International Quality Of Life Assessment Research Articles

Translation, Face and Content Validity of the Persian Version of School Function Assessment

Background: School function assessment (SFA) is a criterion-referenced assessment that uses functional tasks to determine the level of participation and performance of students. The purpose of this study is to assess the face and the content validity of the Persian version of SFA for normal Iranian 6 – 12-year-old children. Methods: This study has a methodological and psychometric design. We used a standard protocol, international quality of life assessment (IQOLA), for translating the SFA test. This protocol includes translation to Persian and backward-translation to English as well; both of these translation qualities are estimated. In order to ensure content validity, 20 occupational therapists, who are experts in the field of pediatrics, completed the content validity index (CVI) and the content validity ratio (CVR) forms through 11 sessions using the IQOLA scale. Twenty elementary school teachers completed these forms as well. Results: The results of face validity showed that all the terms were clear and simple, and all the terms except one were higher than 1.5 in the impact score. The content validity results showed that five item’s score was lower than the acceptable score (< 0.7). Finally, in the expert panel, all the CVI and the CVR items achieved an acceptable score. In this panel, the experts negotiated about the clarity, the simplicity, and the necessity of all the items. Therefore, the Persian version of SFA can evaluate the school function of Iranian children. Conclusions: The Persian version of the SFA achieved a good match in terms of cultural and face validity. Agreements above 80% in the results of face validity confirm that the Persian version of SFA is clear, simple, and understandable for its target population. The content validity results indicate different cultural perceptions for certain items. To determine and construct the validity and the reliability of the Persian version of SFA, other studies are required.

French validation of the Brace Questionnaire (BrQ)

BackgroundQuality of Life (QoL) scales have to be introduced in the treatment evaluation of our patients with adolescent idiopathic scoliosis.Vasiliadis et. al. created the Brace Questionnaire (BrQ), which is specific for brace-treated adolescents. This tool was developed and validated in Greek.The aim of our study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into French.MethodsThe BrQ is made of 34 items on Likert scale, divided in eight domains. The questionnaire was developed for self-completion by the children and is adapted for 9 to 18-year-old patients.The process of cultural adaptation of the questionnaire was in accordance with the International Quality of Life Assessment (IQOLA) guidelines.In the first place, descriptive statistics were used to calculate mean scores and standard deviations for a given question and a domain. The second level was comparative, concerning reliability and validity.ResultsThe internal consistency was satisfactory; Cronbach’s alpha coefficient was 0.85. There were no floor or ceiling effects.ConclusionsThe French version of the BrQ (F-BrQ) is reliable and reproducible, and can therefore be used to evaluate the quality of life of children and adolescents treated with a brace for idiopathic scoliosis.

Translation and Psychometric Properties of Persian Version of Independent Living Scale in Patients with Schizophrenia

Background: Independent living skills are major targets for rehabilitation in patients with schizophrenia. So, assessment of their performance is required to obtain valuable information for planning intervention. The independent living scale (ILS) is a useful assessment tool for this population. Objectives: The aims of this study were to translate the three of five subscales of ILS (“memory/orientation”, “health and safety” and “social adjustment”) into Persian language and evaluate their validity. The remaining two subscales of ILS (“money management”, “home management and transportation”) have already been translated to Persian language by other researchers in Iran. In addition, the reliability of whole Persian version of ILS subscales was evaluated to be used for patients with Schizophrenia. Methods: The three subscales of ILS were translated from English into Persian according to the international quality of life assessment (IQOLA) approach. The translation of the three subscales: memory/orientation, health and safety and social adjustment, were analyzed by experts to develop the final version of each subscale. After translation, face and content validity of scale were performed. In face validity evaluation, the scale was investigated by 6 occupational therapists in terms of simplicity, mastery, relationship and clarity or transparency for each of the items. To assess the validity of content, scale was examined by 15 occupational therapists and content validity ratio (CVR) and content validity index (CVI) of each item were calculated. To assess the reliability of the subscales, test-retest reliability techniques (intraclass correlation coefficient (ICC) and standard error of measure (SEM) were utilized. Results: The simplicity, relevance, clarity and necessity of the translated items were acceptable, according to the CVI and CVR scores. Face validity was also acceptable with respect to agreement rate (> 80%). Test-retest reliability was acceptable with respect to ICC and SEM scores. The values of the ICC were > 0.70 and the values of the SEM were ≤ 1 for the score of subscales and total score. Conclusions: The Persian version of the ILS has acceptable levels of face validity, content validity, and test-retest reliability to use for Iranian patients with Schizophrenia.

