Pain in amaXhosa Women Living With HIV/AIDS: Translation and Validation of the Brief Pain Inventory-Xhosa

Context. Pain has been reported as the second most commonly reported symptom in people living with HIV/AIDS. In South Africa, there are more than five million people living with HIV/AIDS. Approximately, two million belong to the Xhosa cultural group. The prevalence of pain in amaXhosa living with HIV/AIDS was unknown at the commencement of the study. A culturally appropriate, valid, and reliable instrument is required to measure pain and its impact in this population. Objectives. The objectives of this article are to document the process of translation of the Brief Pain Inventory (BPI) into the BPI-Xhosa and to present the results of the validity and reliability testing of the instrument. Methods. A six-stage forward-backward translation process was followed using bilingual and bicultural translators to ensure decentering of the process. The translated BPI-Xhosa, a demographic questionnaire and the European Quality of Life-5 Dimensions Xhosa version (EQ-5D-Xhosa) health-related quality of life instrument were administered to 229 amaXhosa women living with HIV/AIDS in a resource-poor urban settlement in South Africa. Results. A 74.24% (95% CI: 68.2-79.47) prevalence of pain was recorded. The BPI-Xhosa had good concurrent validity when compared with the previously validated EQ-5D-Xhosa. Factor analysis confirmed that the BPI-Xhosa had a two-factor structure (pain severity and pain interference). The instrument had good internal reliability, with Cronbach alphas of 0.77 and 0.83 for the pain severity and pain interference subscales, respectively. Conclusion. The BPI-Xhosa is a valid instrument which can be used to measure pain prevalence, severity, and interference in amaXhosa women living with HIV/AIDS. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.