Arabic-speaking community-dwelling older adults. The AR-SIB can facilitate the implementation of evidence-based fall prevention initiatives tailored to Arabic-speaking older adults.

Translation, cross-cultural adaptation, and psychometric analysis of the Indonesian version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), patient self-report section

Purpose To translate the American Shoulder and Elbow Surgeon (ASES) score into Indonesian and to assess its psychometric properties. Materials and methods The ASES score was translated into Indonesian following the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Next, the validity and reliability of the Indonesia-ASES (I-ASES) were investigated. Patients with shoulder problems at a hospital in Indonesia who were willing to participate completed three questionnaires: the I-ASES, the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12), and the Shoulder Pain and Disability Index (SPADI). Participants were asked to complete the I-ASES a second time after a one-week interval. In adherence to COSMIN guidelines, we assessed construct validity using hypothesis testing, test–retest reliability, internal consistency, floor and ceiling effects, and measurement error. The Bland–Altman method was used to evaluate systematic bias. Results The I-ASES showed good construct validity. No floor or ceiling effects were found. An ICC value of 0.82 was found, indicating a robust level of test–retest reliability. A Cronbach α of 0.90 implied good internal consistency. Bland and Altman analysis showed no systematic bias. The standard error of measurement (SEM), the minimal detectable change at the individual level (MDCind) and at the group level (MDCgrp) were 2.3, 6.5, and 0.6, respectively. Conclusions The I-ASES shows good validity and reliability for evaluating shoulder problems in Indonesian-speaking patients and reveals comparable psychometric properties to those of the other languages version of ASES. Implications for rehabilitation The Indonesian version of the American Shoulder and Elbow Surgeons standardized Shoulder Assessment Form (I-ASES) is now available. I-ASES demonstrated satisfactory reliability and validity. I-ASES can be considered a valid and reliable questionnaire for use in Indonesian patients with shoulder problem.

Cross cultural adaptation and validation of the Hindi version of foot function index

BackgroundThe Foot Function Index (FFI) is a reliable and widely used standardized questionnaire that measures the impact of foot pathology on function. With 571 million Hindi-speaking people living globally and an increasing incidence of foot-related pathologies, it is imperative to cross-culturally translate and adapt a Hindi version of the FFI (FFI-Hi). We aimed to translate, cross-cultural adapt, and psychometrically test the FFI-Hi for use in Hindi-speaking individuals with foot conditions.MethodsThe translation of FFI-Hi was performed according to guidelines given by MAPI Research Trust. A total of 223 Hindi-speaking participants afflicted with foot conditions completed the FFI-Hi alongside the Short Form 36 (SF-36) questionnaire. The study duration spanned between October 2023 and January 2024. The initial phase was the translation and adaptation of FFI to cultural context. Followed by testing of psychometric properties involving of 133 participants for the test-retest reliability of FFI-Hi after a 7-day interval.ResultsThe mean age of the participants was 47.10 (± 8.1) years. The majority of the participants were male (n = 148, 66.4%) and the most common foot condition was plantar fasciopathy (n = 91, 40.8%). The mean score of FF-Hi was 33.7 ± 11.7. The internal consistency of FFI-Hi was good with the Cronbach’s alpha (α) value of 0.891 and excellent reproducibility with the intra-class correlation of 0.90. The 95% minimal detectable change (MCD) and the standard error of measurement of the FFI-Hi was 22.02 and 7.94 respectively. Convergent validity between FFI-Hi subscales and SF-36 domains was moderate. Factor analysis corroborated the multidimensional nature of the FFI-Hi.ConclusionThe FFI-Hindi version was successfully cross-culturally adapted, translated and demonstrated acceptable psychometric properties to be used in clinical practice and research. Further, the context-specific Hindi language version of FFI will enhance the utility of FFI in foot function evaluation and remove language barrier in patients reporting disability and activity limitation related to foot conditions.RegistrationClinical Trials Registry of India (CTRI/2023/07/055734).

