Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version of the Satisfaction and Recovery Index (SRI): Structural Validity, Construct Validity, Internal Consistency, and Test-retest Reliability

Background: The Satisfaction and Recovery Index (SRI) is a generic importance-weighted health satisfaction tool to measure the process and state of recovery following musculoskeletal injuries. The objectives of this study are (۱) to translate and cross-culturally adapt the SRI to Persian and (۲) evaluate its psychometric properties.Methods: The forward-backward translation technique was used for translation, and two rounds of cognitive interviews were conducted to assess cultural appropriateness. Participants (n=۱۰۰, mean age=۳۲.۵, ۸۲%male) had acute (i.e., <۳۰ days) musculoskeletal injuries of any etiology. Structural validity, construct validity, internal consistency, and testretest reliability were evaluated. Results: Participants identified issues in ۳/۶ areas of a coding system during the cognitive interviews: comprehension/clarity, relevance, and inadequate response definition. These issues informed subsequent changes to arrive at the final version of the SRI-P. The SRI-P had adequate construct validity (P<۰.۰۰۱), the confirmatory factor analysis demonstrated a two-factor structure, the internal consistency was acceptable (Cronbach’s α=۰.۸۳), and it was deemed reliable (ICC۲, ۱=۰.۷۲).Conclusion: The psychometric evaluation revealed that the SRI-P has adequate construct validity, internal consistency, and test-retest reliability. Unlike the original English version, the SRI-P has a two-factor structure, which appears to be related to cultural differences in interpreting some of the items. The clinical importance of this study is that the SRI (which captures the state of recovery and how important the various items of the tool are to each patient and how satisfied they are with their recovery) can now be available to surgeons and therapists in the orthopedic and rehabilitation realms in Persian populations.Level of evidence: II