Translation Of Questionnaire Research Articles

Vaccination health literacy: cultural validation and pilot testing of the HLS19-VAC instrument

Abstract Introduction Vaccinаtion health literacy (VHL) is considered an extremely important aspect of health literacy. HLS19-VAC questionnaire is a 14-item ‘subjective’ perception-based instrument used for measuring VHL in the M-POHL Health Literacy Survey 2019-2021, which Serbia was not part of. Aim Translation and cultural validation of the HLS19-VAC questionnaire and using the validated Serbian version (HLS19-VAC_RS) for pilot study research. Materials and methods The English version of HLS19-VAC was translated using a systematic approach; three forward and one back-translations were synthesized and compared by an expert committee. Thereafter, cognitive interviews with 11 participants produced a version that was culturally validated by an expert panel. We conducted a cross-sectional pilot study using a HLS19-VAC_RS, on a convenient sample of the general population in Serbia. VHL was assessed by calculating the score for 4 out of 14 questions. Additional data were collected through a general questionnaire with 30 questions. Descriptive and inferential statistics were used. Results Cognitive interviews showed some problems in wording, and cultural adaptation resulted in minor refinements to eight out of 14 items. The instrument was pretested by 11 experts who adjusted it accordingly to produce culturally validated HLS19 -VAC_RS. Of 439 respondents in a pilot study, 15% had problematic VHL, while the levels of sufficient and excellent VHL were nearly the same (38.5% and 35.1%, respectively). There was difficulty in deciding whether to receive the flu vaccine (15.0%) and to find information about recommended vaccines (12.3%). There was a significant statistical difference in responses to VHL and monthly income and alcohol consumption. Most of the respondents contacted pharmacists as primary sources of information about medication (42.7%). Conclusions HLS19 -VAC_RS could be implemented in a local context as culturally appropriate. Further testing on a population level is needed. Key messages • HLS19-VAC_RS Questionnaire is culturally appropriate for assessing vaccination health literacy in Serbia. • Majority of respodents had sufficient or excellent vaccination health literacy.

Validated translation of telehealth and health app usability questionnaires to 8 European languages

Abstract International projects such as the Joint Action on strengthening eHealth including telemedicine and remote monitoring for health care systems for cancer prevention and care (eCAN) are implemented in countries with different languages, requiring validation of translations of standardized tools. Evaluation frameworks for telemedicine services necessarily include the patient’s perspective, i.a. on the service usability. Due to the lack of validated questionnaires in multiple European languages we sought to develop translation for the languages of the eCAN pilot countries. Based on literature review, we selected mHealth App Usability Questionnaire (MAUQ) and Telehealth Usability Questionnaire (TUQ) and developed a conceptual definition for each item. Next, we performed forward and back translation from English into the target languages, expert review, cognitive interview (CI) with 5-10 cancer or chronic disease patients per language/per questionnaire. Qualitative CI results were scored by 2 independent researchers for consistence of each item with conceptual definitions for final review by native speaker expert. We chose 8 languages (ES, GR, HU, IT, LT, NL, PT, SI) for validation. CI involved 48 respondents (29 females, 60%; 18 aged>60, 38%;23 higher education, 48%) for TUQ and 48 (22 females, 46%; 16 aged>60, 33%; 23 higher education, 48%) for MAUQ. Overall 872 (87%) of TUQ and 728 (84%) of MAUQ item answers were classified as consistent. In more than one language we identified concepts difficult to understand: consistent navigation when moving between screens, distinction between easy to use/learn, social settings. The validation process allowed us to identify opportunities to improve translation and highlighted concepts generally more difficult to understand. We provided validated translation of MAUQ and TUQ in 8 European languages for use in eCAN pilots and future telemedicine evaluation studies. Key messages • eCAN successfully validated translations of telemedicine usability questionnaires for 8 languages. • Multilingual translation validation can provide insights into concepts difficult across languages.