Implementation path of cross-cultural course teaching in private universities based on BTL model

This paper discusses the implementation path of cross-cultural course teaching in private universities based on BTL（Blended Teaching and Learning) model, and systematically analyzes cross-cultural courses from the aspects of theoretical background, teaching status, implementation design and optimization strategies. First, through literature review, the application of BTL model in education and its applicability in cross-cultural course teaching are sorted out, revealing its unique advantages in improving students' cross-cultural communication ability and cultural sensitivity. On this basis, the current teaching status and challenges of cross-cultural courses in private universities are analyzed, and the limitations in teachers, resources and quality assessment are pointed out. The implementation path proposed in this paper starts from the three stages of "before class-during class-after class", combines task orientation and collaborative learning, and constructs a teaching framework that combines theory and practice. In addition, through the optimization of teaching content and the establishment of a multi-dimensional evaluation system, the feedback mechanism of teaching quality is further improved. The research of this paper provides practical and feasible guidance strategies for cross-cultural course teaching in private universities, in order to achieve more efficient cross-cultural education under limited resource conditions and cultivate applied talents with global vision and cross-cultural adaptability.

Analysis of risk factors faced by Chinese international students based on fuzzy comprehensive evaluation model

IntroductionChina has contributed the most international students to the global higher-education sector for over a decade. Existing research has indicated various risk factors faced by international students. However, few studies have examined the risks experienced by Chinese international students. Two research questions were investigated in this study: (1) Which risk factor has the greatest impact on Chinese international students when studying abroad? and (2) Which risk factor is most frequently experienced by Chinese international students when studying abroad?MethodTo address these questions, this study proposes a fuzzy comprehensive evaluation model for evaluating the risk factors faced by Chinese international students. The model comprises six second-level factors and 22 third-level indicators, which was empirically examined by data collected through 556 questionnaires. The analytical hierarchy process and factor analysis were employed to calculate the index weight of second-level factors and third-level indicators.ResultsThe results reveal that the risk factor, psychological discrepancy, has the greatest impact and is most likely to be experienced by Chinese international students. The paper provides an integrated research perspective to study the risk of international students.DiscussionThe paper discussed the factors that impact the risk faced by Chinese international students. The risk faced by Chinese international students was found to be high. Psychological discrepancy, academic choice, and cross-cultural adaptation were the three risk factors that were most likely to be experienced by Chinese international students. Psychological discrepancy, barriers to study, and unforeseen incidents had the highest impact on total risk. Therefore, attention should be paid to these risk factors to avoid the occurrence of risk and its negative impacts.

The Italian version of the Postural Assessment Scale for Stroke Patients (PASS): transcultural translation and validation.

The Postural Assessment Scale for Stroke Patients (PASS) is commonly used by health professionals in Italy in several different translations. This study aimed to provide a validated version in Italian. The main focus is on the evaluator, to guarantee a uniform application and interpretation of the statements and scoring for each item in the Italian context. A standardized protocol was used for the translation and cross-cultural adaptation. A pilot study conducted using the first draft of the scale led to a revised version, PASS-IT. A principal component analysis (PCA) was performed. The correlation with the Trunk Control Test (TCT) was examined for concurrent validity. In addition, the relationship with the Barthel Index (BI) and the Functional Ambulation Categories (FAC) was tested. Patients with recent stroke were tested for intra-rater (N = 49) and inter-rater agreement (N = 30). Cronbach's alpha, item-to-total correlation, corrected inter-item correlation, the intraclass correlation coefficient (ICC), and measurement error were used to evaluate internal consistency and intra-/inter-rater reliability. The PCA showed a two-dimensional structure, with high reliability in both subsections ("non-weight-bearing" α = 0.865; "weight-bearing" α = 0.949). A strong correlation (ρ > 0.80) was found with the TCT, the BI, and the FAC. The PASS-IT showed high internal consistency, intra-rater (ICC = 0.942) and inter-rater reliability (ICC = 0.940). The PASS-IT is a recommended scale, suitable for clinical practice and research in the acute and subacute stage. The introduction of operating instructions resulted in the uniform application. A different order of the items allows faster administration, reducing changes of posture.

