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SHORT COMMUNICATION
The Need for Linguistically and Culturally Adapted Standard Questionnaires to Assess Itch: A
Preliminary Study
Deok-Hee KIM-DUFOR 1 , Adèle POULALIOU 2 and Laurent MISERY 2,3
CNRS, UMR 6285 Lab-STICC, 2 Department of Dermatology, University Hospital of Brest, FR-29200 Brest, and 3 Laboratory of Neurosciences
of Brest, University of Western Brittany, Brest, France. E-mail: [email protected]
1
Accepted May 10, 2017; Epub ahead of print May 12, 2017
Itch was defined as an unpleasant sensation leading to the
need to scratch already in 1660 (1, 2). Nonetheless, the
lexicon regarding to itch varies depending on languages,
cultures and historical periods.
The adequate understanding of the sensations expe-
rienced by patients is undeniably crucial in the patient–
doctor relationship and indispensable for clinical trials,
investigations into quality of life, psychological studies
and pathophysiological research. The International
Working Group on Pruritus Research (AGPI) (3) and
the International Forum for the Study of Itch (IFSI) (4)
underline the need for standard and validated questionn-
aires for the assessment of itch (5). Itch is also frequently
associated with other sensations (pain, burning, tingling,
tickling, prickling, tightness or stinging) (6–8). Only a
reliable assessment can accurately evaluate the effects of
treatments for pruritus (9).
Designing a structured itch questionnaire should consi-
der both the patient’s and the doctor’s perspectives as well
as the need to gather important medical information (5).
High-standard translations and cross-cultural adaptations
are crucial as previously shown in a comparative study on
pain (10). We studied the term of itch and close sensations
in over 20 languages.
METHODS
Dermatologists who are IFSI members received the questionn-
aire as well as 6 native speakers of Greek, Russian, Vietnamese,
Breton and Brazilian Portuguese. The questionnaire was sent to
34 IFSI members and we received 21 answers. They were asked
to translate English words such as pruritus, itch, itching, pain,
burning, tingling, tickling, pricking, prickling, tightness, stinging
and scratching into their own language. In addition to this trans-
lation work, the respondents were asked to give other terms that
describe symptoms or sensations on account of pruritus such as
adjectives, verbs and nouns, onomatopoeia, and mimetic words.
The last two elements can be classified as ideophones, which are
defined as marked words that depict sensory images (11) and
considers the linguistic particularities of certain languages that
cannot be translated into others. We collected terms linked to itch
in 27 languages and classified them according to their language
families (12) (Table SI 1 ). Note that in our study each variety of
a given language is considered a distinct language (French and
Canadian French; Spanish and Cuban Spanish; Portuguese and
Brazilian Portuguese) because cultural differences give rise to the
development of different vocabularies and expressions (13). For
example, the Spanish language has many varieties in 21 sovereign
states and dependent territories. Languages such as the Arabic,
Celtiberian, Basque and East Germanic languages with which the
Spanish language has come in contact have had a lexical influence
such as word borrowings on Spanish (14, 15).
RESULTS
The languages collected and classified by language family
are as follows: two Afro-Asiatic, one Austro-Asiatic, 20
Indo-European (3 Balto-Slavic, 1 Celtic, 4 Germanic,
1 Hellenic, 2 Indo-Iranian, and 9 Italic), 1 Japonic, 1
Koreanic, 1 Turkic, and 1 Uralic. We first focused on the
existence of two different terms, that is, pruritus and itch.
Our data set shows that a single word is used for both
pruritus and itch in 13 languages; two different terms are
distinctively used in 10 languages; and in 4 languages not
only does the term pruritus exist, but the term equivalent
to itch is also interchangeable with the former and vice
versa, see Table I for the lists of languages.
Since the English language has several words that
describe similar sensations such as tingling, pricking,
prickling and stinging, we took a closer look at words
that express a ‘sensation of as though a sharp point were
sticking into one’. Nineteen languages have 2, 3 or 4 dif-
ferent words that express this sensation, and ≥ 5 terms are
present in 8 languages. Among the varieties of the same
languages included in our study, none of the corresponding
terms are the same between the two varieties of Spanish
(Spain and Cuba) and between the two varieties of Por-
tuguese (Portugal and Brazil) whereas no fundamental
difference is found in the two varieties of French (France
Table I. Language groups depending on the existence of two
different terms, pruritus and itch
Same Different Both
Berber/Tamazight a Vietnamese b Danish c
Polish c Catalan c Korean e
Arabic a
Russian c
German c
Swedish c
Greek c
Marathi c
Hindi c
Cuban Spanish c
Italian c
Croatian c
Spanish c
French c
Japanese d
Finnish g
Canadian French c
Portuguese c
Brazilian Portuguese c
Romanian c
Breton c
Luxembourguish c
Turkish f
a
https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555-2693
1
Afro