The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation

Dineke G. van de Fliert; Tom P.C. Schlösser; Diederik H.R. Kempen; Joost P.H.J. Rutges; Pepijn Bisseling; Marinus de Kleuver; Miranda L. van Hooff

doi:10.1007/s43390-023-00746-2

The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation

Dineke G. van de Fliert, Tom P.C. Schlösser, Diederik H.R. Kempen, Joost P.H.J. Rutges, Pepijn Bisseling, Marinus de Kleuver, Miranda L. van Hooff^*

^*Corresponding author for this work

Orthopedics and Sports Medicine

Research output: Contribution to journal › Article › Academic › peer-review

2 Citations (Scopus)

39 Downloads (Pure)

Abstract

Purpose:

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.

Methods:

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.

Results:

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).

Conclusion:

The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients’ perception of appearance in AIS.

Level of evidence:

Level I—diagnostic studies.

Original language	English
Pages (from-to)	79-87
Number of pages	9
Journal	Spine Deformity
Volume	12
Issue number	1
DOIs	https://doi.org/10.1007/s43390-023-00746-2
Publication status	Published - Jan 2024

Bibliographical note

Funding Information:
Dineke G. van de Fliert: none related to this study. Tom P. C. Schlösser: none related to this study. Diederik H. R. Kempen: none related to this study. Joost P. H. J. Rutges: none related to this study. Pepijn Bisseling: none related to this study. Marinus de Kleuver: received a grant from ZonMw. Miranda L. van Hooff: received a grant from ZonMw.

Publisher Copyright:
© 2023, The Author(s).

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Cite this

van de Fliert, D. G., Schlösser, T. P. C., Kempen, D. H. R., Rutges, J. P. H. J., Bisseling, P., de Kleuver, M., & van Hooff, M. L. (2024). The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation. Spine Deformity, 12(1), 79-87. https://doi.org/10.1007/s43390-023-00746-2

@article{5b1586311277452f8ed01484d57cc5e0,

title = "The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation",

abstract = "Purpose: 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. Methods: 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{\textquoteright}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. Results: No floor and ceiling effects were found for domains and total scores. Cronbach{\textquoteright}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). Conclusion: The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients{\textquoteright} perception of appearance in AIS. Level of evidence: Level I—diagnostic studies.",

author = "{van de Fliert}, {Dineke G.} and Schl{\"o}sser, {Tom P.C.} and Kempen, {Diederik H.R.} and Rutges, {Joost P.H.J.} and Pepijn Bisseling and {de Kleuver}, Marinus and {van Hooff}, {Miranda L.}",

note = "Funding Information: Dineke G. van de Fliert: none related to this study. Tom P. C. Schl{\"o}sser: none related to this study. Diederik H. R. Kempen: none related to this study. Joost P. H. J. Rutges: none related to this study. Pepijn Bisseling: none related to this study. Marinus de Kleuver: received a grant from ZonMw. Miranda L. van Hooff: received a grant from ZonMw. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2024",

month = jan,

doi = "10.1007/s43390-023-00746-2",

language = "English",

volume = "12",

pages = "79--87",

journal = "Spine Deformity",

issn = "2212-134X",

publisher = "Elsevier",

number = "1",

}

van de Fliert, DG, Schlösser, TPC, Kempen, DHR, Rutges, JPHJ, Bisseling, P, de Kleuver, M & van Hooff, ML 2024, 'The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation', Spine Deformity, vol. 12, no. 1, pp. 79-87. https://doi.org/10.1007/s43390-023-00746-2

The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation. / van de Fliert, Dineke G.; Schlösser, Tom P.C.; Kempen, Diederik H.R. et al.
In: Spine Deformity, Vol. 12, No. 1, 01.2024, p. 79-87.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis

T2 - patient-based cross-cultural adaptation and measurement properties evaluation

AU - van de Fliert, Dineke G.

AU - Schlösser, Tom P.C.

AU - Kempen, Diederik H.R.

AU - Rutges, Joost P.H.J.

AU - Bisseling, Pepijn

AU - de Kleuver, Marinus

AU - van Hooff, Miranda L.

N1 - Funding Information: Dineke G. van de Fliert: none related to this study. Tom P. C. Schlösser: none related to this study. Diederik H. R. Kempen: none related to this study. Joost P. H. J. Rutges: none related to this study. Pepijn Bisseling: none related to this study. Marinus de Kleuver: received a grant from ZonMw. Miranda L. van Hooff: received a grant from ZonMw. Publisher Copyright: © 2023, The Author(s).

PY - 2024/1

Y1 - 2024/1

N2 - Purpose: 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. Methods: 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. Results: 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). Conclusion: The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients’ perception of appearance in AIS. Level of evidence: Level I—diagnostic studies.

AB - Purpose: 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. Methods: 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. Results: 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). Conclusion: The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients’ perception of appearance in AIS. Level of evidence: Level I—diagnostic studies.

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JO - Spine Deformity

JF - Spine Deformity

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The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation

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