Validity and Reliability of the Persian Version of the Revised Caregiving Appraisal Scale in Iranian Family Caregivers of Older Adults with Dementia

Background: Caregivers’ self-assessments of the care they provide are the main vehicles that help explore their experiences and are thought to have a major role in care outcomes. The rising number of people with dementia and their need for care provided within the family makes family caregiving a major topic for study and evaluation. Objectives: The present study was conducted to assess the psychometric characteristics of the Persian version of the revised caregiving appraisal scale (RCAS) in family caregivers of older adults with dementia. Methods: In this cross-sectional methodological study, 236 family caregivers were recruited through convenience sampling. The revised caregiving appraisal scale (RCAS) was translated using the international quality of life assessment (IQOLA) protocol, and then a panel of experts examined its face and content validities. To ensure construct validity, the translated revised caregiving appraisal scale (RCAS) was completed by 236 family caregivers, and the factor construct of the scale was assessed using five initial factors for confirmatory factor analysis. Internal consistency was confirmed using Cronbach’s alpha, and test-retest using the intraclass correlation coefficient (ICC). The confirmatory factor analysis was performed with LISREL-8.8 software for Windows®. Results: The mean age of the participating caregivers was 53.5 ± 13.13 years. The content and face validities of the scale were confirmed using the feedback of the family caregivers and panel of experts. The confirmatory factor analysis results reported appropriate values for all the fit indices (RMSEA = 0.046, df / χ2 = 2.428, CFI = 0.98, AGFI = 0.84, and GFI = 0.9), and the 5-factor model was confirmed with 27 items. The scale-level Cronbach’s alpha was reported as 0.894 and the scale-level ICC as 0.94. The scale met the minimum reliability standards (Cronbach’s alpha and intraclass correlation coefficient > 0.7). Conclusions: This study has provided some preliminary evidence of the reliability and validity of the Persian version of RCAS when used with family caregivers of older adults with dementia.

Validity and Reliability of the Persian Version of the Disability Assessment for Dementia Scale

Background: As dementia progresses in the course of life, one's functions may be reduced regarding to fulfill the activities of daily living. One of the most important factor to diagnose and determine the severity of dementia is to assess activities of daily living. Objectives: one the most important factor in determining the severity of dementia in the area of activities of daily living is disability assessment for dementia (DAD) scale, which is not available in Persian and there is no validity and reliability report for it in Iranian community. Therefore, the aim of this study was to provide a Persian version of the valid and reliable DAD scale to assess functional disability in patients with dementia of Alzheimer type within the scope of everyday living activities. Patients and Methods: After the permission from the developer of the original scale, we translated the English version to Persian according to the international quality of life assessment (IQOLA) approach. To review the clarity and the necessity of the items translated, content validity index (CVI) and content validity ratio (CVR) methods were applied. Also, to assess the reliability of the scale, test-retest and inter-rater reliability techniques were used. The internal consistency of the items was also measured using the Cronbach’s alpha coefficient. Results: Cronbach’s alpha coefficient was very good for the scale (Cronbach’s α = 0.78) and the inter-rater reliability and test-retest reliability were excellent (intraclass correlation/ICC = 0.99, ICC = 0.99). The clarity and necessity of the translated items based on the scores of CVI and CVR were also acceptable. Conclusions: The Persian version of DAD, during the study, had a very good validity and reliability and can serve as a useful scale in clinical assessment of functional disability in patients with Alzheimer’s in the area of activities of daily living.

French validation of brace questionnaire

Material and methods The BrQ is made of 34 items on Likert Scale, divided in 8 domains. The questionnaire was developed in order that the child could fill in it alone and is adapted for 9 to 18 years old. The lowest scale is 20 and the best 100. The highest scales show a better QoL. The process of cultural adaptation of the questionnaire was in accordance with the International Quality of Life Assessment (IQOLA) Guidelines.

