Pre-final Version Research Articles

Translation, cross-cultural adaptation, and reliability of the Workplace Sitting Breaks Questionnaire into Brazilian Portuguese.

This study aimed to translate, adapt, and analyze the reliability of the Workplace Sitting Breaks Questionnaire (SITBRQ) for use in Brazil. This is a cross-sectional study. The translation and cross-cultural adaptation were conducted considering the following six phases: translation, synthesis of translations, back translation, analysis by a committee of experts, test of the pre-final version, and final version. We included workers aged 18 years or above, both genders, and able to understand, read, and write in Brazilian Portuguese. The final version was applied to workers in two moments (i.e., test and retest), with an interval of 7 days, for reliability calculation. In the translation and cross-cultural adaptation phase, the pre-final version was applied to a sample of 35 workers. For item a of the SITBRQ, there was 100% understanding by respondents, while item b was understood by 94.28%. The reliability phase was conducted with 115 workers. For both items, almost perfect was identified with kappa >0.81. The SITBRQ version into Brazilian Portuguese has adequate adaptation and excellent values of reliability.

Vietnamese Version of the General Medication Adherence Scale (GMAS): Translation, Adaptation, and Validation.

Background: We aimed to translate, cross-culturally adapt, and validate the General Medication Adherence Scale (GMAS) into Vietnamese. Methods: We followed the guidelines of Beaton et al. during the translation and adaptation process. In Stage I, two translators translated the GMAS to Vietnamese. Stage II involved synthesizing the two translations. Stage III featured a back translation. Stage IV included an expert committee review and the creation of the pre-final version of the GMAS, and in stage V, pilot testing was conducted on 42 Vietnamese patients with type 2 diabetes. The psychometric validation process evaluated the reliability and validity of the questionnaire. The internal consistency and test–retest reliability were assessed by Cronbach’s alpha and Spearman’s correlation coefficients. The construct validity was determined by an association examination between the levels of adherence and patient characteristics. The content validity was based on the opinion and assessment score by the expert committee. The Vietnamese version of the GMAS was created, including 11 items divided into three domains. There was a good equivalence between the English and the Vietnamese versions of the GMAS in all four criteria. Results: One hundred and seventy-seven patients were participating in the psychometric validation process. Cronbach’s alpha was acceptable for all questionnaire items (0.817). Spearman’s correlation coefficient of the test–retest reliability was acceptable for the GMAS (0.879). There are significant correlations between medication adherence levels and occupation, income, and the Beliefs about Medicines Questionnaire (BMQ) score regarding construct validity. Conclusions: The Vietnamese version of GMAS can be considered a reliable and valid tool for assessing medication adherence in Vietnamese patients.

Transcultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in intensive care

ObjectiveTo perform the cross-cultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in ICU in Cartagena, Colombia. MethodScale validation study, population comprising all the patients who were hospitalized in six ICU of Cartagena-Colombia. The sample was made up of 181 adult patients with artificial airway, the adaptation to Spanish was determined (translation, backtranslation, expert review, pre-final version, pilot test, final version), facial validity by expert agreement, content validity with the Lawshe index modified by Tristan (cut-off point 0.58), exploratory factor analysis (AFE) with the Bartlett’s test of sphericity and Cattell’s graph; internal consistency measured through the Cronbach alpha statistic. ResultsPatients between the ages of 19 and 88 years participated (mean = 54 ± 17), 91.71% expressed frequent needs for accompaniment, knowing date and time; 61% of the experts agreed with the cross-culturally adapted items, the overall Content Validity Index (CVI) was 0.86 with agreement in understanding eleven items. The AFE suggested retaining 13 items and 3 factors (perception/cognition, elimination and exchange, comfort), which explain the construct. The internal alpha Cronbach consistency was 0.64. ConclusionsThe pictographic material, Spanish version, was shown to be a multidimensional instrument composed of 18 items grouped in 3 factors. Therefore, it is recommended it be applied to the patient with artificial airway and to establish communication as a preliminary point of care in nursing.

