Cross-Cultural Adaptation and Validation of the Spanish Version of the Early-Onset Scoliosis Self-Report Questionnaire (EOSQ-SELF).

BACKGROUND

The Early-Onset Scoliosis Self-Report Questionnaire (EOSQ-SELF) is a recently developed tool designed to assess health-related quality of life (HRQoL) in children with early-onset scoliosis (EOS). It complements the existing EOSQ-24, which relies on parental proxy reporting. While the EOSQ-SELF has demonstrated reliability in English, Chinese, and Turkish populations, it has yet to be validated for Spanish-speaking patients. This study aimed to translate, culturally adapt, and validate the EOSQ-SELF for use in Spanish-speaking children with EOS.

METHODS

A multicenter, prospective validation study was conducted in Puerto Rico from August to November 2024. Participants aged 8 to 18 years with EOS were recruited during routine follow-up visits, regardless of treatment stage. The EOSQ-SELF underwent a rigorous translation and cultural adaptation process, including forward-backward translation and expert panel review. Reliability was evaluated using internal consistency metrics. Content and construct validity were assessed through expert and patient feedback, nonparametric tests, and multiple linear regression.

RESULTS

The final Spanish EOSQ-SELF showed no significant semantic or cultural issues following expert and patient feedback. A total of 42 patients (mean age 10.3±2.4 y; 64% female) were included. The instrument demonstrated excellent internal consistency (Cronbach's α=0.91), with item-total correlations ranging from 0.34 to 0.75. Discriminant validity was confirmed in 75% of domain comparisons, although overlap was observed between "Transfer" and "Pain." Ceiling effects were most prominent in the "Relationships" domain (78%), while the lowest ceiling effect was found in "Pain and Discomfort" (30%).

CONCLUSIONS

The Spanish EOSQ-SELF is a reliable and valid instrument for measuring self-reported HRQoL in Spanish-speaking children with EOS. Despite some ceiling effects in high-functioning domains, the tool remains clinically and scientifically useful for this population.

LEVEL OF EVIDENCE: Level II-prognostic.