CULTURAL ADAPTATION, RELIABILITY AND VALIDITY OF THE PAIN DISABILITY QUESTIONNAIRE IN CHRONIC LOW BACK PAIN

Abstract

Purpose: The aim of this study was to adapt the Pain Disability Questionnaire (PDQ) to Turkish language, and analyze its psychometric properties in patients with chronic low back pain (LBQ). Methods. Ninety-one patients with LBP (51 females and 40 males, age=41.71±12.53 years) for at least three months were included in the study. The PDQ was translated into Turkish in the light of international rules. The patients completed the Turkish PDQ and Oswestry Disability Index (ODI), and functional status was evaluated. Test-retest reliability was determined in 31 patients within one-week using intraclass correlation coefficient (ICC) and Pearson correlation analysis. The relationship between Turkish PDQ and ODI was investigated using Pearson correlation analysis and construct validity. Results. The internal consistency value (Cronbach’s alpha) for Turkish PDQ was a=0.897. The ICC for the test-retest reliability was 0.947. The correlation coefficient for the functional status component of Turkish PDQ and ODI was r=0.583 (p<0.001) and for the psychosocial component of Turkish PDQ and ODI was r=0.473 (p<0.001). There was a strong correlation between total Turkish PDQ and ODI scores (r=0.582, p<0.001). Factor analysis revealed a 2-factor structure in conformity with the original structure. Conclusion: The Turkish PDQ was found to be reliable and valid. The Turkish PDQ would be useful in research and clinical applications for the evaluation and follow-up of chronic musculoskeletal disorders including LBP.

Keywords

• Low Back Pain
• Disability
• Reliability
• Validity

AĞRI ÖZÜRLÜLÜK ANKETİ’NİN KRONİK BEL AĞRISINDA KÜLTÜREL UYUM, GÜVENİRLİK VE GEÇERLİĞİ

Öz

Amaç: Bu çalışmada, kronik bel ağrılı hastalarda Ağrı Özürlülük Anketi’nin (ADA) Türkçe’ye adaptasyonunun ve psikometrik özelliklerinin analizinin yapılması amaçlandı. Yöntem: En az üç aydır bel ağrısı olan 91 hasta (51 kadın ve 40 erkek, yaş=41,71±12,53 yıl) çalışmaya dahil edildi. Türkçe ADA uluslararası kurallara uygun olarak Türkçe diline çevirildi Türkçe ADA ile Oswestry Özürlülük İndeksi (OÖİ) hastalar tarafından doldurularak fonksiyonel durum değerlendirildi. Test-tekrar test güvenirliği için anket bir hafta içinde 31 hastada tekrar uygulandı ve sınıf içi korelasyon katsayısı (ICC) ve Pearson korelasyon analizi kullanılarak belirlendi. Geçerliğin tespiti için Türkçe ADA ile OÖİ arasındaki ilişki Pearson korelasyon analizi ve yapı geçerliği incelendi. Sonuçlar: Türkçe ADA için iç tutarlılık (Cronbach’s alfa) değeri a=0,897’ydi. Anketin test-tekrar test güvenirliği için ICC=0,947’dı. Pearson’un Türkçe ADA ve OÖİ’nin fonksiyonel durum bileşeni için korelasyon katsayısı r=0,583 olarak belirlendi (p<0,001). Türkçe ADA ve OÖİ’nin psikososyal bileşeni için korelasyon katsayısı r=0,473 olarak tespit edildi (p<0,001). Toplam Türkçe ADA skoru ile OÖİ skoru arasında güçlü bir ilişki bulundu (r=0,582, p<0,001). Faktör analizi orjinal yapı ile uyumlu olarak iki faktörlü bir yapıyı ortaya koydu. Tartışma: Türkçe ADA'nın güvenir ve geçerli olduğu bulundu. Türkçe ADA’nın kronik kas-iskelet sistemi bozukluklarından bel ağrısının değerlendirilmesi ve takibine yönelik araştırma ve klinik uygulamalarda yararlı olacağı sonucuna varıldı.