Linguistic validation of the Diabetic foot ulcer scale short form (DFS-SF): a methodological approach

Objective: to presenting the linguistic validation of the Diabetic Foot Ulcer Scale Short-Form (DFS-SF) among patients with ulcer diabetic foot (DFU) to Brazilian Portuguese and evaluate its content, practicability and acceptability.Methods and casuistry: a cross-sectional, methodological research, was conducted among 30 outpatients in follow-up for DF, assessed regarding QoL, sociodemographic and clinical data. International recommendations provided bythe Mapi Research Trust on adaptation procedures were followed: the stages of Forward translation, Backward translation and the Cognitive interview were carried out. The Content Validity Index was calculated and a pre-test were gathered to produce a pre-final version. Practicability and acceptability were also assessed. Results: the semantic, idiomatic, cultural and conceptual equivalences between the linguistic validated and the original version were obtained.The DFS-SF was practical, well accepted and easy to understand. Conclusion: the linguistic validation process of the Brazilian version of the DFS-SF has been completed in accordance with internationally recommended standards.The instrument was easy to apply, to understand and presented short time for administration.

Translation and Cultural Adaptation to Brazilian Portuguese of the Children's Physical Activity Questionnaire (C-PAQ).

Objective To perform the translation and cultural adaptation to Brazilian Portuguese of the Children's Physical Activity Questionnaire Methods The process involved the stages of translation, synthesis, back-translation, and revision by the translation group. A prefinal version of the questionnaire was then created, and, subsequently, the final version. Results Due to the lifestyle of the population, eight activities described in the questionnaire were changed to adapt it to Brazilian culture: six sports activities and two leisure activities. Eight parents/legal guardians answered the questionnaire during the pretest, quickly, without inconsistencies, and without reporting difficulties in understanding when the final interview was conducted. Conclusion The translation and cultural adaptation of the Children's Physical Activity Questionnaire to Brazilian Portuguese resulted in the version called C-PAQ.PT.

Cross-cultural adaptation and validation of the Persian version of the painDETECT questionnaire

Objective The purpose of this study was to translate and cross-culturally adapt the painDETECT questionnaire into the Persian language and assess the clinometric properties of the translated version (P-PDQ). Methods This is a single-center prospective observational study. After forward and backward translations, consensus was achieved by the expert panel on the pre-final version. Semantic equivalence of this version was assessed and necessary modifications were made accordingly to achieve the final version (P-PDQ). One hundred and fifty chronic pain patients were sub-classified into neuropathic pain (NeP (n = 82)) or non-NeP (n = 68) groups by two pain specialists. P-PDQ was then administered to 50 patients twice with an interval of 5–7 days to assess relative reliability. Chronbach’s α and intraclass correlation coefficient (ICC) were calculated to evaluate internal consistency and test-retest reliability of the P-PDQ, respectively. Criterion validity was assessed as the correlation of the P-PDQ and the validated Persian version of the self-report Leeds Assessment of Neuropathic Symptoms and Signs (P-sLANSS). Results Chronbach’s α and ICC of the P-PDQ were 0.76 and 0.97, respectively. The P-PDQ scores were significantly correlated with those of P-sLANSS (ρ = 0.87, p < .01). The mean overall score of P-PDQ was significantly higher in the NeP group (p < .01) which reflects discriminant validity. Sensitivity, specificity, positive and negative predicting values and Youden index were 74.70%, 98.51%, 78.04%, 98.48%, and 0.73, respectively at the cutoff value ≤17. Conclusion The P-PDQ is a reliable and valid tool to distinguish neuropathic component in chronic pain cases.

King’s Parkinson’s Disease Pain Scale (KPPS): Cross-cultural adaptation to Brazilian Portuguese and content validity

Pain is one of the most common and troublesome non-motor symptoms of Parkinson’s disease (PD). The King's Parkinson's Disease Pain Scale (KPPS) is the first scale of its kind to evaluate the burden and characterization of various phenotypes of pain in individuals with PD. The purpose of this study was to adapt the KPPS to Brazilian culture and to assess its content validity using the Delphi method. The process of adapting the original instrument to the Brazilian context occurred in six stages according to international standards. Following the pilot tests with individuals with PD, the pre-final version of the KPPS-Brazil was developed and submitted to judges to assess content validity. Three evaluation rounds were conducted, in which several corrections and changes suggested by the judges were accepted. The Content Validity Index (CVI) was calculated to determine the judges’ degree of agreement. The results demonstrated that the KPPS-Brazil showed a quite satisfactory level of semantic, idiomatic, cultural, and conceptual equivalence. The judges' opinion showed adequate content validity for all of the KPPS-Brazil items and the scale. The use of the KPPS-Brazil will enable an adequate assessment of pain in individuals with PD, contributing to clinical practice and research.

