Cross-cultural adaptation and psychometric evaluation of the Yoruba version of the Back beliefs questionnaire among patients with chronic low-back pain

Abstract

Purpose: To translate, culturally adapt and conduct a psychometric evaluation of the Yoruba version of the Back Beliefs Questionnaire (BBQ) among patients with chronic low-back pain. Methods: The English version of the BBQ was translated into the Yoruba language through a process of forwardbackward translation, reconciliation and harmonization of the reconciled items sequentially. Thereafter, Cronbach's Alpha, Intra-Class Correlation (ICC), Bland-Altman's analysis were used to determine the internal consistency, testretest reliability and limits of agreement of the Yoruba version of the BBQ (BBQ-Y). Other psychometric properties of the BBQ-Y explored comprised acceptability, standard error of measurement (SEM), minimal detectable change (MDC), convergent validity and floor and ceiling effects. While 119 respondents participated in the validity testing, only 51 of them were involved in the reliability testing of the BBQ-Y. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05. Results: The mean age of the respondents all the respondents was 56.8 ± 8.5 years. The BBQ-Y had excellent acceptability with a global Cronbach Alpha score of 0.71. The SEM and MDC of the BBQ-Y were 2.3 and 6.4. The BBQ-Y ICC score for testretest was 0.89, while the Bland-Altman analysis showing limits of agreements for the test-retest reliability were − 6.84 and 5.70. The convergent validity of the BBQ-Y showed a weak correlation (r = 0.273, p = 0.001) with pain intensity using the visual analogue scale. Conclusion: This is the first study to culturally adapt the BBY-Y and determined its psychometric properties. The BBQ-Y has adequate psychometric properties and it is an appropriate outcome measure for use among Yoruba speaking patients with chronic low-back pain.

The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain

“…Cronbach’s α coefficients were interpreted as “inadequate” (< 0.70), “adequate” (0.70–0.79), “good” (0.80–0.89), and “excellent” (> 0.90) [ 62 ]. We hypothesized that the Cronbach’s α coefficients for the Hausa-BBQ would lie within the range of 0.70–0.82 to be considered acceptable [ 31 , 33 , 36 , 40 , 42 ].…”

“…The MDC 95 provides the minimum values considered true change beyond measurement error [ 64 , 65 ]. We hypothesized that the SEM and MDC 95 for the Hausa-BBQ would lie within the range of 2.1–3.8 [ 33 , 36 , 42 ] and 5.9–10.5 [ 35 , 36 , 42 ], respectively. Additionally, 95% limits of agreement (LOA 95% ) were calculated with Bland-Altman plots by plotting the difference between test and retest of Hausa-BBQ scores against the mean scores of the test and retest.…”

“…This was done for both the global and 9-item scores. We hypothesized that the LOA 95% for the Hausa-BBQ would lie within the range of –10.0 to +12.6 [ 31 , 34 , 42 ]. Subgroup reliability analyses regarding ICC, SEM and MDC 95 for urban and rural patients were also performed.…”

“…The three main indigenous languages in Nigeria are Hausa, Igbo, and Yoruba. Recently, the BBQ was successfully adapted into Yoruba [ 42 ]. However, no Hausa version of this tool is available despite Hausa being the largest ethnic group not only in Nigeria but also in sub-Saharan Africa with about 80 million speakers [ 43 ].…”

Convergent and known group validity of the STarT Back Tool in a Nigerian population with chronic low back pain

“…It is also important to state that chronicity of pain has socio-cultural aspects [45,46]. As such, perception and expression of pain are influenced by culture and religion in the African setting [47]. Anecdotally, the psychosocial consequences of pain are moderately expressed or denied among Nigerians, except when it is out of control.…”