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      Validity and reliability of a self-administered foot evaluation questionnaire (SAFE-Q)

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          Abstract

          Background

          The Japanese Society for Surgery of the Foot (JSSF) is developing a QOL questionnaire instrument for use in pathological conditions related to the foot and ankle. The main body of the outcome instrument (the Self-Administered Foot Evaluation Questionnaire, SAFE-Q version 2) consists of 34 questionnaire items, which provide five subscale scores (1: Pain and Pain-Related; 2: Physical Functioning and Daily Living; 3: Social Functioning; 4: Shoe-Related; and 5: General Health and Well-Being). In addition, the instrument has nine optional questionnaire items that provide a Sports Activity subscale score. The purpose of this study was to evaluate the test-retest reliability of the SAFE-Q.

          Patients and methods

          Version 2 of the SAFE-Q was administered to 876 patients and 491 non-patients, and the test-retest reliability was evaluated for 131 patients. In addition, the SF-36 questionnaire and the JSSF Scale scoring form were administered to all of the participants. Subscale scores were scaled such that the final sum of scores ranged between zero (least healthy) to 100 (healthiest).

          Results

          The intraclass correlation coefficients were larger than 0.7 for all of the scores. The means of the five subscale scores were between 60 and 75. The five subscales easily separated patients from non-patients. The coefficients for the correlations of the subscale scores with the scores on the JSSF Scale and the SF-36 subscales were all highly statistically significantly greater than zero ( p < 0.001). The means for the five JSSF Scale classification groups fell within a relatively narrow range, indicating that the SAFE-Q labels are sufficiently similar to permit their use for all of the JSSF Scale classifications.

          Conclusion

          The present study revealed that the test-retest reliability is high for each subscale. Consequently, the SAFE-Q is valid and reliable. In the future, it will be beneficial to test the responsiveness of the SAFE-Q.

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          Most cited references16

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          Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.

          Four rating systems were developed by the American Orthopaedic Foot and Ankle Society to provide a standard method of reporting clinical status of the ankle and foot. The systems incorporate both subjective and objective factors into numerical scales to describe function, alignment, and pain.
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            Development and validation of a questionnaire designed to measure foot-health status.

            The aim of this study was to apply the principles of content, criterion, and construct validation to a new questionnaire specifically designed to measure foot-health status. One hundred eleven subjects completed two different questionnaires designed to measure foot health (the new Foot Health Status Questionnaire and the previously validated Foot Function Index) and underwent a clinical examination in order to provide data for a second-order confirmatory factor analysis. Presented herein is a psychometrically evaluated questionnaire that contains 13 items covering foot pain, foot function, footwear, and general foot health. The tool demonstrates a high degree of content, criterion, and construct validity and test-retest reliability.
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              The Foot Function Index: a measure of foot pain and disability.

              A Foot Function Index (FFI) was developed to measure the impact of foot pathology on function in terms of pain, disability and activity restriction. The FFI is a self-administered index consisting of 23 items divided into 3 sub-scales. Both total and sub-scale scores are produced. The FFI was examined for test-retest reliability, internal consistency, and construct and criterion validity. A total of 87 patients with rheumatoid arthritis were used in the study. Test-retest reliability of the FFI total and sub-scale scores ranged from 0.87 to 0.69. Internal consistency ranged from 0.96 to 0.73. With the exception of two items, factor analysis supported the construct validity of the total index and the sub-scales. Strong correlation between the FFI total and sub-scale scores and clinical measures of foot pathology supported the criterion validity of the index. The FFI should prove useful for both clinical and research purposes.
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                Author and article information

                Contributors
                +81-44-9778111 , +81-44-9779651 , h2niki@marianna-u.ac.jp
                Journal
                J Orthop Sci
                J Orthop Sci
                Journal of Orthopaedic Science
                Springer Japan (Japan )
                0949-2658
                1436-2023
                9 January 2013
                9 January 2013
                March 2013
                : 18
                : 2
                : 298-320
                Affiliations
                [ ]Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511 Japan
                [ ]Unit of Medical Statistics, Faculty of Medical Education and Culture, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511 Japan
                [ ]Department of Orthopaedic Surgery, Tokyo Metropolitan Police Hospital, 4-22-1, Nakano, Nakano-ku, Tokyo, 164-8541 Japan
                [ ]Department of Orthopaedic Surgery, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533 Japan
                [ ]Department of Orthopaedic Surgery, Division of Vital Care and Reconstructive Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686 Japan
                [ ]Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582 Japan
                [ ]Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606 Japan
                [ ]Department of Orthopaedic Surgery, Nara Medical University, 840 Sijyo-cho, Kashihara, Nara 634-8522 Japan
                Article
                337
                10.1007/s00776-012-0337-2
                3607735
                23299996
                866988b9-3af8-4444-b112-3625c4f4e625
                © The Japanese Orthopaedic Association 2012
                History
                : 1 October 2012
                : 4 November 2012
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                © The Japanese Orthopaedic Association 2013

                Orthopedics
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