Shkolina N.V., Shapoval I.I., Orlova I.V., Kedyk I.O., Stanislavchuk M.A.

Summary. Background. Ankylosing spondylitis (AS) is a chronic rheumatic disease that clinical and pathogenetic mechanisms are predictors for occurrence pain maldaptation and resilence violation. The absence of a gold standard and the growing interest in resilience assessment makes this problem particularly relevant in patients with chronic pain. Aim of the study: сreation of a Ukrainian-language version of the Connor — Davidson resilience scale-10 (CD-RISC-10) and its cross-cultural adaptation with assessment of validity in AS patients. Methods and materials. Translation and cross-cultural adaptation of the Connor — Davidson resilience scale-10 (CD-RISC-10) was performed in accordance with the Guidelines for the process of cross-cultural adaptation of self-report measures after permission of authors. 38 patients with AS and 43 persons without AS or other diseases with signs of pain syndrome were examined as a control group. Diagnosis of AS was determined according to modified New York criteria. Patient groups and controls were representative by age and gender, adjusted for gender characteristics of the AS and population prevalence. Statistical analyses of the results were performed using known methods­ of variational statistics in the SPSS23 software (©SPSS Inc.). Results: Translation, cross-cultural adaptation and validation of the Connor — Davidson resilience­ scale 10 (CD-RISC-10) was performed. Test-retest for 2 weeks interval was performed in order to access its reliability. The internal consistency of the scale was confirmed by calculating the alpha-Cronbach coefficient. The reproducibility of the scale was demonstrated by an intraclass correlation coefficient of 0.871 (p<0.05). The paired Student’s T-test did not reveal significant differences between the test-retest groups (p>0.05). The results of the CD-RISC-10 survey in patients with AS and practically healthy controls showed a significant decrease in resilience in patients with AS (23.8±4.39 vs 28.8±6.06), which indicates a violation of the compensatory-adaptive reactions in patients with AS. Also, by the CD-RISC-10 total score, we identified quartiles and classified AS patients according to the resilience category: low resilience (CD-RISC-10 ≤26), moderate (>26 CD-RISC-10 ≤32), and high resilience (CD -RISC 10> 32). Gender differences in resilience of AS patients were found (CD-RISC-10 was higher in men (25.1±4.34) than women (21.2±3.30); p<0.05), that was confirmed by a significant pair correlation of the overall CD-RISC-10 score with gender (r=0.426); p<0.01. Patients with low resilience had a higher disease activity according to BASDAI with a tendency for poorer quality of life according to a specific quality of life questionnaire for AS patients ASQoL compared group with moderate resilience. Conclusions. A Ukrainian-language version of the Connor — Davidson resilience scale 10 (CD-RISC-10) was created and its cross-cultural adaptation and validation performed for further use in the Ukrainian-speaking population. The Ukrainian-language version of the Connor — Davidson resilience scale 10 (CD-RISC-10) has a sufficient level of reliability and internal consistency to allow it to be used scientifically and in clinical practice, and the relationship of disease activity to the impairment of adaptive processes in patients with AS.

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