Linguistic and cultural adaptation of self-reported outcome questionnaires in foot and ankle‑related pathologic conditions, FADI, FAAM and SEFAS, and their testing in Russian patients with different orthopedic pathology

Abstract

Introduction Self-reporting of well-being by patients with disorders of the musculoskeletal system is of value and might be considered in decision making. The international orthopedic community recommends to use the questionnaires FADI, FAAM and SEFAS for assessing the function of the foot and ankle in different conditions, including changes after surgical treatment. The aim of the study was linguistic validation and cross cultural adaptation of the Russian versions of FADI, FAAM and SEFAS measures, including their testing in the population of patients with different foot and ankle disorders. Methods In accordance with current international recommendations, the linguistic and cultural adaptation of FADI, FAAM and SEFAS questionnaires included the procedure of their forward and back translations, testing of the Russian versions via patients’ interviews, expert evaluation of Russian versions by specialists and decentering. Results Test versions of FADI, FAAM and SEFAS questionnaires in Russian were created. The tools were tested in the group of 40 patients with different foot and/or ankle joint disorders, including 10 athletes. The majority of items and questions of the tools were clear, comfortable and easily understood by patients. Based on the results of interviewing, an acceptable indicator of external validity of the Russian versions of the three questionnaires was established; according to the results of a survey by specialists (n = 14), their content validity was confirmed. Due to the fact that some questions of the questionnaires were difficult to understand for > 15% of patients, at the decentering stage, clarifying statements were made to the wording of two questions of the FADI and FAAM questionnaires and one question of the SEFAS questionnaire, what enabled to maximally adapt the new language versions of the questionnaires to the ethno-linguistic features of the Russian language patient population. Discussion Due to the fact that some items of the questionnaires caused misunderstanding and were difficult to understand, clarifications were made to the wording of these items. The final versions of the FADI, FAAM and SEFAZ questionnaires were approved by the Expert Council in accordance with the results of decentering and on the basis of available recommendations. In general, good substantive validity of all three Russian versions of the questionnaires, FADI, FAAM and SEFAS, has been demonstrated. Conclusion The final Russian versions of the FADI, FAAM and SEFAS questionnaires were developed through linguistic validation and cross-cultural adaptation that are equivalent to their original versions and correspond to the ethno-linguistic features of the population. Their use in research and clinical practice is possible after assessment of psychometric properties of these tools.