Cross-cultural adaptation to Spanish of the Japanese Epilepsy Self-Stigma Scale (ESSS)

Abstract

Objective

To culturally and linguistically adapt the Epilepsy Self-Stigma Scale (ESSS) in Spain (content validity).

Methodology

We carried out the adaptation and validation of the pre-version of the Japanese ESSS scale in the Epilepsy Unit of the Hospital Clínic de Barcelona. Following the EMPRO guide, we first translated and back-translated with independent translators. Then, a pilot test was carried out with 26 people with epilepsy to assess the clarity of the questions. Finally, a panel of 11 experts reviewed the clarity and relevance of the items. We had the advice of a Japanese translator and the author of the original article.

Results

In the translation and back-translation phase, linguistic adjustments were made to guarantee semantic and cultural equivalence. After the pilot test, 6 items showed problems (4%–8% participant non-response rate). Specifically, one question was eliminated due to this rate and comments received. In the panel of experts, 7 items were not considered “very relevant” to measure self-stigma on the Likert scale, with percentages of lack of clarity that ranged between 9 and 18%, which is why they were eliminated from the scale. Of the 18 items of the Japanese pre-version, we obtained a 10-item Spanish version, similar to the original Japanese 8-item SSS-E, overcoming cultural differences and maintaining coherence with the original version.

Discussion/conclusion

We developed the first adapted self-stigma scale in epilepsy for use in Spanish (ESSS-E). We validated the 18-item pre-version, addressing cultural differences that complicated consistency with the original version.