French translation, cultural and digital adaptation of the state behavioral scale for sedation assessment in paediatric intensive care

INTRODUCTION: Children admitted to paediatric intensive care units frequently require invasive interventions and mechanical ventilation, requiring meticulous sedation management. Optimal care depends on careful titration of analgesics and sedatives, guided by clinician-administered assessment instruments to ensure proper dosing and minimise adverse effects. The State Behavioral Scale (SBS) is one of the two primary instruments recommended to assess sedation in mechanically ventilated children but has not been translated for French-speaking clinical settings or adapted for integration into an electronic health record (EHR) system. OBJECTIVE: The aim of this study was to translate the original English SBS into French and adapt it culturally and digitally. METHODS: This descriptive study, using a 10-step translation and cultural adaptation process, was conducted following the International Society for Pharmacoeconomics and Outcomes Research Task Force framework for Translation and Cultural Adaptation of Patient-Reported Outcomes Measures. One professional translator and 17 native-speaking expert clinicians participated in this process. The SBS was then adapted for digital use. RESULTS: The translation and cultural adaptation of the SBS ensured conceptual and linguistic equivalence through reconciliation, expert review, and harmonisation. Cognitive debriefing with nine nurses confirmed clarity and usability, leading to minor refinements and a supplementary guidance document. A digital version was developed for integration into the EHR, using selectable descriptors and automated scoring. This adaptation was reviewed by clinical and research experts and validated by the original SBS developer. CONCLUSIONS: A linguistically and culturally adapted version of the SBS for the French context has been developed and is ready for EHR integration and psychometric testing. The digitalised French version of the SBS will enable French-speaking settings to perform accurate and standardised sedation assessment in mechanically ventilated children, helping to prevent adverse effects of undersedation and oversedation and improve patient outcomes.