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CULTURAL ADAPTATION AND VALIDATION OF THE ITALIAN VERSION OF DAWSON’S QUESTIONNAIRE FOR KNEE REPLACEMENT



Abstract

There is no consensus regarding the best method of assessing outcomes after total knee arthroplasty. There are now many questionnaires in the literature, well constructed and validated in the original language. Dawson’s questionnaire (1998) is designed as a 12-item self-administered instrument, and has undergone a complete validation procedure in its original English version.

Aim of this paper is to present the procedure of cultural adaptation and some data from the validation process of the Italian version of the questionnaire.

Two independent translations into Italian and back-translations into English were obtained, from specialised and general translators. The material was then evaluated in a multidisciplinary panel including elderly patients. A provisional version was obtained and tested in a pilot study. Results and comments were reviewed within the panel again which came up with the final version.

The questionnaire was administered to 100 patients scheduled for knee replacement. Other outcomes collected included a general health questionnaire, in its validated Italian version (SF-36), and several objective and radiographic parameters.

The burden on the patient and comprehension’s difficulties were registered. Validation included the assessment of internal consistency, construct and content validity. Correlation between different parameters were investigated. Test-retest reliability was assessed on 20 patients. Comparisons with the data presented in the original paper were performed.

The questionnaires were accepted favourably by the patients, even though the combination with the SF-36 increased the amount of time required for completion. Some difficulties were registered with the comprehension of the answering method, as well as of the meaning of single items. Results of the validation process were substantially equivalent to those of the original paper.