Department of Orthopedic Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, NL, 6525 GA, Nijmegen, The Netherlands.
Department Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Spine Deform. 2024 Jan;12(1):79-87. doi: 10.1007/s43390-023-00746-2. Epub 2023 Aug 10.
Adolescent idiopathic scoliosis (AIS) affects the appearance of spine and trunk. The Spinal Appearance Questionnaire (SAQ) assesses the perception of appearance in AIS patients. The aim of this study is to translate and culturally adapt the recommended short version of the SAQ into Dutch and to test its measurement properties.
A Dutch SAQ (14-item; appearance and expectations domains) was developed following guidelines for translation and cross-cultural adaptation. The COSMIN Study Design checklist was used for measurement properties evaluation. In this multicenter study, the Dutch SAQ, SRS-22R and NPRS (back pain) were administered to 113 AIS patients (aged 15.4 years [SD 2.2], 21.2% male). Floor and ceiling effects were evaluated for content analysis. For reliability, internal consistency (Cronbach's alpha) and test-retest reliability (ICC; n = 34) were evaluated. Predefined hypotheses of relationships with other questionnaires and between subgroups based on scoliosis severity (radiological and clinical) were tested for construct validity. Exploratory factor analysis (EFA) was performed to investigate the validity of the underlying structure of this 14-item questionnaire.
No floor and ceiling effects were found for domains and total scores. Cronbach's alpha ranged from 0.84 to 0.89. ICCs varied from 0.76 to 0.77. For construct validity, 89% (8/9) of the predefined hypotheses were confirmed. Significant higher scores for the appearance domain were found for subgroups based on radiological (Cobb angle; > 25.0°) and clinical outcomes. (Angle of Trunk Rotation; > 9.0°). A two-factor structure was found (EV 5.13; 36.63% explained variance).
The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients' perception of appearance in AIS.
Level I-diagnostic studies.
青少年特发性脊柱侧凸（AIS）会影响脊柱和躯干的外观。脊柱外观问卷（SAQ）评估 AIS 患者对外观的感知。本研究的目的是将推荐的 SAQ 短版翻译成荷兰语，并测试其测量特性。
遵循翻译和跨文化适应指南制定了荷兰 SAQ（14 项；外观和期望领域）。使用 COSMIN 研究设计清单评估测量特性。在这项多中心研究中，113 名 AIS 患者（年龄 15.4 岁[标准差 2.2]，21.2%为男性）接受了荷兰 SAQ、SRS-22R 和 NPRS（背痛）的评估。通过内容分析评估了地板和天花板效应。为了评估可靠性，进行了内部一致性（Cronbach's alpha）和测试-重测可靠性（ICC；n=34）评估。基于脊柱侧凸严重程度（影像学和临床）的构建效度，对与其他问卷之间的预定假设和亚组之间的关系进行了检验。进行探索性因子分析（EFA）以研究此 14 项问卷的潜在结构的有效性。
各领域和总分均无地板和天花板效应。Cronbach's alpha 范围为 0.84 至 0.89。ICC 从 0.76 到 0.77 不等。对于构效关系，89%（8/9）的预定假设得到了证实。基于影像学（Cobb 角；>25.0°）和临床结果（躯干旋转角度；>9.0°）的亚组，外观领域的得分显著更高。发现了两因素结构（EV 5.13；36.63%解释方差）。
荷兰 SAQ 是一种评估 AIS 患者对外观感知的充分、有效和可靠的工具。
I 级诊断研究。
