Translation and cultural adaptation of the Shame and Stigma Scale (SSS) into Portuguese (Brazil) to evaluate patients with head and neck cancer

William Eduardo Pirola, Bianca Sakamoto Ribeiro Paiva, Eliane Marçon Barroso, David W. Kissane, Claudia Valéria Maseti Pimenta Serrano, Carlos Eduardo Paiva

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9 Citations (Scopus)


Introduction: Head and Neck Cancer (HNC) is the sixth leading cause of death from cancer worldwide and its treatment may involve surgery, chemotherapy and/or radiation therapy. The surgical procedure may cause mutilating sequelae, that can alter patient self-image. Thus, HNC is often connected to the negative stigma with decreased quality of life. Few studies assess the social stigma and shame perceived by patients with HNC. Objective: To perform the translation and cultural adaptation of the Shame and Stigma Scale (SSS) into Portuguese (Brazil). Methods: Two independent translations (English into Portuguese) were carried out by two professionals fluent in the English language. After the synthesis of the translations, two independent back-translations (from Portuguese into English) were performed by two translators whose native language is English. All translations were critically assessed by a committee of experts consisting of five members. A sample of 15 patients answered the Brazilian Portuguese version of the SSS to carry out the pretest. At this step, the patients were able to suggest modifications and evaluate the understanding of the items. Results: There was no need to change the scale after this step. Based on the previous steps, we obtained the Portuguese (Brazil) version of the SSS, which was called Escala de Vergonha e Estigma. Conclusion: The Portuguese (Brazil) version of the SSP was shown to be adequate to be applied to the population with HNC and, therefore, the psychometric properties of the tool will be evaluated during following steps. Introdução: O câncer de cabeça e pescoço (CCP) corresponde à sexta causa de morte por câncer no mundo; seu tratamento pode envolver cirurgia, quimio e/ou radioterapia, sendo que a cirurgia pode acarretar sequelas mutiladoras, podendo alterar a autoimagem do paciente. Assim, o CCP é muitas vezes ligado ao estigma negativo, com diminuição da qualidade de vida. Poucos instrumentos avaliam o estigma social e a vergonha percebidos por pacientes com CCP.

Original languageEnglish
Pages (from-to)697-704
Number of pages8
JournalBrazilian Journal of Otorhinolaryngology
Issue number6
Publication statusPublished - Nov 2017


  • Estigma social
  • Head and neck cancer
  • Neoplasias de cabeça e pescoço
  • Qualidade de vida
  • Quality of life
  • Shame
  • Social stigma
  • Vergonha

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