{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:28:39Z","timestamp":1777523319566,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Harvard Medical School, Center for Global Health Delivery\u2013Dubai."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To translate and validate the velopharyngeal insufficiency (VPI) effects on life outcomes (VELO) instrument into Nepali, and test its internal consistency and validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Quality-of-life instrument translation and validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Community served by Nepal\u2019s craniofacial referral hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Twenty-three postpalatoplasty children with VPI, 19 family guardians of VPI cases, and 29 non-VPI controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>The VELO instrument was translated to Nepali by 2 independent bilingual translators, reconciled, backward-translated, compared, and modified using patient cognitive interviews. All VPI children, guardians, and controls completed the VELO-Nepali.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s):<\/jats:title>\n                    <jats:p>The VELO internal consistency was evaluated using Cronbach \u03b1 coefficient. Concurrent validity and discriminant validity were assessed using 2-sample t test: assuming unequal variances.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The VELO was translated and optimized using cognitive interviews. The VELO-Nepali demonstrated excellent internal consistency, with Cronbach \u03b1 coefficients of 0.93, 0.94, and 0.90 for VPI cases, guardians of VPI cases, and non-VPI controls, respectively. The VELO-Nepali exhibited strong discriminant validity between VPI cases ([Formula: see text] = 45.4, standard deviation [SD] = 22.1) and non-VPI controls ([Formula: see text] = 84.9, SD = 12.3), ( P &lt; .001). The VELO-Nepali showed strong concurrent validity with similarities in VPI case scores ([Formula: see text] = 45.4, SD = 22.1), and guardian scores ([Formula: see text] = 52.9, s = 22.8; P = .473).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The translated VELO-Nepali demonstrates strong internal consistency, discriminant validity, and concurrent validity, and can assess quality of life for Nepali VPI patients. This instrument represents the first VPI quality of life assessment validated in Nepali, and supports the feasibility of its implementation in other low- and low-middle-income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665620905173","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T20:43:29Z","timestamp":1581626609000},"page":"967-974","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Nepali Linguistic Validation of the Velopharyngeal Insufficiency Effects on Life Outcomes Instrument: VELO-Nepali"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5860-6097","authenticated-orcid":false,"given":"Michael M.","family":"Lindeborg","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA"},{"name":"Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA"},{"name":"Michael Lindeborg and Pramila Shakya are co-first authors."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pramila","family":"Shakya","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"},{"name":"Michael Lindeborg and Pramila Shakya are co-first authors."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhawani","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiba Kala","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kabita Bhattarai","family":"Gurung","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suman","family":"Niroula","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badri","family":"Rayamajhi","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hema","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhagwati","family":"Gaire","sequence":"additional","affiliation":[{"name":"Department of Burns, Plastic and 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