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The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa
Thesis (PhD)--Stellenbosch University, 2022.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867613907937394688 |
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| access_status_str | Open Access |
| author | De Klerk, Susan |
| author2 | Van Niekerk, Lana |
| author_browse | De Klerk, Susan Van Niekerk, Lana |
| author_facet | Van Niekerk, Lana De Klerk, Susan |
| author_sort | De Klerk, Susan |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (PhD)--Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/125993 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:36.943Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/125993 The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa De Klerk, Susan Van Niekerk, Lana Buchanan, Helen Jerosch-Herold, Christina Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Occupational Therapy. People with disabilities -- Functional assessment -- Western Cape (South Africa) Physical therapy -- Western Cape (South Africa) Hand -- Wounds and injuries -- Western Cape (South Africa) UCTD Thesis (PhD)--Stellenbosch University, 2022. ENGLISH SUMMARY: The Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire is a 30-item patient-reported outcome measure (PROM) designed to measure symptoms and disability in clients with upper limb injury or conditions. The measure was developed in 1996 by the Institute for Work and Health (IWH) in Canada. It has been translated and cross-culturally adapted to at least 50 languages around the world. No evidence existed for translations from the South African context. This country faces a high incidence of hand injury and conditions, especially so in the overburdened public health service sector. PROMs such as the DASH questionnaire, if validated within this context, are essential in allowing accurate self-report and demonstrating the outcomes of intervention offered. An essential requirement is however for the PROM to be available in the client’s language. The research context is that of the public health service, within the Western Cape of South Africa and specifically the Afrikaans-speaking community. This multi-phased study i) explored the evidence on the validity and clinical utility of DASH questionnaire translations from low-income to upper-middle-income countries, ii) translated and cross-culturally adapted the DASH questionnaire into Afrikaans for the Western Cape utilising the practices of Community Translation (CT) and Shared Decision Making (SDM), iii) evaluated the content validity of the new translation through an iterative process during pretesting and cognitive interviewing (CI) and iv) evaluated construct validity (specifically structural validity, internal consistency and cross-cultural validity) of the Afrikaans for the Western Cape DASH questionnaire. A sequential mixed-methods study design was followed with quantitative and qualitative components across the four phases outlined above. Phase one comprised a systematic review methodology as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Consensus-based Standards for Selection of Health Measurement Instruments (COSMIN) guidelines. Phase two considered CT and SDM in addition to recommendations for translation and cross–cultural adaptation as per the IWH. Phase three addressed content validity as per the COSMIN guidelines. Phase four utilised Classical Test Theory (CTT). Structural validity was evaluated through both Confirmatory and Exploratory Factor Analysis (CFA & EFA) utilising appropriate fit indexes. Internal consistency was calculated through Cronbach’s alpha and cross-cultural validity was assessed during Multiple Group Confirmatory Factor analysis (MGCFA) to confirm measurement invariance between the Afrikaans for the Western Cape DASH and the South African English DASH questionnaires, demonstrated through appropriate fit indexes. Phase two to four comprised a sample of participants included as per eligibility criteria considered during each phase. CT was introduced as an approach to translation and cross-cultural adaptation in the public health service context and considered Afrikaans for the Western Cape. The process of translation and cross-cultural adaptation utilising the practices of CT and SDM (introduced for the first time in the context of translation and cross-cultural adaptation of PROMs) is reported on. The content validity of the newly translated Afrikaans for the Western Cape DASH questionnaire was confirmed, and the process of CI well described to illustrate the iterative nature thereof. Structural validity was evaluated initially via CFA and subsequently via EFA when unidimensionality was not confirmed. The Afrikaans for the Western Cape DASH questionnaire yielded a two-factor structure (with internal consistency), and cross-cultural validity was evaluated through MGCFA exploring measurement invariance between the Afrikaans for the Western Cape DASH and South African English DASH questionnaire. Scalar invariance was supported and provides evidence of cross-cultural validity. The Afrikaans for the Western Cape DASH questionnaire was successfully translated and cross-culturally adapted, with evidence of content, structural and cross-cultural validity and can be utilised within the intended context. AFRIKAANSE OPSOMMING: Die Gestremdhede van die Arm, Skouer en Hand (DASH) Vraelys is 'n 30-item pasient-gerapporteerde, uitkomsgebaseerde meetinstrument wat ontwerp is om simptome en gestremdhede by kliente met boonste-ledemaat beserings of toestande te meet. Die instrument is in 1996 ontwikkel deur die Kanadese Institute for Work and Health (IWH). Om dit meer toeganklik te maak is dit kruis-kultureel aangepas en in ten minste 50 verskillende tale vertaal. In die Suid-Afrikaanse konteks, waar die publieke gesondheidsektor oorlaai is deur die hoe voorkoms van handtoestande en -beserings, vind ons egter geen bewyse geldigheid van bestaande vertalings nie. ʼn Pasient gerapporteerde uitkomsgebaseerde meetinstrument soos die DASH-vraelys, indien geldig verklaar vir die Suid-Afrikaanse konteks, is noodsaaklik om sodoende akkurate selfrapportering te bewerkstelling en die uitkomste van intervensie binne hierdie konteks te demonstreer. 