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Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures? A triangulated mixed-methods validation approach

Abstract

Study design

Triangulated mixed-methods validation study.

Objectives

To validate the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ).

Setting

Community in Denmark.

Methods

Participants were invited via a patient organization and its specialized hospital. Eligibility criteria were having a spinal cord injury (SCI), being 18 years or older, and able to understand and respond in Danish. Quantitative data were collected to determine internal consistency and criterion validity of the three subscales of SCL-CSQ, i.e., acceptance, fighting spirit, and social reliance. The Three-Step Test-Interview approach was employed to determine whether items measured what they were intended to measure (i.e., construct validity based on response processes).

Results

The quantitative sample consisted of 107 participants, and the interview sample comprised 11 participants. The acceptance and fighting spirit subscales showed adequate internal consistency (Cronbach’s alpha of 0.72 and 0.76 respectively) and satisfactory criterion validity (expected correlations with quality of life and depression). The social reliance subscale showed inadequate internal consistency (Cronbach’s alpha of 0.58) and criterion validity. All fighting spirit items and all but one acceptance items were interpreted congruently by most participants. Conversely, two social reliance items were only interpreted congruently by 9 and 27%.

Conclusion

The acceptance and fighting spirit subscales of the Danish version of the SCL-CSQ showed good psychometric properties, while the social reliance subscale showed serious issues and should be revised. Researchers and clinicians are urged to reflect on these findings when revising the SCL-CSQ or adapting it to other languages, cultural contexts, and rehabilitation settings.

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Fig. 1: The distribution of responses across the items within their respective subscales.

Data availability

The quantitative dataset generated during the current study is available in deidentified form from the corresponding author upon reasonable request and following approval from the Danish Data Protection Agency.

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Acknowledgements

We would like to thank all the participants for completing the survey and participating in the interviews.

Funding

The study was carried out as part of a Ph.D. project with internal funding from The Specialized Hospital for Polio and Accident Victims in Roedovre, Denmark. No additional funding was required.

Author information

Authors and Affiliations

Authors

Contributions

AA contributed to the conception and design of the study, and was responsible for data collection, quantitative and qualitative data analysis, creating figures and tables, and writing the paper. SLR contributed to the conception and design of the study, and was responsible for qualitative data analysis, provided continuous guidance and feedback on the manuscript, tables, and figures, and approved the final version of the paper. MLE contributed to the conception and design of the study, provided continuous guidance and feedback on the manuscript, tables, and figures, and approved the final version of the paper. HK contributed to the conception and design of the study, provided continuous guidance and feedback on the paper, tables, and figures, and approved the final version of the paper. TEA contributed to the conception and design of the study, provided continuous guidance and feedback on the paper, tables, and figures, and approved the final version of the paper.

Corresponding author

Correspondence to Anders Aaby.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study was registered with University of Southern Denmark’s internal records of scientific projects (case no. 10.672), and ethics approval was not necessary according to Danish law (case no. 20192000-107).

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Aaby, A., Ravn, S.L., Elfström, M.L. et al. Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures? A triangulated mixed-methods validation approach. Spinal Cord (2022). https://doi.org/10.1038/s41393-022-00825-7

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