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Table 4 Item relevance and participants’ suggested edits

From: Measuring the impact of chronic low back pain on everyday functioning: content validity of the Roland Morris disability questionnaire

RMDQ - item number and summary Relevanta
Yes (n/N)
Understanding/ Comprehensionb
Yes (n/N)
Participant quote on Understanding/Comprehensionc Participant suggested change
Yes (n/N)d
Participants suggested change and quote
1 – I stay at home most of the time because of my back Y (22/23) Y (23/23) “Does it (CLBP) limit me from going out and doing the things that I need to do, running errands, going out to … um, for entertainment purposes or just anything” P01–002 Y (1/23) “Mine hasn’t gotten so bad that it’s made me do anything like that, so it seems like an irrelevant question to me [so could be removed]” P02–008
2 – I change position frequently Y (23/23) Y (23/23) “do I need to sit with proper posture, or put weight on one side or the other … in order to be able to sit and be comfortable when I’m sitting” P01–003 N Not applicable
3 – I walk more slowly Y (23/23) Y (23/23) “I was recalling to try to see if I could remember myself having to walk slow due to my back pain” P01–008 N Not applicable
4 – Not doing jobs around home Y (23/23) Y (23/23) “Not being able to lift heavy objects around the house. Again, take the trash out” P01–008 Y (3/23) “It’s uh, I’m not doing any, the word any, you know, I have a very wide range of jobs I have to do around the house you know, so that’s a little confusing to me. You know if it’s, does that mean any of the things that I do or is it just the more physical things” P02–001
“cause of my back, I’m not doing any of the jobs that I usually do around the house. I put no, but there’s some things that I don’t do around the house because of my back” P02–008
“That was one I couldn’t answer. Because it depends. Some days I can like I said, when I mop the floor … it puts me in a very bad position because it makes my back hurt more. When I do that I’m done and there are some days I can’t do it at all” P01–002
5 – I use a handrail to get upstairs Y (23/23) Y (23/23) “it’s asking me if my back pain severe, so severe that I need assistance getting up the stairs or walking assistance” P01–008 Y (2/23) [Should it be reworded?] “Hm, yes. Probably like because of my back, I need assistance getting upstairs. Sometimes, some stairs don’t even have handrails, you know? P01–008
“It was a little not confusing, but like some of these are, like especially the first one [points to item 5], it isn’t really relevant for just asking how are you doing today.” also suggested “Maybe you know [for item 5 & 6] there would be like a box, you know, often, frequently, you know, like 1–2 times a week, you know what I mean?” P02–003
6 – I lie down to rest Y (23/23) Y (23/23) “Like I lay down to rest more often.” P03–005 Y (3/23) “Because in a week’s time, you’d have some good days and bad days, so you can average them out …. It’s like, well, number 6, “Because of my back, I lay down to rest more often.” Uh, that’s, that’s just say-, you know, to me, that’s, it depends if it, if you’re, if it hurts real bad, you know, you maybe, may lie, lay down for a while.” P02–008
“You know? Um, I don’t know. And because of my back, I lay down to rest more often. That seems like that general, broad question... it’s like, you know, is that really have anything to do with today?” P02–003
“Um, “Because of my back, I lie down to rest more often.” Um, on occasions I will, I will lay down but not, it’s not an often type situation.” P03–003
7 – Hold on to get out of an easy chair Y (23/23) Y (23/23) “The way I get out of a chair. (laughs) I mean I’m not, I’m not using my upper body to … I may lean forward more” P01–001 Y (1/23) “Uh, number seven, an easy chair, what, how would you describe an easy chair?... maybe, like you said a recliner, you guys could add that in there.” P01–006
8 – I try and get other people to do things for me Y (23/23) Y (23/23) “Um, yes for that. Occasional if there’s a, if there’s heavy lifting, or um, or uh, constantly moving from point A to point B with a heavy object, or something I previously would have, um, been able to tackle myself, then, um, I know, I know my limitations because of back. Um, I’ll get some help.” P01–003 Y (3/23) “Uh, 8, 8 is a little strange for me. I’m not sure, uh, other people are … I, I don’t know. Just it, it sounds awkward to me … Maybe like other people offer to help me because they see that I’m not as agile as I used to be” P01–001
“[should be reworded] “Um, I would say, due to my back, I often, sometimes need assistance form people.” P01–008
“That’s a general, that’s a general thing too. Um, that would be another good one to say, you know, every day or frequently or just today, um, or instead of “I try,” [maybe reword to] “I tried to get other people to do things for me today”. Maybe for, you know, so” P02–003
9 – I get dressed more slowly Y (22/23) Y (23/23) “I answered it no. Because I don’t feel like um, I, I dress any slower, I just do it more carefully.” P02–007 Y (2/23) “The only thing I would see is because where it says, bec- … I get dressed more slowly than usual because of my back, I would put back pain. That would be it”. P01–002
“I just feel like that question (item 9) does not fit in whatsoever in the questionnaire” P01–008
10 – I only stand for short periods Y (23/23) Y (23/23) [I was thinking] “Because I can’t stand be, been, uh, stand up for a long period, so I, I do different kind of movements, like sitting down, um, stand up, because it, it bother” P01–007 N Not applicable
11 – I try not to bend or kneel Y (23/23) Y (23/23) [I was thinking] “Like if I have to pick up something, say if I drop something or I have to pick up something, depending on what it is, I’m like, “Oh Lord, I got it,” you know, but I have to do what I have to do.” P01–002 N Not applicable
12 – I find it difficult to get out of a chair Y (23/23) Y (23/23) [I was thinking] “Uh, a chair with or without arms, a plastic chair, a wooden chair, a chair that has a pad on it. Any of those type of chairs. I don’t, I don’t really have a problem getting up.” P01–003 N Not applicable
13 – Back is painful most of the time Y (23/23) Y (23/23) [it’s asking] “Do you feel pain more than you don’t feel pain.” 03–002 N Not applicable
14 – Turn over in bed Y (23/23) Y (23/23) “I was thinking that sometimes, I have to turn round a lot in bed … Like toss and turn. I have to accommodate myself by putting a pillow between my legs sometimes and I only sleep comfortably on my left side, as far as I’ve been noticing.” P01–008 N Not applicable
15 – Appetite is not very good Y (21/23) Y (23/23) “I was, um, thinking about well my back hurts tonight I’m not gonna eat. (laughs) You know if I feel like eating I will, if I don’t, I won’t..” P01–002 Y (2/23) “not really [relevant]. Only because I’ve never had an issue with appetite because of back pain” P02–003.
