Translation, Validation, and Cross-Cultural Adaptation of the Patient and Observer Scar Assessment Scale (Posas) Into Persian Publisher



Guity M ; Naghizadeh H ; Ayati Firoozabadi MA ; Khabiri SS ; Arabzadeh A
Source: Archives of Bone and Joint Surgery Published:2025

Abstract

Objectives: This study aimed to translate, culturally adapt, and validate the Patient and Observer Scar Assessment Scale (POSAS) for Persian-speaking populations, ensuringits 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 © 2025 Elsevier B.V., All rights reserved.