The Bronchitis Emphysema Symptom Checklist
(BESC) is a 57-item questionnaire developed by
Kinsman and colleagues24 to measure symptoms,
sensation, and feeling. This tool is in the public domain
and has never been used in Thailand. Thus, it was
translated to the Thai language based on the process
of translation by the World Health Organization
(WHO).25
Firstly, forward translation into Thai language
was done by one author and verified by a second author.
Secondly, three bilingual nursing instructor panels,
one specializing in COPD and two specializing
in chronic care, validated the translation. Thirdly,
back-translation to English was done by a Thai
instructor who earned a doctoral degree in language
education in the USA and did not have any knowledge
about the BESC. Comparing the back translation and
the original version it was found that 50 items of the
57 items matched, whereas, the remaining 7 items of
the BESC were quite similar in meaning. Lastly,
pre-testing was carried out with 15 Thais with COPD
and it was found that the respondents could understand
and describe the meaning of symptoms.
Since the original version of the BESC included
the dimension of symptom frequency, a dimension of
symptom distress was added into this tool by applying
a 5-point scale ranging from 1 to 5 (1 = not at all,
2 = a little bit, 3 = somewhat, 4 = quite a bit, and
5 = very much). Higher scores indicate more distress
of symptoms. This dimension was verified in content
validity by three experts specialized in COPD, who
were two nursing instructors and one Advanced
Practice Nurse (APN), and yielded a scale content
validity index (S-CVI) of .92. Moreover, two experts
suggested removing 4 redundant items, which were:
tired, chest congestion, irritable and forgetting things,
and added 1 item, which was; pain in other regions.
Thus, the total number of this tool is 54 items.
The internal consistency reliability testing of the BESC
was undertaken in the pilot study with 10 persons with
COPD. Cronbach’s alpha was .92 and .95 for
symptom prevalence and distress, respectively.
For this main study, they were . and .,
respectively.
The Bronchitis Emphysema Symptom Checklist(BESC) is a 57-item questionnaire developed byKinsman and colleagues24 to measure symptoms,sensation, and feeling. This tool is in the public domainand has never been used in Thailand. Thus, it wastranslated to the Thai language based on the processof translation by the World Health Organization(WHO).25Firstly, forward translation into Thai languagewas done by one author and verified by a second author.Secondly, three bilingual nursing instructor panels,one specializing in COPD and two specializingin chronic care, validated the translation. Thirdly,back-translation to English was done by a Thaiinstructor who earned a doctoral degree in languageeducation in the USA and did not have any knowledgeabout the BESC. Comparing the back translation andthe original version it was found that 50 items of the57 items matched, whereas, the remaining 7 items ofthe BESC were quite similar in meaning. Lastly,pre-testing was carried out with 15 Thais with COPDand it was found that the respondents could understandand describe the meaning of symptoms.Since the original version of the BESC includedthe dimension of symptom frequency, a dimension ofsymptom distress was added into this tool by applyinga 5-point scale ranging from 1 to 5 (1 = not at all,2 = a little bit, 3 = somewhat, 4 = quite a bit, and5 = very much). Higher scores indicate more distressof symptoms. This dimension was verified in contentvalidity by three experts specialized in COPD, whowere two nursing instructors and one AdvancedPractice Nurse (APN), and yielded a scale contentvalidity index (S-CVI) of .92. Moreover, two expertssuggested removing 4 redundant items, which were:tired, chest congestion, irritable and forgetting things,and added 1 item, which was; pain in other regions.Thus, the total number of this tool is 54 items.The internal consistency reliability testing of the BESCwas undertaken in the pilot study with 10 persons withCOPD. Cronbach’s alpha was .92 and .95 forsymptom prevalence and distress, respectively.For this main study, they were . and .,respectively.
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