Cross-cultural Adaptation and Validation of the Itching Severity Scale in Children and Adolescents with Atopic Dermatitis

OBJECTIVE To translate, adapt and validate the Itch Severity Scale to a Brazilian version (ISS-Ped) in order to measure the severity of pruritus in children and adolescents with atopic dermatitis. METHODS This is a methodological study of validation of an instrument following recommended protocols. The translated version was evaluated by a group of experts including one professional with experience in instrument validation, three English teachers, one linguistics teacher and seven allergists. After this, the scale was applied to 42 parents of children aged between 2 and 18 years old with atopic dermatitis, and 42 parents of children without pruritic diseases. Results were evaluated according to the severity of atopic dermatitis and disease control, and they were compared between groups with and without atopic dermatitis. RESULTS More than 90% of the questions were clear to the parents. The ISS-Ped showed a strong positive correlation with the severity of atopic dermatitis (Pearson: 0.74; p<0.001) and a good correlation with the control of dermatitis (point-biserial correlation coefficient: 0.65; p<0.001). The scale showed excellent internal consistency (Cronbach's α: 0.96) and adequate test and retest agreement (95% confidence interval of intraclass correlation coefficient: 0.89-0.99; p<0.001). CONCLUSIONS The ISS-Ped is a feasible, valid, reliable and satisfactorily equivalent. The translated scale was appropriate to assess the severity of itching in children and adolescents with eczema, allowing comparisons in the clinical practice and in the research setting.