Dysmenorrhea Symptoms Interference Scale (DSI) in Serbian - Translation and psychometric properties evaluation

Background and Objective: Dysmenorrhea, painful menstruation, affects 20–90% of women and it can significantly impair their quality of life. To evaluate the severity and consequences of dysmenorrhea specific questionnaires have been developed. The aim of this study was to translate and culturally adapt the Dysmenorrhea Symptoms Interference Scale (DSI) for the Serbian-speaking population and assess its psychometric properties. Materials and Methods: This study included 350 Serbian-speaking female students with primary dysmenorrhea symptoms at least once during the past 12 months attending health sciences at the University of Pristina temporarily settled in Kosovska Mitrovica. They completed the general socio-epidemiologic questionnaire, the DSI and Depression, Anxiety and Stress Scale-21 (DASS-21). The DSI was translated according to the recommended methodology for the cultural adaptation of questionnaires, and its psychometric characteristics (internal consistency, validity based on internal structure, discriminant and convergent validity) were tested. Results: There were no major changes in the items during the process of translation or validation. The Cronbach’s alpha coefficient for the whole scale was 0.928, whereas if an item was deleted, it was above 0.8 for all items. The McDonald’s omega coefficient was 0.951, indicating good internal consistency. The CI‒TC coefficients were greater than 0.40 for all the items, indicating that all the items were significant elements of the DSI. Exploratory factor analysis confirmed one-factor structure of the Serbian DSI version (total variance explained 64.16%). Confirmatory factor analysis showed adequate values of fit indices (goodness of fit 0.998; root mean square error of approximation 0.032). The DSI significantly correlated (ρ = 0.520; p = 0.001) with DASS-21, confirming its adequate convergent validity. Moreover, DSI scores significantly (p = 0.001) differed between students with mild and severe dysmenorrhea proving good discriminant validity. Conclusions: The Serbian version of the DSI showed adequate psychometric properties and it can be applied both in research and in broad clinical use.