Translation in Arabic, adaptation and validation of the SF-36 Health Survey for use in Tunisia

Ultrasound-guided Pulsed Radiofrequency in the Management of Thoracic Postherpetic Neuralgia: A Randomized, Double-blinded, Controlled Trial

OBJECTIVES

This study was designed to evaluate the efficacy and safety of ultrasound-guided pulsed radiofrequency (PRF) for the intercostal nerves (ICNs) in the management of thoracic postherpetic neuralgia.

METHODS

After 2 weeks of treatment by pregabalin 150 mg/12 hours, patients were randomly allocated into 2 groups. The PRF group, after ultrasound-guided localization of the ICN of the affected thoracic dermatome, sensory stimulation of the ICN was tested. Thereafter, the patient received 2 cycles PRF at 42°C temperature, for 120 seconds. The sham group, after stimulation, the same time was spent to mimic PRF. The same procedures were repeated to the upper and lower adjacent ICNs. Pain intensity using Visual Analogue Scale (VAS), and total analgesics consumption were assessed at the baseline, every 2 weeks for 6 months then after 9 and 12 months. The duration of effective pain relief was recorded. Quality of life was evaluated using self-evaluation questionnaires (SF-36) at baseline then after 1, 3, 6, and 12 months.

RESULTS

PRF group expressed a significant decrease on the VAS throughout the study period. VAS<30 was reported in the PRF group until the 22nd week. Pregabalin and acetaminophen consumption was significantly lower in the PRF group. The 8 domains of the SF-36 revealed a significant improvement in the PRF group when compared with the sham group throughout the study period except for the physical role which displayed nonsignificant improvement.

CONCLUSIONS

Ultrasound-guided PRF for ICNs in combination with pharmacotherapy seems to be a safe and effective treatment modality for postherpetic neuralgia.

Recognising ethnocultural diversity in chronic pain assessment: validation of the Pictorial Representation of Illness and Self Measure (PRISM) for use with culturally diverse communities

BACKGROUND

A comprehensive and accurate assessment of pain is critical for successful pain management. However, there is a lack of reliable and valid assessment tools for exploring multidimensional aspects of the chronic pain experience in culturally and linguistically diverse communities. This study investigates the reliability and validity of the Pictorial Representation of Illness and Self Measure + (PRISM+) for evaluating pain-related suffering and the sociocultural context of chronic pain within culturally and linguistically diverse patient cohorts.

METHOD

Three prospective validation studies are reported for three culturally and linguistically diverse communities. Two hundred and fifty-one patients with chronic pain who self-identified as Assyrian (n = 85), Arabic (n = 83) or Vietnamese (n = 83) completed a PRISM+ assessment, alongside a battery of standardised pain assessments. To evaluate construct validity, the position of the 'pain' disk placement was correlated with the Brief Pain Inventory (BPI), Depression Anxiety and Stress Scale (DASS), and the Short-Form 36 Health Survey (SF-36). For content validity, thematic analysis of patient narratives accompanying each disk placement was conducted. Test-retest reliability of repeated 'pain' and five additional disks (PRISM+) values was analysed using intra-class correlation coefficients.

RESULTS

The PRISM pain assessment demonstrated moderate to good test-retest reliability for Arabic (ICC 0.76; 95% CI 0.65-0.84), Assyrian (ICC 0.65; 95% CI 0.50-0.76) and Vietnamese (ICC 0.82; 95% CI 0.73-0.88) patients. Moderate correlations between the PRISM 'pain' disk and sub-scores for the BPI, DASS and SF-36 were found (p < 0.001). Patient interpretations of the 'pain' disk aligned with accepted definitions of suffering, supporting content validity for PRISM. For the additional disks (PRISM+), moderate to good test-retest reliability (ICC 0.67-0.88) was observed and qualitative analysis highlighted each disk reflected social and cultural values.

CONCLUSION

The PRISM demonstrates acceptable psychometric properties for measuring pain-related suffering for participants with chronic pain across three culturally and linguistically diverse communities. The use of additional disks (PRISM+) presents a reliable and valid option for exploring social and cultural dimensions of chronic pain in clinical encounters.

Validity and reliability of the Setswana translation of the Short Form-8 health-related quality of life health survey in adults

Background

The absence of culturally relevant measures in indigenous languages could pose a challenge to epidemiological studies on health-related quality of life (HRQoL) in developing nations.

Aim

To explore the feasibility and determine the validity and reliability of the Setswana translation of the HRQoL Short Form-8 (SF-8) among Setswana-speaking adults.

Setting

Potchefstroom in the North West province.

Methods

Sixty healthy men (n = 26) and women (n = 34), aged 45.5 ± 9.3 years, completed a Setswana translation of the SF-8 questionnaire and the original English version twice, with a 4-week interval between completions.

