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The Patient-Rated Wrist Evaluation questionnaire: Translation, validation, and cross-cultural adaptation in Serbian
Aleksandar Matejić1, Masa Petrovic2, Bojana Salovic3
1Institute for Orthopedic Surgery "Banjica", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Background:
No validated Serbian-language patient-reported outcome measure exists for wrist and hand conditions. The Patient-Rated Wrist/Hand Evaluation (PRWHE) demonstrates superior responsiveness over broader instruments such as the Disabilities of the Arm, Shoulder, and Hand (DASH) for pathology confined to the wrist and hand.
Purpose:
To translate, culturally adapt, and validate the PRWHE for Serbian-speaking patients with hand and wrist disorders.
Study Design:
Clinical measurement, cross-sectional validation study.
Methods:
One hundred sixty-three patients (52.1% male; mean age 52.4 ± 15.8 years) with hand and wrist conditions were enrolled. Translation adhered to internationally accepted cross-cultural adaptation guidelines. Participants completed the Serbian PRWHE, DASH, and SF-12. Internal consistency (Cronbach's α), test-retest reliability (ICC; n = 15, 2-week interval), confirmatory factor analysis, and convergent validity (Pearson/Spearman correlations) were assessed.
Results:
Internal consistency was excellent for the Pain (α = 0.90) and Function (α = 0.94) subscales. Test-retest reliability was excellent (ICC = 0.96; 95% CI: 0.92-0.98; p < 0.001), with no systematic bias on Bland-Altman analysis (p = 0.550). Confirmatory factor analysis confirmed the two-factor structure with satisfactory loadings (range: 0.73-0.93; RMSEA = 0.09; CFI = 0.95). Convergent validity was supported by significant correlations with the DASH (r = 0.23, p < 0.001) and moderate negative correlations with the SF-12 Physical Component Summary (r = -0.33 to -0.43, p < 0.001).
Conclusions:
The Serbian PRWHE demonstrates strong psychometric properties and is a valid, reliable instrument for assessing pain and functional disability in wrist and hand conditions. Its availability enables standardized, patient-centered assessment in Serbian-speaking populations and supports cross-cultural research in hand therapy.