Rabbani M G, Haq S A, Bellamy N, Islam M N, Choudhury M R, Naheed A, Ahmed S, Shahin A
Department of Rheumatology, BSM Medical University, Shahbag, Dhaka, Bangladesh,
Rheumatol Int. 2015 Jun;35(6):997-1003. doi: 10.1007/s00296-014-3192-y. Epub 2014 Dec 16.
The aim of this study was to develop and to validate a Bengali version of the Western Ontario and McMaster Osteoarthritis (WOMAC) index in Bangladesh. The WOMAC was translated into the local language of Bangladesh (Bengali) and adapted in the local sociocultural context, following the standard guidelines by Beaton et al. Content validity of the preliminary Bengali version was assessed by using the index of content validity (ICV) and floor and ceiling effects. Patients were assessed at the Department of Rheumatology of Bangabandhu Sheikh Mujib Medical University and were diagnosed to have knee OA by American College of Rheumatology criteria and recruited according to the requirements of the validation study. Convergent and divergent validity were measured by comparing with Health Assessment Questionnaire (HAQ) and the Short Form-36 (SF-36), and internal consistency was assessed using Cronbach's alpha coefficient. The questionnaire was readministered to 40 patients within a week for assessing reliability by using intra-class correlation coefficient (ICC) and Spearman's rank correlation coefficient. In addition, factor analysis of Bengali WOMAC questionnaire was performed to examine the number of factors influencing a common set of items. A Bengali version was developed with changes in three items to suit local practices. The ICV of the content validity was 1 for all items. The Bengali WOMAC had similar construct validity when compared to the HAQ (ρ 0.74, n = 70) and SF-36 bodily pain and physical functioning. It had dissimilar construct validity to SF-36 mental health domain except WOMAC pain. Factor analysis revealed five factors with eigenvalues of more than 1.0. Cronbach's alpha and ICC exceeded 0.7 in all domains. In the test-retest reliability testing, Spearman's ρ for all items exceeded 0.4 (n = 40). This study has demonstrated that the Bengali version of WOMAC is a valid tool for assessing quality of life of patients with knee osteoarthritis in Bangladesh and is reliable.
本研究的目的是在孟加拉国开发并验证西加拿大和麦克马斯特大学骨关节炎指数（WOMAC）的孟加拉语版本。按照Beaton等人的标准指南，将WOMAC翻译成孟加拉国的当地语言（孟加拉语），并根据当地社会文化背景进行调整。通过内容效度指数（ICV）以及地板效应和天花板效应评估初步孟加拉语版本的内容效度。在班加班杜·谢赫·穆吉布医科大学风湿病科对患者进行评估，根据美国风湿病学会标准诊断为膝关节骨关节炎，并根据验证研究的要求进行招募。通过与健康评估问卷（HAQ）和简短健康调查问卷36项（SF-36）进行比较来测量收敛效度和区分效度，并使用克朗巴赫α系数评估内部一致性。在一周内对40名患者重新进行问卷调查，通过组内相关系数（ICC）和斯皮尔曼等级相关系数评估信度。此外，对孟加拉语WOMAC问卷进行因子分析，以检查影响一组共同条目的因子数量。开发了一个孟加拉语版本，对三个条目进行了修改以适应当地实际情况。所有条目的内容效度ICV均为1。与HAQ（ρ = 0.74，n = 70）以及SF-36身体疼痛和身体功能相比，孟加拉语WOMAC具有相似的结构效度。除WOMAC疼痛外，它与SF-36心理健康领域的结构效度不同。因子分析揭示了五个特征值大于1.0的因子。所有领域的克朗巴赫α系数和ICC均超过0.7。在重测信度测试中，所有条目的斯皮尔曼ρ系数均超过0.4（n = 40）。本研究表明，WOMAC的孟加拉语版本是评估孟加拉国膝关节骨关节炎患者生活质量的有效且可靠的工具。