Measuring recovery in Arabic countries: Translation of the self-efficacy for personal recovery scale.

To translate the Self-Efficacy for Personal Recovery Scale (SEPRS) into Arabic and evaluate the psychometric properties of the Arabic version. An established translation methodology was employed, involving back-translation, comparison, forward-translation, comparison, and piloting. The pre-final version of the Arabic translated scale was tested for clarity with young people with a primary diagnosis of mental health problem. The final Arabic version and standardized measures of hope and loneliness were administered to 119 young people in two rounds. Internal consistency was adequate (Cronbach's alpha = 0.87 in round 1, 0.91 in round 2). Consistent with the English version, a one-factor solution best fitted the data. The correlation between SEPRS and hope was R = 0.60 (round 1) and R = 0.61 (round 2), indicating convergent validity. The correlation between SEPRS and loneliness was R = -0.52 (round 1) and R = -0.60 (round 2). Correlation between test and retest was R = -0.998 indicated adequate test-retest reliability. Minimal floor and ceiling effects were detected. The use of the Arabic SEPRS with Arabic-speaking samples is supported. Further research to investigate divergent validity is warranted.

Cross-Cultural Validation of the 5-Item Compliance Questionnaire for Rheumatology to the Arabic Language in Patients with Rheumatoid Arthritis.

PurposeA simple measure to assess drug adherence in Saudi patients with rheumatoid arthritis (RA) is required. The aim of this study was to translate and validate the 5-Item Compliance Questionnaire for Rheumatology (CQR5) into Arabic.Patients and MethodsThe questionnaire was translated and culturally adapted to Arab patients in six steps: initial translation, synthesis of the translation, back translation, expert committee review, test of the pre-final version, and development of the Arabic CQR5 (ACQR-5). The resulting version was tested for validity in patients with RA.ResultsA total of 103 adult patients with RA were recruited from rheumatology clinics at a university hospital in Riyadh, Saudi Arabia. After extensive translation, the final tool (CQR) was piloted in 15 patients. The final validation was performed with 88 patients. Of these, 80 (90.9%) were female and 43.2% were seropositive. The mean (±SD) age and disease duration were 50 (±13) and 11.4 (±8.2) years, respectively. Cronbach’s alpha reliability was 0.886, and the Kaiser-Meyer-Olkin measure of sampling adequacy for factor analysis was 0.870 (p<0.001). The mean ACQR-5 was 17.78 (2.70), with 14 (15.9%) classified as low adherents and the remaining 74 (84.1%) as high adherents. Binary logistic regression revealed that increasing age (odds ratio [OR] 1.082, 95% confidence interval [CI]: 1.025–1.142, p=0.005) and a trend toward the presence of other comorbidities (OR 3.111, 95% CI: 0.961–10.070, p=0.058) were associated with low adherence.ConclusionACQR-5 is a simple and feasible tool for identifying adherence levels in patients with RA in Saudi Arabia. A high level of adherence was observed in this study. Additional studies are required to assess ACQR-5 validity and adherence levels in a larger, more diverse population.

Psychometric Properties of the Chinese Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia.

A quality of life questionnaire specific to sarcopenia (SarQoL®) was successfully developed. There is a huge demand for translation and validation in Chinese. The aim of this study was to translate the SarQoL® into Chinese and investigate its psychometric properties. The translation and cross-cultural adaptation process recommended by the developers of the initial questionnaire was followed. A total of 159 participants were investigated. The translation process consists of five steps: (1) two bilinguals independently translate initial English to Chinese; (2) synthesize the two translations into one; (3) backward translations; (4) expert committee review and (5) test of the pre-final version. The validation consists of three parts: (1) validity (discriminative power, construct validity); (2) reliability (internal consistency, test-retest reliability) and (3) floor and ceiling effects. There was no difficulty in translation process. Regarding the validity, good discriminant validity {quality of life for sarcopenic subjects [35.56 (29.73-42.70)] vs. non-sarcopenic ones [73.22 (60.09-82.90)], p < 0.001} and consistent construct validity [high correlations (spearman's r) of SarQoL® with generic Short Form-36 version 2 questionnaire (0.250 to 0.824) and EuroQoL-5-Dimension questionnaire (- 0.114 to - 0.823)] were found in SarQoL®. Regarding reliability, high internal consistency (Cronbach's alpha coefficient was 0.867) and excellent test-retest reliability (intraclass coefficient correlation was 0.997, 95% CI 0.994-0.998) were found. No ceiling/floor effect was reflected. A valid SarQoL® questionnaire is now available for Chinese population. It can provide a better understanding of the sarcopenia disease burden and serve as a therapeutic outcome indicator in research.

