Translation and validation of Neck Bournemouth Questionnaire to Brazilian Portuguese

Kamonseki, Danilo Harudy; Cedin, Luísa; Tavares-Preto, Jaqueline; Peixoto, Beatriz de Oliveira; Rostelato-Ferreira, Sandro

doi:10.1016/j.rbre.2016.11.006

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Original articles • Rev. Bras. Reumatol. 57 (2) • Mar-Apr 2017 • https://doi.org/10.1016/j.rbre.2016.11.006 copy

Translation and validation of Neck Bournemouth Questionnaire to Brazilian Portuguese

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To translate the Neck Bournemouth Questionnaire to Brazilian Portuguese, cross-culturally adapt, and to verify its validity and its reliability.

Methods:

The development of the Brazilian version of Neck Bournemouth Questionnaire (Brazil-NBQ) was based on the guideline proposed by Guillemin. The applied process consisted of translation, back-translation, committee review and pre-test. Sixty-one volunteers presenting neck pain participated in this study. Thirty-five of them participated during pre-testing phase to verify the instrument comprehension, and the remaining 26 took part during psychometric analysis. Psychometric evaluation included interrater and intrarater reliability and construct validity (correlation among Brazil-NBQ, SF-36, Numerical rating score and Neck Disability Index).

Results:

Some terms and expressions were changed to obtain cultural equivalence for Brazil-NBQ during the translation phase. The NBQ showed an intrarater ICC of 0.96 and interrater ICC of 0.87. Construct validity analysis showed moderate correlations with SF-36 and strong correlation with Numerical rating score and Neck Disability Index.

Conclusion:

Neck Bournemouth Questionnaire was translated and culturally adapted to Portuguese language, and it demonstrated to be valid and reliable to evaluate patients’ neck pain.

Keywords:
Translation; Questionnaire; Neck; Outcome assessment

Question topic	"T1 and T2"	Modification to "T12" consensual version
1. Over the past week, on average how would you rate your neck pain? No pain/worst pain possible	T1 - Durante a última semana, em média, como você classificaria sua dor no pescoço? Nenhuma dor/Pior dor possível T2 - Na última semana como é que, em média, você classifica o grau de dor que sentiu no pescoço? Nenhuma dor/Pior dor possível	Durante a última semana, qual foi o nível de dor do seu pescoço? Nenhuma dor/Pior dor possível
2. Over the past week, how much has your neck pain interfered with your daily activities (housework, washing, dressing, lifting, reading, driving)? No interference/unable to carry out activities	T1 - Durante a última semana, quanto sua dor no pescoço interferiu nas suas atividades diárias (trabalho de casa, lavar, vestir, levantar, ler, dirigir)? Nenhuma interferência/Incapaz de desenvolver atividades T2 - Na última semana, em que medida a sua dor cervical (pescoço) interferiu em suas atividades diárias (limpar a casa, tomar banho, vestir-se, levantar, ler e dirigir)? Nenhuma interferência/Incapaz de realizar atividades	Durante a última semana, quanto a sua dor no pescoço prejudicou nas suas atividades diárias (trabalho de casa, tomar banho, colocar roupa, levantar, ler e dirigir)?Não prejudicou/Incapaz de desenvolver atividades
3. Over the past week, how much has your neck pain interfered with your ability to take part in recreational, social, and family activities? No interference/unable to carry out activities	T1 - Durante a última semana, quanto sua dor no pescoço interferiu com sua capacidade de tomar parte em atividades recreativas, sociais e familiares? Nenhuma interferência/Incapaz de desenvolver atividades T2 - Na última semana, em que medida, a sua dor cervical (pescoço) interferiu nas suas atividades recreativas, sociais e familiares? Nenhuma interferência/Incapaz de realizar atividades	Durante a última semana, quanto a sua dor no pescoço prejudicou nas suas atividades recreativas, sociais e familiares? Não prejudicou/Incapaz de realizar atividades
4. Over the past week, how anxious (tense, uptight, irritable, difficulty in concentrating/relaxing) have you been feeling? Not at all anxious/extremely anxious	T1 - Durante a última semana, quão ansioso(a) (tenso(a), nervoso, irritável, dificuldade em se concentrar/relaxar) você tem se sentido? Nada ansioso(a)/Extremamente ansioso(a) T2 - Na última semana, sentiu-se ansioso (tenso, nervoso, irritado, com dificuldades para se concentrar/relaxar)? Não ansioso/Extremamente ansioso	Durante a última semana, você sentiu-se ansioso (tenso, nervoso, irritado, com dificuldade para se concentrar/relaxar)? Não ansioso/Muito ansioso
5. Over the past week, how depressed (down-in-the-dumps, sad, in low spirits, pessimistic, unhappy) have you been feeling? Not at all depressed/extremely depressed	T1 - Durante a última semana, quão depressivo(a) (deprimido(a), triste, melancólico(a), pessimista, infeliz) você tem se sentido? Nada deprimido (a)/Extremamente deprimido (a) T2 - Na última semana, sentiu-se deprimido ("pra baixo", triste, pessimista, infeliz)? Não deprimido/Extremamente deprimido	Durante a última semana, você sentiu-se deprimido ("para baixo", triste, pessimista, infeliz)? Não deprimido/Muito deprimido
6. Over the past week, how have you felt your work (both inside and outside the home) has affected (or would affect) your neck pain? Have made it no worse/have made it much worse	T1 - Durante a última semana, como você sentiu que seu trabalho (tanto dentro como fora de casa) afetou (ou afetaria) sua dor no pescoço? Não fez piorar/Tornou muito pior T2 - Na última semana, sentiu que o seu trabalho (tanto em casa como fora) piorou (ou poderia ter piorado) a sua dor cervical (pescoço)? Não piorou/Piorou	Durante a última semana, quanto a sua dor no pescoço piorou (ou poderia ter piorado) com o trabalho (tanto em casa como fora)? Não piorou/Piorou muito
7. Over the past week, how much have you been able to control (reduce/help) your neck pain on your own? Completely control it/no control whastsoever	T1 - Durante a última semana, quanto você foi capaz de controlar (reduzir/ajudar) por si mesmo(a) sua dor no pescoço? Controlei completamente/Nenhum controle absolutamente T2 - Na última semana, conseguiu controlar (reduzir) sozinho(a) sua dor cervical (pescoço)? Controle total/Nenhum tipo de controle	Durante a última semana, quanto você conseguiu controlar (reduzir) sozinho a sua dor no pescoço? Controlei completamente/Nenhum tipo de controle

