Shrestha Sunil, Sapkota Simit, Paudyal Vibhu, Moon Zoe, Horne Rob, Gan Siew Hua
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.
Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal.
J Pain Res. 2024 Nov 14;17:3741-3753. doi: 10.2147/JPR.S455852. eCollection 2024.
Adherence to pain medication is crucial for cancer patients, since non-adherence can lead to increased suffering, reduced quality of life and increased healthcare costs. Although the five-item Medication Adherence Report Scale (MARS-5) is a validated tool for assessing medication adherence, but it has not been translated and validated into the Nepalese language. This study aimed to translate, culturally adapt and validate the MARS-5 in Nepalese language for Nepalese cancer patients who were experiencing pain.
The cross-sectional validation study utilized a convenience sampling method. Initially, a pre-test was conducted with 25 patients. The MARS-5 was then forward and backward translated following the EORTC QLG translation procedure. The final translated version was reviewed by experts and subjected to a second pre-test. Construct validity was assessed through principal component analysis, and internal consistency was measured using Cronbach's alpha coefficient. Inter-rater reliability was evaluated using the Intra-Class Correlation coefficient (ICC).
The study included 204 cancer patients (ages 18-86, 55% female). The Nepalese version of the MARS-5 was translated without significant issues and underwent pre-testing with participants. Participants discussed the scale during these pre-tests, providing feedback on its clarity and comprehensibility. While formal assessment tools were not employed, the iterative nature of the pre-testing process allowed for the refinement of the translation based on participant feedback, indicating a robust understanding of the scale among participants. The ICC of test-retest reliability was found to be 0.860. The Kaiser Meyer Olkin's value was 0.690, and Cronbach's alpha was 0.72, indicating good construct validity and high internal consistency. The medication non-adherence rate was 11.3%.
The MARS-5 was successfully translated, culturally adapted, and validated in Nepalese for use among Nepalese cancer patients experiencing pain. The Nepalese version of MARS-5 is a reliable tool for evaluating medication adherence in this population.
坚持服用止痛药物对癌症患者至关重要，因为不坚持服药会导致痛苦加剧、生活质量下降以及医疗费用增加。尽管五项药物依从性报告量表（MARS-5）是评估药物依从性的有效工具，但尚未翻译成尼泊尔语并进行验证。本研究旨在将MARS-5翻译成尼泊尔语，进行文化调适，并针对有疼痛症状的尼泊尔癌症患者进行验证。
横断面验证研究采用便利抽样法。最初，对25名患者进行了预测试。然后按照欧洲癌症研究与治疗组织（EORTC）QLG翻译程序对MARS-5进行了正向和反向翻译。最终翻译版本由专家进行评审，并进行了第二次预测试。通过主成分分析评估结构效度，使用克朗巴赫α系数测量内部一致性。使用组内相关系数（ICC）评估评分者间信度。
该研究纳入了204名癌症患者（年龄18 - 86岁，55%为女性）。MARS-5的尼泊尔语版本翻译过程中没有出现重大问题，并对参与者进行了预测试。参与者在这些预测试中讨论了该量表，对其清晰度和可理解性提供了反馈。虽然未使用正式评估工具，但预测试过程的迭代性质允许根据参与者反馈对翻译进行完善，这表明参与者对该量表有较强的理解。重测信度的ICC为0.860。凯泽 - 迈耶 - 奥尔金值为0.690，克朗巴赫α系数为0.72，表明结构效度良好且内部一致性高。药物不依从率为11.3%。
MARS-5已成功翻译成尼泊尔语，进行了文化调适，并针对有疼痛症状的尼泊尔癌症患者进行了验证。尼泊尔语版MARS-5是评估该人群药物依从性的可靠工具。
