Subjective Happiness Scale: Measurement properties of the online and paper-pen administrations in Nepali adults with musculoskeletal pain.

Cognitive debriefing was done face-to-face only, so the study did not test whether online participants would have given different feedback. The stable group used no change in pain, not no change in happiness, to estimate test-retest reliability. Responsiveness and minimum important change were not tested, so the scale was not shown to detect changes in happiness over time or after treatment. The online sample was smaller than the hard-copy sample (60 versus 119), and the samples differed in age, education, occupation, financial independence, pain frequency, and comorbidities. Some hard-copy follow-up assessments were done by telephone, which differed from the initial paper method. Findings may not generalise to children, other health conditions, other countries, or other languages. The study removed item 4 before testing, so the original 4-item scale was not evaluated in this sample.

This research did not receive a specific grant from public, commercial, or not-for-profit funding agencies. One author was supported by an International Association for the Study of Pain fellowship during manuscript writing. The authors declare no competing interest.

Do not read the online administration as equally reliable for repeated measurement. The online version met validity hypotheses but had lower test-retest reliability and larger smallest detectable change than the paper version.