Nakarmi Shweta, Haq Syed Atiqul, Vaidya Binit
National Center for Rheumatic Diseases, Kathmandu, Nepal.
Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Int J Rheum Dis. 2019 Oct;22(10):1877-1883. doi: 10.1111/1756-185X.13690. Epub 2019 Sep 8.
Among many self-reported outcome measures, Western Ontario and McMaster Universities Arthritis Index (WOMAC) is one of the commonly used indexes for osteoarthritis patients. Despite high prevalence of musculoskeletal problems in Nepal, there is no validated tool available in the local language. Thus, this study aimed to translate the English WOMAC® into Nepali, and validate it for use in the future.
Guidelines by Beaton et al were followed for translation and cross-cultural adaptation of the original WOMAC into Nepali language. Diagnosed cases of knee osteoarthritis (OA) attending the rheumatology outpatient department of National Center for Rheumatic Diseases, Kathmandu were enrolled in the study. These patients were interviewed with the Nepali version. Internal consistency was measured by Cronbach's alpha and test-retest reliability by intra-class correlation coefficient (ICC). Correlation between domains of WOMAC was tested with visual analog scale (VAS) and numerical rating scale (NRS) of pain and stiffness.
The test-retest reliability was good with ICC of >0.75 for all domains and items. Internal consistency was acceptable with Cronbach's alpha scores of 0.852, 0.704 and 0.955 for pain, stiffness and physical function domains, respectively. Strong correlation was observed between WOMAC stiffness domain and VAS for stiffness and NRS for stiffness with rho (ρ) values of 0.750 and 0.759, respectively. Moderate correlation was seen between WOMAC pain and VAS for pain and NRS for pain with ρ of 0.658 and 0.584, respectively.
Nepali WOMAC is a reliable and valid instrument for assessment of disease severity and its impact in Nepali-speaking patients with OA.
在众多自我报告的结局指标中，西安大略和麦克马斯特大学骨关节炎指数（WOMAC）是骨关节炎患者常用的指标之一。尽管尼泊尔肌肉骨骼问题的患病率很高，但当地语言中没有经过验证的工具。因此，本研究旨在将英文的WOMAC®翻译成尼泊尔语，并对其进行验证以供未来使用。
遵循Beaton等人的指南，将原始的WOMAC翻译成尼泊尔语并进行跨文化改编。纳入在加德满都国家风湿病中心风湿病门诊就诊的膝关节骨关节炎（OA）确诊病例。用尼泊尔语版本对这些患者进行访谈。通过Cronbach's α系数测量内部一致性，通过组内相关系数（ICC）测量重测信度。用疼痛和僵硬的视觉模拟量表（VAS）和数字评定量表（NRS）测试WOMAC各领域之间的相关性。
所有领域和项目的重测信度良好，ICC均>0.75。疼痛、僵硬和身体功能领域的Cronbach's α系数分别为0.852、0.704和0.955，内部一致性可以接受。WOMAC僵硬领域与僵硬的VAS和僵硬的NRS之间观察到强相关性，ρ值分别为0.750和0.759。WOMAC疼痛与疼痛的VAS和疼痛的NRS之间观察到中度相关性，ρ值分别为0.658和0.584。
尼泊尔语WOMAC是评估尼泊尔语OA患者疾病严重程度及其影响的可靠且有效的工具。
