Validation and psychometric evaluation of the Italian version of the Spinal Cord Injury Secondary Conditions Scale

Study design Validation cross-sectional study. Objective To adapt the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS) to Italian and to assess the validity and reliability of this instrument. Setting Multicentre study in outpatient clinics of three urban spinal units across Italy. Methods After a five-step translation/validation process, the Italian SCI-SCS was administered in a toolset composed of a sociodemographic questionnaire, the Modified Barthel Index, the Short-Form 8, the Patient Health Questionnaire 9, and the General Anxiety Disorder 7. The Italian SCI-SCS construct validity was assessed through exploratory factor analysis (EFA). The internal consistency and test–retest reliability of the instrument were evaluated using Cronbach’s α and the intraclass correlation coefficient (ICC) for the total scale and its subscales. Pearson’s correlation coefficient with all administered instruments was calculated to evaluate the concurrent validity. Results One-hundred fifty-six participants were recruited from February to October 2018. EFA suggested a three-factor structure explaining 45% of the total variance. After experts’ consideration about the clinical relevance of its components, a final version of the Italian SCI-SCS with four different subscales and 15 items was proposed. The total scale Cronbach’s α was 0.73. The ICC agreement for test–retest reliability was 0.91. Correlations of the Italian SCI-SCS with the administered instruments were statistically significant (p<0.05), highlighting congruent hypothesized relations. Conclusion Findings of this study provided a first psychometric evaluation of the SCI-SCS. The modified Italian version of this tool may represent a valuable instrument for the longitudinal assessment of the impact of secondary conditions in peo