Translation and Alternate Forms Reliability of the Visual Analogue Scale in the Three Major Nigerian Languages

A Peer Reviewed Publication of the College of Allied Health & Nursing at Nova Southeastern University Dedicated edicated to allied health professional practice and education http://ijahsp.nova.edu Vol. 7 No. 3 ISSN 1540-580X Translation and Alternate Forms Reliability of the Visual Analogue Scale in the Three Major Nigerian Languages Adesola C. Odole, BMR, MSc, PhD1 Aderonke O. Akinpelu, BSc, MEd, PhD2 1. 2. Lecturer, Department of Physiotherapy, College of Medicine, University of Ibadan Senior Lecturer, Department of Physiotherapy, College of Medicine, University of Ibadan Nigeria CITATION: Odole, AC., Akinpelu, AO. Translation and Alternate Forms Reliability of the Visual Analogue Scale in the Three Major Nigerian Languages. The Internet Journal of Allied Health Sciences and Practice Practice. July 2009, Volume 7 Number 3. ABSTRACT Purpose: Our aims were to translate the anchors on the Visual Analogue Scale (VAS) into the three major Nigerian Languages and determine the adequacy of the alternate forms reliability of the VAS in these translations. Methods: The anchors on the V VAS were translated into Yoruba, Igbo, and Hausa languages by lilinguistic nguistic experts and taken through back translation, clinical committee review, and pre–testing. Sixty–seven seven Hausa, 54 Igbo, and 165 Yoruba Knee/Hip OA patients were assessed on the original and translated versions of VAS. Scores on each translated anchor of the VAS were correlated with scores on the original VAS (anchors in English language) to assess the alternate forms reliability of the VAS in these translations. Results: The subjects 31 males, 134 females [Yoruba]; 17 males, 50 females [Hausa]; and 20 males, 34 females [Igbo] were aged 56.1 + 10.1, 54.3 + 6.4 and 52.8 + 13.9 years respectively. Significant positive correlations existed between each of the translated anchors and the original English Version [r = 0.63; P< 0.05 [Yoruba]; r = 0.98, P < 0. 0.05 05 [Hausa]; r = 0.93; P< 0.05 [Igbo]. Conclusion: The VAS, when its anchors are translated into Yoruba, Hausa, and Igbo languages, is reliable and therefore recommended for use in the Nigerian clinical linical settings. INTRODUCTION Pain is a complex, subjective, personal experience.¹ The Int International Association for the Study of Pain ain has defined pain as an unpleasant and emotional experience associated with actual potential tissue damage or described in such damage.² Pain is a highly subjective experience, and the response to noxious stimuli will be modified by psychologi psychological cal factors such as state of mind, past experience and conditioning influences, and sociological factors such as gender and culture. 3 Pain is the most important symptom of OA (a prevalent musculoskeletal condition) and the reason why sufferers from the disease seek treatment.4 Despite the subjective nature of the pain experience, there is the need to assess and measure pain intensity so as to objectively evaluate the course of disease and the effectiveness of therapeutic interventions. The quantif quantification 5, of this pain experience by physiotherapists remains an important component of outcome measures in physiotherapy. 5,6 Many scales have been developed to provide a quantifiable measure of pain. 7 Measures of pain are primarily classified as behavioral and subjective. Other measures include the biologica biological and non-subjective measures. Essentially, they hey are used to quantify the pain perception of individuals experiencing pain. The accuracy of the assessment is dependent on the efforts of the health care provider and the person experiencing cing pain.8 These measures of pain include the Visual Analogue Scale, the Numerical Pain Scale and the McGill Pain Questionnaire uestionnaire.9-12 The Visual Analogue Scale (VAS) is the most common simple scale 1 used in pain research. It represents the intensity dimens dimension by a 10 cm plain line with two anchor points of “no pain” n” and “worst © The Internet Journal of Allied Health alth Sciences and Practice, 200 2009 Translation and Alternate Forms Reliability of the Visual Analogue Scale in the Three Major Nigerian Languages 2 pain I ever felt.” The patient is requested to draw a line at the point that best describes his or her pain level. It is the most widely used scale in the assessment of pain in the clinical setting and has been reported to be sensitive and reliable. 13-15 Many studies have been carried out on the VAS in various populations. 16-21 Unfortunately, there are not many of such published studies from the Nigerian environment. Soyanwo et al has reported that the VAS is comprehended by Nigerians, irrespective of their educational status. 17 Nigeria is a multi–ethnic country with over 500 indigenous languages. The three major Nigerian indigenous languages are Hausa, Igbo, and Yoruba. 22 Although the VAS has been clinically utilized within the Nigerian context, there have been few published studies on the translation and the alternate forms reliability of this scale into major Nigerian languages in order to further encourage its use within the Nigerian context. The aims of this study were to translate the anchors on the VAS into Yoruba, Hausa, and Igbo languages [major Nigerian languages] and determine the adequacy of the alternate forms’ reliability of the VAS in these translations as applied to the Nigerian patients. We hypothesized that there would be no significant correlation between the participants’ scores on each of the Yoruba, Hausa, Igbo, and English version of VAS. MATERIALS AND METHODS The University of Ibadan/University College Hospital Institutional Review Committee approved the study and informed consent of all the participants was sought and obtained. Translation of anchors on the VAS into Yoruba, Hausa, and Igbo We followed the recommended guidelines for the process of translation of self-report measures by Beaton et al 23 to translate the anchors on the VAS into Yoruba, Hausa, and Igbo languages. The VAS [English, appendix 1] was translated into Yoruba, Hausa, and Igbo by linguistic experts who were knowledgeable on the construct of pain assessment. The English VAS was given to Yoruba and Igbo linguistics experts from the Department of Linguistics and African Studies, University of Ibadan, Nigeria, to translate the anchors into Yoruba and Igbo languages and a Hausa linguistic expert from the Ahmadu Bello University, Nigeria to translate the anchors into Hausa language. Copies of the Yoruba, Hausa, and Igbo translated anchors of the VAS were given to ten bilingual persons [five for Yoruba, two for Igbo, and three for Hausa] who were not associated with the forward-translation process to back translate the translated anchors into English. Copies of the back-translated versions were reviewed by a clinical committee of two bilingual physical therapists and three OA Knee/Hip patients for each of the translated anchors. It was discovered that the meanings of the anchors (...truncated)