Translation, Reliability and Validity of the Greek Version of the 5-D Itch Scale in People With Chronic Kidney Disease Receiving Haemodialysis

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BACKGROUND: Chronic kidney disease-associated pruritus (CKD-aP) is a condition that causes significant distress to people undergoing haemodialysis (HD). It significantly impacts individuals' sleep habits, everyday activities, social interactions, mental health and overall quality of life. A number of tools have been developed to evaluate the severity of pruritus. The 5-D itch scale is one of the most widely used tools for assessing various aspects of pruritus. In Greece, there is no validated and culturally adapted tool to assess pruritus in individuals with CKD receiving HD. Hence, this study aimed to evaluate the reliability and validity of the Greek version of the 5-D itch scale. MATERIALS AND METHODS: The English version of the 5-D itch scale was translated into the Greek language according to international guidelines and was cross-culturally adapted in people with CKD on HD (Ν = 120). The intraclass correlation coefficient was used to assess the reliability of the instrument after the test-retest procedure (n = 30). Confirmatory factor analysis was conducted in order to test how well the 5-D itch scale one-factor model fits the data. Internal consistency reliability was determined by the calculation of Cronbach's alpha coefficient (n = 120). Convergent validity was tested through the correlation with the Kidney Disease Quality of Life Instrument Short-Form (KDQOL-SF) scale and the visual analogue scale. Statistical significance was set at p < 0.05. Analyses were conducted using IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). RESULTS: The sample consisted of 120 people with CKD receiving HD (60.0% males, n = 72), with a mean age of 65.7 years (SD ±13 years), of whom 80 individuals reported CKD-aP. Regarding confirmatory factor analysis, this solution had a good model fit (χ2/df = 1.93; root mean square error of approximation (RMSEA) = 0.03; comparative fit index (CFI) = 0.92; Tucker Lewis index (TLI) = 0.93 and standardized root mean square residual (SRMR) = 0.05). The intraclass correlation coefficients were significant (p < 0.001) in all items and over 0.85. Cronbach's alpha for the 5-D itch scale total score was 0.75, indicating good reliability. The reliability index had minor changes after removing its items; thus, no item needed to be removed from the scale. The correlation of the 5-D itch scale with the KDQOL-SF (p = 0.002) indicates the good convergent validity of the scale. CONCLUSION: The Greek version of the 5-D itch scale is an instrument with good reliability and validity, possessing the potential to be utilised by healthcare professionals for the purpose of the assessment of CKD-aP among Greek-speaking people undergoing HD.

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