The Brazilian version of the SRS-22r questionnaire for idiopathic scoliosis

BACKGROUND: The SRS-22r questionnaire is a well-accepted instrument used to measure health-related quality of life in patients with idiopathic scoliosis. No validated tool exists in Brazil for idiopathic scoliosis, and the use of the SRS-22r in non-English Laguage contries requires its transcultural adaptation. OBJECTIVE: The objective of this study was to culturally adapt the translated Brazilian version of the SRS-22r questionnaire and to determine its reliability using statistical tests for internal consistency and test-retest reliability. METHOD: The transcultural adaptation process was carried out according to the recommendations of the American Academy of Orthopedic Surgeons. The pre-final version was administered to 44 patients with idiopathic scoliosis. The mean age of the participants was 18.93 years and the mean curve magnitude was 54.6°. A subgroup of 30 volunteers completed the questionnaire a second time one week later to determine the scale's reproducibility. Internal consistency was determined using Cronbach's alpha coefficient, and the test-retest reliability was determined using the Intraclass Correlation Coefficient (ICC). RESULTS: No floor effects were observed using the Brazilian version of the SRS-22r. Ceiling effects were observed in the Pain and Satisfaction with Management domains. The internal consistency values were very good for 3 domains and good for 2 domains. The ICC values were excellent for all domains. CONCLUSIONS: The high values of internal consistency and ICC reproducibility suggest that this version of the questionnaire can be used in Brazilian patients with idiopathic scoliosis. .

Validade concorrente da versão Brasileira do SRS-22r com o Br-SF-36 / Concurrent validity of the Brazilian version of SRS-22r with Br-SF-36

CONTEXTUALIZAÇÃO: A validade concorrente, relevante na adaptação transcultural, refere-se à relação entre o desempenho do instrumento de interesse e o desempenho de instrumento semelhante com validade conhecida. OBJETIVO: Realizar a validação concorrente da versão brasileira do questionário revisado da Scoliosis Research Society (Br-SRS-22r) com a versão brasileira do Short Form-36 (Br-SF-36). MÉTODOS: Foram selecionados 54 pacientes com escoliose idiopática com média de 19,9 anos (±7,7) e curvaturas com média de 31,6° (±20,5° graus) Cobb, variando entre 10º e 92º. Os questionários tiveram seus resultados convertidos em escores, e a análise estatística correlacionou os domínios concorrentes utilizando o cálculo de coeficiente de Spearman. RESULTADOS: Os domínios de melhor correlação foram função do Br-SRS-22r com função física do Br-SF-36 (r=0,83) e dor do Br-SRS-22r com dor do Br-SF-36 (r=0,86). Entretanto, os domínios autoimagem e satisfação com o tratamento do Br-SRS-22r apresentaram baixa correlação com seus domínios concorrentes do Br-SF-36. DISCUSSÃO: Houve uma correlação satisfatória entre os questionários, sendo que as melhores correlações indicam maior semelhança nos parâmetros avaliados entre os respectivos instrumentos. As melhores correlações foram as dos domínios função e dor, não ocorrendo em saúde mental, possivelmente devido às dificuldades de interpretação de suas questões no Br-SF-36. Para os domínios autoimagem e satisfação com o tratamento do Br-SRS-22r, a correlação é pouco satisfatória por não serem especificamente abordados pelo SF-36. CONCLUSÃO: A versão brasileira do SRS-22r apresentou resultados satisfatórios para a validação concorrente com o Br-SF-36, sendo considerada válida para a versão adaptada à cultura brasileira.

BACKGROUND: An important parameter in cross-cultural adaptations, and concurrent validity are the relationships between the performance of an instrument of interest and the performance of a similar instrument with known validity. OBJECTIVE: To determine the concurrent validity of the Brazilian version of the revised questionnaire of the Scoliosis Research Society (Br-SRS-22r) and the Brazilian version of the Short-Form-36 questionnaire (SF-36). METHODS: Fifty-four patients with idiopathic scoliosis were selected. The mean age was 19.9 yrs. (±7.7) and the mean Cobb angle of curvature was 31.6° (±20.5°), ranging from 10º to 92º. The results from each questionnaire were converted into scores and, in the statistical analyses, the relationships between the concurrent domains were analyzed using Spearman's correlation coefficient. RESULTS: The best correlations were found between the function and pain domains: function in the Br-SRS-22r and physical function in the Br-SF-36 (r=0.83); pain in the Br-SRS-22r and pain in the Br-SF-36 (r=0.86). However, the domains of self-image and satisfaction with treatment with the Br-SRS-22r showed moderate and poor correlations with their corresponding domains in the Br-SF-36. There were moderate correlations between the questionnaires, with the best correlations showing greater similarity in the evaluated parameters between the respective instruments. Unlike the function and pain domains, the mental health domains did not have a good correlations, possibly because of difficulties in interpreting of the questions in the Br-SF-36. For the self-image and satisfaction domains, the correlations were moderate and poor because these topics were not specifically covered by the SF-36. CONCLUSIONS: The Brazilian version of the SRS-22r demonstrated moderate concurrent validity results in relation to the Br-SF-36, and this version adapted for the Brazilian culture was deemed valid.