The Ukrainian version of the Perceived Injustice Questionnaire: A psychometric evaluation.

Perceived injustice is increasingly recognized as a key factor influencing mental health in war survivors. This cross-sectional study aimed to evaluate the psychometric properties of the Ukrainian translation of the Perceived Injustice Questionnaire (PIQ) among individuals directly exposed to the war in Ukraine. 170 war-exposed Ukrainians completed the Ukrainian PIQ and measures of post-traumatic tress disorder (PCL-5), depression (PHQ-9), generalized anxiety disorder (GAD-7), and potentially traumatic life events (LEC-5). Internal consistency, factor structure, and criterion validity were assessed. While the factor structure of the English version could not be reproduced, indicating an issue with factor validity in the Ukrainian version, the Ukrainian PIQ demonstrated strong correlations with post-traumatic stress disorder (PTSD) symptoms (r = .71, p <.01), moderate associations with depression (r = .62, p <.01) and generalized anxiety disorder (r = .61, p <.01), and a weaker link with potentially traumatic life events (PTLEs, r = .35, p <.01). It significantly predicted PTSD, depression, and generalized anxiety disorder (GAD) symptoms beyond PTLE exposure, explaining 33% of variance in depression, 31% in GAD, and 45% in PTSD These findings provide evidence supporting the construct validity of the PIQ in terms of its relationships with mental health outcomes. The Ukrainian PIQ also demonstrated excellent overall reliability (α = .90), with factor reliabilities ranging from α = .74 to α = .81. The Ukrainian version of the PIQ demonstrates promising psychometric properties and emerges as a highly significant correlate of mental health outcomes. This underscores its potential utility in clinical practice for assessing the treatment needs of Ukrainians affected by the consequences of war. Moreover, the findings highlight the importance of developing therapy modules specifically tailored to address perceived injustice. Further research is warranted to investigate the cross-cultural adaptability and comparability of the PIQ.

How Argentinian Consumers Perceive the Safety of Irradiated Foods.

Food irradiation is a process used for various purposes, the main function of which is food safety. Although food irradiation has been used to ensure food safety, most consumers are unaware of the basic concepts of irradiation, misinterpreting information and showing a negative perception towards food treated with ionizing radiation. This research aimed to develop the cross-cultural adaptation and validation of the Awareness Scale on Consumption of Irradiated Foods (ASCIF) for the Argentine population and culture. The scale included 31 items covering 4 factors: safety of irradiated foods (S), concepts (C), labeling (L), and awareness (A), which were able to assess the Argentine population's knowledge of irradiated foods. The total number of respondents was 500 and the data were collected by means of an electronic survey. Statistical tests were carried out which met the validity assumptions and confirmed the validity and consistency of the psychometric scale by means of confirmatory factor analysis (CFA), Cronbach's alpha coefficient, and exploratory structural equation modelling (ESEM). Analysis of the results showed that the majority of consumers are unaware of the benefits of irradiated foods. It was found that the scale met the criteria for evidence of validity and consistency, proving to be an efficient tool for assessing potential challenges and opportunities in the Argentinian market for irradiated foods. The process was approved by the Research Ethics Committees of Brazil and Argentina and followed the adaptation methodologies of the International Test Commission (ITC) with processes of translations and retranslations and application of the scale in Argentina.

