Fulden Sari1, Zilan Bazancir Apaydin2, Hakan Apaydin3, Mehmet Kayaalp4, Abdulsamet Erden5, Serdar Can Güven3, Berkan Armağan3, Ahmet Omma6, Orhan Kucuksahin4, Şükran Erten4

1Department of Physiotherapy and Rehabilitation, Bingöl University, Bingöl, Türkiye
2Department of Physiotherapy and Rehabilitation, Medipol University, Ankara, Türkiye
3Department of Internal Medicine, Division of Rheumatology, Ankara City Hospital, Ankara, Türkiye
4Department of Internal Medicine, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye
5Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
6Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Ankara, Türkiye

Keywords: Fibrosis, questionnaire, reliability, scleroderma, validity.


Objectives: This study aimed to translate the Scleroderma Skin Patient-Reported Outcome (SSPRO) questionnaire to the Turkish (SSPRO-T) language and to assess its validity and reliability.

Patients and methods: Fifty-four systemic sclerosis (SSc) patients (51 females, 3 males; mean age: 49.8±10.4 years; range, 22 to 65 years) participated in the reliability and validity analysis between October 2022 and December 2022. The translation and cross-cultural adaptation of the SSPRO-T was applied in accordance with the procedure described by the Beaton guidelines. The SSPRO-T, the Scleroderma Health Assessment Questionnaire (SHAQ), the Health Assessment Questionnaire Disability Index (HAQ-DI), Skindex-29, and patient global skin severity were conducted in all participants for construct validity. The SSPRO-T was retested to assess its reliability after seven days.

Results: The SSPRO-T had a four-factor structure. The total SSPRO-T score and its subgroups correlated positively with SHAQ, HAQ-DI, Skindex-29, and patient global skin severity. The internal consistency and reliability were excellent in overall SSPRO-T and in the subgroups: physical effect, emotional effect, physical limitation, and social effect (Cronbach’s α=0.94, 0.80, 0.95, 0.93, and 0.84, respectively). The SSPRO-T had excellent test-retest reliability (r=0.91, p<0.001). In addition, no floor effect or ceiling effect was observed.

Conclusion: The SSPRO-T questionnaire is a reliable and valid tool and can be used in research and clinical practice in Turkish patients with SSc.

Citation: Sari F, Bazancir Apaydin Z, Apaydin H, Kayaalp M, Erden A, Güven SC, et al. Reliability and validity of the Turkish version of Scleroderma Skin Patient-Reported Outcome in patients with systemic sclerosis. Arch Rheumatol 2024;39(1):52- 59. doi: 10.46497/ArchRheumatol.2023.10183.

Ethics Committee Approval

The study protocol was approved by the Ankara City Hospital Clinical Research Ethics Committee Ethics Committee (date: 12.10.2022, no: E2-22-2567). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Concept: F.S., Z.B.A.; Design: F.S., Z.B.A., H.A., S.C.G., B.A., A.E., O.K.; Supervision: F.S., Z.B.A., H.A., O.K.; Data collection and/or processing: F.S., Z.B.A., H.A., M.K., S.C.G., B.A., A.E., A.O.; Analysis and/or interpretation: F.S., Z.B.A.; Literature review: F.S., Z.B.A., H.A.; Writing: F.S., Z.B.A.; Critical review: F.S., Z.B.A., H.A., M.K., S.C.G., B.A., A.E., A.O., O.K., .E.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.