Skip to main content
Top
Published in: European Spine Journal 10/2016

01-10-2016 | Original Article

A validation study on the traditional Chinese version of Spinal Appearance Questionnaire for adolescent idiopathic scoliosis

Authors: Jing Guo, Ajax Hong Yin Lau, Jack Chau, Bobby Kin Wah Ng, Kwong Man Lee, Yong Qiu, Jack Chun Yiu Cheng, Tsz Ping Lam

Published in: European Spine Journal | Issue 10/2016

Login to get access

Abstract

Purpose

“Simplified Chinese” version of Spinal Appearance Questionnaire (SC-SAQ) for patients with adolescent idiopathic scoliosis (AIS) was available but did not fit for communities using “Traditional Chinese” as their primary language. We developed a traditional Chinese version of SAQ (TC-SAQ) and evaluated its reliability and validity.

Methods

TC-SAQ was administered to 112 AIS patients, of which 101 bilingual (English and Chinese) patients completed E-SAQ and the traditional Chinese version of Scoliosis Research Society-22 questionnaire (TC-SRS-22). Internal consistency and test–retest reliability were evaluated. Concurrent validity was evaluated by comparing TC-SAQ score with E-SAQ score, and convergent validity by comparing TC-SAQ score with TC-SRS-22 self-image domain score, and discriminant validity by analyzing the relationship between TC-SAQ score and patients’ characteristics.

Results

Internal consistency of individual TC-SAQ domain was high (Cronbach’s α = 0.785 to 0.940), except for general (Cronbach’s α = 0.665) and shoulders (Cronbach’s α = 0.421) domain. Test–retest reliability of TC-SAQ was good (ICCs of each domain from 0.798 to 0.865). Concurrent validity demonstrated an excellent correlation between TC-SAQ and E-SAQ scores (r = 0.820 to 0.954, P < 0.0001 for all domains). Correlation between TC-SAQ domains and TC-SRS-22 self-image domain was weak to moderate. TC-SAQ total score and individual domain scores (except waist and chest domains) were positively correlated to major curve magnitude.