Content validity of the Persian version of the Pediatric Evaluation of Disability Inventory (PEDI)

Introduction: According to change in the approach to the rehabilitation of children with disability, function is an effective characteristic of the quality of life for these children. Pediatric Evaluation of Disability Inventory (PEDI) was designed to assess the function of 6 months to 7 and half years old children. The aim of this study was to translate the Pediatric Evaluation of Disability Inventory (PEDI) to Persian, and to evaluate the content validity of this Persian version. Material and methods: The translation process was based on International Quality of Life Assessment (IQOLA) Project. The Persian version of PEDI was prepared in three stages: Translation (from English to Persian and in reverse, by four translators), examination of the quality of the Persian translation (By eight rehabilitation specialists, skilled in English language), and examination of its content validity (by 15 pediatric rehabilitation specialists). Results : Respondents rated the translated version of the PEDI as acceptable. Content validity of the Persian translation of PEDI, without changing its content was confirmed. Conclusion: The results show that the Persian translation of the PEDI is acceptable and has content validity. Keywords: Functional Performance, Pediatric Evaluation of Disability Inventory (PEDI), Content Validity, Outcome Measure

French validation of Brace Questionnaire

Material and methods The BrQ is made of 34 items on Likert Scale, divided in 8 domains. The questionnaire was developed in order that the child could fill in it alone and is adapted for 9 to 18 years old. The lowest scale is 20 and the best 100. The highest scales show a better QoL. The process of cultural adaptation of the questionnaire was in accordance with the International Quality of Life Assessment (IQOLA) Guidelines.

Measuring reliability and validity of Persian version of spirituality scale among elderly Iranian population

Objective: The aim of this study was to measure the validity and reliability of Persian version of spirituality scale among elderly Iranian people. Methods: Based on the international quality of life assessment (IQOLA) project approach, Persian version of the spirituality scale was prepared. Data on 200 elderly people (over 60 years old) were entered into SPSS software. Results: The findings of the descriptive results of the current study showed that there was no correlation between the demographic data collected in this study such as age, religion and marital status with spirituality. On the other hand, after performing the exploratory factor analysis, calculating test-retest and intra-class correlation coefficient and measuring Cronbach's Alpha coefficient for internal consistency, the results showed that respectively the reliability, the face and content validity of the questionnaire were confirmed in high level. Also, through the exploratory factor analysis, the construct validity was confirmed. Conclusions: The Persian version of the spirituality scale in the elderly people with an acceptable reliability and validity can be used in clinical assessment and research.

Polish validation of brace questionnaire

The aim of the study was to undertake the process of cultural adaptation of the Brace Questionnaire (BrQ) into Polish. The BrQ is an instrument for measuring quality of life of scoliotic adolescents who are being treated conservatively with wearing of a corrective brace [1]. The BrQ consists of 34 Likert-scale items associated with eight domains. Material and methods The translation from the original Greek into Polish was performed. The process of cultural adaptation of the questionnaire was compliant with the guidelines of the International Quality of Life Assessment (IQOLA) Project. It involved 30 adolescents, ages ranging between 10.0 and 17.0 years, all with Adolescent Idiopathic Scoliosis (AIS) and all wearing the same kind of brace (Cheneau). The statistical analysis calculated the reliability (internal consistency), floor and ceiling effects of the BrQ [2-5]. Results The age was 14.0 +/- 1.6 years. The adolescents were wearing the brace for more than 3 months. Cobb angle was 33.6 +/- 11.6 degrees. The internal consistency was satisfactory: Cronbach’s alpha coefficient was 0.82, p<0.001. There was no floor or celing effect.

