Physiotherapy, Health and Rehabilitation Science, Western University, London, ON, Canada.
Collaborative Program in Musculoskeletal Health Research, Bone and Joint Institute, Western University, London, ON, Canada.
Health Qual Life Outcomes. 2020 Mar 30;18(1):88. doi: 10.1186/s12955-020-01339-7.
The shortened version of the Western Ontario Rotator Cuff Index (Short-WORC) is a patient reported outcome measure that evaluates quality of life (QoL) of patients with rotator cuff pathology. However, formal content validation of the full or Short-WORC has not been reported. This study aims to understand how 1) people interpret and calibrate responses to items on the Short-WORC and 2) compensatory strategies that might enhance function and thereby affect responses.
This study uses cognitive interviewing, a qualitative methodology that focuses on the interpretation of questionnaire items. Patients with rotator cuff disorders (n = 10), clinicians (n = 6) and measurement researchers (n = 10) were interviewed using a talk aloud structured interview that evaluated each of the 7 items of the Short-WORC. All interviews were recorded and transcribed verbatim by one researcher (R.F). Analysis was done through an open coding scheme using a previously established framework.
Overall, the items on the Short-WORC were well received by participants. Through the interviews, the 6 themes of: Comprehension, Inadequate response definition, Reference Point, Relevance, Perspective Modifiers and Calibration Across Items emerged. The items of working above the shoulder (90%), compensating with the unaffected arm (88%) and lifting heavy objects (92%) were the most relevant to participants. Participants calibrated their scores on the items of sleeping and styling (19%) the most. Perspective modifiers of gender, influenced the calibrations of items of styling your hair (30%) and dressing or undressing (19%). Compensatory strategies of task-re allocation and using assistive devices/resources were frequently mentioned by participants. Overall, participants had minor comprehension issues, but found the 7- items of the Short-WORC to be relevant to QoL.
Therefore, the findings demonstrate that the Short-WORC is not cognitively complex, but varies with patient perspectives. Overall, the Short-WORC provides evidence of demonstrating strong content validity when used for rotator cuff disorder patients.
Western Ontario Rotator Cuff Index（WORC）的简化版是一种评估肩袖病变患者生活质量（QoL）的患者报告结局测量工具。然而，尚未报告对完整 WORC 或简化版 WORC 进行正式的内容验证。本研究旨在了解：1）人们如何解释和校准对简化版 WORC 项目的反应；2）可能增强功能从而影响反应的补偿策略。
本研究使用认知访谈，这是一种专注于问卷项目解释的定性方法。对 10 名肩袖疾病患者、6 名临床医生和 10 名测量研究人员使用大声说出的结构化访谈进行访谈，评估了简化版 WORC 的 7 个项目中的每一个。所有访谈均由一名研究人员（R.F.）进行记录和逐字转录。通过使用先前建立的框架进行开放编码方案进行分析。
总体而言，简化版 WORC 的项目得到了参与者的好评。通过访谈，出现了 6 个主题：理解、反应定义不足、参考点、相关性、视角修饰符和项目之间的校准。对参与者而言，最相关的项目是肩部以上工作（90%）、用未受影响的手臂代偿（88%）和举重物（92%）。参与者对睡眠和造型（19%）项目的评分校准最多。性别视角修饰符影响了造型头发（30%）和穿衣或脱衣（19%）项目的校准。参与者经常提到任务重新分配和使用辅助设备/资源的补偿策略。总体而言，参与者的理解问题较小，但发现简化版 WORC 的 7 个项目与 QoL 相关。
因此，研究结果表明，简化版 WORC 认知上并不复杂，但因患者观点而异。总体而言，简化版 WORC 为肩袖疾病患者使用时提供了强有力的内容有效性证据。
