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Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain.

ABSTRACT: BACKGROUND: Pain catastrophizing has been found to be an important predictor of disability and days lost from work in patients with low back pain. The most commonly used outcome measure to identify pain catastrophizing is the Pain Catastrophizing Scale (PCS). To enable the use of the PCS in clinical settings and research in Norwegian speaking patients, the PCS had to be translated. The purpose of this study was therefore to translate and cross-culturally adapt the PCS into Norwegian and to test internal consistency, construct validity and reproducibility of the PCS. METHODS: The PCS was translated before it was tested for psychometric properties. Patients with subacute or chronic non-specific low back pain aged 18?years or more were recruited from primary and secondary care. Validity of the PCS was assessed by evaluating data quality (missing, floor and ceiling effects), principal components analysis, internal consistency (Cronbach's alpha), and construct validity (Spearman's rho). Reproducibility analyses included standard error of measurement, minimum detectable change, limits of agreement, and intraclass correlation coefficients. RESULTS: A total of 38 men and 52 women (n?=?90), with a mean (SD) age of 47.6 (11.7) years, were included for baseline testing. A subgroup of 61 patients was included for test-retest assessments. The Norwegian PCS was easy-to-comprehend. The principal components analysis supported a three-factor structure, internal consistency was satisfactory for the PCS total score (? 0.90) and the subscales rumination (? 0.83) and helplessness (? 0.86), but not for the subscale magnification (? 0.53). In total, 86% of the correlation analyses were in accordance with predefined hypothesis. The reliability analyses showed intraclass correlation coefficients of 0.74?-?0.87 for the PCS total score and subscales. The PCS total score (range 0-52 points) showed a standard error of measurement of 4.6 points and a 95% minimum detectable change estimate of 12.8 points. CONCLUSIONS: The Norwegian PCS total score showed acceptable psychometric properties in terms of comprehensibility, consistency, construct validity, and reproducibility when applied to patients with subacute or chronic LBP from different clinical settings. Our study support the use of the PCS total score for clinical or research purposes identifying or evaluating pain catastrophizing.

SUBMITTER: Fernandes L

PROVIDER: S-EPMC3407790 | biostudies-other | 2012

REPOSITORIES: biostudies-other

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Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain.

Fernandes Linda L Storheim Kjersti K Lochting Ida I Grotle Margreth M

BMC musculoskeletal disorders 20120622

<h4>Background</h4>Pain catastrophizing has been found to be an important predictor of disability and days lost from work in patients with low back pain. The most commonly used outcome measure to identify pain catastrophizing is the Pain Catastrophizing Scale (PCS). To enable the use of the PCS in clinical settings and research in Norwegian speaking patients, the PCS had to be translated. The purpose of this study was therefore to translate and cross-culturally adapt the PCS into Norwegian and t ...[more]