The translation and validation of the surgical anxiety questionnaire into the modern standard Arabic language: results from classical test theory and item response theory analyses

BackgroundPreoperative anxiety is commonly found in patients who are waiting for surgery and can lead to negative surgical outcomes. Understanding the sources of surgical anxiety allows healthcare providers to identify at-risk patients and implement psychosocial interventions such as counseling, relaxation techniques, and cognitive‒behavioral therapy to minimize anxiety. Few comprehensive psychiatric measures are available to assess preoperative anxiety in Arabic.ObjectiveOur study aimed to translate, adapt, and validate the Surgical Anxiety Questionnaire (SAQ) into the modern standard Arabic language, also known as Fusha al-Asr Arabic.MethodsTo translate the questionnaire, the research team used the gold standard process of forward translation by two independent translators along with back translation evaluation by four trained medical doctors. A cross-sectional study was conducted using an online survey completed by 208 Arabic speakers (mean age 38 years, 44% women) from four countries. Psychometric analyses, which included internal consistency, test-retest reliability, convergent validity, confirmatory factor analysis, and item response analysis, were performed. Convergent validity tests were performed against the Generalized Anxiety Disorder 2-item Scale (GAD-2), Patient Health Questionnaire-4 (PHQ-2), Perceived Stress Scale 4 (PSS-4), and Arabic version of the Visual Analog Scale for anxiety (VAS-A).ResultsThe mean SAQ of our sample was 19.38 ± 12.63 (possible range 0–68). The Arabic SAQ translation demonstrated excellent internal consistency, with McDonald’s omega and a Cronbach’s alpha of approximately 0.90. The test-retest reliability was also high, with an intraclass coefficient of 0.94. The SAQ showed strong convergent validity against the GAD-2 (r = 0.94, p < 0.01). The SAQ also showed weak-moderate correlations with the PHQ-2 (r = 0.26, p < 0.01), PSS-4 (r = 43, p < 0.01), and VAS-A (r = 0.36, p < 0.01) scores. The original three-factor structure was supported by confirmatory factor analysis, confirming the original structure reported in the original English language version. The results for fitness indices showed acceptable preliminary results (CFI/TLI approximately 0.90), and deleting some items improved the model fit (CFI/TLI > 0.90, RMSEA < 0.08). We suggest retaining the original factorial solution until further validation studies can be conducted. The item response theory (IRT) results identified no items that were excessively difficult or subject to guessing. The multidimensional IRT provided evidence that the SAQ items form a multidimensional scale assessing surgical anxiety that fits the classical model reasonably well.ConclusionThe SAQ has demonstrated acceptable reliability and validity; thus, it is a trustworthy and valid tool for evaluating preoperative anxiety in Arabic speakers. Future research could benefit from using the SAQ in both surgical and psychiatric research.

Scan of the postgraduate educational environment domains questionnaire: a reliable and valid tool for the evaluation of educational environment in postgraduate medical education

BackgroundThe educational environment plays a critical role in shaping learners’ perceptions and experiences in medical education. Evaluating and enhancing the quality of this environment is essential for the continuous improvement of medical training programs. The Scan of the Postgraduate Educational Environment Domains (SPEED) is a concise instrument that assesses three domains of the educational environment. This study aimed to translate the SPEED questionnaire into Persian and evaluate its validity and reliability in the context of postgraduate.MethodsA cross-sectional study was conducted with 200 first and second-year medical residents. The Persian translation of the SPEED questionnaire was assessed for content validity, and confirmatory factor analysis was performed to evaluate its structural validity. Cronbach’s alpha coefficient was calculated to assess internal consistency reliability.ResultsThe Persian-translated SPEED questionnaire demonstrated satisfactory content validity, with all items exceeding the minimum acceptable values for content validity ratio and index. Confirmatory factor analysis indicated an acceptable fit for the 3-dimensional structure of the SPEED instrument. Internal consistency reliability analysis showed high reliability for the content, atmosphere, and organization domains.ConclusionThe Persian-translated version of the SPEED questionnaire is a valid and reliable tool for assessing the domains of the educational environment in postgraduate medical education.

