Translation and validation of Portuguese of a questionnaire for evaluation of psychosomatic symptoms in adults with atopic dermatitis

Abstract

BACKGROUNDatopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis. OBJECTIVESthe objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. METHODSadaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient. RESULTSfactor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions. CONCLUSIONSthe Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research.

Quality of life measurement in atopic dermatitis. Position paper of the European Academy of Dermatology and Venereology (EADV) Task Force on quality of life

“…Several publications describe the creation and validation of QoL instruments, and their culturally validated local versions, in AD patients and in parents/caregivers (Table ). The DLQI, DFI and PIQoL‐AD have also been used in the validation process of non‐QoL instruments …”

“…The DLQI, DFI and PIQoL-AD have also been used in the validation process of non-QoL instruments. [121][122][123] Quality of life measurement in atopic dermatitis • Each scale provides a single number; smaller values denote better health…”

Complexo esclerose tuberosa: perfil clínico e epidemiológico e avaliação do Índice de Qualidade de Vida em Dermatologia dos doentes acompanhados no ambulatório de Dermatologia Pediátrica da Divisão de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

“…As escalas doença-específicas são mais precisas em detectar alterações do estado de saúde do indivíduo do que as genéricas. 62 Vários instrumentos de medida específicos foram traduzidos, adaptados e validados no Brasil, como o Acne Quality of Life (AQoL-Br) 63 , o Psychosomatic Scale for Atopic Dermatitis (PSS-AD) 64,65 , o MELASQoL (Melasma Quality of Life Scale) 66 significativamente menor e identificaram como possíveis fatores de risco para a baixa qualidade de vida: mutação no gene TSC2, epilepsia, início precoce e curso longo da doença, alta frequência de convulsão, deficiência intelectual e TANDs. 69 O questionário PedsQL TM 4.0 foi desenvolvido como abordagem modular para a aferição da qualidade de vida relacionada à saúde pediátrica, com tradução e validação para a versão em língua portuguesa aplicável à cultura brasileira.…”