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      Cultural adaptation, reliability and validity of Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Brazilian Portuguese Translated title: Adaptação cultural, confiabilidade e validade do Japanese Orthopaedic Association Back Pain Evaluation Questionnaire para o português brasileiro

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          ABSTRACT

          Objective

          To describe the translation and cultural adaptation of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire into Brazilian Portuguese, and verifies the reliability and validity of this new version.

          Methods

          A cross-cultural adaptation of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire was performed using the following steps: translation, back-translation, committee review, and pre-testing phase (50 subjects). The psychometric properties were evaluated by application of the questionnaire to 102 patients. Reliability was assessed by homogeneity and stability of measures. The criterion-related validity was tested by comparing scores of Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Oswestry and Medical Outcomes Study 36 - Item Short questionnaires.

          Results

          Excellent internal consistency was found in both test (Cronbach’s α of 0.90) and re-test (Cronbach’s α of 0.91). The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire showed good reliability and the correlations ranged from reasonable (0.64) to very good (r=0.91).

          Conclusion

          The Brazilian Portuguese version of Medical Outcomes Study 36 - Item Short was easy to apply and understand. The questionnaire had a great impact on assessment and multidimensional care of patients with low back pain.

          RESUMO

          Objetivo

          Realizar a tradução e a adaptação cultural para a língua portuguesa do Brasil do Japanese Orthopaedic Association Back Pain Evaluation Questionnaire para avaliação de dor lombar, e verificar a confiabilidade e a validade da nova versão.

          Métodos

          A adaptação cultural foi realizada de acordo com as seguintes etapas: tradução, retrotradução, revisão por comitê e pré-teste (50 indivíduos). Após, as propriedades psicométricas foram avaliadas aplicando-se o questionário (teste) em 102 pacientes. A confiabilidade foi verificada por avaliação da homogeneidade e da estabilidade das medidas. A validade de critério foi testada comparando-se as pontuações do Japanese Orthopaedic Association Back Pain Evaluation Questionnaire com os questionários Oswestry e Medical Outcomes Study 36 - Item Short.

          Resultados

          Observou-se excelente consistência interna no pré-teste (Cronbach α de 0,90) e no teste (Cronbach α de 0,91). O Japanese Orthopaedic Association Back Pain Evaluation Questionnaire apresentou boa confiabilidade, e as correlações variaram de razoável (0,64) a muito boa (r=0,91).

          Conclusão

          A versão em língua portuguesa do Brasil é de fácil aplicação e compreensão, além de apresentar grande acréscimo na avaliação e no cuidado multidimensional de pacientes portadores de dor lombar.

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          Most cited references26

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          Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations

          Background Research questionnaires are not always translated appropriately before they are used in new temporal, cultural or linguistic settings. The results based on such instruments may therefore not accurately reflect what they are supposed to measure. This paper aims to illustrate the process and required steps involved in the cross-cultural adaptation of a research instrument using the adaptation process of an attitudinal instrument as an example. Methods A questionnaire was needed for the implementation of a study in Norway 2007. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. Results The adaptation process included investigation of conceptual and item equivalence. Two forward and two back-translations were synthesized and compared by an expert committee. Thereafter the instrument was pretested and adjusted accordingly. The final questionnaire was administered to opioid maintenance treatment staff (n=140) and harm reduction staff (n=180). The overall response rate was 84%. The original instrument failed confirmatory analysis. Instead a new two-factor scale was identified and found valid in the new setting. Conclusions The failure of the original scale highlights the importance of adapting instruments to current research settings. It also emphasizes the importance of ensuring that concepts within an instrument are equal between the original and target language, time and context. If the described stages in the cross-cultural adaptation process had been omitted, the findings would have been misleading, even if presented with apparent precision. Thus, it is important to consider possible barriers when making a direct comparison between different nations, cultures and times.
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            Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity.

            Translation, revision, back-translation, and 3-way validity were performed. The objective of this study was to translate a version of the Oswestry Disability Index (ODI) into Brazilian Portuguese and evaluate its reliability. Reports in the literature have identified a need for internationally standardized and reliable measurements to analyze back pain. The ODI has become one of the principal outcome measurements used in the management of spinal disorders. The cross-cultural adaptation was performed according to the internationally recommended methodology, using the following guidelines: translation, back-translation; revision by a committee, and pretesting. The psychometric properties were evaluated by administering the questionnaire to 120 subjects with back pain. Reliability was estimated through stability and homogeneity assessment. The validity was tested comparing ODI scores with the following measurements: Roland-Morris Disability Questionnaire, SF-36, and a Numerical Pain Scale. Good internal consistency was found (Cronbach's alpha = 0.87). Intraclass correlation coefficient for test-retest reliability was 0.99. The ODI showed moderate correlation with pain measurement (r = 0.66). Relatively high correlation was also found between the ODI and the Roland-Morris scores (r = 0.81). There was significant correlation (P < 0.001) between ODI scores and the 8 scales of the SF-36. The data showed that the cultural adaptation process was successful and that the adapted instrument demonstrated having excellent psychometric properties, reliable in the Brazilian culture.
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              Low back pain

              Low back pain is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations. Few cases of back pain are due to specific causes; most cases are non-specific. Acute back pain is the most common presentation and is usually self-limiting, lasting less than three months regardless of treatment. Chronic back pain is a more difficult problem, which often has strong psychological overlay: work dissatisfaction, boredom, and a generous compensation system contribute to it. Among the diagnoses offered for chronic pain is fibromyalgia, an urban condition (the diagnosis is not made in rural settings) that does not differ materially from other instances of widespread chronic pain. Although disc protrusions detected on X-ray are often blamed, they rarely are responsible for the pain, and surgery is seldom successful at alleviating it. No single treatment is superior to others; patients prefer manipulative therapy, but studies have not demonstrated that it has any superiority over others. A WHO Advisory Panel has defined common outcome measures to be used to judge the efficacy of treatments for studies.
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                Author and article information

                Journal
                Einstein (Sao Paulo)
                Einstein (Sao Paulo)
                eins
                Einstein
                Instituto Israelita de Ensino e Pesquisa Albert Einstein
                1679-4508
                2317-6385
                Jul-Sep 2017
                Jul-Sep 2017
                : 15
                : 3
                : 313-321
                Affiliations
                [1 ]Universidade Federal de São Paulo, Santos, SP, Brazil.
                [2 ]Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
                [3 ]Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
                [4 ]Santa Casa de Misericórdia de Santos, Santos, SP, Brazil.
                Author notes
                Corresponding author: Patrícia Rios Poletto – Universidade Federal de São Paulo, Campus Baixada Santista, Departamento de Ciências do Movimento Humano – Rua Silva Jardim, 136 – Zip code: 11015-020 Santos, SP, Brazil – Phone: (55 13) 3229-0100 – E-mail: patricia.poletto@ 123456gmail.com

                Conflict of interest: none.

                Article
                S1679-45082017AO3890
                10.1590/S1679-45082017AO3890
                5823045
                29091153
                131b7f46-5727-4912-a711-7092b91cb6f9

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 October 2016
                : 28 June 2017
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 22, Pages: 9
                Categories
                Original Article

                low back pain,surveys and questionnaires,translating,validation studies,dor lombar,inquéritos e questionários,tradução,estudos de validação

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