Results

The Setswana SF-8 presented good concurrent validity with the Spearman’s correlation coefficients (ρ) of 0.72 for role physical to 0.91 for social functioning. The Cronbach’s alpha coefficients for the first and second measurements were 0.87 and 0.87, respectively, for the Setswana-translated SF-8 and 0.86 and 0.89 for the original English SF-8. The reliability coefficients were moderate for the mental health (ρ = 0.60), social functioning (ρ = 0.56) and role emotional (ρ = 0.50) domains, as well as the mental component summary (ρ = 0.50) and physical component summary (ρ = 0.45), but fair for the role physical (ρ = 0.43), body pain (ρ = 0.43), general health (ρ = 0.42), physical functioning (ρ = 0.41) and vitality (ρ = 0.38) domains on the translated Setswana version of the SF-8.

Conclusion

The Setswana SF-8 version was feasible, acceptable and had acceptable concurrent validity and fair to moderate evidence of test–retest reliability for assessing HRQoL among adult Setswana-speaking community dwellers.

[Sexual disorders among spinal cord injury patients]

OBJECTIVE

Spinal cord injury (SCI) can alter to varying degrees patients' sexuality. The goals of this study were to evaluate sexual dysfunctions (SD) among a sample of Tunisian patients with SCI and to determine the associated factors.

METHODS

A cross-sectional descriptive study was conducted on a sample of 30 patients with SCI. Sexuality was evaluated by : Male Sexual Quotient (MSQ) and Sexual Health Inventory for Men (SHIM). Other parameters were collected : sociodemographic, clinical, functional capacity, psychological profile and quality of life (QoL) (Short-Form 36 SF36).

RESULTS

The mean age was 41±9.6 years (23-56). The frequency of SD in this study was 69.2 %. The most affected items in the MSQ (76 %) were erection, orgasm, seduction and performance. The SD were associated with alteration of SF36 domains. We noted positive correlations on the one hand between the MSQ score and the role physical (RP) and general health (GH) sub scores of SF36 and on the other hand between the SHIM and the sub scores RP, mental and physical component score (MCS and PCS). The MSQ score was negatively correlated with the HAD score. No other associations were noted.

CONCLUSION

Our study showed a high frequency of SD in SCI patients including Tunisians. SD were mainly associated with impaired QOL and the anxio-depressive profile. The absence of other associations could be explained mainly by the peculiarity of our culture which still considers sexuality and SD as a taboo and secondary subject.

Epworth sleepiness scale in medical residents: quality of sleep and its relationship to quality of life

BACKGROUND

Resident doctors are continuously exposed to prolonged working hours and night shifts, making them susceptible to the many physical, psychological, and cognitive side effects of sleep deprivation, which may affect their quality of life. Therefore, this study aimed to determine the prevalence of sleep penury in resident doctors and to assess the association between self-apprehended sleepiness and quality of life.

METHODS

A cross-sectional study was carried out in the governmental hospitals in the North of the West Bank between May 2017 and September 2017. Doctors enrolled in residency programmes completed questionnaires about general, sociodemographic, and sleep characteristics. The doctors completed the Arabic Version of the Epworth Sleepiness Scale (ArESS) to assess subjective daytime sleepiness and the RAND 36-item short-form health survey (SF-36) to determine quality of life.

RESULTS

A total of 101 participants were enrolled. Daytime sleepiness was observed in 37.6% (n = 38) of the participants with an ESS score of ≥10. There was a notable negative correlation between the ESS and quality of health index in the physical composition (r = - 0.351, p < 0.001) demonstrated in the following four subscales: the physical functioning (p < 0.001), role limitations due to physical health (p = 0.045), body pain (p = 0.036), and general health (p < 0.001) components of the SF-36 scale. Females and residents of the centre region had poorer mental quality (p = 0.006 and 0.020, respectively).

CONCLUSIONS

More than one third of the resident doctors suffer from daytime sleepiness according to the ESS. This was proven to significantly affect several aspects of their quality of life, including physical function and health, body pain, and general health. Sleep deprivation and improvement of quality of life require health promotion actions among medical residents.

Translation, validation, and cultural adaptation of the Rhinosinusitis Disability Index and the Chronic Sinusitis Survey into Arabic

BACKGROUND

Disease-specific quality of life instruments assess the impact of chronic rhinosinusitis on patients' quality of life (QoL). To the extent of our knowledge, there are no Arabic versions of two instruments-the Rhinosinusitis Disability Index (RSDI) and the Chronic Sinusitis Survey (CSS).

OBJECTIVE

Develop an Arabic-validated version of both instruments, thus allowing its use among the Arabic population.

DESIGN

Prospective cross-sectional study for instrument validation.