Measuring Health Related Quality of Life (Hrqol) in Renal Transplant Patients: Psychometric Properties and Cross-Cultural Adaptation of Kidney Transplant Questionnaire (Ktq-25) in Persian

BackgroundDifferent measuring tools have been used to understand the outcomes of renal replacement therapies. The goal of renal transplantation is both to ensure survival, and to promote quality of life in the patients. One of the widely used disease-specific instruments to measure the quality of life is the Kidney Transplant Questionnaire (KTQ-25).ObjectivesThe current study aimed to perform a cross-cultural adaptation and assess the psychometric properties of the KTQ-25 to Persian.Materials and MethodsThe KTQ-25 was trasnlated according to International Quality of Life Assessment (IQOLA) translation methodology. Cronbach’s alpha coefficient, and test-re-test were used to determine internal consistency, and reliability respectively.ResultsIn the test–re-test reliability of all questionnaire items, Pearson correlation was r = 0.96 (P < 0.001). Cronbach’s alpha coefficient estimated the internal consistency for each scale andalpha equal or more than 0.73 was considered satisfactory. Criterion-related validity, measured by the correlation coefficients between the KTQ-25 and the SF-36 Health Survey, was r = 0.63 (P < 0.001).ConclusionsThe psychometric properties of the Kidney Transplant Questionnaire (KTQ-25) in Persian have proven to be satisfactory, therefore the application of this questionnaire in clinical practice can be recommended.

Validation of the Japanese version of the quality of recovery score QoR-40

The quality of recovery score QoR-40 is a recovery-specific and patient-rated questionnaire to assess the early postoperative health status of patients. However, the Japanese version of the QoR40 has not been established. The aim of this study was to validate the quality of recovery 40 Japanese version (the QoR-40J) according to the methods adopted by the International Quality of Life Assessment (IQOLA) project. After obtaining ethics committee approval and consent, 192 general and otological surgical patients were studied. The QoR-40J was used to measure postoperative health status on day 3 and 1month after surgery. The level of quality of life was also evaluated using a general, health-related quality of life questionnaire (Short-Form Health Survey-36 sub-scales; SF-36), at 1month after the surgery. Psychometric analysis including the following properties: test-retest reliability, internal consistency, predictive validity, and measurement of responsiveness, was performed to validate the QoR-40J. Test-retest reliability (Spearman's correlation coefficient) and internal consistency (Cronbach's α) of the QoR-40J were 0.887 and 0.91, respectively. A significant relationship was observed between the total QoR-40J score and duration of hospitalization (r=-0.291) and between the global QoR-40J score and postoperative scores of the SF-36 sub-scales (physical function, ρ=0.287; vital score, ρ=0.349). The standardized mean of the QoR-40J, a measurement of responsiveness, was 0.70. The results of the psychometric analysis indicated that the QoR-40J has characteristics of acceptable validity, reliability, and responsiveness in clinical practice in Japan. The QoR-40J may aid in evaluating the quality of recovery after surgery or the quality of methods of anesthesia.

Tradução e adaptação cultural do Penn Shoulder Score para a Língua Portuguesa: PSS-Brasil

To produce the Brazilian version of Penn Shoulder Score (PSS) designated to measure pain, satisfaction, and function of patients with shoulder painful musculoskeletal conditions. The Brazilian version development of PSS questionnaire was based on the protocol proposed by the American Academy of Orthopaedic Surgeons (AAOS) and International Quality of Life Assessment (IQOLA). The process consists of translation, synthesis, back-translation, expert Committee review, pretest and evaluation of documents by the Committee and author of the PSS. This pre-final version was administered to a sample of 90 subjects with clinical diagnosis of painful musculoskeletal shoulder, male and females, aged over 18 years. In applications, the patients were inquired about their understanding of each item, and items not understood by 20% or more of patients were analyzed and modified by the Committee, requiring three questionnaire applications (n = 30). The application of pre-final versions of the PSS revealed the difficulties encountered by patients, which were resolved by transforming the self-applied questionnaire in an instrument applied through interview. The translation and cultural adaptation resulted in the final Brazilian version of the PSS questionnaire.

