The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Translation, Validation, and Cross-Cultural Adaptation of the Patient and Observer Scar Assessment Scale (POSAS) into Persian

Document Type : RESEARCH PAPER

Authors
Mohammadreza Guity
Hamed Naghizadeh
Mohammad Ayati Firoozabadi
Seyyed Saeed Khabiri
Aidin Arabzadeh
Joint Reconstruction Research Center, Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran
10.22038/abjs.2025.84746.3857
Abstract
Objectives: This study aimed to translate, culturally adapt, and validate the Patient and Observer Scar Assessment Scale (POSAS) for Persian-speaking populations, ensuring its applicability and reliability in both clinical and research settings in Iran.
Methods: The cross-cultural adaptation process involved forward and backward translations, expert panel reviews, and pre-testing. A total of 60 post-surgical patients participated in the study. Psychometric evaluations included content validity, internal consistency, and test-retest reliability. Content Validity Ratios (CVRs) and Content Validity Indices (CVIs) were calculated, with thresholds set at 0.51 and 0.79, respectively. Reliability was assessed using Cronbach’s alpha coefficients (≥0.7) and test-retest stability over a two-week interval.
Results: The Persian POSAS demonstrated robust psychometric properties. All items exceeded the CVI threshold, achieving strong expert consensus (CVR ≥0.51). Cronbach’s alpha coefficients were 0.88 and 0.81 for the Observer Scar Assessment Scale (OSAS) and Patient Scar Assessment Scale (PSAS), respectively, indicating high internal consistency. Test-retest reliability confirmed stability over time. These results were consistent with previous adaptations in other languages, including Arabic and Italian.
Conclusion: The Persian adaptation of POSAS is a valid and reliable tool for scar assessment, filling a critical gap in patient-centered care for Persian-speaking populations. This tool enables standardized evaluation of scars and supports clinical research. Future studies should explore its responsiveness to therapeutic interventions and its applicability across diverse patient demographics.
        Level of evidence: Ⅲ
Keywords
Cross-cultural research
Cultural adaptation
Persian validation
Psychometric validation
Scar assessment
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 10
October 2025
Pages 649-655

  • Receive Date 24 December 2024
  • Revise Date 07 March 2025
  • Accept Date 05 April 2025