The simple translation of a questionnaire may lead to misinterpretation due to language and cultural differences. When using questionnaires developed in other countries and languages in scientific studies it is necessary, besides the translation, to carry out a cross-cultural adaptation and validation. Our objective was to review the literature on cross-cultural adaptation and validation (CCAV) of health questionnaires, and to synthesize and propose recommendations based on the scientific literature to facilitate this process. The CCAV should follow a systematic process. Two steps are recommended: 1) cross-cultural adaptation: direct translation, synthesis, back translation, expert committee consolidation and pre-testing, and 2) validation (with up to seven steps): assessment of internal consistency, reliability, intra- and inter-observer reliability, face, content, criterion and construct validity. Lack of equivalence between questionnaires limits the comparability of results among populations with different cultures and languages and the exchange of information in the scientific community.

The adoption of common European standards on prevention of WRSD/OSD will contribute to reduce the incidence of OSD and their socio-economic burden.

BackgroundNurses and nursing aides are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multifaceted intervention to prevent and manage MSP in two hospitals.Material and methodsWe performed a two-armed cluster randomized controlled trial, with a late intervention control group. Clusters were independent hospital units with nursing staff as participants. The intervention comprised three evidence-based components: participatory ergonomics, health promotion activities and case management. Both the intervention and the control group received usual occupational health care. The intervention lasted one year. MSP and work functioning data was collected at baseline, six and 12-month follow-up. Odds ratios (OR) and their 95% confidence intervals (95%CI) were calculated for MSP risk in the intervention group compared to the control group using logistic regression through GEE. Differences in work functioning between the intervention and control group were analyzed using linear regression through GEE. The incidence of sickness absence was calculated through logistic regression and Cox proportional hazard modeling was used to analyze the effect of the intervention on sickness absence duration.ResultsEight clusters were randomized including 473 nurses and nursing aides. At 12 months, the intervention group showed a statistically significant decrease of the risk in neck, shoulders and upper back pain, compared to the control group (OR = 0.37; 95%CI = 0.14–0.96). A reduction of low back pain was also observed, though non statistically significant. We found no differences regarding work functioning and the incidence and duration of sickness absence.ConclusionsThe intervention was effective to reduce neck, shoulder and upper back pain. Our results, though modest, suggests that interventions to prevent and manage MSP need a multifactorial approach including the three levels of prevention, and framed within the biopsychosocial model.

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OSD definitions vary between European countries and are not directly comparable, which hampers comparisons between statistics collected in different countries. Awareness of this fact and further efforts for standardization are necessary.

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Background Musculoskeletal pain (MSP) is the leading cause of years lived with disability. In consequence, to reduce MSP and its associated sickness absence is a major challenge. Previous interventions have been developed to reduce MSP and improve return to work of workers with MSP, but combined approaches and exhaustive evaluation are needed. The objective of the INTEVAL_Spain project is to evaluate the effectiveness of a multifaceted intervention in the workplace to prevent and manage MSP in nursing staff. Methods The study is designed as a two-armed cluster randomized controlled trial with a late intervention control group. The hospital units are the clusters of randomization and participants are nurses and aides. An evidence-based multi-component intervention was designed combining participatory ergonomics, case management and health promotion. Both the intervention and the control groups receive occupational health care as usual. Data are collected at baseline, and after six and 12 months. The primary outcomes are prevalence of MSP and incidence and duration of sickness absence due to MSP. Secondary outcomes are work role functioning and organizational preventive culture. The intervention process will be assessed through quantitative indicators of recruitment, context, reach, dose supplied, dose received, fidelity and satisfaction, and qualitative approaches including discussion groups of participants and experts. The economic evaluation will include cost-effectiveness and cost-utility, calculated from the societal and the National Health System perspectives. Discussion Workplace health programs are one of the best options for the prevention and control of non-communicable diseases. The main feature of this study is its multifaceted, multidisciplinary and de-medicalized intervention, which encompasses three evidence-based interventions and covers all three levels of prevention, which have not been previously unified in a single intervention. Also, it includes a comprehensive quantitative and qualitative evaluation of the intervention process, health results, and economic impact. This study could open the possibility of a new paradigm for the prevention and management of MSP and associated sickness absence approach at the workplace. Trial registration Current Controlled Trials ISRCTN15780649 Retrospectively registered 13th July 2018.

The health-related QoL utilities of patients with premalignant conditions are similar to those without gastric diseases whereas patients with present cancer show decreased utilities. Moreover, women had consistently lower utilities than men. These results confirm that the use of a single standardized instrument such as the EQ-5D-5L for all stages of the gastric carcinogenesis cascade is feasible and that it captures differences between conditions and gender dissimilarities, being relevant information for authors pretending to conduct further cost-utility analysis.