Anahtar Kelimeler

• Ağrı Disabilite Anketi
• Bel ağrısı
• Güvenilirlik
• Geçerlilik

Kaynakça

1. 1. Leroux I, Dionne CE, Bourbonnais R, Brisson C. Prevalence of musculoskeletal activity limitation and associated factors among adults in the general population in the 1998 Quebec Health Survey. J Rheumatol. 2005;32(9):1794-804.
2. 2. Picavet H, Schouten J. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study. Pain. 2003;102(1-2):167-78.
3. 3. Wijnhoven HA, De Vet HC, Picavet HSJ. Prevalence of musculoskeletal disorders is systematically higher in women than in men. The Clinical journal of pain. 2006;22(8):717-24.
4. 4. Duthey B. Priority Medicines for Europe and the World" A public health approach to innovation. WHO Background paper. 2013;6.
5. 5. Dueñas M, Ojeda B, Salazar A, Mico JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. Journal of pain research. 2016;9:457.
6. 6. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European journal of pain. 2006;10(4):287-.
7. 7. Blyth FM, March LM, Brnabic AJ, Jorm LR, Williamson M, Cousins MJ. Chronic pain in Australia: a prevalence study. Pain. 2001;89(2-3):127-34.
8. 8. Overmeer T, Linton SJ, Holmquist L, Eriksson M, Engfeldt P. Do evidence-based guidelines have an impact in primary care? A cross-sectional study of Swedish physicians and physiotherapists. Spine. 2005;30(1):146-51.

9. 9. Dansie E, Turk DC. Assessment of patients with chronic pain. British journal of anaesthesia. 2013;111(1):19-25.
10. 10. Waterhouse M. Why pain assessment must start with believing the patient. Nursing times. 1996;92(38):42-3.
11. 11. Eti Aslan F. Ağrı Değerlendirme Yöntemleri. CÜ Hemşirelik Yüksekokulu Dergisi. 2002;6(1):9-16.
12. 12. Giordano PCM, Alexandre NMC, Rodrigues RCM, Coluci MZO. The Pain Disability Questionnaire: a reliability and validity study. Revista latino-americana de enfermagem. 2012;20(1):76-83.
13. 13. Koç M, Bayar K. Fonksiyonel Bel Ağrısı Skalası’nın Türkçe uyarlaması: geçerlik ve güvenirlik çalışması. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):82-9.
14. 14. Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29(5):581-5.
15. 15. Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine. 2001;26(24):2738-43.
16. 16. Anagnostis C, Gatchel RJ, Mayer TG. The pain disability questionnaire: a new psychometrically sound measure for chronic musculoskeletal disorders. Spine. 2004;29(20):2290-302.
17. 17. Kopec JA, Esdaile JM. Functional disability scales for back pain. Spine. 1995;20(17):1943-9.
18. 18. Yoon J, Choi KH, Kim TW, Yang SY, Sim MK. Reliability and validity of the korean version of the pain disability questionnaire. Annals of rehabilitation medicine. 2013;37(6):814.
19. 19. Revill S, Robinson J, Rosen M, Hogg M. The reliability of a linear analogue for evaluating pain. Anaesthesia. 1976;31(9):1191-8.20. Ohnhaus EE, Adler R. Methodological problems in the measurement of pain: a comparison between the verbal rating scale and the visual analogue scale. Pain. 1975;1(4):379-84.
20. 21. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000;25(22):2940-53.
21. 22. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-91.
22. 23. Gatchel R, Mayer T. Occupational musculoskeletal disorders:Introduction and overview of the problem. In: Mayer T, Gatchel R, Polatin P, editors. Occupational Musculoskeletal Disorders: Function, Outcomes and Evidence. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 3-8.
23. 24. Waddell G, Main CJ, Morris EW, Venner RM, Rae PS, Sharmy SH, et al. Normality and reliability in the clinical assessment of backache. Br Med J (Clin Res Ed). 1982;284(6328):1519-23.
24. 25. Saltychev M, Mattie R, McCormick Z, Bärlund E, Laimi K. Psychometric properties of the oswestry disability index. International Journal of Rehabilitation Research. 2017;40(3):202-8.
25. 26. Kopec JA. Measuring functional outcomes in persons with back pain: a review of back-specific questionnaires. Spine. 2000;25(24):3110-4.