Cross-cultural adaptation and use of the epilepsy psychosocial effects scale: Comparison between the psychosocial effects of chronic epilepsy in Sweden and the United Kingdom

Purpose: To establish Swedish weightings for the Epilepsy Psyche-Social Eff ects Scale (EPSES) and examine differences between Sweden and the U.K. in a ttitudes toward chronic epilepsy. Methods: After translation and back-translation of the EPSES into Swedish, weightings were established through a paired comparison study in which 24 e pilepsy professionals participated. The EPSES was then given to a hospital- based sample of 57 patients with chronic epilepsy and the results compared with a British sample matched for age, sex, and frequency of seizures. Results. in the professional judgments of the EPSES statements, there were statistically significant differences in only four of 32 statements. Attitu des to employment, to medication, and to fear of seizures were considered m ore serious in the U.K., whereas social isolation was considered more a pro blem in Sweden. Patient attitudes to chronic epilepsy were found to be larg ely similar in the U.K. and Sweden; however, attitudes to employment, to th e future, and to fear of seizures were significantly more a problem for pat ients in the U.K. Conclusions: The results indicate a great similarity in the interpretation of problems as measured by the EPSES in the U.K, and in Sweden. The differe nces in attitudes found are discussed in relation to economic and legislati ve differences between the two countries. Social as well as cultural differ ences should be taken into account when using standardized questionnaires. It is suggested that culturally specific weightings should be calculated an d that these should be reevaluated at regular intervals.