Interpretation and content validity of the items of the Hamilton inventory to evaluate outcomes in Persian-speaking patients with complex regional pain syndrome: A cognitive interview approach

Background: The Hamilton Inventory for complex regional pain syndrome (CRPS) is a multidisciplinary assessment tool to evaluate signs and symptoms in patients with CRPS, developed in the English language. Purpose: This study aims to translate and cross -culturally adapt this tool for Persian -speaking patients with CRPS. Furthermore, this study aimed to understand how 1) Persian -speaking experts and patients interpret and calibrate responses to items on the Hamilton Inventory and 2) compensatory strategies that might affect responses. Study design: A cross sectional study with cognitive interview method. Methods: Ten health care providers and 10 patients with CRPS were interviewed using cognitive interviewing techniques (talk -aloud, semi -structured interview probes). All interviews were recorded and transcribed verbatim. A directed content analysis was done to analyze the interviews using a previously established framework. Results: Overall, the items on the Hamilton Inventory were well received by participants. Areas, where questions were unclear to some participants were recorded and categorized into five themes: Clarity and Comprehension (100%) in item 1 from the health professional tool and (65%) from the eleven items of the patient -reported tool. Perspective modifiers of culture influenced the calibrations of items "I feel my condition has negatively affected my relationships." (12%) and "My symptoms affect my comfort level with intimacy." (20%) from the patient -reported tool. Conclusion: The findings of this study demonstrate that there is no need for substantive changes to the items of the Hamilton Inventory, as they tend to be understood by Persian -speaking experts and patients with CRPS. (c) 2024 Elsevier Inc. All rights reserved.