Cross-cultural adaptation and validation in French of the cold intolerance symptom severity (CISS) questionnaire and potential work exposure scale (PWES) in patients with hand pathologies - 30/05/26

Doi : 10.1016/j.hansur.2026.102687

Konzelmann Michel ^a,^c,^{^{1
KM and VP contributed equally for this work.},}⁎ , Vuistiner Philippe ^c,^{^{1
KM and VP contributed equally for this work.}}, Burrus Cyrille ^b,^c, Luthi François ^b,^d, Léger Bertrand ^c

^a Assessment and Consultation Service, Clinique Romande de Réadaptation, Avenue du Grand Champsec 90, 1950 Sion, Switzerland

^b Rehabilitation of Locomotor Apparatus Service, Clinique Romande de Réadaptation, Avenue du Grand Champsec 90, 1950 Sion, Switzerland

^c Department of Medical Research of the Suva Clinics, Clinique Romande de Réadaptation, Avenue du Grand Champsec 90, 1950 Sion, Switzerland

^d Department of Locomotor Apparatus, Hôpital Orthopédique, Lausanne, Switzerland

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 30 May 2026

Highlights

•	Cold intolerance is a very frequent problem after hand injuries or surgery.
•	Questionnaires are very simple tools to evaluate cold intolerance.
•	We validated two questionnaires in French with a comprehensive validation process
•	They can be used for prevalence study or describe outdoor job.
•	The two questionnaires are free of used.

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Abstract

Background

Cold intolerance is frequent after hand injuries and is the worst long-lasting problem that negatively affects other impairments in some patients. Two questionnaires are available to assess cold intolerance (CISS, PWES), but not in French. This study aimed to translate, cross-culturally adapt, and validate these questionnaires in French.

Methods

Population: outpatient and hospitalized patients between 2019 and 2024.

Translation, back translation, cross-cultural adaptation according to standard guidelines.

Ten experts evaluated the preliminary French versions for content validity.

Preliminary French versions were administered to 30 patients.

Final French versions to 70 patients for validation: internal consistency, test–retest reliability, construct validity, and floor or ceiling effect.

Results

Translation, back translation, and cross-cultural adaptation were easy with only minor changes.

Preliminary French versions well accepted by patients, and all 10 experts rated content validity very good.

Internal consistency was good: Cronbach α was 0.90 (95% CI [0.87−0.92]) for CISS; 0.80 (95% CI [0.65−0.95]) for PWES.

Factor analysis revealed one factor for each questionnaire.

Construct validity was good, 100% of our hypotheses were confirmed for CISS and 75% for PWES.

Test–retest reliability was excellent: 0.94 (95% CI [0.91−0.96]) for CISS; 0.90 (95% CI [0.78−0.95]) for PWES.

No floor or ceiling effects for either questionnaire.

Conclusion

Both questionnaires have good psychometric properties F-CISS could be used with confidence and had to be validated in other populations. For the PWES, due to small sample used for validation, we consider these results as preliminary and need to be confirmed on a larger sample.

Le texte complet de cet article est disponible en PDF.

Keywords : Cold intolerance, PROMs, CISS, PWES, Psychometric properties, Hand

Abbreviations : PRO, DASH, MHQ, PWES, CISS, CRPS, CVI, I-CVI, S-CVI, S-CVI/AVE, F-CISS, F-PWES, COSMIN, ICC, HFS, SF-36, PCS, MCS, BP, VAS