PMID: 22726668

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Project description:BackgroundCatastrophizing has been recognized as an important contributor to chronicity in individuals with chronic pain syndromes including low back pain (LBP). The Pain Catastrophizing Scale (PCS) is perhaps the most widely used tool to evaluate the degree of pain catastrophizing. However, its use is limited in Hausa-speaking countries due to the lack of a validated translated version.ObjectiveTo translate and cross-culturally adapt the PCS into Hausa (Hausa-PCS), and evaluate its psychometric properties in mixed urban and rural patients with chronic LBP.MethodsThe PCS was translated and cross-culturally adapted into Hausa in accordance with established guidelines. To evaluate its psychometric properties, a consecutive sample of 200 patients with chronic LBP was recruited from urban and rural Nigerian hospitals. Validity was evaluated by exploring content validity, factorial structure (confirmatory factor analysis [CFA]), construct validity (Spearman's rho for a priori hypotheses) and known-groups validity. Reliability was evaluated by calculating internal consistency (Cronbach's α), intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC) and limits of agreement with 95% confidence interval (LOA95%).ResultsThe Hausa-PCS was comprehensible with good content validity. The CFA confirmed a 3-factor structure similar to the original English version. The concurrent validity was supported as 83% (5/6) of the a priori hypotheses were confirmed. Known-groups comparison showed that the questionnaire was unable to differentiate between male and female or urban and rural patients (p > 0.05). Internal consistency and ICC were adequate for the Hausa-PCS total score (α = 0.84; ICC = 0.90) and the subscale helplessness (α = 0.78; ICC = 0.89) but for the subscales rumination (α = 0.69; ICC = 0.68) and magnification (α = 0.41; ICC = 0.43). The LOA95% for the Hausa-PCS total score was between - 8.10 and + 9.75, with SEM and MDC of 3.47 and 9.62 respectively.ConclusionThe Hausa-PCS was successfully developed and psychometrically adequate in terms of factorial structure, construct validity, internal consistency and test-retest reliability when applied in mixed urban and rural patients with chronic LBP. However, the internal consistency and reliability coefficients (ICC) for the individual subscales are inadequate. Thus, we support the use of the total score when evaluating pain catastrophizing for clinical or research purposes.

Project description:BackgroundAssessed dimensions of low back pain (LBP) vary in prevalence studies. This may explain the heterogeneity in frequency estimates. To standardize definitions of LBP, an English consensus with 28 experts from 12 countries developed the "Delphi Definitions of Low Back Pain Prevalence" (DOLBaPP). The optimal definition and the shorter minimal definition with the related questionnaires for online, paper, and face-to-face use and telephone surveys are suitable for population-based studies. The definitions have to be adapted to different languages and cultures to provide comparable frequency estimates. The objective was to culturally adapt and pre-test the English definitions and corresponding Delphi DOLBaPP questionnaire forms into German.MethodsThe German DOLBaPP adaptation was conducted using the systematic approach suggested by Beaton et al. A pre-test of the Delphi DOLBaPP optimal paper questionnaire including an additional evaluation form was conducted in a sample of 121 employees (mainly office workers). In order to evaluate the comprehensibility, usability, applicability, and completeness of the adapted questionnaire, response to the questionnaire and 6 closed evaluation questions were analyzed descriptively. Qualitative methods were used for the 3 open questions of the evaluation form.ResultsThe cultural adaptation of the DOLBaPP for a German-speaking audience required little linguistic adaptation. Conceptual equivalence was difficult for the expression "low back pain". The expert committee considered the face validity of the pre-final version of the related Delphi DOLBaPP questionnaires as good. In the pre-test, most participants (95%) needed less than 5 minutes to fill in the optimal Delphi DOLBaPP questionnaire. They were generally positive regarding length, wording, diagram, and composition. All subjects with LBP (n=61 out of 121 - 50.4%) answered the questions on functional limitation, sciatic pain, frequency and duration of symptoms as well as pain severity.ConclusionThe results indicate that the cross-cultural German adaptation of the DOLBaPP Definitions and the corresponding questionnaires was successful. The definitions can be used in epidemiological studies to measure the prevalence of LBP. Some critical issues were raised regarding the general features of the Delphi DOLBaPP questionnaires. Future research is needed to evaluate these instruments.

