Translation, cultural adaptation and validation of the Swahili Pain Catastrophizing Scale among refugees who survived torture and/or war trauma in Kenya: An observational study

Abstract

Abstract Background and Aims Accurate assessment of any patient relies on the use of appropriate measurements which are culturally‐ and linguistically‐applicable and valid. The following study aimed to translate, cross‐culturally adapt and test the nomological validity, structural validity, internal consistency, test‐retest reliability, sensitivity‐to‐change and feasibility of the Swahili version of the Pain Catastrophizing Scale (Swa‐PCS) among refugees who survived torture/war trauma living with chronic pain in Kenya. Methods An observational study was conducted. Translation and cultural adaptation of the original PCS for the Swahili‐speaking refugee population in Kenya, who survived torture or war trauma was undertaken. Following this process, a validation study was conducted on the newly‐adapted instrument, to ascertain the psychometric properties (nomological validity, structural validity, internal consistency, test‐retest reliability, sensitivity‐to change, and ceiling and floor effects). Results Fifty participants were included in this study. Correlations between pain catastrophization and fear‐avoidance behavior measures were significant (r = 0.538, p < 0.01). Ceiling effects were 42−48% with no floor effects. Standard errors of measurement values were between 0.938 and 3.38. Minimal‐detectable‐change values were between 2.17 and 7.82. Internal consistency was satisfactory to good, for the whole and subsections respectively (range α = 0.693−0.845). Magnification had the lowest α. Test−retest reliability was also satisfactory to good (range ICC = 0.672−0.878). Confirmatory factor analysis confirmed that the Swa‐PCS had three factors which explained the majority of the variance. Root mean square error of approximation and comparative fit index were calculated for goodness‐of‐fit assessment, and were 0.18 and 0.83, respectively. Conclusion This study showed that the adapted Swa‐PCS displayed overall satisfactory to good internal consistency, test‐retest reliability and sensitivity‐to‐change. Furthermore, the Swa‐PCS scores were related to fear‐avoidance behavior scores as expected (nomological validity). Structural validation of the Swa‐PCS requires further investigation. Further testing of the psychometric properties of the Swa‐PCS is however warranted.

Keywords

• cross‐cultural adaptation/validation
• Kenya
• pain catastrophization scale
• refugees
• survivors of torture