Cross-cultural adaptation and validation of the Norwegian version of the Leicester Cough Questionnaire in chronic obstructive pulmonary disease

ABSTRACT Background Cough is a common symptom among patients with chronic obstructive pulmonary disease (COPD), but there are currently no patient-reported outcome measures (PROM) for subjective cough symptoms in Norwegian. Objective The objective was to translate and validated the most widely used PROM for chronic cough, the Leicester Cough Questionnaire (LCQ) from English to Norwegian (NLCQ) using established guidelines. Methods Forward and backward translations were performed using external translators. All phases were discussed in an expert workgroup until consensus was achieved. Ten patients were interviewed about the pre-final version to assess understandability and ease to complete. The final NLCQ was externally proofread and tested for content and construct validity, internal consistency, test–retest reliability and measurement error. Results Mean (SD) age was 67 (7.9) years, and 62% of the sample were female (n = 56/89). According to GOLD stages, 10% had mild, 27% moderate, 35% severe and 22% very severe COPD, respectively. GOLD stages were missing for five patients (6%). The NLCQ showed acceptable accordance with the original, acceptable understandability and ease to complete, satisfactory content reliability, total score construct validity, internal consistency and test–retest reliability. Test–retest bias was low, but measurement error was larger than previously reported. The standard error of measurement and smallest detectable change were 1.56 and 4.32, respectively. Construct validity and factor analysis raised concerns regarding the three subdomains. Conclusion The present cross-cultural adaptation of the NLCQ showed satisfactory reliability and overall validity. Due to concerns for the validity of the three domains, we suggest use should be restricted to the NLCQ total score until these are reassessed.

Cross-cultural adaptation, reliability and validity of the Fremantle Knee Awareness Questionnaire in Italian subjects with painful knee osteoarthritis

Background and aimGrowing attention is being given to utilising physical function measures to better understand and manage knee osteoarthritis (OA). The Fremantle Knee Awareness Questionnaire (FreKAQ), a self-reported measure of body-perception specific to the knee, has never been validated in Italian patients. The aims of this study were to culturally adapt and validate the Italian version of the FreKAQ (FreKAQ-I), to allow for its use with Italian-speaking patients with painful knee OA.MethodsThe FreKAQ-I was developed by means of forward–backward translation, a final review by an expert committee and a test of the pre-final version to evaluate its comprehensibility. The psychometric testing included: internal structural validity by Rasch analysis; construct validity by assessing hypotheses of FreKAQ correlations with the knee injury and osteoarthritis outcome score (KOOS), a pain intensity numerical rating scale (PI-NRS), the pain catastrophising scale (PCS), and the Hospital anxiety and depression score (HADS) (Pearson’s correlations); known-group validity by evaluating the ability of FreKAQ scores to discriminate between two groups of participants with different clinical profiles (Mann–Whitney U test); reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation coefficient, ICC2.1); and measurement error by calculating the minimum detectable change (MDC).ResultsIt took one month to develop a consensus-based version of the FreKAQ-I. The questionnaire was administered to 102 subjects with painful knee OA and was well accepted. Internal structural validity confirmed the substantial unidimensionality of the FreKAQ-I: variance explained was 53.3%, the unexplained variance in the first contrast showed an eigenvalue of 1.8, and no local dependence was detected. Construct validity was good as all of the hypotheses were met; correlations: KOOS (rho = 0.38–0.51), PI-NRS (rho = 0.35–0.37), PCS (rho = 0.47) and HADS (Anxiety rho = 0.36; Depression rho = 0.43). Regarding known-groups validity, FreKAQ scores were significantly different between groups of participants demonstrating high and low levels of pain intensity, pain catastrophising, anxiety, depression and the four KOOS subscales (p ≤ 0.004). Internal consistency was acceptable (α = 0.74) and test–retest reliability was excellent (ICC = 0.92, CI 0.87–0.94). The MDC95 was 5.22 scale points.ConclusionThe FreKAQ-I is unidimensional, reliable and valid in Italian patients with painful knee OA. Its use is recommended for clinical and research purposes.