Project description:BackgroundThe Modified Low Back Pain Disability Questionnaire (MLBPDQ) is used for evaluating the functional disability in patients with low back pain (LBP). However, the measurement characteristics of the MLBPDQ among Arab patients are unknown. In this study, we aimed to translate and cross-culturally adapt the MLBPDQ into Arabic and evaluate its psychometric properties.MethodsAn Arabic version of the MLBPDQ was developed through forward translation, translation synthesis, and backward translation. Sixty-eight patients (55 males and 13 females) with a mean age 37.01 ± 7.57 years were recruited to assess its psychometric properties. Reliability was evaluated using internal consistency (Cronbach’s α), test retest reliability (utilizing intraclass correlation coefficient [ICC]), standard error of measurement (SEM), minimal detectable change at 95% confidence level (MDC95%), and 95% limits of agreement (LOA). The construct validity was investigated by correlating the new translation with four other measures of LBP (using Spearman’s rho). Finally, receiver operating characteristic curve was constructed to compute the sensitivity, using the area under the curve (AUC), and the minimum important change (MIC). An alpha level of 0.05 was set for statistical tests and all the psychometric values were tested against a priori hypotheses.ResultsThe culturally aligned MLBPDQ showed good internal consistency (Cronbach’s α = 0.85). The ICC, SEM, MDC95%, and LOA between baseline and two days later were 0.98, 1.60, 4.43, and -4.23 to 7.70, respectively, while the values between baseline and 14 days later were 0.94, 2.77, 7.67, and -6.59 to 13.53, respectively. The scale also demonstrated moderate to excellent correlation (rho = 0.54–0.86) with the other four questionnaires. The AUC value of the Arabic-MLBPDQ was 0.68, and the MIC was 3 points.ConclusionThe Arabic version of the MLBPDQ demonstrates adequate psychometric properties and can be used to assess disability level in patients with LBP in Arabic-speaking communities.

Project description:IntroductionNegative attitudes and beliefs about low back pain (LBP) can lead to reduced function and activity and consequently disability. One self-report measure that can be used to assess these negative attitudes and beliefs and to determine their predictive nature is the Back Beliefs Questionnaire (BBQ). This study aimed to translate and cross-culturally adapt the BBQ into Hausa and assess its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP.MethodsThe BBQ was translated and cross-culturally adapted into Hausa (Hausa-BBQ) according to established guidelines. To assess psychometric properties, a consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the questionnaire along with measures of fear-avoidance beliefs, pain catastrophizing, functional disability, physical and mental health, and pain. One hundred of the 200 patients completed the questionnaire twice at an interval of 7-14 days to assess test-retest reliability. Internal construct validity was assessed using exploratory factor analysis, and external construct validity was assessed by examining convergent, divergent, and known-groups validity. Reliability was assessed by calculating internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and limits of agreement using Bland-Altman plots. Reliability (ICC, SEM and MDC95) was also assessed separately for rural and urban subgroups.ResultsThe factor analysis revealed a four-factor solution explaining 58.9% of the total variance with the first factor explaining 27.1%. The nine scoring items loaded on the first factor hence supporting a unidimensional scale. The convergent and divergent validity were supported as 85% (6:7) of the predefined hypotheses were confirmed. Known-groups comparison showed that the questionnaire discriminated well for those who differed in education (p < 0.05), but not in age (p > 0.05). The internal consistency and ICC (α = 0.79; ICC = 0.91) were adequate, with minimal SEM and MDC95 (1.9 and 5.2, respectively). The limits of agreements were -5.11 to 5.71. The ICC, SEM and MDC95 for the urban and rural subgroups were comparable to those obtained for the overall population.ConclusionsThe Hausa-BBQ was successfully adapted and psychometrically sound in terms of internal and external construct validity, internal consistency, and test-retest reliability in mixed urban and rural Hausa-speaking populations with chronic LBP. The questionnaire can be used to detect and categorize specific attitudes and beliefs about back pain in Hausa culture to prevent or reduce potential disability due to LBP.

Project description:BackgroundMeasuring functional status in palliative care may help clinicians to assess a patient's prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the psychometric validation process of a Polish translation of this tool (PPSv2-Polish).MethodsTwo hundred patients admitted to a free-standing hospice were evaluated twice, on the first and third day, for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPSv2-Polish was evaluated simultaneously with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index, to determine its construct validity.ResultsA high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P?<?0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen's kappa 0.91; P?<?0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P?<?0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; -?0.62; and 0.58, respectively (P?<?0.0001).ConclusionPPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.

Dataset Information

Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain.

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Cross-cultural adaptation and validation of the Norwegian pain catastrophizing scale in patients with low back pain.

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