Cross-cultural Adaptation, Validity, and Reliability of the Persian Version of Back Pain and Body Posture Evaluation Instrument for Adults

Background and Objectives: Back pain and neck pain are prevalent health concerns, emphasizing the importance of identifying effective risk factors for prevention. This study aimed to cross-culturally adapt and validate a tool assessing back and neck pain in adults, with a specific focus on body posture, to the Persian language. Methods: A methodological study was conducted involving forward and backward translation of the original English questionnaire into the Persian language. Face validity was evaluated with feedback from 30 participants, and content validity was determined using content validity ratio (CVR) and content validity index based on expert opinions from 10 physiotherapy specialists. A total of 237 participants were involved in the study, with 90 completing the questionnaire again after one week for test re-test reliability assessment. Results: The Persian version of the questionnaire demonstrated high content validity with a CVR above 0.6. The Persian version had suitable face validity. Test re-test reliability, assessed using percentage agreement and the Kappa coefficient, revealed satisfactory results, with all percentages above 70%. Notably, the intraclass correlation coefficient for questions 16 and 20 was 0.898 and 0.878, respectively. Conclusion: The Persian version of the tool exhibits high validity and reliability, making it a valuable instrument for use within the Persian-speaking community.

ICD-11 adjustment disorder: Translation and validation of the Danish international adjustment disorder questionnaire among a working population of social educators

Adjustment disorder is frequently used as a diagnostic category for work-related stress disorders in Denmark. However, the diagnostic category is poorly delineated in ICD-10 which has hampered clinical practice as well as research studying the development of work-related adjustment disorders. In ICD-11, the diagnostic category of adjustment disorder has been refined and a new self-report measure is available to operationalize symptoms. The aim of the current study is to translate the International Adjustment Disorder Questionnaire (IADQ) to Danish and test the psychometric properties of the scale in a sample of social educators. A total of 609 social educators in current employment participated in an online survey including the IADQ and data was analyzed using confirmatory factor analysis. Findings suggested that a two-factor model reflecting the distinction between preoccupation and failure to adapt as part of the diagnostic criterion fitted the data best, although strong factor correlations and one cross-factor loading suggests that differentiating between the dimensions of preoccupation and failure to adapt is difficult. Relationships to burnout, posttraumatic stress and general distress support the validity of the Danish translation of the IADQ. Further research should explore the structure of adjustment disorder among other working populations.

Breastfeeding Basic Competence in Primary Care: A Spanish Translation and Cross-Cultural Validation of the CAPA Questionnaire.

The number of validated questionnaires that assess the level of breastfeeding competence of primary care professionals who attend lactating mothers is limited. To validate the CAPA (Competència en l'Atenció Primària sobre Alletament [Breastfeeding Competence in Primary Care]) questionnaire into Spanish in collaboration with professionals from the primary care services of the Comunidad de Madrid (Spain). In this multicentric study, four bilingual healthcare professionals translated the CAPA questionnaire into Spanish and back-translated it into Catalan. The cross-cultural adaptation included a discussion by an expert committee, a review by a philologist, and a pilot study that involved 13 healthcare residents. We randomly selected professionals from specialties involved in breastfeeding. The re-test was conducted 3 weeks later, aiming to avoid changes in the studied population. We performed a factor analysis to identify underlying constructs and hypothesis-testing to assess the validity of the questionnaire and estimated the Cronbach Alpha and intraclass correlation coefficient (ICC) to assess its reliability. A total of 198 professionals participated by responding to the questionnaire. Factorial analysis showed that the questionnaire was unidimensional. Hypothesis testing showed that, of all the considered professional groups, midwives achieved the highest mean score (M = 131.7, SD = 10.9, p < 0.001). Amongst the other professionals, only 26.5% achieved a basic level of breastfeeding competence. The Cronbach alpha and ICC were 0.852 (95% CI [0.821, 0.880]) and 0.890 (95% CI [0.800. 0.937]). The Spanish CAPA questionnaire is a valid and reliable tool for assessing breastfeeding basic competence among primary care professional groups who attend lactating mothers.

French translation of the Peyronie's disease questionnaire: A pilot study

BackgroundThe Peyronie's Disease Questionnaire (PDQ) was designed to quantitatively assess the symptoms and psychosexual consequences of Peyronie's disease but has only been validated in four languages. The aim of the study was to provide a French translation of the PDQ, to make it available to the French-speaking urology community. MethodsAfter a double translation of the PDQ from English into French, followed by a back translation by four expert translators, a conciliation process enabled the creation of the final French version. For each item, participants were asked to answer two sub-questions. The percentage of responses “I fully understood the question” to sub-question (a) constituted the validation criterion for the translation. ResultsThe final French version was submitted to a series of 30 men with Peyronie's disease whose average age was 59 (±12) years. For each question, the comprehension rate was over 95%, and for 12/15 items it was 100%. For the remaining 3 items, men declared that they did not feel disturbed or bothered by the questions and none of the questions were misunderstood. ConclusionThis pilot study shows that our translation of the PDQ is valid and comprehensible by all participants, regardless of the age or level of education. This French version should be validated further in other French-speaking populations before final validation. Level of evidence2.