Neck Bournemouth Questionnaire	Differences between BT1 and BT2 versions
1. Over the past week, on average how would you rate your neck pain?	BT1: In the past week, what was pain level of your neck? BT2: Over the past week, how would you rate your neck pain?
2. Over the past week, how much has your neck pain interfered with your daily activities (housework, washing, dressing, lifting, reading, driving)? No interference/unable to carry out activities	BT1: In the past week, how much did your neck pain affect your activities of daily living (housework, taking a bath, washing clothes, standing up, reading and driving)? Not at all/Unable to perform activities BT2: Over the past week, how much has your neck pain interfered with your daily activities (housework, washing, dressing, lifting, reading and driving)? No interference/Unable to carry out activities
3. Over the past week, how much has your neck pain interfered with your ability to take part in recreational, social, and family activities? No interference/unable to carry out activities	BT1: In the past week, how much did your neck pain affect your recreational, social and family activities? Not at all/Unable to perform activities BT2: Over the past week, how much has your neck pain interfered with your recreational, social and family activities? No interference/Unable to carry out activities
4. Over the past week, how anxious (uptight, irritable, difficulty in concentrating/relaxing) have you been feeling?	BT1: In the past week, did you feel anxious (irritate, with difficulty concentrating/relaxing)? BT2: Over the past week, how anxious have you felt (irritated, with difficulty in concentrating/relaxing)?
5. Over the past week, how depressed (down-in-the dumps) have you been feeling? Not at all depressed/extremely depressed	BT1: In the past week, did you feel depressed ("low")? Not depressed/Very depressed BT2: Over the past week, how depressed ("down") have you felt? Not depressed/Very depressed
6. Over the past week, how have you felt your work (both inside and outside the home) has affected (or would affect) your neck pain? Have made it no worse/have made it much worse	BT1: In the past week, how much did your neck pain get worse (or could have become worse) with work (inside or outside the home)? Did not get worse/Got very much worse BT2: Over the past week, how much has your neck pain worsened (or could it have worsened) with work (both at home and away from home)? Did not worsen/Worsened a lot
7. Over the past week, how much have you been able to control (reduce/help) your neck pain on your own?	BT1: In the past week, to what extent were you able to control (reduce) your neck pain by yourself? BT2: Over the past week, how much have you managed to control (reduce) your neck pain by yourself?

Items	Intrarater		Interrater
	ICC	95% IC	ICC	95% IC
NBQ 1	0.88	0.76-0.94	0.79	0.59-0.9
NBQ 2	0.91	0.81-0.95	0.87	0.73-0.94
NBQ 3	0.91	0.82-0.96	0.86	0.72-0.93
NBQ 4	0.92	0.84-0.96	0.87	0.74-0.94
NBQ 5	0.93	0.85-0.96	0.89	0.78-0.95
NBQ 6	0.83	0.67-0.92	0.62	0.31-0.81
NBQ 7	0.77	0.55-0.89	0.66	0.37-0.83
Total score	0.96	0.91-0.98	0.87	0.73-0.93

Brazil-NQB	SF-36 scales	Pearson's coefficient correlation
		r	p-value
NBQ 1	Bodily pain	-0.665	0.001
NBQ 2	Physical functioning	-0.439	0.025
NBQ 3	Social functioning	-0.502	0.009
NBQ 4	Role-emotional scale	-0.460	0.017
NBQ 5	Mental health scale	-0.509	0.008
NBQ 6	Question 8	-0.587	0.002
NBQ 7	General health scale	-0.443	0.024

Variables	Neck Bournemouth Questionnaire
	r	p
Numerical rating score	0.70	0.001
Neck Disability Index	0.79	0.001

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[1] *Corresponding author. E-mail: fisiot.danilo@hotmail.com (D.H. Kamonseki).