Danish translation of the Neck Dissection Impairment Index

Background Shoulder pain and impairment are known complications to neck dissections (NDs) as part of the surgical management of head and neck cancer (HNC). The Neck Dissection Impairment Index (NDII) is a validated shoulder function-related quality-of-life instrument and an important patient reported outcome measure after head-neck surgery. The correct translation of questionnaires into other languages is important for both individual assessment of patients and future research. Aims Translation of the NDII into Danish. Methods The NDII was translated from English into Danish using forward and backward translational procedures. Pilot-testing was performed on the pre-final version of the translated questionnaire. Results Pilot-testing found the translation easily comprehensible, but a few changes were made to improve language flow. Conclusions NDII was successfully translated into Danish using forward and backward translations. Further validation on a larger scale is warranted. Significance NDII is an important aid to identifying patients with impairments and optimize the aftercare following ND for HNC. Translation of validated questionnaires into other languages is important for future research and international comparison of surgery outcome.

116 Cross-cultural Translation, Adaptation and Validation of the Burnt Hand Outcome Tool (BHOT) from English to French Canadian

Abstract Introduction The Burnt Hand Outcome Tool (BHOT) is a comprehensive patient-reported outcome measure to assess the multiple impacts of hand burn injuries. However, this tool is currently only available in English. The aim of this study was to create a French Canadian, cross-cultural translation and adaptation of the BHOT and to investigate its reliability and validity. Methods The BHOT was translated and culturally adapted following published good practice principles for patient-reported outcome measures. The steps included translation to French, backward translation, expert committee review, and cognitive debriefing with 5 adults having burn injuries excluding their hands. Then, 39 adults with hand burn injuries tested the pre-final French version of the questionnaire (BHOT-F) in order to determine its clinimetric properties. Reliability was investigated by determining the Cronbach’s alpha internal consistency coefficient. Construct convergent validity was assessed by comparing the BHOT-F to the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Content validity was evaluated based on comments extracted from interviews with the participants and a committee of burn care experts. Results The BHOT-F was modified during the adaption process to ensure its clarity. Cronbach’s alpha was 0.94 indicating excellent internal consistency and was &amp;gt; 0.75 for all sub-domains. The BHOT-F and the QuickDASH were strongly correlated (rs = .86; p &amp;lt; 0.01). Content validity was deemed satisfying. Conclusions The French-Canadian version of the BHOT is a reliable and valid tool that can confidently be used in clinical practice for adults with hand burn injuries and compared to data generated with Anglophone populations.

Translation, cross-cultural adaptation, and psychometric properties of the Brazilian Portuguese version of the DiAbeTes Education Questionnaire (DATE-Q)

BackgroundThe DiAbeTes Education Questionnaire (DATE-Q) is a self-administered tool developed to evaluate disease-related knowledge and to assess knowledge of five core components of rehabilitation programs: physical exercise, diet, psychosocial well-being, disease self-management, and complications. ObjectiveTo translate and cross-culturally adapt into Brazilian Portuguese, and to test the psychometric properties of the DATE-Q for its use in Brazil. MethodsThe process of translation and cross-cultural adaptation consisted of five steps: translation into Brazilian Portuguese, synthesis of translation, back translation, expert committee, and pilot test of pre-final version. The pre-final version was applied to a sample of 30 patients with diabetes. Psychometric properties (internal consistency, reliability, construct validity, and ceiling and floor effects) of the final version of the Brazilian Portuguese version of the DATE-Q were tested in a sample of 200 adults with diabetes. ResultsThere was no conceptual divergence between the original and the translated versions. Ten (50%) items of the DATE-Q were culturally adapted. Internal consistency (Cronbach’s alpha coefficient = 0.6), reliability (intraclass correlation coefficient = 0.5), and construct validity (correlation between Diabetes Knowledge Scales and DATE-Q total scores: ρ = 0.7; P < 0.001) were confirmed. Ceiling or floor effects were not identified. The highest scoring item was about healthy eating. The average time for completion of the DATE-Q was 5 min and 51 s, and the completion rate was 100% for all items. ConclusionThe Brazilian Portuguese version of the DATE-Q showed adequate psychometric properties, and results suggested that the tool can be used to assess disease-related knowledge in adults with diabetes in Brazil.