Romanian Translation and Cultural Adaptation of the Seizure Severity Questionnaire.

Four translators were involved in obtaining conceptual analogies and the cultural importance of the translated notions. The final version was obtained for the Romanian population, with the same appearance as the original instrument. Sixty-seven patients with epilepsy completed the SSQ and the Patient-Weighted Quality of Life in Epilepsy Inventory-QOLIE-31-P. Females had a lower mean SSQ total score (TS) and perceived seizures less seriously than men. Patients with epilepsy with aura had a higher mean SSQ TS, with a more severe seizure perception, compared to those without aura. According to the frequency of seizures, patients with epilepsy with rare seizures had the lowest mean SSQ total score (TS) compared to those with frequent seizures. Patients who were on monotherapy had a less severe perception of epileptic seizures compared to those who were treated with two or more antiepileptic drugs. All QOLIE-31-P domains and TS correlated statistically significantly with the SSQ TS. This study explored SSQ translation, evaluated preliminary results, and showed the correlation between seizure frequency and severity, clinical factors, and quality of life. This tool could be useful for measuring seizure severity in Romanian patients with epilepsy and conducting comparative studies.

Questionnaire Translation and Validation of Problem-Focused Coping in Increasing Work to Family Enrichment in Context of Laos

This study aims to translate and validate a questionnaire of problem-focused coping in increasing work to family enrichment in the context of Laos. The questionnaire is translated by using forward and backward translation process with two Lao bilingual translations: then this questionnaire is evaluated through three validity criteria (content validity, face validity, and construct validity) and reliability process. The findings show that the questionnaire translation is available locally, culturally acceptable, and conceptual equivalence for Lao language. Lao questionnaire version is fulfilled acceptable standards of validity and reliability analysis. This study suggests that the Lao questionnaire version is locally accepted to proceed for further actual study in Lao context.

Factors Leading Young Christian Adults to Elope in the Anglican Church of Kenya, Taveta East Archdeaconry

This study sought to establish factors leading young Christian adults to the practice of eloping among youth in the Anglican Church, Taveta East Archdeaconry. It was guided by the Human Psychosocial Development Theory, Ecological Model Theory, and Moral Development Theory. It adopted a descriptive research design. The target population was eloping aged 20 - 40 years, 5 clergies, and 61 parents. The study used a purposive sampling method. The study’s sample size was 176. Face-to-face interviews were used for the clergy. Focus group discussions were used for the parents. The questionnaires' accuracy and reliability were verified by the inter-rater method. The analyses made use of the statistical package for social sciences version 28. Data was analyzed using descriptive statistics, such as frequencies, mean, and percentages. Qualitative data was organized into themes for analysis. The study findings include; factors such as; peer influence, financial difficulties in a family, little guidance and counseling in church; parents’ support for eloping practice; phone; youth failing to embrace the Christian faith, which contribute to the practice of eloping among the Christian youth in Taveta East Archdeaconry. Language barrier posed a challenge to some respondents. Some were more conversant with Kiswahili than English prompting the translation of questionnaires from English to Kiswahili. Questionnaires require more time to reach the respondents, filling and returning them. This was solved by early communication to clergy and timely distribution. The number of respondents per focus group in some parishes was less than expected. This was solved by increasing the number of respondents in another station.

Urdu translation, cross-cultural validation and reliability of ECOS-16 questionnaire among post-menopausal women with osteopenia.

