Field testing and psychometric properties of Thai version of the Boston carpal tunnel questionnaire

Pichitchai Atthakomol; Jirawat Nudchapong; Kamonwan Sangseekaew; Worapaka Manosroi; Siam Tongprasert; Tinakon Wongpakaran; Nahathai Wongpakaran

doi:10.3389/fneur.2023.1132218

Field testing and psychometric properties of Thai version of the Boston carpal tunnel questionnaire

Front Neurol. 2023 Jul 18:14:1132218. doi: 10.3389/fneur.2023.1132218. eCollection 2023.

Authors

Pichitchai Atthakomol¹, Jirawat Nudchapong¹, Kamonwan Sangseekaew², Worapaka Manosroi³, Siam Tongprasert⁴, Tinakon Wongpakaran⁵, Nahathai Wongpakaran⁵

Affiliations

¹ Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
² English for International Communication Program, International College, Chiang Mai Rajabhat University, Chiang Mai, Thailand.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁴ Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁵ Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Abstract

Introduction: The Boston Carpal Tunnel Questionnaire (BCTQ) is a widely recommended patient-reported outcome measure to evaluate symptoms and functions in carpal tunnel syndrome (CTS) patients. We aimed to evaluate the translation and cross-cultural adaptation of the Thai version of the BCTQ (Thai BCTQ) and to investigate the psychometric properties including internal consistency, test-retest reliability, construct validity and responsiveness.

Methods: The Thai BCTQ was field tested with 15 healthy volunteers and 15 CTS patients to evaluate the item-objective congruence of each item. Following that, one hundred and twenty-four CTS patients were included for psychometric evaluation in this study. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was examined using the intraclass correlation coefficient (ICC). To evaluate construct validity, Spearman's rank correlation of the symptom severity scale (Thai BCTQ -S), the functional status scale (Thai BCTQ -F) and the subscales of the Thai MHQ were analyzed. Responsiveness was determined using the standardized response mean (SRM).

Results: Minor modification of the Thai version was made to better explain the term "tingling". The Thai BCTQ-S, Thai BCTQ-F and Thai BCTQ demonstrated adequate Cronbach's alpha values (0.91-0.94) and good test-retest reliability (ICC=0.89-0.98). Regarding related dimensions, a strong correlation (r=0.67, P<0.008) was found between the Thai BCTQ-F and the Function subscale of Thai MHQ as well as between Thai BCTQ-F and the Activities of Daily Living subscale of the Thai MHQ (r=0.75, P<0.008). In unrelated dimensions, there was a relatively weak correlation between the Thai BCTQ-S and the Aesthetics subscale of the Thai MHQ (r=0.32, P=0.0116). The SRM of the Thai BCTQ was 1.46, indicating large responsiveness.

Discussion: The Thai BCTQ has adequate internal consistency in both the symptom and function scales as well as good construct validity and test-retest reliability indicating it is suitable for evaluating Thai CTS patients. This tool also has a high ability to detect clinically significant changes in symptoms and function over time after receiving conservative or surgical treatment.

Keywords: Boston carpal tunnel questionnaire; Thai; field testing; reliability; responsiveness; validity.