Translation, Adaptation and Validation of the Bengali Version of Spinal Cord Independence Measure-III

Abstract

Background: Spinal Cord Independence Measure (SCIM) is a standardized tools widely used by occupational therapist for measuring functional independence. In Bangladesh, occupational therapists who are working in spinal cord injury unit are using the original version of SCIM that was developed in the context of English speaking country. Literature suggest that it is better to translate and adapt an existing tools in native language rather than create a whole new instrument. A translated tools with good psychometric properties provides consistent and truthful findings as well as help therapist to administer the tools with less effort to their patient group. This study was designed to translate, culturally adapt and validate the Bengali-version of SCIM-III. Methods: This was a mixed method study including both qualitative and quantitative study design. Translation and adaptation of the Spinal Cord Injury Measure was carried out by qualitative analysis. Analytical and cross-sectional study design also carried out to reveal linguistic validation and primary psychometric proprieties. This study included translation and back translation of the items from the original English version of the instrument to Bangla, along with face, content, convergent and divergent validation. As well as four aspects of reliability measurement including test-retest, split-half and measurement of internal consistency was identified from this study. Result and discussion: SCIM-III showed excellent face and content validity. Expert panel and occupational therapist reported that it present similar meaning compared to original English version. All questions are answered appropriately by the participants, Regarding, operational equivalence, it was found that same layout, order and format of the SCIM-III was maintained. However, expert panel recommended that there need to be adapt some new items regarding work. Education, rest and sleep, instrumental activities of daily living to measure all aspect of activities of daily living. The average score of performance independence of person with SCI was 30.44±25.76, and, in person without SCI, 101±0. This difference was statistically significant (p>.000). The SCIM-III had strong positive correlation with the score of FIM, which is statistically significant. The internal consistency of the scale was adequate, with a Cronbach‟s alpha coefficient of Abstract xii .899 and .95 for each item (p<.000). The interclass correlation coefficient found as 1.00 showed excellent reproducibility for each item (p<.000). Conclusion: The study has shown that the Bengali version of SCIM-III can be easily and safely used for clinical and research trials in future. Bengali version of SCIM-III is easily understand by the patients as it is follow the cultural context of Bangladesh. Future study should be developed prior the permission of author of original scale regarding the recommended changes to add new items provided by expert panel and occupational therapist to make this tool more global. Key words: Translation, Cultural Adaptation, Validity, Reliability, Spinal Cord Independence Measure