Sharma Saurab, Higgins Cassie, Cameron Paul, Bimali Inosha, Hales Tim G, Bennett Michael I, Colvin Lesley, Smith Blair H
Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia; Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand; Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK.
J Pain. 2022 Mar;23(3):424-433. doi: 10.1016/j.jpain.2021.09.004. Epub 2021 Sep 25.
Neuropathic pain research and clinical care is limited in low- and middle-income countries with high prevalence of chronic pain such as Nepal. We translated and cross-culturally adapted the Self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS)-a commonly used, reliable and valid instrument to screen for pain of predominantly neuropathic origin (POPNO)-into Nepali (S-LANSS-NP) and validated it using recommended guidelines. We recruited 30 patients with chronic pain in an outpatient setting for cognitive debriefing and recruited 287 individuals with chronic pain via door-to-door interviews for validation. For known-group validity, we hypothesized that the POPNO group would report significantly more pain intensity and pain interference than the chronic pain group without POPNO using a cut-off score of ≥10/24. The S-LANSS-NP was comprehensible based on the ease of understanding the questionnaire and lack of missing responses. The validation sample consisted of predominantly low-levels of literacy (81% had 5 years or less education); 23% were classified as having POPNO. Internal consistency was good (alpha = .80). Known-group validity was supported (chronic pain with POPNO reported significantly greater pain intensity than those without). The S-LANSS-NP is a comprehensible, unidimensional, internally consistent, and valid instrument to screen POPNO in individuals with chronic pain with predominantly low-levels of literacy for clinical and research use. PERSPECTIVE: This paper shows that the Nepali version of the S-LANSS is comprehensible, reliable and valid in adults with chronic pain and predominantly low-levels of literacy in rural Nepal. The study could potentially develop research and clinical care of neuropathic pain in this resource-limited setting where chronic pain is a significant problem.
在尼泊尔等慢性疼痛高发的低收入和中等收入国家，神经性疼痛的研究和临床护理十分有限。我们将利兹神经病理性症状和体征自评量表（S-LANSS）——一种常用的、可靠且有效的主要用于筛查神经性起源疼痛（POPNO）的工具——翻译成尼泊尔语（S-LANSS-NP）并进行了跨文化调适，然后按照推荐指南对其进行了验证。我们在门诊招募了30名慢性疼痛患者进行认知访谈，并通过挨家挨户访谈招募了287名慢性疼痛患者进行验证。对于已知组效度，我们假设使用≥10/24的临界值，POPNO组报告的疼痛强度和疼痛干扰将显著高于无POPNO的慢性疼痛组。基于问卷易于理解且无缺失回答，S-LANSS-NP是可理解的。验证样本主要是低文化水平者（81%接受过5年或更少的教育）；23%被归类为患有POPNO。内部一致性良好（α = 0.80）。已知组效度得到支持（患有POPNO的慢性疼痛患者报告的疼痛强度明显高于无POPNO的患者）。S-LANSS-NP是一种可理解的、单维度的、内部一致且有效的工具，可用于筛查慢性疼痛且文化水平主要较低的个体中的POPNO，供临床和研究使用。观点：本文表明，S-LANSS的尼泊尔语版本在尼泊尔农村慢性疼痛且文化水平主要较低的成年人中是可理解的、可靠且有效的。该研究可能会在这个慢性疼痛是一个重大问题的资源有限环境中推动神经性疼痛的研究和临床护理。
