Translation and Validation of the Chinese Diabetic Foot Ulcer Scale - Short Form

Background: The need to assess quality of life (QOL) in patients with a diabetic foot ulcer (DFU) has been well documented. However, no appropriate instrument was available for the Chinese population. Objective: The Diabetic Foot Ulcer Scale - Short Form (DFS-SF) is a reliable and valid 29-item instrument comprising six scales, which is used for assessing QOL in patients with DFU. This study aimed to translate the DFS-SF into Chinese and evaluate its psychometric performance. Methods: The Chinese DFS-SF went through the full linguistic validation process and was evaluated in 60 Hong Kong Chinese patients with current or healed DFU. Results: The internal consistency of all scales of the Chinese DFS-SF was consistently high (Cronbach's alpha ranged from 0.8 to 0.92). Item convergent and discriminant validity was satisfactory (median corrected item-scale correlation ranged from 0.63 to 0.84). Moreover, the instrument also demonstrated good construct validity when correlated with the SF-36. Sensitivity was shown between patients with healed DFU and those whose DFU was not healed, those with different types of foot ulcer, those with different Wagner grade, and those with differing episodes of DFU. Conclusions: The newly translated Chinese DFS-SF may be used to assess the impact of DFU in Chinese patients.