The cross-cultural adaptation of the Type D Personality Scale (DS-14) for use with patients diagnosed with Ischemic Heart Disease (IHD) in Sri Lanka

Abstract

Ischemic Heart Disease (IHD) has been classified as a major cardiovascular disease in the world and is the main cause of death in Sri Lanka. Negative affectivity (NA) and social inhibition (SI) are two traits which increase the risk of IHD. The DS-14 evaluates an individual’s general level of distress, based on NA and SI. This study was aimed to cross-culturally adapt the DS-14 for use in Sinhala speaking patients diagnosed with IHD in Sri Lanka. Permission to validate the scale was obtained from the developers. The translation and back-translation were done by two professional translators and a pretest was conducted among five IHD patients to reconstruct the wording prior to the Delphi process. The Delphi process which assessed the content and consensual validity of the scale included an expert panel of two psychiatrists and four clinical psychologists. Delphi ratings received from stage one were summarized and presented for a second round and the re-ratings were evaluated for the degree of consensus. Following the Delphi Process, items for DS-14’s Sinhala version were chosen based on the following criteria: (i) if 70% or more of the re-ratings were in category 0–3, that item/sub-scale was omitted or reworded to make it acceptable. If reworded, the Delphi Process was repeated for that item/sub-scale, and (ii) if 70% or more of the re-ratings were in categories 4–6 and 7–9, that item/subscale was retained. No items were removed from the original scale. Rewording of some items was done according to suggestions made by some experts to retain the conceptual meaning when translated to Sinhala. The DS-14’s Sinhala version has shown encouraging psychometric properties and can be used in research and clinical practice for the purpose of screening patients with IHD for type D personality.