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Validation of the Nepali Version of the Self-reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) in Adults With Chronic Pain and Predominantly Low-literacy Levels

  • Saurab Sharma
    Correspondence
    Address reprint requests to Saurab Sharma, PhD, Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Otago Medical School, University of Otago, 201 Great King Street, Dunedin Central, Dunedin 9016, New Zealand.
    Affiliations
    Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia

    Centre for Musculoskeletal Outcomes Research, University of Otago, Dunedin, New Zealand

    Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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  • Cassie Higgins
    Affiliations
    Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
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  • Paul Cameron
    Affiliations
    Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK

    NHS Fife, Dunfermline, Scotland, UK

    School of Medicine, Cardiff University, Cardiff, UK
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  • Inosha Bimali
    Affiliations
    Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
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  • Tim G. Hales
    Affiliations
    Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
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  • Michael I. Bennett
    Affiliations
    Academic Unit of Palliative Care, School of Medicine, University of Leeds, Leeds, UK
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  • Author Footnotes
    †† L.C. and B.H.S. contributed equally.
    Lesley Colvin
    Footnotes
    †† L.C. and B.H.S. contributed equally.
    Affiliations
    Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
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  • Author Footnotes
    †† L.C. and B.H.S. contributed equally.
    Blair H. Smith
    Footnotes
    †† L.C. and B.H.S. contributed equally.
    Affiliations
    Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, UK
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  • Author Footnotes
    †† L.C. and B.H.S. contributed equally.
Published:September 25, 2021DOI:https://doi.org/10.1016/j.jpain.2021.09.004

      Highlights

      • Neuropathic pain (NeuP) care and research is limited in low-income countries.
      • The Self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a common and valid tool to screen NeuP.
      • We validated a Nepali translation of the S-LANSS in Nepali adults with chronic pain.
      • It can be used to screen NeuP in chronic pain for clinical and research use in Nepal.
      • It can potentially expand NeuP knowledge.

      Abstract

      Neuropathic pain research and clinical care is limited in low- and middle-income countries with high prevalence of chronic pain such as Nepal. We translated and cross-culturally adapted the Self-report version of the Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS)—a commonly used, reliable and valid instrument to screen for pain of predominantly neuropathic origin (POPNO)—into Nepali (S-LANSS-NP) and validated it using recommended guidelines. We recruited 30 patients with chronic pain in an outpatient setting for cognitive debriefing and recruited 287 individuals with chronic pain via door-to-door interviews for validation. For known-group validity, we hypothesized that the POPNO group would report significantly more pain intensity and pain interference than the chronic pain group without POPNO using a cut-off score of ≥10/24. The S-LANSS-NP was comprehensible based on the ease of understanding the questionnaire and lack of missing responses. The validation sample consisted of predominantly low-levels of literacy (81% had 5 years or less education); 23% were classified as having POPNO. Internal consistency was good (alpha = .80). Known-group validity was supported (chronic pain with POPNO reported significantly greater pain intensity than those without). The S-LANSS-NP is a comprehensible, unidimensional, internally consistent, and valid instrument to screen POPNO in individuals with chronic pain with predominantly low-levels of literacy for clinical and research use.

      Perspective

      This paper shows that the Nepali version of the S-LANSS is comprehensible, reliable and valid in adults with chronic pain and predominantly low-levels of literacy in rural Nepal. The study could potentially develop research and clinical care of neuropathic pain in this resource-limited setting where chronic pain is a significant problem.

      Key words

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