title: Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients.
abstract: In this cross-sectional study the psychometric properties are examined of the adapted Dutch translation of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients (ISS>15).
  
  
  METHODS
  Patients (N=173) completed the SMFA, the World Health Organization Quality of Life assessment instrument-BREF (WHOQOL-BREF), the Dutch Impact of Event Scale (IES), the Hospital Anxiety and Depression Scale (HADS) and the Cognitive Failure Questionnaire (CFQ). The Abbreviated Injury Score and the Injury Severity Score were established to determine the injured body area and the severity of the injuries. Exploratory factor analysis (method: PAF) was performed. Correlations were calculated between our SMFA factors and scores on the WHOQOL-BREF, IES, HADS and CFQ. The SMFA scores of the factors Upper extremity dysfunction and Lower extremity dysfunction were compared between subgroups of patients with and without injuries in respectively the upper extremities and the lower extremities. For responsiveness analysis, data were compared with the baseline SMFA measurement of a reference group.
  
  
  RESULTS
  A three-factor structure was found: Lower extremity dysfunction, Upper extremity dysfunction, and Emotion. Strong correlations between the SMFA and the other questionnaires were found. Patients with injury of the lower extremities had significantly higher scores on the factor Lower extremity dysfunction than patients without injury of the lower extremities (p=0.017). In none of the factors, a significant difference in mean scores was found between patients with and without injury of the upper extremities. Severely injured patients had significantly higher SMFA scores than the reference group (p<0.001).
  
  
  CONCLUSIONS
  The adapted Dutch translation of the SMFA showed good psychometric properties in severely injured patients. It appeared to be useful to get a general overview of patients' Health Status as well as patients' Health Related Quality Of Life.
authors.affiliation: Network Emergency Care Brabant, Elisabeth Twee Steden Hospital, Tilburg, The Netherlands. Electronic address: k.v.delft@elisabeth.nl.
authors.forename: C C H M
authors.initials: CC
authors.lastname: van Delft-Schreurs
authors.affiliation: Department of Surgery, Elisabeth Twee Steden Hospital, Tilburg, The Netherlands; CoRPS, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. Electronic address: m.a.c.vanson@tilburguniversity.edu.
authors.forename: M A C
authors.initials: MA
authors.lastname: van Son
authors.affiliation: Network Emergency Care Brabant, Elisabeth Twee Steden Hospital, Tilburg, The Netherlands. Electronic address: m.d.jongh@elisabeth.nl.
authors.forename: M A C
authors.initials: MA
authors.lastname: de Jongh
authors.affiliation: Department of Orthopaedics, Elisabeth Twee Steden Hospital, Tilburg, The Netherlands. Electronic address: t.gosens@elisabeth.nl.
authors.forename: T
authors.initials: T
authors.lastname: Gosens
authors.affiliation: Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: m.verhofstad@erasmusmc.nl.
authors.forename: M H J
authors.initials: MH
authors.lastname: Verhofstad
authors.affiliation: CoRPS, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Department of Medical Psychology, Elisabeth Twee Steden Hospital, Tilburg, The Netherlands. Electronic address: jo.d.vries@elisabeth.nl.
authors.forename: J
authors.initials: J
authors.lastname: de Vries
mesh_terms: D050281:Bones of Lower Extremity / Q000293:injuries*; D001133:Bones of Upper Extremity / Q000293:injuries*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Factor structure; Injury; Psychometrics; Responsiveness; SMFA; Validity