Furtado Rochelle, MacDermid Joy C
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; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON Canada.
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; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, ON Canada.
J Hand Ther. 2023 Jul-Sep;36(3):713-718. doi: 10.1016/j.jht.2022.10.006. Epub 2023 Mar 11.
The Single Assessment Numeric Evaluation (SANE) is a single item patient reported outcome measure (PROM) of function, in where patients rate how normal they feel in relation to a specific joint or problem. Although validated for some orthopedic conditions, it is not yet validated for a population with shoulder pathologies; nor have other studies explored the content validity. This study aims to understand how 1) patients with shoulder conditions interpret and calibrate responses to the SANE and 2) how they define normal.
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 the SANE. 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 for classification of interpretation variances.
Overall, the single-item SANE was well received by all participants. Through the interviews, the themes of: Comprehension (20% of participants), Reference Point (20% of participants), Relevance (10% of participants), and Perspective Modifiers (50% of participants) emerged as potential sources of interpretation variances. Clinicians indicated this tool facilitates discussion when trying to create realistic recovery expectations for patients post-operatively. The word "normal" was defined by the themes of: 1) levels of current pain compared to pre-injury, 2) personal expectations of recovery and 3) pre-injury activity levels.
Overall, respondents found the SANE to be cognitively simple, but it was clear that the interpretation of the question and what factors calibrated their responses were highly variable between respondents. The SANE is perceived favorable by patients and clinicians, while providing a low response burden. However, the construct being measured may vary between patients.
单项评估数值评定法（SANE）是一种由患者报告的关于功能的单项结局指标，患者需对自己相对于特定关节或问题的感觉正常程度进行评分。尽管该方法已在某些骨科疾病中得到验证，但尚未在肩部疾病人群中得到验证；也没有其他研究探讨其内容效度。本研究旨在了解：1）肩部疾病患者如何解释和校准对SANE的回答；2）他们如何定义正常。
本研究采用认知访谈，这是一种专注于问卷项目解释的定性方法。对患有肩袖疾病的患者（n = 10）、临床医生（n = 6）和测量研究人员（n = 10）进行了大声思考结构化访谈，以评估SANE。所有访谈均由一名研究人员（R.F.）记录并逐字转录。分析通过开放编码方案进行，使用先前建立的解释差异分类框架。
总体而言，所有参与者对单项SANE的接受度良好。通过访谈，出现了理解（20%的参与者）、参考点（20%的参与者）、相关性（10%的参与者）和视角修正因素（50%的参与者）等主题，这些是解释差异的潜在来源。临床医生表示，在试图为术后患者建立现实的恢复期望时，该工具有助于进行讨论。“正常”一词的定义主题为：1）与受伤前相比的当前疼痛程度；2）个人恢复期望；3）受伤前的活动水平。
总体而言，受访者发现SANE在认知上很简单，但很明显，问题的解释以及校准他们回答的因素在受访者之间差异很大。患者和临床医生对SANE的评价较好，同时回答负担较低。然而，不同患者所测量的结构可能有所不同。