SETTING

Tertiary university hospital.

SUBJECTS AND METHODS

This study was conducted between September 2015 and October 2016. We followed the international comprehensive guidelines for translation and cross-cultural adaptation of QoL instruments.

MAIN OUTCOME MEASURES

Test-retest reliability, discriminant validity, and responsiveness ability of both the RSDI and CSS Arabic versions.

SAMPLE SIZE

124.

RESULTS

The sample comprised 75 patients diagnosed with chronic rhinosinusitis and 49 healthy control subjects. The Arabic version of both instruments showed high internal consistency (Cronbach's alpha: RSDI=0.97, CSS=.88) and the ability to differentiate between diseased and healthy volunteers (P less than .0001). The translated versions also detected significant change in response to an intervention (P less than .0001).

CONCLUSION

These Arabic validated versions of the RSDI and CSS can be used for both clinical and research purposes.

LIMITATIONS

This study was performed in only one tertiary hospital.

CONFLICT OF INTEREST

None.

Conflict and well-being: a comparative study of health-related quality of life, stress, and insecurity of university students in the West Bank and Jordan

PURPOSE

A significant body of research indicates that the conflict environment is detrimental to the quality of life and well-being of civilians. This study assesses the health-related quality of life, stress, and insecurity of the West Bank, which has been engaged in conflict for seven decades, in comparison to a demographically and culturally similar population in Jordan, a neighboring nation with no conflict. We expect the Jordanian sample to report better functioning.

METHODS

We collected 793 surveys from university students (mean age = 20.2) in Nablus, West Bank (398 [50.2%]) and Irbid, Jordan (395 [49.8%]). The survey instrument consisted of the SF-36 to measure HRQoL, the PSS-4 to measure stress, and an insecurity scale, along with demographic characteristics.

RESULTS

Our findings indicate that outcomes in the West Bank were not significantly worse than in Jordan, and in some cases represented better functioning, especially in the SF-36 measures.

CONCLUSIONS

Our counterintuitive results suggest that health and well-being outcomes are dependent on many factors in addition to conflict. For one, it may be that the better perceived health and well-being of the Palestinians is because they have developed a culture of resilience. Additionally, Jordanians are undergoing a period of instability due to internal struggles and surrounding conflicts.

[Quality of life in adult patient (Tunisian) with severe OSA]

INTRODUCTION

The negative impact of obstructive sleep apnea (OSA) on quality of life of affected individuals is a central consequence of this disease. The recognition of the quality of life as a therapeutic target is a relatively new concept.

OBJECTIVES

To evaluate the quality of life and its determinants in patients with OSA.

MATERIALS AND METHODS

We conducted a cross-sectional study during the period from 1st July 2012 to 30th June 2013. The target population was patients with OSA and in employment examined in consultations of pneumology in the teaching hospital Farhat-Hached in Sousse (Tunisia). This study was based on a generic questionnaire (SF-36) to assess the quality of life.

RESULTS

The study population included 103 cases with a mean age of 55.15±11.4years and a sex ratio of 0.71. Our patients were obese in 95.1 % of cases with an average BMI of 39.13±7.19kg/m². The majority of our patients had an impaired quality of life with an average score of 44.76 (SF36) and extremes of 22 and 70. There was a positive linear relationship between physical and mental components of the SF-36 and gender, age, BMI, and anxiety and depressive disorders.

CONCLUSION

The OSA is a demanding disease whose impact on the quality of life seems important and requires special attention. The management of this disease should not be limited to controlling the disease but aspire to overall patient satisfaction.

SF-36 total score as a single measure of health-related quality of life: Scoping review

According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the "SF-36 Total/Global/Overall Score" cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the "SF-36 Total Score"; 13 studies did not specify their methods but referred to the SF-36 developers' studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the "SF-36 Total/Global/Overall Score" has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.

Validation of the Mongolian version of the SF-36v2 questionnaire for health status assessment of Mongolian adults

BACKGROUND

Ulaanbaatar, Mongolia, is one of the world's worst air-polluted cities, but effects of this air pollution on the population health status have not yet been evaluated. Therefore, we developed a Mongolian version of the SF-36v2 questionnaire to investigate the health status of Mongolian population.

METHODS

Health checkups were conducted in Ulaanbaatar and the health status was measured using a Mongolian translated version of the SF-36v2 questionnaire. The reliability and validity of the Mongolian SF-36v2 questionnaire, and the relationship between health status and respiratory condition were examined.