Cross-culture adaptation and validation of Indonesian language version of Pittsburgh Sleep Quality Index

Hemodialysis (HD) patients have a high rate of poor sleep. The Pittsburgh Sleep Quality Index (PSQI) is the most popular self-reported instrument to measure sleep quality. No study has tested the psychometric efficiency of the Bahasa (Indonesian language) PSQI in hemodialysis (HD) patients, and no cross-cultural adaptation has been done. The purpose of this research was to translate the PSQI into Bahasa and improve its psychometric properties for use in evaluating HD patients in Indonesia. This study used instrument translation, cultural adaptation, content validation, and equivalence to crossculturally validate and adapt an instrument. The hemodialysis center at a West Java medical facility served as a source of potential HD patients throughout the period of October 2022 to February 2023. A content validity index (CVI) was calculated for each item and the entire scale. The factor structure of the Bahasa PSQI has been evaluated by confirmatory factor analysis and internal consistency was calculated using Cronbach's alpha. The online survey received a response rate of 62.8% from a total of 220 patient with HD (about ten responders each item). The level of language clarity was 87.8%, and the level of cultural relevance was 84.5%. The CVI varied from 0.92 to 1.00. Each factor had factor loading ranging from 0.51 to 0.62. that Cronbach alpha for total score was 0.803, and the subscale ranged from 0.771 to 0.863. Our research provides preliminary evidence of the validity and reliability of the translated and adapted tool using data from HD patients in Indonesian hospitals.

Cross-Cultural Adaptation and Validation of the Central Sensitization Inventory Among Chinese Patients with Chronic Non-Specific Low Back Pain.

This research aims to develop and validate the Chinese version of the Central Sensitization Inventory (CSI-CV) for patients suffering from chronic non-specific low back pain (CNSLBP). The study evaluates both the validity and reliability of the CSI-CV. The cross-cultural adaptation of the scale strictly adhered to the principles of Bombardier and Beaton. Initially, two professors of Chinese-English translation independently translated the original CSI scale into the target language, and then collaborated with an expert in cross-cultural adaptation to merge into a single version. This version was back-translated into English by two professors whose native language is English. Following this, the scale underwent preliminary review by bilingual experts and the research team, and was preliminarily tested, ultimately culminating in the formation of the CSI-CV version. A total of 310 patients with CNSLBP completed the CSI-CV, while 50 of them repeated the survey one week later to test the stability of the scale. The CSI-CV's reliability, validity, and internal consistency were assessed through exploratory factor analysis (EFA), correlation coefficients, and Cronbach's α. EFA revealed five distinct factors from the 25 CSI-CV items, covering physical symptoms, emotional distress, fatigue and sleep disturbances, headaches and jaw symptoms, and urinary issues, with a total explained variance of 60.24%. The Cronbach's α was 0.910, and the intraclass correlation coefficient (ICC) was 0.924, indicating strong reliability. Moderate correlations were observed between CSI-CV scores and Five-Level EuroQol Five-Dimensional Questionnaire (r = -0.515), the Brief Pain Inventory (r = 0.586) and Oswestry Disability Index (r = 0.416), demonstrating significant associations with these measures. The CSI-CV exhibits excellent internal consistency, factor structure, and reliability. Its successful cultural adaptation offers valuable insights for improving treatment approaches for patients with CNSLBP.

Cross cultural adaptation and validation of audiovisual educational material for use in indigenous patients with rheumatoid arthritis

Cross cultural adaptation and validation of audiovisual educational material for use in indigenous patients with rheumatoid arthritis

Cross-cultural adaptation and validation of Work Productivity and Activity Impairment questionnaires for caregivers of patients with pediatric inflammatory bowel disease in Spain. A multicenter study.

