Abstract
BackgroundEven though traumatization is linked to substantially reduced health-related quality of life, help-seeking and service utilization among trauma survivors are very low. To date, there has not been available in Iceland a culturally attuned, self-reported measure on help-seeking barriers after trauma. This study aimed to translate and cross-culturally adapt the English version of Barriers to Help-Seeking for Trauma (BHS-TR) scale into the Icelandic language and context.MethodsThe BHS-TR was culturally adapted following well-established and rigorous guidelines, including forward-backward translation, expert committee review, and pretesting through cognitive interviews. Two rounds of interviews with 17 female survivors of intimate partner violence were conducted using a think-aloud technique and verbal probing. Data were analyzed using qualitative content analysis, a combination of deductive and inductive approaches.ResultsIssues with the BHS-TR that were uncovered in the study were classified into four categories related to general design, translation, cultural aspects, and post-trauma context. The trauma-specific issues emerged as a new category identified in this study and included concepts specific to trauma experiences. Therefore, modifications were of great importance—resulting in the scale becoming more trauma-informed. Revisions made to address identified issues improved the scale, and the process led to an Icelandic version, which appears to be semantically and conceptually equivalent to the original version; additionally, the results provided evidence of content validity.ConclusionsAs a cognitive interview study, it adds to the growing cognitive interviewing methodology literature. Furthermore, the results provide essential insights into the self-report response process of trauma survivors, highlighting the significance of making health-related research instruments trauma-informed.
Highlights
Even though traumatization is linked to substantially reduced health-related quality of life, helpseeking and service utilization among trauma survivors are very low
We changed the English language Barriers to Help-Seeking for Trauma (BHS-TR) scale so it was a better fit for Icelandic people who have had trauma in their lives
Traumatization is linked to an increased risk of suffering from an array of mental and physical conditions associated with functional impairment and substantially reduced health-related quality of life (HRQoL) [9, 10], even years after exposure [11]
Summary
Even though traumatization is linked to substantially reduced health-related quality of life, helpseeking and service utilization among trauma survivors are very low. Traumatization is linked to an increased risk of suffering from an array of mental and physical conditions associated with functional impairment and substantially reduced health-related quality of life (HRQoL) [9, 10], even years after exposure [11]. This suffering is evident in cases of complex and interpersonal trauma [7, 12].
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