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Cross-cultural Translation, Validity and Reliability of the Children Fatigue Scale
(CFS), the Sleep Disturbance Scale for Children (SDSC), the Body Image
Instrument (BII) and the State Self-esteem Scale (SSES) in Thai Adolescent
Survivors of Childhood Cancer

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B. Silapavitayatorn, J. Mesukko, S. Niyomkar, and P. Thungjaroenkul 1
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Faculty of Nursing, Chiang Mai University, Thailand

Background: Adolescent survivors of childhood cancer were affected by late effects from treatment
including fatigue, sleep disturbance, negative body image, and low self-esteem, leading to poor quality of
life. Instruments for measuring these late effects were developed in Western countries, which are different
in culture and context from Thailand. It is necessary to translate these instruments into Thai to effectively
measure these late effects in Thai adolescent survivors of childhood cancer.

Objective: To translate Children Fatigue Scale (CFS), Sleep Disturbance Scale for Children (SDSC),
Body Image Instrument (BII), and State Self-Esteem Scale (SSES) into Thai and test their validity and
reliability.
Oral Presentation Abstracts
Methods: This was a cross-sectional study. Four instruments were translated into Thai, using cross-cultural,
back translation based on Brislin’s translation model. Multi-stage sampling was used to obtain 473 Thai
adolescent survivors of childhood cancer aged 13-18 years. Data were collected using the demographic
data questionnaire and four translated questionnaires. The content validity was evaluated by six experts.
Item Content Validity Index (I-CVI) and Scale Content Validity Index (S-CVI) were calculated. The reliability
was evaluated with 10 participants in a pilot study, and with 473 participants in the main study. The internal
consistency reliability was calculated by using Cronbach’s alpha coefficients.

Results: The instruments were used to evaluate all participants once. The results revealed that I-CVI of
each instrument range from 0.83-1.00, and S-CVI of CFS, SDSC, BII, and SSES was 1.00, 0.98, 0.99, and 0.99. The
Cronbach’s alpha of CFS, SDSC, BII, and SSES was 0.96, 0.92, 0.89, and 0.86 for the pilot study and 0.93, 0.88,
0.86, and 0.87 for the main study.

Conclusion: The Thai version of these instruments have high validity and reliability. Therefore, these
instruments can be effectively used to measure fatigue, sleep disturbance, body image, and self-esteem in
Thai adolescent survivors of childhood cancer.

Keywords: adolescent survivors of childhood cancer, cross-cultural translation, late effects

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Correspondence: Busayarat Silapavitayatorn, Faculty of Nursing, Chiang Mai University, Thailand
E-mail: busayarat_si@cmu.ac.th

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