“The appetite thing was weird [not sure if it was needed]”.02–005
16 - Putting on socks (or stockings) Y (23/23) Y (23/23) “Um, yes, on occasion. And I, I’m kind of picturing myself, you know, bending over, sitting on the bed, and trying to do it. Or just crouching down on the floor, trying to tie my shoes and, and there is some pain there” P01–003 Y (2/23) “Um, I think again, if it’s just thinking of today, I would put, “Today, I had trouble putting on my socks.” P02–003
“um, you really should put like every, like I said “bend your knee,” or like, if you’re standing up and you’re just, hold on to something and put on your sock.” P01–006
17 – Walk short distances Y (23/23) Y (23/23) [I was thinking] “you know, like in, in my position I cannot just, I cannot walk, walk for a long period, so I was thinking of myself.” P01–007 Y (1/23) “It’s like, “Today, I only walked a short distance because of my back,” [inclusion of today] P02–003
18 – Sleep less well Y (23/23) Y (23/23) “I was thinking about exactly what it says, how do I sleep.” P01–002 Y (2/23) “I would say … Ah, how I would word this? My quality of sleep is not as good … is not as good … is not what it should be because of my back pain.” P01–002
“I’ll probably say, do you have trouble sleeping at night due to back pain?” P01–008
19 – I get dressed with help Y (23/23) Y (23/23) “[it’s asking] Does anybody else put on clothes for me?” P01–006 N Not applicable
20 – I sit down most of the day Y (23/23) Y (23/23) “I said, uh, yes, I do sit down because of my back. That’s for sure, and I also stand up too.’ P01–005 Y (1/23) “I sit down for the, for the most of the day because of my back. Yes, that’s a relevant question but there is some that probably you’d have to ask from a different time period. Like” P01–008
21 – I avoid heavy jobs Y (23/23) Y (23/23) “No. Just avoiding heavy jobs, period.” P03–007 Y (1/23) “I would say, “Today, I avoided a heavy job because of my back” [inclusion of today] P02–003
22 – Irritable and bad tempered with people Y (23/23) Y (23/23) [I was thinking] “I’m … It’s like I’m upset with myself and it carries over to other people” P01–001 Y (3/23) “Um, again, I would just put like partial or sometimes … you know, it might not apply to someone everyday but it does apply to them sometime throughout the course of their day or, you know” P03–003
so, using today, I said no, but I mean, in general, yeah, I think, you know, if you’re having more increased pain, you’re going to be a little cranky crank. (laughs). You know?” P02–003
“The yes or no doesn’t really [make sense]... For me, it doesn’t because, you know, that sort of says, because of my back, I’m more irritable. That makes me think you’re irritable all the time … [but it] depends on the severity of the pain.” P02–008
23 – I go upstairs more slowly Y (23/23) Y (23/23) [I was thinking] “Yes, I wouldn’t go up, running stairs” P01–006 Y (1/23) “I didn’t answer number 23 because it’s … it’s because of my back I go upstairs more slowly than usual and like I said I avoid stairs, period.” P01–002
24 – I stay in bed most of the time Y (23/23) Y (23/23) “Um, I guess 24 is basically saying, you know, um, I stay in bed all day long because of my back pain.” P03–003 Y (1/23) “I stay in bed most of the time because of my back.” Uh, that would be like on a day when it’s really, really bad … Some people may, but it just seems more of a broad question, rather than just for today.” P02–008
  1. aThis column highlights if any participants raised concerns over the relevance of items
  2. bThis column represents if any participants raised concerns with the comprehension or understanding of items
  3. cThis column presents a participant quote following being asked “What were you thinking about?”
  4. dThis column represents whether participants have suggested amendments to this item and displays the number of participants who made suggestions