Validation and standardization of a german version of the "Burn Specific Health Scale" questionnaire/Evaluation of an ICF-based rehabilitation program for burn injured patients

Project No. FF-FR 0234


completed 06/2016


A severe burn injury often has physical, psychological and social consequences for those affected. Frequently, life-long restrictions affect all areas of life. During the acute treatment and rehabilitation process, doctors and therapists try to keep these restrictions as low as possible in order to achieve the highest possible quality of life for those patients. In order to optimize such treatment concepts on the basis of scientific research, the use of adequate, reliable and valid instruments for measuring the quality of life after burn injury is indispensable. The Burn Specific Health Scale-B (BSHS-B) is one of the most commonly used instruments measuring quality of life after burns and has already been translated and validated into many languages. Our aim was to establish a German version of the BSHS-B which can be used for our planned main project Evaluation des ICF-orientierten "Rehabilitationskonzepts thermische Verletzungen" . Furthermore we want to provide it for all German speaking burn facilities.


Translation and cross-cultural adaption from the original English version into German language was conducted according to the method suggested by Beaton et al. (2000). In a pilot study 20 burn patients evaluated the translated version concerning comprehensibility and content validity (qualitative validation). The final version was then validated by 364 patients treated in our burn center (quantitative validation). Internal consistency and test-retest-reliability were assessed. Criterion validity was determined by correlating the subscales with relevant instruments (SF-36, HADS, DASH). The structure of the German version was investigated by principal component analysis. Confirmatory factor analysis was used to compare the structure with the original nine-factor structure according to Kildal et al. (2001) and the simplified second-order three-factor structure by Willebrand and Kildal (2008).


Qualitative testing revealed adequate comprehension and content validity. Cronbach´s alpha ranges from α=.80 to α=.92. The test-retest reliability ranged from r=.72 to r=.97. The subscales correlated significantly and in the expected direction with measures of criterion validity (r=.41 to r=.77). The principal component analysis revealed 8 components which together explain 72.46% of the variance. Item loadings range between .65 and .95. The results show satisfactory overlap with the original data structure (Kildal et al. 2001), except the domains Affect und Sexuality are merged in one factor. The confirmatory factor analysis revealed the best model fit for the second-order three-factor structure without the domain Work. Results are similar to those reported for the original version, demonstrating good factorial validity for the german version. In summary, a Ludwigshafen German version of the BSHS-B could be created, which has good psychometric properties as well as a high degree of cultural adaptation to the German-speaking burn injury population and has not lost its comparability with other versions. It is suitable for the measurement of the quality of life of burn injured patients and can thus be used in clinical practice, in scientific questions, for international comparisons and in the evaluation of treatment concepts.

Last Update:

5 Jul 2017


Financed by:
  • Deutsche Gesetzliche Unfallversicherung e. V. (DGUV)
Research institution(s):
  • BG Unfallklinik Ludwigshafen

-cross sectoral-

Type of hazard:




Description, key words:

Burn Specific Health Scale questionnaire, ICF, burn injury