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Simplified Chinese Version of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire

Cross-cultural Adaptation, Reliability, and Validity for Patients With Low Back Pain

Yao, Min, PhD; Li, Zhen-jun, MD; Zhu, Sen, MD; Wang, Jun-yan, MD; Pan, Yan-fang, MD; Tian, Zi-rui, MD; Shen, Li-yang, MD; Cheng, Shao-dan, MD; Wang, Yong-jun, PhD; Cui, Xue-jun, PhD

doi: 10.1097/BRS.0000000000002424
HEALTH SERVICES RESEARCH
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Study Design. Cross-cultural adaptation and cross-sectional psychometric testing in a convenience sample of patients with low back pain.

Objective. The aim of this study was to translate and adapt the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) into a simplified Chinese version, and assess its reliability and validity.

Summary of Background Data. No simplified Chinese version of the JOABPEQ was previously available.

Methods. We translated and culturally adapted the original English JOABPEQ to develop a Chinese version, based on cross-cultural adaptation guidelines. Principal component analysis with varimax rotation was used to confirm the factor structure of each subscale. Internal consistency was evaluated with Cronbach alpha. Test-retest reliability was examined in stable patients, who completed the questionnaire again at 4 days to 2 weeks from baseline. The validity of the translated Chinese version was assessed by examining the relationship between the JOABPEQ and Chinese versions of the Roland–Morris Disability Questionnaire (RMDQ), the Oswestry Disability Index (ODI), the Short Form Health Survey (SF-36), and the Numerical Pain Rating Scale. Ceiling and floor effects were considered present if more than 15% of respondents achieved the lowest or highest possible total score.

Results. The JOABPEQ showed excellent internal consistency (α = 0.886). The test-retest reliability (intraclass correlation coefficients) ranged from 0.951 to 0.977. The convergent validity of the Chinese version was supported by its high correlation with other physical functional status measures (RMDQ, ODI, and SF-36 Physical Function; r values from −0.645 to −0.726), and moderate correlation with other measures (SF-36 Bodily pain and Social functioning subscales; r values 0.426–0.546). Q5 Mental health was highly correlated with SF-36 items (r values 0.337–0.640). There was a floor effect in Q1 low back pain (38, 20.65%).

Conclusion. The results indicate that the simplified Chinese version of the JOABPEQ is a reliable and valid instrument to measure the multidimensional status in patients with low back pain.

Level of Evidence: 4

Institute of Spine Disease, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China

Daning Road Community Health Service Center, Shanghai, China

Shanghai Guanghua Hospital, Shanghai, China.

Address correspondence and reprint requests to Xue-jun Cui, PhD, Shanghai, China; E-mail: 13917715524@139.com

Received 13 October, 2016

Revised 14 May, 2017

Accepted 16 June, 2017

Zhen-jun Li contributed equally to this work and should be considered co-first author.

National Natural Science Foundation of China (81373666), Municipal Hospitals Cutting-edge Technologies Emerging Joint Project (SHDC12013113), Municipal Science and Technology Commission of Shanghai-TCM key project (14401970400, 16401970100), National Research Projects of the State Administration of Traditional Chinese Medicine (201407001-2), Special Project of Scientific Research Base by State Administration of Traditional Chinese Medicine (JDZX2012118) National Research Projects of the State Administration of Traditional Chinese Medicine (201407001–2), and Special Project of Scientific Research Base by State Administration of Traditional Chinese Medicine (JDZX2012118) funds were received in support of this work.

No relevant financial activities outside the submitted work.

The manuscript submitted does not contain information about medical device (s)/drug (s).

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