| Summary: | Thesis (M.Sc.(Physiotherapy)), Faculty of Health Sciences, University of the Witwatersrand, 2009 === Background Lower back pain (LBP) is a very prevalent and potentially disabling
condition throughout the world not excluding South Africa. Most people in South
Africa make use of Government hospitals making the results of this research
applicable to the general population. Questionnaires like the Oswestry Disability
Index (ODI) are easy and effective research tools to assess disability from LBP
but most of them are developed in English. In South Africa however, many
people are often not literate in English or struggle to fill in a questionnaire
correctly without some assistance. This is possibly due to the previous education
system adopted by the Apartheid government, variety of different cultures and
the 11 official languages.
Objectives To formulate a culturally adapted English version of the ODI suitable
for possible use in the Zulu speaking population. Secondly, to establish whether
there is a relationship between the degree of assistance needed to fill in the
questionnaire and the level of education of the subject. Thirdly, to measure the
internal consistency of the modified ODI and lastly to identify inconsistencies
when using a translator for data collection.
Study Design Explorative cross-sectional study
Methods Cultural adaptation of the ODI was done suitable for the Zulu speaking
population. Recordings were made of the participants filling in the modified ODI
to identify problematic questions and inconsistencies in translations offered by
the research assistant. The amount of assistance needed for each participant
was scored with a rating scale and relationships were shown with regards to level
of education. The internal consistency of the modified ODI was determined.
Results A culturally adapted English version of the ODI was produced and
problematic phrases altered. Two groups were identified from the data collection
process; the assisted (20) and the Independent group (36).Overall the assisted
group had lower levels of education and needed up to 100% assistance with the
questionnaire compared with the Independent group. The overall Internal
consistency of the questionnaire was found to be 0.8183 (Chronbach alpha)
which is considered as good reliability. Inconsistencies with translations were
identified and reported.
Conclusion A significant amount of the target population needed assistance
when filling in the English ODI despite the cultural adaptation thereof. This may
be due to lower levels of education and the fact that they were mostly schooled in
Zulu. Making use of a translator may not be the most reliable form of data
collection but keeping in mind the literacy levels in South Africa, it may be a more
accurate way of collecting correct data from individuals compared with incurring
massive costs in translating of documents into a target language.
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