Reliability and Validity Study of the Turkish Version of the Clinical Opiate Withdrawal Scale

Noro Psikiyatr Ars. 2015 Mar;52(1):89-94. doi: 10.5152/npa.2015.7169. Epub 2015 Mar 1.

Abstract

Introduction: The aim of the present study was to perform reliability and validity analyses of the Turkish version of the Clinical Opiate Withdrawal Scale which is used to determine the severity of opiate withdrawal.

Methods: Initially, the Clinical Opiate Withdrawal Scale (COWS) was translated into Turkish and subsequently back-translated into English. The originality of the back-translated version was approved by the author who developed the scale. After the translation was completed, the scale was used to assess the withdrawal symptoms of 100 patients with opiate withdrawal and 41 patients with alcohol withdrawal. Cronbach's alpha was used in the reliability assessment; explanatory and confirmatory factor analyses were used in structural validity assessment; and in scale validity, ROC analysis was used among diagnosis groups.

Results: The Cronbach's alpha internal consistency coefficient was calculated as 0.74 in reliability analyses. The correlation coefficient was found to be 0.975 (p<0.001) for inter-rater reliability. Factor analysis was conducted for the structural validity of the scale and findings that support the unidimensional structure of the scale were observed. In the confirmatory factor analysis, CFI, GFI and RMSEA values were found to be 0.905, 0.905 and 0.079, respectively. It was detected that COWS was successful in distinguishing between opiate and alcohol withdrawal symptoms and the area under the ROC curve was 0.878.

Conclusion: This study showed that the Turkish version of COWS can be used reliably and validly for assessing opiate withdrawal.

Keywords: COWS; Clinical Opiate Withdrawal Scale; opiate withdrawal; reliability; validity.