Original articleCross-cultural adaptation and validation of the Argentine “American Shoulder and elbow surgeons, patient self-report section” questionnaire
Introduction
Shoulder musculoskeletal disorders are common medical conditions which cause pain, mobility problems and disability. These conditions may limit work activity and may affect quality of life, causing a significant socio-economic burden (Luime et al., 2004; Schmidt et al., 2014). In recent years, care models have given patients a primary role in decision making; hence, self-reported outcome measures are becoming increasingly recognized and used in medical research. A systematic review compared the psychometric properties of different self-reported questionnaires to assess shoulder musculoskeletal disorders. The American Shoulder and Elbow Surgeons questionnaire patient section (ASES-p) obtained the highest general score and was one of the best in all the evaluated items (Schmidt et al., 2014).
The ASES-p has two domains: pain and function (activities of daily living, ADLs) (Richards et al., 1994). Both domains were validated initially in 2002 (Michener et al., 2002). After that, the scale has been validated in different countries of North and South America, Europe and Africa, demonstrating good psychometric properties (Michener et al., 2002; Goldhahn et al., 2008; Padua et al., 2010; Yahia et al., 2011; Moser et al., 2012; Celik et al., 2013; Piitulainen et al., 2014). Also the possibility to include two activities reported by the patient give the opportunity of more personalized assessment.
The questionnaire has been translated into Spanish (Vrotsou et al., 2016), but it has not been adapted to the Argentine population yet. Although Spain and Argentina speak the same language, linguistic differences between Spanish-speaking countries may affect the interpretation of the different items included in the questionnaire. This might mainly occur because some of the terms used in the Spanish version are not used in Argentina. For example, the equivalent for the English term “bra”, translated as sujetador in Spain, is corpiño in Argentina. Differences in terminology could affect interpretation and therefore answers. The language within a country is an indirect indicator of culture. Ignoring specific language differences between countries could negatively influence the validation of the tool, since the differences in scores could be due to real differences in health status or to an incorrect interpretation (Ware et al., 1995). Additionally, it is important to have validated scales in our country in order to use them in future research studies and in daily clinical practice as an outcome measure. Therefore, the aim of this study was to conduct the translation, cross-cultural adaptation and validation of the ASES-p questionnaire into Argentine Spanish for patients with shoulder musculoskeletal disorders.
Section snippets
Materials and methods
Before starting with the study, the protocol was officially authorized by the American Shoulder and Elbow Surgeons Society, the original developer. This study was granted by the Research Ethics Committee of Durand Hospital, Autonomous City of Buenos Aires, Argentina, and it consisted of three consecutive phases: translation, cross-cultural adaptation and validation. Written consent was obtained from each participant before data collection.
Translation, cross-cultural adaptation and pilot study
The members of the Committee found no discrepancies during the translation and back-translation process of the ASES-p. During the pilot test, no participant reported difficulties in understanding the questionnaire. Therefore, since there were no modifications made, the final version of the ASES-p questionnaire was developed, and the results arising from the pilot test were included in the final analysis (APPENDIX 2).
Validation
The flow chart of the validation process is shown in Fig. 1.
The demographic
Discussion
In the present study, the translation, cross-cultural adaptation and validation of the self-report section of the American Shoulder and Elbow Surgeons questionnaire (ASES-p) into Argentine Spanish were conducted. This instrument is used worldwide and has demonstrated good psychometric properties (Michener et al., 2002; Goldhahn et al., 2008; Padua et al., 2010; Yahia et al., 2011; Moser et al., 2012; Celik et al., 2013; Piitulainen et al., 2014).
The Argentine version of the ASES-p questionnaire
Conclusion
In the current study, we conducted the translation, cross-cultural adaptation and validation of the self-report section of the ASES-p questionnaire into Argentine Spanish. The current study allowed us to use the Argentine version of the ASES-p in the Argentine population and provided foundations to further investigate other psychometric properties to identify the optimal Patient Reported Outcome Measure for shoulder impairments.
Ethical committee aproval
This study was approval by the Ethic's Committee of Durand Hospital, Buenos Aires City Argentina.
Conflicts of interest
None.
Statement of financial disclosure
These authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.
Acknowledgements:
We would like to acknowledge to Adriel Chara, María Francisca Dominguez, Emiliano Navarro, Daniela Gilgado, Clarisa Schwerdt, María Eugenia Pereira, Agustina Ciarlantini, Mauro Andreu, David Logerstedt, Lori Michener, Physical Therapy Unit of Durand Hospital for their valuable contribution and recommendations.
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