RESULTS

Factor analysis of the Mongolian SF-36v2 questionnaire showed that the "Role-physical" and "Role-emotional" were classified into a single subscale. The "Mental health" and "Vitality" were each divided into two subscales. Cronbach's alpha and intraclass correlation coefficient (ICC) for reproducibility were >0.7, except for "General health perceptions" (Cronbach's alpha and ICC < 0.7), "Social functioning" (Cronbach's alpha < 0.7), and "Vitality" (ICC < 0.7). The SF-36v2 subscales and the corresponding items of the COOP/WONCA charts were correlated, and subjects with respiratory symptoms showed lower SF-36v2 scores compared to normal subjects, suggesting external validity. Subjects with respiratory symptoms showed significantly lower scores for the majority of the SF-36v2 subscales than those with normal lung function. In subjects with combined ventilatory impairment, "Physical functioning", "Role-physical", "Bodily pain", and "Vitality" scores were significantly lower than those with normal lung function.

CONCLUSIONS

The Mongolian version of the SF-36v2 questionnaire provides substantial reliability and validity, and is useful for evaluating the health status of Mongolian adults with ventilatory impairment. Health status measured by SF-36v2 was significantly aggravated by combined ventilatory impairment when compared with normal lung function.

Life under occupation: citizenship and other factors influencing the well-being of university students living in the West Bank

There is substantial evidence that individuals affected by conflict suffer poor physical and mental outcomes, particularly in indicators of well-being. This study assesses the health-related quality of life (HRQoL), perceived stress and insecurity of Palestinian young adults in the West Bank. We surveyed 398 university students from Nablus (mean age = 20.1) using the SF-36 to measure HRQoL, the PSS-4 to assess stress and a context-specific insecurity instrument. A third of participants reported Israeli citizenship, and the results indicated better outcomes in these individuals in several outcomes, with the noteworthy exception of insecurity. This study is one of the first to assess citizenship of West Bank Palestinians as a potential covariate to predict measures of well-being. Because citizenship is such a meaningful issue for Palestinians and is related to individual freedom and access to resources, this study suggests that there are complex dynamics outside of typical demographic variables that contribute to well-being.

Assessment of the measurement properties of quality of life questionnaires in Brazilian women with breast cancer

BACKGROUND

There are several questionnaires available to assess quality of life in breast cancer, however the choice of the best questionnaire often does not take into account the adequacy of these questionnaires' measurement properties.

OBJECTIVE

To test the measurement properties of two generic quality of life questionnaires and one quality of life questionnaire specific for women with breast cancer.

METHOD

We assessed 106 women after surgery for breast cancer. The assessment included application of the SF-36, WHOQOL-bref, and FACT-B+4 questionnaires as well as the Global Perceived Effect and Pain Numerical Rating scales. The participants were interviewed on three occasions to investigate internal consistency, floor and ceiling effects, construct validity, reproducibility, and responsiveness.

RESULTS

Most of the instruments' domains showed adequate internal consistency (Cronbach's alpha varying from 0.66 to 0.91). Reliability varied from poor to substantial (ICC2,1 between 0.39 and 0.87) and agreement varied from negative to very good. The SF-36 presented doubtful agreement and showed floor and ceiling effects in three domains. The domains of the generic questionnaires presented moderate to good correlation with the FACT-B+4 (Pearson varying from 0.31 to 0.69). The internal responsiveness varied from small to large (ES varying from -0.26 to 0.98) and external responsiveness was found in only some of the instruments' domains.

CONCLUSIONS

Most of the measurement properties tested for the WHOQOL-bref and FACT-B+4 were adequate as was their ability to assess quality of life in women with breast cancer. The SF-36 showed inadequacy in agreement and floor and ceiling effects and should not be used in women with breast cancer.

Physiotherapy intervention as a complementary treatment for people living with HIV/AIDS

Background

The advent of highly active antiretroviral therapy has dramatically extended the life expectancy of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Despite this increased longevity, HIV disease and its pharmacological treatment can cause long-term and acute health complications, many of which can be treated successfully by physiotherapy. The purpose of this paper is to report the effect of a 12-week rehabilitation program on several health-related markers in a 43-year-old woman living with HIV.

Methods

This case study examined the effect of a 12-week exercise and manual therapy intervention on morphology, pain, cardiopulmonary fitness, strength, neurological balance, immune markers (CD4 cell count), and quality of life in a 43-year-old woman living with HIV.

Results

The results showed complete elimination of pain and shortness of breath on exertion. There was also a reduction in resting heart rate, waist circumference, exercise duration, muscle strength, and endurance. The patient showed an increase in peak expiratory flow rate, maximal heart rate attained, upper arm, forearm, and thigh circumference, and CD4+ cell count. The patient also showed improvements in the quality of life domains of general health, pain, energy/fatigue, social and physical functioning, and emotional well-being.

Conclusion

Physiotherapy interventions consisting of exercise and manual therapy appear beneficial in several areas as an adjunct therapy in HIV management.