Cross-cultural adaptation, validity, and reliability of the Nepali version of the Exercise Adherence Rating Scale: a methodological study

Health and Quality of Life Outcomes

Jayana N. Shrestha¹  Shambhu P. Adhikari²  Rubee Dev³ 

[1] Department of Physiotherapy, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal;Department of Physiotherapy, School of Medical Sciences, Kathmandu University, Dhulikhel, Nepal;Department of Physiotherapy, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal;School of Public Health, Sun Yat-Sen University Global Health Institute, San Yat-Sen University, Guangzhou, China;

关键词: Cross-cultural adaptation;    Exercise adherence rating scale;    Reliability;    Validity;   

DOI  :  10.1186/s12955-020-01588-6

来源: Springer

【 摘 要 】

BackgroundThe Exercise Adherence Rating Scale (EARS) is a commonly used outcome tool, which helps to identify the adherence rate of exercises and reasons for adherence and non-adherence. There is no evidence of the availability of any measurement tools to assess exercise adherence in the Nepalese context and cultural background. Therefore, we conducted a cross-cultural adaptation of the EARS into the Nepali language and investigated its reliability and validity.MethodsCross-cultural adaptation of the EARS was done based on Beaton guidelines. Psychometric properties were evaluated among 18 participants aged 18 years or older with pre-diabetes or confirmed diagnosis of any disease who were prescribed with home exercises by physiotherapists. Any disease that limited participants from doing exercise and individuals unwilling to participate were excluded. Reliability was evaluated through internal consistency, using Cronbach’s alpha. Exploratory Factor Analysis (EFA) was performed to explore construct validity and confirm its unidimensionality. Receiver Operating Characteristic (ROC) curve was analyzed to identify cut-off score, sensitivity and specificity of the tool.ResultsThe Cronbach’s alpha was 0.94 for EARS-adherence behavior. The EFA of 6-items adherence behavior revealed the presence of one factor with an eigenvalue exceeding one. The scree-plot suggested for extraction of only one factor with strong loading (75.84%). The Area Under the Curve was 0.91 with 95% confidence interval 0.77–1.00 at p = 0.004. The cutoff score was found 17.5 with 89% sensitivity and 78% specificity.ConclusionsThe EARS was cross-culturally adapted to the Nepali language. The reliability and construct validity of the Nepali version of the EARS were acceptable to assess exercise adherence in Nepali-speaking individuals. This validated tool might facilitate the evaluation of exercise-related interventions. Future studies could investigate other psychometric properties of the Nepali EARS.

【 授权许可】

CC BY