Validity and Reliability of Lymphoedema Functioning, Disability and Health Questionnaire (Lymph-ICF) Thai Version

Objective: The study objective is to adapt the Lymphoedema functioning, disability and health questionnaire (Lymph-ICF) for use in the Thai language and to investigate the validity and reliability of the Thai version. Materials and Methods: This study was done in 5 stages in line with established guidelines for cross-cultural adaptation of self-report measures; 1) Initial translation 2) Synthesis of the translations 3) Back translation 4) Expert committee review and 5) Test of the prefinal version. The face validity was assessed by interview content experts. In the assessment of the validity of the construct, the Spearman correlation coefficient was used to examine the correlations between the scores of the Thai Lymph-ICF and the scores of the Thai EQ-5D-5L. The intraclass correlation coefficient (ICC) was used to establish test-retest reliability while Cronbach’s alpha was used to determine the internal consistency of the whole questionnaire and of each domain. Results: Fifty participants were evaluated for validity and reliability. Face validity was supported. Construct validity showed strong correlations between the scores of the Thai Lymph-ICF and the scores of the Thai EQ-5D-5L. Internal consistency and test-retest reliability were both excellent. Conclusion: The Lymph-ICF Thai version was shown to be both valid and reliable for evaluating the quality of life of patients with breast cancer-related lymphoedema.

Short-form quality care questionnaire-palliative care has acceptable measurement properties in Brazilian cancer patients

BackgroundOur objective was to perform the translation, cross-cultural adaptation, and validation of the Quality Care Questionnaire-Palliative Care (QCQ-PC) into Brazilian Portuguese for cancer patients in palliative care. The translation and cross-cultural adaptation comprised the following stages: translation, synthesis of translations, back-translation, analysis by a committee of experts, testing of the pre-final version, and definition of the final version. The evaluated measurement properties were: structural validity using factor analysis, test–retest reliability using the intraclass correlation coefficient (ICC), internal consistency using Cronbach’s alpha, and construct validity using the correlations between the QCQ-PC and other questionnaires already validated in Brazil.ResultsTwo hundred and twenty-five cancer patients were included for validity analyses, and a subsample of 30 patients was used for test–retest reliability. The most adequate fit indexes were for the short version of the QCQ-PC (SF-QCQ-PC), with two domains and 12 items. There was adequate reliability and internal consistency, with values of the ICC ≥ 0.83 and Cronbach’s alpha ≥0.82. There were correlations > 0.30 between the SF-QCQ-PC and the Karnofsky Performance Scale, the Palliative Prognostic Index, the sadness domain of the Edmonton Symptom Assessment System, the Barthel Index, and all domains related to the McGill Quality of Life Questionnaire and the European Organization for Research in the Treatment of Cancer Questionnaire-core.ConclusionThe short version of the SF-QCQ-PC has acceptable psychometric properties for use in Brazil.

Reliability and Validity of Cross Culturally Adapted Punjabi Version of NDI (NDI-P) in Patients with Neck Pain: A Psychometric Analysis.

Neck disability index (NDI) is one of the commonest patient-reported outcome measures used to evaluate disability related to neck pain. Its application to non-English-speaking Punjabi population is limited as a validated and cross-culturally adapted Punjabi version of NDI is not available. The purpose of the study was to analyze the psychometric properties of Punjabi version of neck disability index (NDI-P) in patients with neck pain. The translation and cross-cultural adaptation of Punjabi version of NDI was done according to well-recommended guidelines. The pre-final version was tested on a set of 15 patients and suitable modifications were made. The final version was administered to 100 patients with neck pain of more than 2weeks duration. Psychometric properties comprising internal consistency, test-re-test reliability, construct validity and factorial structure of the questionnaire were determined. The developed NDI-P showed excellent internal consistency (Chronbach alpha of NDI-P is 0.87), test-re-test reliability (ICC 0.840) and construct validity (Spearman correlation coefficient with VAS 0.547). Factor analysis proved the questionnaire to be having a 2-factor structure with a total variance of 56.58%. NDI (P) is a reliable and valid instrument for measurement of disability related to neck pain in Punjabi population. It can be used both in research and clinical care settings in future.

