Translation, adaptation, and psychometric evaluation of the Burn-Specific Pain Anxiety Scale (BSPAS) for Czech patients with burn injuries

Abstract

This study aimed to adapt the Burn-Specific Pain Anxiety Scale (BSPAS) for use in the Czech language and evaluate its validity and reliability. Conducted across three university hospitals in the Czech Republic—Prague, Brno, and Ostrava—from September 2022 to February 2024, the study involved 203 inpatients and outpatients from burn units who met inclusion criteria and consented to participate. The adaptation process included rigorous analysis of validity and reliability, employing language, content, and construct validity assessments. Language validity was ensured through back translation, whereas content validity was confirmed through expert evaluations. Exploratory factor analysis revealed at least a two-factor structure with satisfactory factor loading. Loading of factors to questions was consistent between BSPAS-9 and BSPAS-5. Confirmatory factor analysis further substantiated the model fit for both five- and nine-item versions (RMSEA 0.06 and 0.1 respectively). Internal consistency was assessed using item-total correlation, yielding acceptable results (range 0.63–0.82 for nine items and 0.71–0.82 for five items). Cronbach's alpha coefficients were 0.94 for the nine-item version and 0.91 for the five-item version. These findings indicate that the Czech version of the BSPAS is a valid and reliable tool for assessing pain-related anxiety in patients with burns. Additionally, we show that in our population, the information from the nine-item version is well captured by the five-item version and pain alone explains most of the variance in BSPAS scores.