Development and validation of a patient-reported checklist for dermatological complications in chronic spinal cord injury.

STUDY

DESIGN

Cross-Sectional.

OBJECTIVES

This study aimed to develop and conduct initial validation of a comprehensive, patient-reported checklist for identifying dermatological complications in individuals with chronic SCI.

SETTING

Sina Trauma and Surgery Research Center, Sina Hospital, Tehran, Iran.

METHODS

A multiphase, cross-sectional methodological study was conducted. The items were generated via a literature review and expert opinion, followed by content validation with a panel of 11 specialists via the content validity ratio (CVR) and content validity index (CVI). After face validation with patient representatives, the final checklist was field-tested in structured interviews with individuals from a national SCI registry. Interrater reliability was assessed with Cohen's kappa.

RESULTS

The final 16-item checklist demonstrated excellent content validity, with all the items meeting CVR thresholds and achieving high scale-level CVI scores (relevance=0.88, simplicity=0.92, clarity=0.89). Interrater reliability was excellent Cohen's kappa = 0.89). The tool was administered to 139 individuals with chronic SCI (mean age 43.9 years; 76.8% male), 44.6% (n = 62) of whom reported at least one complication. Among the 102 complications identified, those related to fungal infections (25.5%) and early-stage pressure injuries (20.6%) were the most prevalent. The mean onset time for the first complication was 2.7 months' post-injury.

CONCLUSIONS

The Spinal Cord Injury Skin Complications Checklist (SCI-SCC) is a valid and reliable patient-reported tool for screening dermatological issues in this population. Its integration into routine clinical practice can facilitate standardized monitoring, promote early detection, and ultimately improve patient-centered care for individuals living with chronic SCI.