Polish adaptation of Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity

Bad Sobernheim Stress Questionnaire-Brace and Bad Sobernheim Stress Questionnaire-Deformity are relatively new tools aimed at facilitating the evaluation of long-term results of therapy in persons with idiopathic scoliosis undergoing conservative treatment. To use these tools properly in Poland, they must be translated into Polish and adapted to the Polish cultural settings. The process of cultural adaptation of the questionnaires was compliant with the guidelines of International Quality of Life Assessment (IQOLA) Project. In the first stage, two independent translators converted the originals into Polish. Stage two, consisted of a comparison of the originals and two translated versions. During that stage, the team of two translators and authors of the project identified differences in those translations and created a combination of the two. In the third stage, two independent translators, who were native speakers of German, translated the adjusted version of the Polish translation into the language of the original document. At the last stage, a commission composed of: specialists in orthopedics, translators, a statistician and a psychologist reviewed all translations and drafted a pre-final version of the questionnaires. Thirty-five adolescent girls with idiopathic scoliosis who were treated with Cheneau brace were subjected to the questionnaire assessment. All patients were treated in an out-patient setting by a specialist in orthopedics at the Chair and Clinic of Orthopedics and Traumatology. Median age of patients was 14.8 SD 1.5, median value of the Cobb's angle was 27.8 degrees SD 7.4. 48.6% of patients had thoracic scoliosis, 31.4% had thoracolumbar scoliosis, and 20% patients had lumbar scoliosis. Median results obtained by means of the Polish version of BSSQ-Brace and BSSQ-Deformity questionnaires were 17.9 SD 5.0 and 11.3 SD 4.7, respectively. Internal consistency of BSSQ-Brace and BSSQ-Deformity was at the level of 0.80 and 0.87, whereas the value of the absolute stability factor was 0.82 and 0.88. Overall, the Polish versions of the BSSQ-Brace and BSSQ-Deformity Questionnaires are characterized by high values of internal consistency factor and absolute stability factor. Following the process of adaptation, the authors obtained a tool that is instrumental in clinical evaluations and complies with methodological criteria.

The reliability and validity of the short version of the WHO Quality of Life Instrument in an Arab general population

BACKGROUND AND OBJECTIVES:There is rising interest in quality of life (QOL) research in Arabian countries. The aim of this study was to assess in a nationwide sample of Kuwaiti subjects the reliability and validity of the World Health Organization Quality of Life (WHOQOL-BREF), a shorter version of the widely used QOL assessment instrument that comprises 26 items in the domains of physical health, psychological health, social relationships, and the environment.METHODS:A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending large cooperative stores and municipal government offices in the six governorates completed the Arabic translation of the questionnaire. The indices assessed included test-retest reliability, internal consistency, item internal consistency (IIC), item discriminant validity (IDV), known-groups and construct validity.RESULTS:There were 3303 participants (44.8% males, 55.2% females, mean age 35.4 years, range 16 to 87 years). The intra-class correlation for the test-retest statistic and the internal consistency values for the full questionnaire and the domains had a Cronbach's alpha≥0.7. Of the 24 items that constitute the domains, 21 met the IIC requirement of correlation ≥0.4 with the corresponding domain, while 16 met the IDV criterion of having a higher correlation with their corresponding domain than other domains. Domain scores discriminated significantly between well and sick groups. In the factor analysis, four strong factors emerged with the same construct as in the WHO report.CONCLUSION:The Arabic translation of the WHOQOL-BREF has impressive reliability and validity indices. The poor IDV findings are due to the multidimensional nature of the questionnaire. The highly significant validity indices should reassure researchers that the questionnaire represents the same constructs across cultures. Negatively worded items possibly need refinement.

Validation of a Chinese version of the oral health impact profile-14

To translate the original English version of oral health impact profile (OHIP)-14 into Chinese version and to test the psychometric properties of the Chinese version for use among the Chinese adults. The original English version of OHIP-14 was translated into Chinese, and pre-tested and cross-cultural adapted. Subsequently the Chinese version with a general questionnaire was administered to adults aged 18 approximately 65 years by a trained interviewer. Reliability of the translated scale was assessed in terms of internal consistency using Cronbach's alpha and corrected item-total correlation. Construct validity was evaluated by factor analysis and criterion-related validity was evaluated by examining the associations between perceived oral health status, perceived need for dental care and OHIP-14 scores. Formal psychometric properties were tested according to the standard procedure of the international quality of life assessment (IQOLA) project. A total of 592 adults were surveyed. There were 550 valid questionnaires involving 38 ones with missing data. Cronbach's alpha of the translated scale was 0.93, corrected item-total correlation ranged from 0.53 to 0.71. The 14 items were divided into four domains. There was certain logical relation between the items in the same domains. There was highly significant association between perceived oral health status, perceived need for dental care and OHIP-14 scores. The translated Chinese version of OHIP-14 demonstrated good reliability and validity. Its good psychometric properties provide the theoretical evidence for further use in Chinese population. It is available for use by researchers in oral health related quality of life studies in Chinese adults.

Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project

Few studies and no international comparisons have examined the impact of multiple chronic conditions on populations using a comprehensive health-related quality of life (HRQL) questionnaire. The impact of common chronic conditions on HRQL among the general populations of eight countries was assessed. Cross-sectional mail and interview surveys were conducted. Sample representatives of the adult general population of eight countries (Denmark, France, Germany, Italy, Japan, The Netherlands, Norway and the United States) were evaluated. Sample sizes ranged from 2031 to 4084. Self-reported prevalence of chronic conditions (including allergies, arthritis, congestive heart failure, chronic lung disease, hypertension, diabetes, and ischemic heart disease), sociodemographic data and the SF-36 Health Survey were obtained. The SF-36 scale and summary scores were estimated for individuals with and without selected chronic conditions and compared across countries using multivariate linear regression analyses. Adjustments were made for age, gender, marital status, education and the mode of SF-36 administration. More than half (55.1%) of the pooled sample reported at least one chronic condition, and 30.2% had more than one. Hypertension, allergies and arthritis were the most frequently reported conditions. The effect of ischemic heart disease on many of the physical health scales was noteworthy, as was the impact of diabetes on general health, or arthritis on bodily pain scale scores. Arthritis, chronic lung disease and congestive heart failure were the conditions with a higher impact on SF-36 physical summary score, whereas for hypertension and allergies, HRQL impact was low (comparing with a typical person without chronic conditions, deviation scores were around -4 points for the first group and -1 for the second). Differences between chronic conditions in terms of their impact on SF-36 mental summary score were low (deviation scores ranged between -1 and -2). Arthritis has the highest HRQL impact in the general population of the countries studied due to the combination of a high deviation score on physical scales and a high frequency. Impact of chronic conditions on HRQL was similar roughly across countries, despite important variation in prevalence. The use of HRQL measures such as the SF-36 should be useful to better characterize the global burden of disease.

Validation of Italian multiple sclerosis quality of life 54 questionnaire

OBJECTIVESHealth related quality of life (HRQOL) inventories are multi-dimensional measures of patient-centred health status developed for clinical research. The MS quality of life 54 (MSQOL-54) is an MS-specific HRQOL inventory...

Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project

This article presents information about the development and evaluation of the SF-36 Health Survey, a 36-item generic measure of health status. It summarizes studies of reliability and validity and provides administrative and interpretation guidelines for the SF-36. A brief history of the International Quality of Life Assessment (IQOLA) Project is also included.

Cross-Cultural Comparisons of the Content of SF-36 Translations across 10 Countries: Results from the IQOLA Project

Increasingly, translated and culturally adapted health-related quality of life measures are being used in cross-cultural research. To assess comparability of results, researchers need to know the comparability of the content of the questionnaires used in different countries. Based on an item-by-item discussion among International Quality of Life Assessment (IQOLA) investigators of the content of the translated versions of the SF-36 in 10 countries, we discuss the difficulties that arose in translating the SF-36. We also review the solutions identified by IQOLA investigators to translate items and response choices so that they are appropriate within each country as well as comparable across countries. We relate problems and solutions to ratings of difficulty and conceptual equivalence for each item. The most difficult items to translate were physical functioning items that refer to activities not common outside the United States and items that use colloquial expressions in the source version. Identifying the origin of the source items, their meaning to American English-speaking respondents and American English synonyms, in response to country-specific translation issues, greatly helped the translation process. This comparison of the content of translated SF-36 items suggests that the translations are culturally appropriate and comparable in their content.