Researchers and translators created a valid and reliable Brazilian version of the Sickle Cell Self-Efficacy Scale (SCSES), originally developed in the US, which they effectively applied to adolescents and young adults with sickle cell disease (SCD), according to findings published in Hematology, Transfusion, and Cell Therapy.

Researchers at the Federal University of Minas Gerais in Brazil collaborated on a 6-step methodological study to assess whether the SCSES could effectively be applied to 55 adolescents and young adults with SCD following a process of translation, cross-cultural adaptation, and validation.

Two translators independently forward-translated the SCSES which the research team compared to develop a mutually agreed-upon version. Another 2 translators independently translated this version back into English and the team compared this back-translation with the original version.

An expert committee consisting of 5 nurses evaluated the English and Brazilian Portuguese translations, scoring them from 1 to 4 according to the level of translation improvement required. The research team calculated a Content Validity Index of 0.98 from these scores, indicating which questions required further revisions.

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The researchers conducted an electronic pretest of this revised version, analyzing the responses of 10 adolescents and young adults with SCD to assess understanding of each question. Alterations to improve clarity and understanding produced the final version of the Brazilian SCSES.

The researchers administered the final SCSES version to 55 adolescents and young adults. Forty-three of these 55 respondents repeated a retest an average of 17 days following the first test to assess reproducibility.

Comparison of the test and retest answers demonstrated excellent agreement. Statistical analysis revealed an average intraclass correlation coefficient of 0.923, reflecting instrument temporal reproducibility and stability, and an acceptable Cronbach’s alpha coefficient of 0.84, indicating reliable internal consistency of the instrument.

“There are several advantages in adapting instruments already validated in other languages, instead of elaborating them from scratch. Using validated questionnaires can elicit comparable data,” the authors said. “They save time, financial, and human resources, and they facilitate the exchange of information and dissemination of knowledge among the scientific community.”


de Sousa IA, Reis IA, Pagano AS, Telfair J, Torres H de C. Translation, cross-cultural adaptation and validation of the sickle cell self-efficacy scale (SCSES). Hematol Transfus Cell Ther. Published online April 15, 2022. doi:10.1016/j.htct.2022.02.010