Conclusions

TC-SAQ had good internal consistency and test–retest reliability. Concurrent validity evaluated against the original English version was excellent. TC-SAQ was both reliable and valid for clinical use for AIS patients using traditional Chinese as their primary language.
Appendix
Available only for authorised users
Literature
1.
go back to reference Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371:1527–1537CrossRefPubMed Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371:1527–1537CrossRefPubMed
3.
go back to reference Guo J, Lam TP, Wong MS, Ng BK, Lee KM, Liu KL, Hung LH, Lau AH, Sin SW, Kwok WK, Yu FW, Qiu Y, Cheng JC (2014) A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria. Eur Spine J 23:2650–2657. doi:10.1007/s00586-013-3146-1 CrossRefPubMed Guo J, Lam TP, Wong MS, Ng BK, Lee KM, Liu KL, Hung LH, Lau AH, Sin SW, Kwok WK, Yu FW, Qiu Y, Cheng JC (2014) A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria. Eur Spine J 23:2650–2657. doi:10.​1007/​s00586-013-3146-1 CrossRefPubMed
4.
go back to reference Smith PL, Donaldson S, Hedden D, Alman B, Howard A, Stephens D, Wright JG (2006) Parents’ and patients’ perceptions of postoperative appearance in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 31:2367–2374. doi:10.1097/01.brs.0000240204.98960.dd Smith PL, Donaldson S, Hedden D, Alman B, Howard A, Stephens D, Wright JG (2006) Parents’ and patients’ perceptions of postoperative appearance in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 31:2367–2374. doi:10.​1097/​01.​brs.​0000240204.​98960.​dd
5.
go back to reference Theologis TN, Jefferson RJ, Simpson AH, Turner-Smith AR, Fairbank JC (1993) Quantifying the cosmetic defect of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 18:909–912 Theologis TN, Jefferson RJ, Simpson AH, Turner-Smith AR, Fairbank JC (1993) Quantifying the cosmetic defect of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 18:909–912
6.
go back to reference Raso VJ, Lou E, Hill DL, Mahood JK, Moreau MJ, Durdle NG (1998) Trunk distortion in adolescent idiopathic scoliosis. J Pediatr Orthop 18:222–226PubMed Raso VJ, Lou E, Hill DL, Mahood JK, Moreau MJ, Durdle NG (1998) Trunk distortion in adolescent idiopathic scoliosis. J Pediatr Orthop 18:222–226PubMed
7.
go back to reference Sanders JO, Harrast JJ, Kuklo TR, Polly DW, Bridwell KH, Diab M, Dormans JP, Drummond DS, Emans JB, Johnston CE, 2nd, Lenke LG, McCarthy RE, Newton PO, Richards BS, Sucato DJ (2007) The Spinal Appearance Questionnaire: results of reliability, validity, and responsiveness testing in patients with idiopathic scoliosis. Spine (Phila Pa 1976) 32:2719–2722. doi:10.1097/BRS.0b013e31815a5959 Sanders JO, Harrast JJ, Kuklo TR, Polly DW, Bridwell KH, Diab M, Dormans JP, Drummond DS, Emans JB, Johnston CE, 2nd, Lenke LG, McCarthy RE, Newton PO, Richards BS, Sucato DJ (2007) The Spinal Appearance Questionnaire: results of reliability, validity, and responsiveness testing in patients with idiopathic scoliosis. Spine (Phila Pa 1976) 32:2719–2722. doi:10.​1097/​BRS.​0b013e31815a5959​
8.
go back to reference Sanders JO, Polly DW, Jr., Cats-Baril W, Jones J, Lenke LG, O’Brien MF, Stephens Richards B, Sucato DJ (2003) Analysis of patient and parent assessment of deformity in idiopathic scoliosis using the Walter Reed Visual Assessment Scale. Spine (Phila Pa 1976) 28:2158–2163. doi:10.1097/01.brs.0000084629.97042.0b Sanders JO, Polly DW, Jr., Cats-Baril W, Jones J, Lenke LG, O’Brien MF, Stephens Richards B, Sucato DJ (2003) Analysis of patient and parent assessment of deformity in idiopathic scoliosis using the Walter Reed Visual Assessment Scale. Spine (Phila Pa 1976) 28:2158–2163. doi:10.​1097/​01.​brs.​0000084629.​97042.​0b
9.
go back to reference Carreon LY, Sanders JO, Polly DW, Sucato DJ, Parent S, Roy-Beaudry M, Hopkins J, McClung A, Bratcher KR, Diamond BE (2011) Spinal appearance questionnaire: factor analysis, scoring, reliability, and validity testing. Spine (Phila Pa 1976) 36:E1240–1244. doi:10.1097/BRS.0b013e318204f987 Carreon LY, Sanders JO, Polly DW, Sucato DJ, Parent S, Roy-Beaudry M, Hopkins J, McClung A, Bratcher KR, Diamond BE (2011) Spinal appearance questionnaire: factor analysis, scoring, reliability, and validity testing. Spine (Phila Pa 1976) 36:E1240–1244. doi:10.​1097/​BRS.​0b013e318204f987​
10.
go back to reference Mulcahey MJ, Chafetz RS, Santangelo AM, Costello K, Merenda LA, Calhoun C, Samdani AF, Betz RR (2011) Cognitive testing of the spinal appearance questionnaire with typically developing youth and youth with idiopathic scoliosis. J Pediatr Orthop 31:661–667. doi:10.1097/BPO.0b013e318221ea8b CrossRefPubMed Mulcahey MJ, Chafetz RS, Santangelo AM, Costello K, Merenda LA, Calhoun C, Samdani AF, Betz RR (2011) Cognitive testing of the spinal appearance questionnaire with typically developing youth and youth with idiopathic scoliosis. J Pediatr Orthop 31:661–667. doi:10.​1097/​BPO.​0b013e318221ea8b​ CrossRefPubMed
