title: Cross-cultural adaptation and validation of the South African Pain Catastrophizing Scale (SA-PCS) among patients with fibromyalgia.
abstract: BACKGROUND
  Pain catastrophization has recently been recognized as a barrier to the healthy development of physical functioning among chronic pain patients. Levels of pain catastrophization in chronic pain patients are commonly measured using the Pain Catastrophizing Scale (PCS).
  
  
  OBJECTIVE
  To cross-culturally adapt and validate the South African PCS (SA-PCS) among English-, Afrikaans- and Xhosa-speaking patients with fibromyalgia living in the Cape Metropole area, Western Cape, South Africa.
  
  
  METHODS
  The original PCS was cross-culturally adapted in accordance with international standards to develop an English, Afrikaans and Xhosa version of the SA-PCS using a repeated measures study design. Psychometric testing included face/content validity, internal consistency (Cronbach's alpha-α), test-retest reliability (intraclass coefficient correlations-ICC), sensitivity-to-change and cross-sectional convergent validity (by comparing the adapted SA-PCS to related constructs).
  
  
  RESULTS
  The cross-culturally adapted English, Afrikaans and Xhosa SA-PCS showed good face and content validity, excellent internal consistency (with Chronbach's α = 0.98, 0.98 and 0.97 for the English, Afrikaans and Xhosa SA-PCS, as a whole, respectively), excellent test-retest reliability (with ICC's of 0.90, 0.91 and 0.89 for the English, Afrikaans and Xhosa SA-PCS, respectively); as well as satisfactory sensitivity-to-change (with a minimum detectable change of 8.8, 9.0 and 9.3 for the English, Afrikaans and Xhosa SA-PCS, respectively) and cross-sectional convergent validity (when compared to pain severity as well as South African versions of the Tampa scale for Kinesiophobia and the revised Fibromyalgia Impact Questionnaire).
  
  
  CONCLUSIONS
  The SA-PCS can therefore be recommended as simple, efficient, valid and reliable tool which shows satisfactory sensitivity-to-change and cross-sectional convergent validity, for use among English, Afrikaans and Xhosa-speaking patients with fibromyalgia attending the public health sector in the Western Cape area of South Africa.
authors.affiliation: Division of Physiotherapy, Department of Interdisciplinary Health Sciences, Faculty of Medical and Health Sciences, Stellenbosch University, Tygerberg, South Africa. ldmorris@sun.ac.za
authors.forename: Linzette D
authors.initials: LD
authors.lastname: Morris
authors.forename: Karen A
authors.initials: KA
authors.lastname: Grimmer-Somers
authors.forename: Quinette A
authors.initials: QA
authors.lastname: Louw
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D044383:Black People / Q000523:psychology; D058443:Catastrophization / Q000208:ethnology / Q000523:psychology*; D016001:Confidence Intervals; D003431:Cross-Cultural Comparison; D005260:Female; D005356:Fibromyalgia / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011594:Psychometrics; D015203:Reproducibility of Results; D013019:South Africa; D011795:Surveys and Questionnaires / Q000592:standards*; D044465:White People / Q000523:psychology