Cross-cultural adaptation and validation of nasal obstruction symptom evaluation questionnaire in Slovenian language

Urbančič, Jure; Soklič Košak, Tanja; Jenko, Klemen; Božanić Urbančič, Nina; Hudoklin, Peter; Delakorda, Matej; Juvanec, Ajda; Zupančič Urbančič, Katarina; Vadnjal, Jana; Gluvajić, Daša

doi:10.1515/sjph-2017-0003

Figures & Tables

Effect size estimate (the left side showing large discrimination, the right side showing efficacy of intervention).

NOSE (the original questionnaire)_

	Very mild problem	Moderate problem	Fairly bad problem	Severe problem
Nasal congestion or stuffiness	1	2	3	4
Nasal blockage or obstruction	1	2	3	4
Trouble breathing through my nose	1	2	3	4
Trouble sleeping	1	2	3	4
Unable to get enough air through my nose during exercise or exertion	1	2	3	4

Cross-cultural adaptation (phases and steps leading to adapted and validated QoL tool)_

Phase I	Cross-cultural adaptation of the original NOSE questionnaire in five steps, according to emerging guidelines (7, 15). Step I Two experts in rhinology blinded one to another translated the original NOSE questionnaire. Step II A third expert reviewed both translations and created a new version. Step III A fourth expert reviewed it, blinded to both initial versions. Step IV The latest version was sent to a translator with no medical background to form and backtranslate. Step V A board of experts (3 rhinologists, 1 audiologist, 3 general ENT consultants, 1 family medicine practitioner, 1 ENT specialist in training, 1 non-medical translation consultant) reviewed results and synthesized the final version of NOSE-si. It was proofread, and the final report was created.
Phase II	The pilot phase consisted of submitting NOSE-si to a limited number (n=33) of patients in the study group and control group.Patient and expert comments with results were reevaluated by an expert committee and a preliminary statistical analysis was done to compare the pilot version of NOSE-si to the original tool and other CCA processed NOSE questionnaires (13, 16).Since high degree of internal consistency reliability was found, the expert committee accepted NOSE-si as the final version.
Phase III	Both the study and control group were enrolled. Retesting was scheduled 7-14 days after the initial testing for the study group and controls (90 patients). Patients had to fill out the same questionnaire and send it back to the researchers.
Phase IV	The postintervention test in the study group (90 days after surgery - submucosal resection of nasal septum).

Clinical characteristics of study patients_

	Study group(with complaints)(n=58)	Control group(no complaints)(n=58)	P value(study vs. control)
Sex
Male	15 (25.7%)	27 (46.6%)
Female	43 (74.3%)	31 (53.4%)	0.004 ‡ Fisher’s Exact test
Age (y)	37.8 (± 13.92)	40.1 (± 14.43)	0.452 Independent samples Mann Whitney U test
Body mass index (BMI)	25.21 (± 4.19)	22.85 (± 3.86)	0.003 Independent samples Mann Whitney U test
Smokers	16 (27.6%)	14 (24.1%)	0.832 ‡ Fisher’s Exact test
Mean NOSE-si score	70.52 (± 15.46)	3.97 (± 5.9)	<0.001 T-test

NOSE-si correlation (inter-item and item-total correlation; original NOSE field names are used)_

Inter-Item Correlation Matrix
	Nasal congestion or stuffiness	Nasal blockage or obstruction	Trouble breathing through my nose	Trouble sleeping	Unable to get enough air through my nose during exercise or exertion
Nasal congestion or stuffiness	1.000	0.916	0.899	0.822	0.881
Nasal blockage or obstruction	0.916	1.000	0.909	0.844	0.887
Trouble breathing through my nose	0.899	0.909	1.000	0.851	0.875
Trouble sleeping	0.822	0.844	0.851	1.000	0.800
Unable to get enough air through my nose during exercise or exertion	0.881	0.887	0.875	0.800	1.000

Cross-cultural adaptation and validation of nasal obstruction symptom evaluation questionnaire in Slovenian language

Figures & Tables

Figure 1

NOSE (the original questionnaire)_

Cross-cultural adaptation (phases and steps leading to adapted and validated QoL tool)_

Clinical characteristics of study patients_

NOSE-si correlation (inter-item and item-total correlation; original NOSE field names are used)_

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