'n Noodsaaklike vereiste is egter dat die instrument in die klient se taal beskikbaar moet wees. Die navorsingskonteks is dus die van die openbare gesondheidsdiens in die Wes-Kaap van Suid-Afrika, meer spesifiek die Afrikaanssprekende gemeenskap van die Wes-Kaap. Hierdie multi-fase studie ondersoek die Afrikaanstalige, Wes-Kaapse DASH vraelys deur: i) die bewyse van geldigheid en kliniese bruikbaarheid van die DASH vraelys vertalings in lae – inkomste tot hoer-middel inkomste lande te ondersoek; ii) die DASH vraelys in Afrikaans te vertaal en kruis-kultureel aan te pas vir die Wes-Kaap met gebruikmaking van Gemeenskapsvertaling (GV) en gedeelde besluitnemingspraktykvoering; iii) die inhouds-geldigheid van die nuwe vertaling te evalueer deur middel van die iteratiewe proses van kognitiewe onderhoudsvoering gedurende voortoetsing en kognitiewe onderhoudsvoering en; iv) die konstrukgeldigheid (spesifiek strukturele geldigheid, interne konsekwentheid en kruis-kulturele geldigheid) van die Afrikaans vir die Wes-Kaapse DASH vraelys te evalueer. ’n Opeenvolgende gemengde-metode studie ontwerp, met kwalitatiewe en kwantitatiewe komponente oor die vier fases soos hierbo uiteengesit, is gevolg. Fase een behels ʼn sistematiese oorsig met betrekking tot die Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) en die Consensus-based Standards for Selection of Health Measurement Instruments (COSMIN) riglyne. Fase twee het GV en gedeelde besluitneming, tesame met aanbevelings vir vertaling en kruis-kulturele aanpassing, soos uiteengsit deur die IWH, in ag geneem. Fase drie het, met in agnome van die COSMIN riglyne, inhoudsgeldigheid aangespreek. Fase vier maak gebruik van Classical Test Theory (CTT). Strukturele geldigheid is ge-evalueer deur beide bevestigende en verkennende faktor analise, met oorweging van toepaslike pas indekse. Interne konsekwentheid is verseker deur Cronbach’s alpha, terwyl kruis-kulturele geldigheid bepaal is deur veelvuldige groep bevestigende faktor analise. Sodoende is meting onveranderlikheid tussen die Afrikaans vir die Wes-Kaap en die Suid-Afrikaanse Engelse DASH vraelyste bevestig en gedemonstreer deur toepaslike pas indekse. Fases twee tot vier bevat ʼn steekproef van deelnemers wat ingesluit is op grond van geskiktheidskriteria oorweeg gedurende elke fase. GV, as ʼn benadering tot vertaling en kruis-kulturele aanpassing in die publieke gesondheidsektor is bekendgestel, met Wes-Kaapse Afrikaans wat in ag geneem is. Die proses van vertaling en kruis-kulturele aanpassing deur gebruik van GV en gedeelde besluitname (vir die eerste keer bekendgestel in die konteks van vertaling en kruis-kulturele aanpassing) word gerapporteer. Die inhoudsgeldigheid van die nuwe Afrikaanstalige, Wes-Kaapse DASH vraelys is bevestig en die proses van kognitiewe onderhoudvoering word goed beskryf ten einde die iteratiewe aard daarvan te illustreer. Strukturele geldigheid is aanvanklik deur bevestigende faktor analise en daarna deur verkennende faktor analise evalueer toe een-dimensionaliteit nie bevestig is nie. Die Wes-Kaapse Afrikaanstalige DASH vraelys, het ʼn twee faktor model opgelewer (met interne konsekwentheid). Ten einde meting onveranderlikheid tussen die Wes-Kaap Afrikaanstalige en die Suid-Afrikaanse Engelse DASH vraelys te bevestig, is kruis-kulturele geldigheid ge-evalueer deur veelvuldige groep bevestigende faktor analise. Skalare onveranderlikheid word ondersteun en verskaf bewyse van kruis-kulturele geldigheid. Die Wes-Kaapse Afrikaanstalige DASH vraelys is suksesvol vertaal en kruis-kultureel aangepas met bewese inhouds -, strukturele – en kruis-kulturele geldigheid en kan dus gebruik word binne die omgewing waarvoor dit bedoel is. Doctorate 2022-11-15T12:49:39Z 2023-01-16T12:44:43Z 2022-11-15T12:49:39Z 2023-01-16T12:44:43Z 2022-12 Thesis http://hdl.handle.net/10019.1/125993 en_ZA Stellenbosch University xv, 244 pages : illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | People with disabilities -- Functional assessment -- Western Cape (South Africa) Physical therapy -- Western Cape (South Africa) Hand -- Wounds and injuries -- Western Cape (South Africa) UCTD De Klerk, Susan The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title | The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title_full | The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title_fullStr | The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title_full_unstemmed | The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title_short | The validity of the disabilities of the arm, shoulder and hand (DASH) questionnaire in Afrikaans for the Western Cape of South Africa |
| title_sort | validity of the disabilities of the arm shoulder and hand dash questionnaire in afrikaans for the western cape of south africa |
| topic | People with disabilities -- Functional assessment -- Western Cape (South Africa) Physical therapy -- Western Cape (South Africa) Hand -- Wounds and injuries -- Western Cape (South Africa) UCTD |
| url | http://hdl.handle.net/10019.1/125993 |
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