Introduction. The WPAI-UC/CD-Caregiver questionnaires assess the impact of ulcerative colitis (UC) or Crohn's disease (CD) on parents'/caregivers' work life and daily activities. Our objective was to adapt and validate these questionnaires in the Spanish population. Methods. A translation and back-translation were done. The document was assessed by an expert committee and a pilot group of families of patients with pediatric inflammatory bowel disease (p-IBD). For validation, the parents/caregivers of patients with p-IBD (10-18 years old) were recruited. The expert committee and the pilot group conducted a subjective assessment of the format and time necessary to complete the questionnaires. Cronbach's alpha coefficient was estimated and a factor analysis with varimax rotation was done. Kaiser- Meyer-Olkin (KMO) coefficients and Bartlett's sphericity test were estimated to test the adequacy of the factor analysis. Results. A total of 370 patients (median age: 14.1 years) and 263 parents/caregivers of patients with UC or unclassified IBD and 261 parents/caregivers of patients with CD were included. The KMO coefficients (0.6947 and 0.7179) and Bartlett's sphericity test (p < 0.001) confirmed the adequacy of the factor analysis. The 6 items targeted the same domain. The factor model accounted for 99.99% and 94.68% of variance, and Cronbach's alpha coefficients (0.6581 and 0.6968) showed an adequate consistency. The format and the median time of 2 minutes to complete the questionnaires were considered optimal. Conclusions. The versions of the WPAI-Caregiver questionnaires validated in the Spanish population may be used in families whose children have IBD.

The STarT Back Screening Tool: The Nepali Translation, Cross-Cultural Adaptation and Measurement Properties in Adults With Non-Specific Low Back Pain.

The STarT Back Screening Tool (SBST) stratifies low back pain (LBP) patients based on their risk of chronicity to guide treatment accordingly. The absence of its validated Nepali version limits stratified LBP care in Nepal. The study aimed to translate and cross-culturally adapt the SBST into Nepali and evaluate its measurement properties in adults with LBP. The measurement properties of the Nepali SBST were evaluated in 102 Nepali adults with non-specific LBP. We assessed content validity, internal consistency, test-retest reliability, construct and discriminant validity. Item redundancy was evaluated using Cronbach's alpha (α>0.90), test-retest reliability using Intraclass Correlation Coefficient (ICC2,1) and Cohen's kappa using established cutoffs score for categorising patients into risk groups, construct validity using hypothesis testing (if a minimum of 75% of the hypotheses were supported), and discriminant validity using Area Under the Curve (AUC) with the reference scales administered at baseline. Cronbach's alphascores were 0.72 for the overall scale and 0.66 for the psychosocial subscale. Test-retest reliability values were good to excellent with ICC2,1 of 0.94 (95% CI: 0.87-0.97) for the overall scale and 0.87 (95% CI: 0.73-0.94) for the psychosocial subscale and Kappa values of 0.68 (95% CI: 0.43-0.93) for the overall scale and 0.79 (95% CI: 0.52-1.00) for psychosocial subscale. Construct validity was confirmed as 100% of a priori hypotheses were met. Acceptable discriminative validity was observed with reference scales with AUCs (0.75-0.80). Nepali SBST demonstrates the reliability and validity of screening for chronicity risk in Nepali adults with LBP. Future studies should evaluate its responsiveness, predictive abilities, and effectiveness in stratifying LBP patients in the Nepalese context.

Social Media Use and Cross-Cultural Adaptation of Chinese Students Overseas: A Systematic Review

Due to the progress of globalization, as well as the advancement of transportation and communication tools, there is a greater interconnectedness among nations and regions worldwide. A common trend of it is the increasing prevalence of students opting to pursue tertiary education overseas. Asia has emerged as the largest exporter, sending the largest proportion of international students to the world, especially China. When studying in foreign countries, international students may encounter challenges from life and studies; then, social media has become a pivotal tool in their lives for obtaining information and interpersonal communication. This study intends to conduct a systematic review of the influence of social media on the cross-cultural adaptation of Chinese overseas students, who constitute the largest cohort of international students, and adopts databases Web of Science, Scopus and ScienceDirect. From 2014 to 2023, 15 studies met the inclusion criteria. The United States was the most studied geographic country, and most studies delved into cross-cultural adaptation from socio-cultural and psychological aspects, with less research from the academic aspect. Besides, these studies largely proved the positive role of social media in facilitating the attainment of social capital and enhancing psychological well-being among Chinese overseas students. Nevertheless, a few studies also showed the drawbacks of social media use. There is a call for studies on the correlation between academic adaptation of Chinese overseas students and social media use, as well as to explore international students’ proper use of social media.