11.
go back to reference Roy-Beaudry M, Beausejour M, Joncas J, Forcier M, Bekhiche S, Labelle H, Grimard G, Parent S (2011) Validation and clinical relevance of a French–Canadian version of the spinal appearance questionnaire in adolescent patients. Spine (Phila Pa 1976) 36:746–751. doi:10.1097/BRS.0b013e3181e040e7 Roy-Beaudry M, Beausejour M, Joncas J, Forcier M, Bekhiche S, Labelle H, Grimard G, Parent S (2011) Validation and clinical relevance of a French–Canadian version of the spinal appearance questionnaire in adolescent patients. Spine (Phila Pa 1976) 36:746–751. doi:10.​1097/​BRS.​0b013e3181e040e7​
12.
go back to reference Wei X, Zhu X, Bai Y, Wu D, Chen J, Wang C, Chen Z, Yang C, Li J, Li M (2012) Development of the Simplified Chinese Version of the Spinal Appearance Questionnaire: cross-cultural adaptation and psychometric properties evaluation. Spine (Phila Pa 1976) 37:1497-1504. doi:10.1097/BRS.0b013e3182407e25 Wei X, Zhu X, Bai Y, Wu D, Chen J, Wang C, Chen Z, Yang C, Li J, Li M (2012) Development of the Simplified Chinese Version of the Spinal Appearance Questionnaire: cross-cultural adaptation and psychometric properties evaluation. Spine (Phila Pa 1976) 37:1497-1504. doi:10.​1097/​BRS.​0b013e3182407e25​
13.
go back to reference Carreon LY, Sanders JO, Diab M, Polly DW, Diamond BE, Sucato DJ (2013) Discriminative properties of the Spinal Appearance Questionnaire compared with the Scoliosis Research Society—22 Revised. Spine Deformity 1:328–338CrossRef Carreon LY, Sanders JO, Diab M, Polly DW, Diamond BE, Sucato DJ (2013) Discriminative properties of the Spinal Appearance Questionnaire compared with the Scoliosis Research Society—22 Revised. Spine Deformity 1:328–338CrossRef
16.
go back to reference Li M, Wang CF, Gu SX, He SS, Zhu XD, Zhao YC, Zhang JT (2009) Adapted simplified Chinese (mainland) version of Scoliosis Research Society-22 questionnaire. Spine (Phila Pa 1976) 34:1321–1324. doi:10.1097/BRS.0b013e31819812b7 Li M, Wang CF, Gu SX, He SS, Zhu XD, Zhao YC, Zhang JT (2009) Adapted simplified Chinese (mainland) version of Scoliosis Research Society-22 questionnaire. Spine (Phila Pa 1976) 34:1321–1324. doi:10.​1097/​BRS.​0b013e31819812b7​
17.
go back to reference Cheung KM, Senkoylu A, Alanay A, Genc Y, Lau S, Luk KD (2007) Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine (Phila Pa 1976) 32:1141–1145. doi:10.1097/01.brs.0000261562.48888.e3 Cheung KM, Senkoylu A, Alanay A, Genc Y, Lau S, Luk KD (2007) Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine (Phila Pa 1976) 32:1141–1145. doi:10.​1097/​01.​brs.​0000261562.​48888.​e3
18.
19.
go back to reference Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46:1417–1432CrossRefPubMed Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46:1417–1432CrossRefPubMed
20.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25:3186–3191 Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25:3186–3191
22.
go back to reference Nunnally JC (1978) Psychometric theory, 2nd edn. McGraw-Hill, New York Nunnally JC (1978) Psychometric theory, 2nd edn. McGraw-Hill, New York
24.
go back to reference Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed
25.
go back to reference Haher TR, Gorup JM, Shin TM, Homel P, Merola AA, Grogan DP, Pugh L, Lowe TG, Murray M (1999) Results of the Scoliosis Research Society instrument for evaluation of surgical outcome in adolescent idiopathic scoliosis. A multicenter study of 244 patients. Spine (Phila Pa 1976) 24:1435–1440 Haher TR, Gorup JM, Shin TM, Homel P, Merola AA, Grogan DP, Pugh L, Lowe TG, Murray M (1999) Results of the Scoliosis Research Society instrument for evaluation of surgical outcome in adolescent idiopathic scoliosis. A multicenter study of 244 patients. Spine (Phila Pa 1976) 24:1435–1440
26.
go back to reference Howard A, Donaldson S, Hedden D, Stephens D, Alman B, Wright J (2007) Improvement in quality of life following surgery for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 32:2715–2718. doi:10.1097/BRS.0b013e31815a51cd Howard A, Donaldson S, Hedden D, Stephens D, Alman B, Wright J (2007) Improvement in quality of life following surgery for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 32:2715–2718. doi:10.​1097/​BRS.​0b013e31815a51cd​
Metadata
Title
A validation study on the traditional Chinese version of Spinal Appearance Questionnaire for adolescent idiopathic scoliosis
Authors
Jing Guo
Ajax Hong Yin Lau
Jack Chau
Bobby Kin Wah Ng
Kwong Man Lee
Yong Qiu
Jack Chun Yiu Cheng
Tsz Ping Lam
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4590-5

Other articles of this Issue 10/2016

European Spine Journal 10/2016 Go to the issue