Structural validity of the Dutch version of the disability of arm, shoulder and hand questionnaire (DASH-DLV) in adult patients with hand and wrist injuries.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Arm*/pathology ; Disability Evaluation* ; Shoulder*/pathology; Hand Injuries/*diagnosis ; Surveys and Questionnaires/*standards ; Wrist Injuries/*diagnosis; Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Disabled Persons ; Female ; Hand Injuries/epidemiology ; Humans ; Male ; Middle Aged ; Netherlands/epidemiology ; Pain Measurement/methods ; Pain Measurement/standards ; Reproducibility of Results ; Retrospective Studies ; Wrist Injuries/epidemiology ; Young Adult

Background: Fractures of the hand and wrist are one of the most common injuries seen in adults. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire has been developed as a patient-reported assessment of pain and disability to evaluate the outcome after hand and wrist injuries. Patient reported outcomes (PROs) can be interpreted as pain, function or patient satisfaction. To be able to interpret clinical relevance of a PRO, the structural validity and internal consistency is tested. The Dutch version of the DASH has not yet been validated. The aim of this study was to evaluate the structural validity and the internal consistency of the existing Dutch version of the DASH. The relevance of reporting subscale scores was investigated.
Methods: This study was a retrospective analysis of cross-sectional data of 370 patients with an isolated hand or wrist injury. Adult patients aged 18 to 65 years treated conservatively or surgically were included. Patients unable to understand or read the Dutch language were excluded. Confirmatory factor analysis was used to investigate the structural validity, while Cronbach's alpha and coefficient omega were used to assess internal consistency.
Results: All investigated models (a single factor model, a 3-correlated factor, and a bifactor model) were associated with a good model fit. Both the single factor and the 3-correlated factor model were associated with factor loadings of at least 0.70. In addition, the covariance between the factors in the 3-correlated factor model was positive (at least 0.89) and statistically significant (p < 0.001). In the bifactor model, the additional value of subscales was limited as the items loaded high on the general factor but low on the subscale factors.
Conclusion: This study indicates that the Dutch version of the DASH should be considered as an unidimensional trait. A single score should be reported.

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Keywords: Bifactor model; Confirmatory factor analysis; Disability arm shoulder hand; Hand; Structural validity; Wrist

Date Created: 20180702 Date Completed: 20190311 Latest Revision: 20190311

20240513

PMC6026503

10.1186/s12891-018-2114-7

29960600