Translation and Cultural Adaptation of the Return to Sport After Serious Injury Questionnaire (RSSIQ) Into Turkish

Abstract

The Return to Sport After Serious Injury Questionnaire (RSSIQ) was developed to assess psychological readiness to resume sport involvement after injury. However, its applicability to Turkish-speaking athletes has not been established. Consequently, the current study aimed to translate, culturally adapt, and validate the RSSIQ for Turkish athletes. The translation and cross-cultural adaptation were conducted following established guidelines. A total of 244 athletes (80 females, 164 males) aged 18–45 who had completed rehabilitation participated. Structural validity was evaluated using confirmatory factor analysis (CFA), while criterion-related validity was determined by examining correlations with the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale. Internal consistency and test-retest reliability were evaluated. CFA confirmed the two-factor structure of the Turkish RSSIQ with acceptable fit indices (CFI = .98, RMSEA = .082). The RSSIQ correlated significantly with the ACL-RSI, supporting criterion-related validity. Internal consistency was strong (Cronbach’s α = .95 for "Return Concerns" and .84 for "Renewed Perspective"), and test-retest reliability was satisfactory. The Turkish RSSIQ demonstrated strong psychometric properties, maintaining its original structure. The adaptation process helps to ensure its applicability in Turkish rehabilitation settings, capturing cultural nuances associated with psychological readiness. The validated Turkish RSSIQ is a reliable tool for assessing psychological readiness in injured athletes who were absent from sport for at least two months due to injury. It has potential utility in clinical and research settings to enhance rehabilitation strategies. Future studies should explore longitudinal changes and intervention strategies.

Keywords

• Athletic injury recovery
• Factor analysis
• Measurement reliability
• Scale validation
• Psychological readiness

References

1. Alpar, R. (3rd Eds.). (2006). Spor Bilimlerinde Uygulamalı Istatistik. Nobel Yayın Dağıtım.
2. Ardern, C. L., Taylor, N. F., Feller, J. A., & Webster, K. E. (2013). A Systematic Review of the Psychological Factors Associated With Returning to Sport Following Injury. British Journal of Sports Medicine, 47(12), 1120–1126. https://doi.org/10.1136/bjsports-2012-091203
3. Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014
4. Borsa, J. C., Damásio, B. F., & Bandeira, D. R. (2012). Cross-Cultural Adaptation and Validation of Psychological Instruments: Some Considerations. Paidéia (Ribeirão Preto), 22(53), 423-432. https://doi.org/10.1590/S0103-863X2012000300014
5. Brewer, B. W., Andersen, M. B., & Van Raalte, J. L. (2002). Psychological Aspects of Sport Injury Rehabilitation: Toward A Biopsychosocial Approach. In D. I. Mostofsky & L. D. Zaichkowsky (Eds.), Medical and Psychological Aspects of Sport and Exercise (41–54). Fitness Information Technology.
6. Brewer, B. W., Shinnick, R., Cornelius, A. E., Van Raalte, J. L., & Badiei, F. (2025). Patterns of Change in Athletic Identity After Anterior Cruciate Ligament Reconstruction. International Journal of Environmental Research and Public Health, 22(1), 76. https://doi.org/10.3390/ijerph22010076
7. Brislin, R. W. (1986). The Wording And Translation of Research Instruments. In W. J. Lonner & J. W. Berry (Eds.), Field Methods in Educational Research (pp. 137–164). Sage.
8. Faleide, A. G. H., & Inderhaug, E. (2023). It is Time to Target Psychological Readiness (Or Lack of Readiness) In Return to Sports After Anterior Cruciate Ligament Tears. Journal of Experimental Orthopaedics, 10(1), 94. https://doi.org/10.1186/s40634-023-00657-1

9. Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research, 18(3), 382–388. https://doi.org/10.1177/002224378101800313
10. Fuller, C. W., Ekstrand, J., Junge, A., Andersen, T. E., Bahr, R., Dvorak, J., M. Hägglund, P. McCrory, & Meeuwisse, W. H. (2006). Consensus Statement on Injury Definitions and Data Collection Procedures in Studies of Football (Soccer) Injuries. British Journal of Sports Medicine, 40(3), 193-201. https://doi.org/10.1111/j.1600-0838.2006.00528.x
11. Glazer, D. D. (2009). Development and Preliminary Validation of The Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale. Journal of Athletic Training, 44(2), 185–189. https://doi.org/10.4085/1062-6050-44.2.185
12. Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. Journal of clinical epidemiology, 46(12), 1417-1432. https://doi.org/10.1016/0895-4356(93)90142-N
13. Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (7th Eds.). (2010). Multivariate data analysis. Pearson Prentice Hall.
14. Harput, G., Tok, D., Ulusoy, B., Eraslan, L., Yildiz, T. I., Turgut, E., Demirci S., Düzgün İ., Bayrakci Tunay, V., & Ergun, N. (2017). Translation and cross-cultural adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish. Knee Surgery, Sports Traumatology, Arthroscopy, 25, 159-164. https://doi.org/10.1007/s00167-016-4288-6
15. Johnston, L. H., & Carroll, D. (1998). The Psychological Impact of Injury: Effects of Prior Sport and Exercise Involvement. British Journal of Sports Medicine, 32(1), 50–54. https://doi.org/10.1136/bjsm.32.1.50
16. Kline, R. B. (Eds). (2016). Principles and Practice of Structural Equation Modeling. Guilford Publications.
17. Laher, S., & Cockcroft, K. (2017). Moving from Culturally Biased to Culturally Responsive Assessment Practices in Low-Resource, Multicultural Settings. Professional Psychology: Research and Practice, 48(2), 115-121. https://doi.org/10.1037/pro0000102
18. Nunnally, J. C., & Bernstein, I. H. (3rd Eds.). (1994). Psychometric Theory. McGraw-Hill, New York, NY.
19. Podlog, L., & Eklund, R. C. (2005). Return to Sport After Serious Injury: A Retrospective Examination of Motivation and Psychological Outcomes. Journal of Sport Rehabilitation, 14(1), 20–34. https://doi.org/10.1123/jsr.14.1.20
20. Podlog, L., & Eklund, R. C. (2007). Professional Coaches' Perspectives on the Return to Sport Following Serious Injury. Journal of Applied Sport Psychology, 19(2), 207–225. https://doi.org/10.1080/10413200701188951
21. Podlog, L., Banham, S. M., Wadey, R., & Hannon, J. C. (2015). Psychological Readiness to Return to Competitive Sport Following Injury: A Qualitative Study. The Sport Psychologist, 29(1), 1–14. https://doi.org/10.1123/tsp.2014-0063
22. Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Methods of Psychological Research Online, 8(2), 23–74. https://doi.org/10.1007/BF03395793
23. Sheean, A. J., Lubowitz, J. H., Brand, J. C., & Rossi, M. J. (2023). Psychological Readiness to Return to Sport: Fear of Reinjury is the Leading Reason for Failure to Return to Competitive Sport and is Modifiable. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 39(8), 1775-1778. https://doi.org/10.1016/j.arthro.2023.04.020
24. Webster, K. E., Feller, J. A., & Lambros, C. (2008). Development and Preliminary Validation of A Scale to Measure the Psychological Impact of Returning to Sport Following Anterior Cruciate Ligament Reconstruction Surgery. Physical Therapy in Sport, 9(1), 9-15. https://doi.org/10.1016/j.ptsp.2007.09.003
25. Van Mechelen, W., Hlobil, H., & Kemper, H. C. (1992). Incidence, Severity, Etiology And Prevention of Sports Injuries: A Review of Concepts. Sports medicine, 14, 82-99.