Translation and Validation of the Breast Cancer and Lymphedema Symptom Experience Index (BCLE‐SEI) in Marathi

Background A common side effect of breast cancer treatment is breast cancer–related lymphedema (BCRL), which is associated with many symptoms, such as swelling, heaviness, tightness, pain, discomfort and poor quality of life. The breast cancer and lymphedema symptom experience index (BCLE‐SEI) captures the presence of BCRL‐related symptoms and distress. However, the BCLE‐SEI is not available in Marathi, one of the most commonly spoken Indian languages. The purpose of this study was to translate and validate the BCLE‐SEI in Marathi. Methodology The BCLE‐SEI was forward‐ and backward‐translated, and the consolidated back translation was checked for equivalence following established guidelines. The BCLE‐SEI‐Marathi was then validated among 169 Marathi‐speaking women with or at risk of developing BCRL. Content validity, structural validity, internal consistency, test–retest reliability, construct validity (through hypothesis testing) and known group validity were tested. Three different thresholds were used when testing known group validity. Results Content validity of the BCLE‐SEI‐Marathi was confirmed by 98% of the participants. Exploratory factor analysis identified two factors in the symptom occurrence subscale and three factors in the symptom distress subscale, which explained 49% and 53.8% of the total sample variance, respectively. Internal consistency of dimensions (factors) ranged from α = 0.82 to 0.94. Construct validity was established through hypothesis testing. The test–retest reliability was strong (Spearman’s rho of 0.88 ( p < 0.01, 95% CI: 0.8–0.9)). The BCLE‐SEI total score was able to distinguish the participants with BCRL from those at risk for BCRL. Conclusion This study demonstrated that the BCLE‐SEI‐Marathi questionnaire is a valid and reliable tool to assess the occurrence and distress of symptoms in Marathi‐speaking women with or at risk of BCRL. Trail Registration: Clinical Trials Registry India: CTRI/2017/11/010326