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

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.