Validation of the Multidimensional Scale of Perceived Social Support

Inview of the role of social support as a coping resource, and its association with stressors and mental and physical wellbeing (Bruwer et al., 2008), there is a growing impetus in the use of the Multidimensional Scale of Perceived Social Support (MSPSS) to evaluate perceived social support across cultures (Cheng & Chan, 2004). Although MSPSS was initially designed to assess social support in adolescents to assess perceptions of social support adequacy among adolescents from three different sources: family, friends, and significant others, a growing body of research about the utility of the MSPSS revealed that it’s a useful measure for many populations including cardiovascular disease populations and the elderly (Canty-Mitchell & Zimet, 2000; Edwards, 2004). There are no developed tools or translated scales in Hausa language for the assessment of social support among stroke survivors in Nigeria. Since MSPSS was developed in English (see Figure Appendix D2), it was necessary to carry out a translation and trans-cultural adaptation of the questionnaire where it was intended to be used. Therefore, the aim is to carry out linguistic validation of the MSPSS in Hausa language and further evaluate its psychometric properties for future use in clinical research and practice in Nigeria.

The procedure involved in the development of Hausa version of MSPSS (see Appendix H) involved the process of linguistic and psychometric validations of the Hausa- MSPSS. These cognitive processes were to ensure that the Hausa-MSPSS was measuring the same concept as the original scale, thereby enabling comparisons between different cultures.

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Description of the Study Instrument

MSPSS (Appendix D2) is a well validated and psychometrically rigorous 12 items

concise instrument used for measuring the hierarchical structure of perceived social support from family (items 3, 4, 8and 11), friends (items 6, 7, 9, and 12), and a significant others (items 1, 2, 5, and 10) (Zimet et al., 1988). Though not developed specifically for stroke patients, MSPSS was designed to address several issues concerning social support. MSPSS has a number of properties which suggest that it may be a valuable tool for use in research in a variety of populations, including cardiovascular disease and the elderly (Canty-Mitchell & Zimet, 2000; Cheng & Chan, 2004; Cheng & Chan, 2004; Edwards, 2004).Previous studies have indicated MSPSS to have good internal consistency, test-retest reliability, and strong factorial validity in addition to good construct validity (Bruwer et al., 2008; Canty-Mitchell & Zimet, 2000; White et al., 2007). The perceived social support is measured on a 7-point likert-type scale (1 very strongly disagree; 2 strongly disagree; 3 mildly disagree; 4 neutral; 5 mildly agree; 6 strongly agree; 7 very strongly agree).

The forward translation of the English version of the MSPSS to Hausa was carried out by 2 independent professional translators of the Freedom Radio Nigeria muryar jama’a 99.5FM (an independent radio). The aim of the forward translation step was to obtain a version in Hausa language with conceptual, semantic and operational equivalence to the original U.S. English version. The MSPSS was translated to Hausa by two bilingual translators, whose mother tongues were Hausa and proficient in English. The two bilingual translators worked independently, so that neither of them would influence the other’s translation. One of them, with experience working as a professional translator in health related areas, was familiar with the aims and constructs being assessed by the instrument, whereas, the other was not, nor had any prior knowledge of the instrument’s

77 objectives. A series of five meetings were conducted by a multidisciplinary expert committee for review and comparison of the two drafts. After reconciliation, the translation that was more equivalent to the original English version and appropriate for Hausa was selected.

The second step involved backward translation of the draft Hausa-MSPSS questionnaire in to English. The backward translation of the reconciled Hausa language version was done in the source language (U.S. English) by a professional translator who was a native Hausa speaker and fluent in English, and had no prior knowledge of the instrument. The backward translated version was compared with the original MSPSS by the multidisciplinary team and an initial version of Hausa-MSPSS was proposed. During the translation process, translation discrepancies and linguistic issues were taken into consideration and modifications were made accordingly.

Cognitive debriefing and patient testing was conducted with a non-random sample of 30 stroke patients. Respondents with mean age of 58.76 years took an average of about 5- 10 minutes to complete the questionnaire. The cognitive testing was to ensure that the final Hausa version was understandable, acceptable and the language used was simple and appropriate for the intended future use of the questionnaire. This preliminary test was done by face-to-face interviews in order to acquire feedback remarks and suggestions on the Hausa scale from the interviewees. Based on the clinicians' review and respondents' feedback the initial Hausa version was revised. A summary report on the revisions was sent to the copyright owners and it was accepted by them.

The final version of the Hausa-MSPSS questionnaire was administered among 35 stroke patients. These patients returned to the clinic again to complete the Hausa MSPSS a

78 week after the first evaluation. The data collected were used in reliability and test-retest reliability analyses.

Finally, the psychometric properties of the translated Hausa-MSPSS were assessed using data collected from 140 consecutive stroke survivors from the three stroke referral hospitals in Kano, Nigeria. The age of the patients ranged from 40 to 80 years old. Using AMOS 18, a series of CFA was performed to examine the nature of and relations among latent constructs. CFA categorically tests a priori hypotheses about relations between observed variables and latent variables or factors (Brown, 2006; Jackson et al., 2009). Besides testing the questionnaire, the feasibility of administering the questionnaire under field conditions was also noted.