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

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).

Table 2

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

Table 3

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‡‡
Age (y)	37.8 (± 13.92)	40.1 (± 14.43)	0.452*
Body mass index (BMI)	25.21 (± 4.19)	22.85 (± 3.86)	0.003*
Smokers	16 (27.6%)	14 (24.1%)	0.832‡‡
Mean NOSE-si score	70.52 (± 15.46)	3.97 (± 5.9)	<0.001**

‡‡ Fisher’s Exact test

* Independent samples Mann Whitney U test

‡‡ Fisher’s Exact test

** T-test

Table 4

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

Item-Total Statistics
	Scale Mean if Item Deleted	Scale Variance if Item Deleted	Corrected Item-Total Correlation	Squared Multiple Correlation	Cronbach’s Alpha if Item Deleted
Nasal congestion or stuffiness	6.02	32.208	0.929	0.875	0.961
Nasal blockage or obstruction	5.91	32.027	0.942	0.892	0.959
Trouble breathing through my nose	5.92	31.933	0.934	0.875	0.960 0.971
Trouble sleeping	6.09	32.800	0.864	0.755	0.965
Unable to get enough air through my nose during exercise or exertion	5.84	32.567	0.905	0.828	0.965

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

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Articles in this issue

DOI: https://doi.org/10.1515/sjph-2017-0003 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026

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Language: English, Slovenian

Page range: 18 - 23

Submitted on: Dec 16, 2015

Accepted on: May 26, 2016

Published on: Jul 28, 2016

Published by: National Institute of Public Health, Slovenia

In partnership with: Paradigm Publishing Services

Keywords:

nasal obstruction,

quality of life instruments,

cross-cultural adaptation of questionnaires

Related subjects:

Medicine,

Clinical medicine,

Hygiene and environmental medicine

© 2016 Jure Urbančič, Tanja Soklič Košak, Klemen Jenko, Nina Božanić Urbančič, Peter Hudoklin, Matej Delakorda, Ajda Juvanec, Katarina Zupančič Urbančič, Jana Vadnjal, Daša Gluvajić, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 56 (2017): Issue 1 (March 2017)

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

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Table 2

Table 3

Table 4

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