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The Burn Specific Health Scale-Brief: Measurement invariant across European countries

Van Loey, Nancy E. PhD; Van de Schoot, Rens PhD; Gerdin, Bengt MD, PhD; Faber, Albertus W. MSc; Sjöberg, Folke MD, PhD; Willebrand, Mimmie PhD

Journal of Trauma and Acute Care Surgery: May 2013 - Volume 74 - Issue 5 - p 1321–1326
Original Articles

BACKGROUND: The Burn Specific Health Scale Brief (BSHS-B), which is the only multidimensional measure to evaluate burn-specific aspects of health status, has previously been validated in several languages across the world. However, the stability of the underlying construct was not cross-culturally evaluated. The current study reports on measurement invariance across two samples of Swedish- and Dutch- speaking patients with burns.

METHODS: In a prospective study, 231 and 275 Swedish and Dutch-Belgian patients with burns, completed the BSHS-B at 9 or 12 months, respectively, after burn. Using a multigroup confirmatory factor analysis, measurement invariance across languages (Swedish and Dutch) was tested.

RESULTS: The results of the confirmatory factor analysis in the total sample revealed that the scale structure for the earlier reported three-factor structure and the original nine-factor structure was adequate. However, an eight-factor structure in which hand function and simple abilities were merged provided the best fit. This structure was used to test measurement invariance across the two language groups. The two-group outcomes testing measurement invariance across Swedish- and Dutch-speaking patients indicated a stable, configural invariance.

CONCLUSION: The BSHS-B seems to function uniformly across both language groups. The BSHS-B can be used to compare cross-cultural results in both countries.

LEVEL OF EVIDENCE: Prognostic study, level III.

From the Department of Psychosocial and Behavioural Research (N.E.V.L.), Association of Dutch Burns Centres, Beverwijk; Departments of Clinical and Health Psychology (N.E.V.L.), and Methods and Statistics (R.V.D.S.), Utrecht University, Utrecht; and Department of Clinical Psychology (A.W.F.), Martini Hospital, Groningen, the Netherlands; Department of Surgical Sciences (B.G.), Plastic Surgery, Uppsala University, Sweden; Department of Neuroscience, Psychiatry (M.W.), Uppsala University, Sweden; Department of Clinical and Experimental Medicine, Linköping University, and the Burn Centre; and Departments of Hand, Plastic Surgery and Intensive Care (F.S.), Linköping University Hospital, Sweden.

Submitted: July 5, 2012, Revised: November 8, 2012, Accepted: November 9, 2012.

Address for reprints: Nancy E. Van Loey, PhD, Association of Dutch Burn Centres, PO Box 1015, 1940 EA Beverwijk, the Netherlands; email:

© 2013 Lippincott Williams & Wilkins, Inc.