Translation and cross-cultural adaptation of the traumatic injuries distress scale to persian

Document Type : Original Article


1 School of Physical Therapy, Western University, London, ON, Canad

2 Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada

3 Department of Health and Rehabilitation Sciences, Western University, London, ON, Canada

4 University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

5 School of Physical Therapy, Western University, London, ON, Canada

6 Department of Orthopedic Surgery, Western University, London, ON, Canada

7 School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada

8 Roth

9 McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, ON, Canada


Objective: Psychological factors have been consistent predictors of recovery following
musculoskeletal injuries. The Traumatic Injuries Distress Scale (TIDS) is a risk-based
prognostic screening tool that has been developed for predicting recovery from acute
musculoskeletal trauma. The purpose of this study was to translate and cross-culturally
adapt the TIDS to Persian.
Methods: The forward-backward translation technique was used to translate the TIDS
from English to Persian. The final version was obtained by consensus with the translation
committee. Cognitive interviews were used to evaluate lingual accuracy and cultural or
contextual appropriateness. 13 participants completed cognitive interviews based on the
talk-aloud and probing approach to explore individual items.
Results: Participants (age range 22-58) had no problems in questions two, six, eight, and
11. Participants identified potential issues in 4/6 areas of a cognitive interview coding
system: comprehension/clarity, inadequate response definition, perspective modification,
reference point, and calibration across items. These issues informed changes made to
arrive at the final version of the P-TIDS.
Conclusions: The TIDS, which is a tool to assess psychological distress following
musculoskeletal trauma was translated and culturally adapted to Persian. Through
cognitive interviewing, some issues were identified that were related to cross-cultural
interpretation and application of the items that were resolved through rewording and
recalibration of the tool. The TIDS-Pcan be a significant addition to the toolbox of Persian
healthcare providers for assessing the risk of developing chronic pain post-musculoskeletal
trauma. Psychometric studies are now underway to further evaluate the properties of the
translated tool.