Cross-cultural adaptation and validation for Portuguese (Brazilian) of the pictorial representation of illness and self measure instrument in orofacial pain patients

J Orofac Pain. Summer 2013;27(3):271-5. doi: 10.11607/jop.1070.


Aims: To translate the Pictorial Representation of Illness and Self Measure (PRISM) instrument from German to Portuguese (Brazilian) and adapt it to the Brazilian cultural context, and then assess its reliability and validity in orofacial pain patients.

Methods: The PRISM was translated to Portuguese then back-translated to German. The translated PRISM was evaluated by a multidisciplinary committee and administered as a pre-test to 30 Portuguese-speaking orofacial pain patients. Psychometric properties were obtained after testing 116 orofacial pain patients. Validity was obtained through correlation analyses of scores obtained from PRISM and other psychometric tests, including the Numerical Pain Scale (NPS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HAD).

Results: The adapted instrument showed high levels of reliability, proven by means of the test-retest procedure, and calculation of the Intraclass Correlation Coefficient (ICC = 0.991). Significant correlations were found between PRISM and the other tests. Correlation with NPS was moderate (-0.42), whereas correlations with ISI (-0.24), HAD-anxiety (-0.25), and HAD-depression (-0.22) were weak.

Conclusion: The cross-cultural adaptation process of PRISM was successful and the adapted version offers reliable and valid psychometric properties in the Brazilian context.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Brazil
  • Cross-Cultural Comparison*
  • Cross-Sectional Studies
  • Diagnostic Self Evaluation*
  • Facial Pain / diagnosis*
  • Facial Pain / psychology
  • Female
  • Humans
  • Language
  • Male
  • Middle Aged
  • Pain Measurement
  • Photography
  • Prospective Studies
  • Psychological Tests*
  • Psychometrics
  • Quality of Life
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Stress, Psychological