Construct Validity of the Chinese Version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong Version)

Abstract 

With increasing economic globalization, including health care, it is important to use standardized outcome measures applicable to a broad spectrum of patients in a wide array of countries. The purpose of this study was to verify construct and content validity and reliability of the Chinese version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong version). The PRWE was translated into Chinese, and face validity was established by inviting experts and patients to participate in the panel review of the questionnaire. A correlation field study was performed using a convenience sample of 47 patients with wrist injuries. Patients were assessed at baseline and six weeks after the initial measurement. The following measures were taken: the Chinese version of the PRWE and the Medical Outcome Short Form (36) Health Survey (SF-36), Visual Analogue Scale (VAS) for pain, active wrist range of motion, grip strength, and the Jebsen Hand Function Test. Statistical analysis consisted of Pearson correlation coefficients (convergent validity), factor analysis (content validity), paired t-test (convergent validity), and the Cronbach alpha (internal consistency). Clinically relevant correlations existed between “Pain at rest” and the VAS “resting pain” (r=0.785, p<0.0001) as well as between “Pain on repeated wrist movement” and the VAS “exertion pain” (r=0.872, p<0.0001). The “Physical Component Summary” of the SF-36 was found significantly correlated with the PRWE function subset total score (r=−0.618, p<0.0001), and the PRWE total score (r=−0.645, p<0.0001). The specific function subset score also correlated with the wrist flexion range (r=−0.308, p<0.0001) and the grip strength (r=−0.488, p=0.035). Two factors were found that accounted for 61% of the variance. The Cronbach alpha coefficients ranged from 0.7805 to 0.9502, indicating that the internal consistency of the questionnaire items was sound and reliable. Positive correlations between the wrist ranges of motion (ROM) and the specific function subset score showed that the function subset measured dimensions related to wrist-specific performance in activities of daily living. Factor analysis results supported the construct validity of the PRWE-Hong Kong version in wrist-injured patients. Internal consistency testing results suggested that item consistency within subset items was good and persisted over time. In conclusion, the Chinese version of the PRWE is a reliable and valid self-rated tool in measuring treatment outcome. It supplements traditional objective clinical measures and is potentially applicable in Hong Kong clinical settings.