The burden of face affected questionnaire in patients with systemic sclerosis: Translation, cross-cultural adaptation and psychometric properties in the Turkish version

Aim of the work: Facial skin involvement is one of the most important features in systemic sclerosis (SSc) patients with physical, emotional and social effects. A newly developed burden of face affected (BoFA) questionnaire is available to quantify the disability associated with facial involvement in SSc patients. This study aimed to translate the BoFA questionnaire into Turkish (BoFA-T) and investigate its psychometric properties. Patients and Methods: Forty-nine SSc patients were included in the study. The translation and cross-cultural adaptation of the BoFA-T were conducted. The BoFA-T, the scleroderma mouth handicap in SSc scale (MHISS), the Rosenberg self-esteem scale (RSS), and the perceived stress scale (PSS) were applied to construct validity. The patients were re-evaluated 7 days later to assess the test-retest reliability of the BoFA-T. Results:The mean age of the 49 patients was 48.5 +/- 9.97 years, age at diagnosis 40.1 +/- 11.5 years,48 females and 1 male. 24 had diffuse cutaneous and 25 limited cutaneous SSc. The mean BoFA-T was 16.81 +/- 22.37, MHISS was 16.93 +/- 12.19, RSS was 2.04 +/- 1.92 and PSS was 24.89 +/- 12.31. BoFA-T has excellent internal consistency (Cronbach's alpha = 0.97) and test-retest reliability (ICC = 0.94, 95 %CI = 0.88-0.97). The correlation of BoFA-T with MHISS (r = 0.56, p < 0.001), RSS (r = 0.51, p < 0.001), and PSS (r = 0.57, p < 0.001) was moderate. The BoFA-T questionnaire consists of three-factor subgroups (''self-esteem'', ''future anxiety'', and ''sexuality''), and no floor or ceiling effects were observed in relation to BoFA-T. Conclusion: The BoFA-T demonstrates appropriate psychometric properties and may be effectively utilized to assess facial involvement and disability in Turkish SSc patients.