Lymphedema quality of life questionnaire (LYMQOL): cross-cultural adaptation and validation in Italian women with upper limb lymphedema after breast cancer

Purpose There is growing interest in measures that assess upper-limb lymphedema after breast cancer. Since no validated Italian version of the Lymphedema Quality of Life Questionnaire for upper limbs (LYMQOL-UL) exists, we aimed to culturally adapt and validate an Italian version (LYMQOL-UL-IT) in order to allow its use in Italian patients. Materials and methods The LYMQOL-UL-IT was developed by means of forward-backward translation, review by an expert committee and a test of the pre-final version to evaluate its comprehensibility. The psychometric testing included reliability by internal consistency (Cronbach’s alpha) and test-retest reliability (intraclass correlation coefficient, ICC(2.1)), measurement error by calculating the minimum detectable change (MDC95), construct validity by confirmatory factor analysis, and evaluation of a priori hypotheses about the correlations between the four LYMQOL-UL domains, single items of the LYMQOL-UL, and measures of health-related quality of life and pain intensity (Spearman’s rank correlation coefficient). Results The consensus-based version of LYMQOL-UL-IT was administered to 139 patients with upper-limb stable secondary iatrogenic lymphedema after breast cancer. The adapted questionnaire was well accepted as it was completed in less than 10 min, without missing answers or comprehension problems. Internal consistency was acceptable (α = 0.92-0.95). Test-retest reliability was good-to-excellent (ICC(2.1) = 0.73-0.96). The MDC95 for the four domains of the questionnaire was as follows: 0.64 scale points for Function, 0.40 for Appearance, 0.53 for Symptoms, and 0.81 for Mood. Factor analysis confirmed a 4-dimensional structure as originally conceived and the a priori hypotheses were met. Conclusion The LYMQOL-UL-IT is reliable, sensitive to change and valid in patients with upper-limb stable secondary iatrogenic lymphedema after breast cancer. It can be used for clinical and research purposes. Implications for rehabilitation Lymphedema is a frequently unnoticed clinical condition that not only impacts physical functioning but often restricts the health-related quality of life in breast cancer survivors. The Italian version of the Lymphedema Quality of Life Questionnaire for upper limbs (LYMQOL-UL-IT) is reliable, sensitive to change and valid in patients with upper-limb lymphedema after breast cancer. The LYMQOL-UL-IT tool can be recommended for clinical and research purposes.

Adaptación transcultural y validez de un pictograma para evaluar necesidades de comunicación en adultos con vía aérea artificial en cuidados intensivos

ObjectiveTo perform the cross-cultural adaptation and validity of a pictogram to assess communication needs in adults with artificial airway in ICU in Cartagena, Colombia. MethodScale validation study, population comprising all the patients who were hospitalized in six ICU of Cartagena-Colombia. The sample was made up of 181 adult patients with artificial airway, the adaptation to Spanish was determined (translation, backtranslation, expert review, pre-final version, pilot test, final version), facial validity by expert agreement, content validity with the Lawshe index modified by Tristan (cut-off point 0.58), exploratory factor analysis (AFE) with the Bartlett's test of sphericity and Cattell's graph; internal consistency measured through the Cronbach alpha statistic. ResultsPatients between the ages of 19 and 88years participated (mean: 54±17); 91.71% expressed frequent needs for accompaniment, knowing date and time; 61% of the experts agreed with the cross-culturally adapted items, the overall Content Validity Index (CVI) was 0.86 with agreement in understanding eleven items. The AFE suggested retaining 13 items and 3 factors (perception/cognition, elimination and exchange, comfort), which explain the construct. The internal alpha Cronbach consistency was 0.64. ConclusionsThe pictographic material, Spanish version, was shown to be a multidimensional instrument composed of 18 items grouped in 3 factors. Therefore, it is recommended it be applied to the patient with artificial airway and to establish communication as a preliminary point of care in nursing.