Procedure

First, the CSS-36 was translated into Spanish as spoken in Peru in according to recommendations for cross-cultural adaptation of self-report measures (Beaton et al., 2000):

Two bilingual native Spanish speakers (first was a mental health professional with knowledge of the subject and second was a professional translator with no knowledge of the subject) performed two independent translations from English to Spanish. From comparison of the two translations, an initial Spanish version of the CSS-36 was developed.

Initial Spanish version was translated into English by two freelance translators whose native language was English, but who spoke Spanish fluently.

The four translators mentioned above, together with two experts in the field and members of the research team, evaluated all translated versions and the original version, from which a preliminary version of the CSS-36 in Spanish was developed.

Preliminary version of the CSS-36 was administered to 10 adults to assess their comprehensibility and readability. Experts together with translators reviewed results of initial version to modify the CSS-36 items if necessary. Respondents did not suggest any modifications, which allowed us to have a final version of the CSS-36 in Spanish.

Table 2 shows a sample of items from the original English version and final Spanish translated version of the CSS-36.

Sample items of the original English version and the final Spanish translated version of the COVID Stress Scales (CSS-36).

The final version of the CSS-36 was applied during the months of January and February 2021, a period in which greater restrictions established by the Peruvian government to try to mitigate impact of COVID-19 were announced. As part of these restrictions, all regions of Peru were categorized as high, very high, or extreme risk. All gatherings including family, social, cultural, and political events were banned. Citizens were also advised to follow all lockdown measures. During the period of application, a contagion rate of approximately 1,790 daily cases and a total rate of 8,855 deaths were observed (Ministerio de Salud, 2021).

An online form was created consisting of the sociodemographic questionnaire and the 36 items of the CSS-36 through the Google Forms platform, which was shared through social networks (Facebook and Instagram) and WhatsApp. The study was reviewed by both the Universidad César Vallejo and the Universidasd Privada del Norte. Approval was received from the Ethics Committee of the Universidad Privada del Norte in Peru (registration number: 20213002 dated January 10, 2021). As part of the consideration for the corresponding aspects of ethics and confidentiality, each participant was not asked for identification data that could expose them or violate their right to privacy. Therefore, the study does not involve any risk to participants.