Cross-cultural adaptation and validation of the osteoporosis assessment questionnaire short version (OPAQ-SV) for Chinese osteoporotic fracture females

Development and Validation of Objective and Subjective Osteoporosis Knowledge Instruments Among Chinese Orthopaedic Surgeons

BACKGROUND

Clinicians must be knowledgeable about osteoporosis so that they can convey information regarding the prevention of fragility fractures to their patients. The purposes of this study were to develop objective and subjective knowledge instruments for osteoporosis and fragility fractures and then test their reliability and validity among Chinese orthopaedic surgeons.

METHODS

A 2-round procedure was used to develop the objective and subjective knowledge instruments. A cross-sectional online survey was distributed to 293 orthopaedic surgeons; 189 surgeons returned the questionnaires. We examined internal consistency, test-retest reliability, criterion validity, and discriminant validity; we also compared the subjective knowledge level with the objective knowledge level among surgeons.

RESULTS

Our results showed that the Subjective Knowledge Scale (SKS) regarding Osteoporosis and Fragility Fractures had a high Cronbach alpha coefficient (0.915), and the objective Osteoporosis Knowledge Test for Clinicians (OKTC) had an adequate Kuder-Richardson 20 coefficient (0.64). Item analyses were conducted, and a short version of the OKTC (the OKTC-SF) was developed. The SKS, the OKTC, and the OKTC-SF all showed good test-retest reliability, criterion validity, and discriminant validity. The percentage of surgeons with a high subjective knowledge level was higher than the percentage of surgeons who selected the correct answer for several corresponding questions related to objective knowledge.

CONCLUSIONS

The SKS, the OKTC, and the OKTC-SF all demonstrated good reliability and validity. However, the orthopaedic surgeons may have overestimated their knowledge level regarding osteoporosis. Targeted continuing medical education that is based on individual knowledge level is needed to improve the undertreatment of osteoporosis among patients with fragility fractures.

Translation and cross-cultural adaptation of Osteoporosis Knowledge Assessment Tool (OKAT) for Chinese populations in Australia

The increased prevalence of osteoporosis among Chinese-speaking communities in Australia deemed it necessary to have a culturally appropriate tool for assessing knowledge. This study describes the cultural adaption of the validated Osteoporosis Knowledge Assessment Tool (OKAT). The adapted tool is readable and understandable for diverse Chinese-speaking communities.

PURPOSE

With an expected increasing prevalence of osteoporosis among Chinese-speaking communities in Australia, a cross-culturally adapted questionnaire is necessary to assess knowledge levels among the group. We aimed to cross-culturally adapt the Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire for Chinese-speaking populations in Australia.

METHODS

Cross-cultural adaptation guidelines were employed to culturally adapt the OKAT to simplified Chinese. This involved translation, revision, retroversion, and expert discussion before finalizing the Chinese version of OKAT. The participants were recruited through convenience sampling from a cohort of Chinese-speaking populations who attended a bone health promotion program. The adapted questionnaire was piloted with Chinese-speaking communities in the Greater Western Sydney area for face and content validity. The adapted questionnaire was compared with the original version for response agreement using Cohen's kappa goodness of fit. The face validity of the adapted tool was analysed through a binary scale rating for readability and understandability.

RESULTS

The cross-culturally adapted version of OKAT has a 71.8% total response agreement with the original version of OKAT. The cross-culturally adapted OKAT yielded higher total scores than the translated version. The cross-culturally adapted tool had a good face and content validity.

CONCLUSION

The cross-culturally adapted version of OKAT improves the overall readability and understandability of the questionnaire among Chinese-speaking populations in Australia.

Utilizing a Digital Multi-Language Patient Questionnaire for Diagnostic Imaging Examinations

In diagnostic imaging (DI) practice, patient questionnaires allow clinical staff to gather medical history information directly from patients. However, language barriers can prevent patients from completing the questionnaires and may endanger patient safety if the patient fails to indicate critical medical information. Interpreters are commonly employed to help patients convey important medical details; however, there are limits to their practical utilization. Thus, the purpose of this study was to evaluate the feasibility and practicality of a digital multi-language questionnaire designed to help overcome the language barriers between patients and clinical staff. The standard English-language questionnaire for bone mineral density (BMD) examinations was used in this study. It was translated into several languages and presented in an electronic form to patients in a language most suitable for them. The completed questionnaires, along with the patient responses, were automatically converted into English, allowing them to be reviewed by DI staff through a radiological information system (RIS) and picture archiving and communication system (PACS). Patients and clinical staff commented on the comfort of using the translated questionnaires. The modified Wald method was used to establish the confidence interval. The results showed that all patients and clinical staff were comfortable using the translated questionnaires. Ultimately, in this study we have developed a digital multi-language questionnaire for BMD examinations which can be converted into different languages and be stored in RIS and PACS. To the best of our knowledge, this approach had not been applied or tested elsewhere.