Escala de Calidad de vida Osteoporosis (ECOS-16) was originally developed in Spanish to evaluate the quality of life (QoL) in post-menopausal women (PMW) with osteoporosis or osteopenia based on the osteoporosis-specific QoL instruments. ECOS-16 has been translated into several languages, but the Urdu version is not yet available. To translate the ECOS-16 Questionnaire into Urdu and determine its validity and reliability in PMW with osteopenia. This was a linguistic validity and reliability study. ECOS-16 was translated into Urdu using Beaton's guidelines. Content validity was examined using Waltz's four-point ordinal scale. Twenty osteopenia-afflicted PMW aged 48-70 underwent pilot testing for face validity. Discriminant validity was determined by an independent T-test between PMW women with and without osteopenia. Convergent validity was assessed using Spearman's correlation coefficient. Cronbach's alpha and Intraclass correlation coefficient (ICC2,1) assessed internal consistency and test-retest reliability. The factor analysis was used to describe the factors. Each question's content validity ratio (CVR) was 0.83-1.00, while the scale's S-CVR was 0.96. Each question's Likert scale content validity index (CVI) was 0.91-0.93, while the scale's S-CVI was 0.91. Significant discriminant validity was found between groups in weeks I and II (p-value < 0.001). A correlation coefficient of 0.89 and 0.96 (p-value < 0.001) between Urdu ECOS-16 total score and SF-36 and EQ-5D scores suggests convergent validity. One component explained 83.86% of Urdu ECOS-16's variance in factor analysis. Excellent test-retest reliability (ICC2,1 = 0.990, 95% CI, 0.985-0.994, p-value < 0.001). Cronbach's alpha for standardized items was 0.995. ECOS-16 translated in Urdu is a valid and reliable questionnaire to assess QoL in PMW with osteopenia. It has a simple and easy language that can be understood easily by the Urdu-speaking population.

Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City.

The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages. To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC). This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children. The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency. The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

German translation and cross-cultural comparison of a mobility questionnaire (MobQues47) for ambulant children and adolescents with cerebral palsy

German translation and cross-cultural comparison of a mobility questionnaire (MobQues47) for ambulant children and adolescents with cerebral palsy

Arabic Translation of Breast Questionnaire and its Validity and Reliability for Women after Mastectomy from Breast Cancer

Arabic Translation of Breast Questionnaire and its Validity and Reliability for Women after Mastectomy from Breast Cancer

Dutch adaptation of the Prosocial Behavior Questionnaire (PBQ-NL): a validity and reliability study in adolescents and young adults

ABSTRACT This study assessed the psychometric properties of the Dutch translation of the Prosocial Behavior Questionnaire (PBQ-NL), a self-report questionnaire that distinguishes altruistic, reactive, and proactive prosocial behaviours. Participants were 381 Dutch adolescents and young adults aged 13–30 (M age = 18.62, SD = 2.59, 65.1% female). Test-retest reliability data were available for 199 participants. A Confirmatory Factor Analyses supported the three-factor structure of the questionnaire, with adequate six-month test-retest reliability. Altruistic and reactive prosocial behaviours correlated significantly and positively with prosocial behaviours directed at family/peers and the larger society, but not with depression or aggression. Conversely, proactively motivated prosocial behaviour correlated significantly and negatively with prosocial behaviour directed at family and positively with experienced opportunities for contribution to the larger society, aggression, and depression. These findings show that the PBQ-NL is a reliable measure to disentangle self- and other-serving motivations that underly prosociality during adolescence and young adulthood.

Pilot Testing and Vernacular Translation of EORTC Patient Satisfaction Questionnaire (PATSAT-C33 and OUT-PATSAT7) at a Tertiary Care Cancer Center in India

Purpose Pilot testing and translation of the English version of European Organization for Research and Treatment of Cancer (EORTC) patient satisfaction cancer core questionnaire (PATSAT-C33) and complementary outpatient module (OUT-PATSAT7) into two Indian vernacular languages (Hindi and Marathi). Methods Patients undergoing fractionated radiotherapy for cancer with basic proficiency in respective language were included in the study after written informed consent. The English version of EORTC PATSAT-C33 and OUT-PATSAT7 questionnaire was pilot tested in 20 patients. The questionnaire was then translated into two Indian vernacular languages (Hindi and Marathi) using EORTC translation methodology. This included forward-translation by two independent professional translators into target languages (Hindi and Marathi) to create an intermediate version; back-translation into English by another independent pair of linguistic experts; and harmonization by comparing back-translated versions (English) to the original English version for reconciliation. The EORTC translation group provided suggestions and proofread the reconciliated versions (Hindi and Marathi) which were then administered to 20 patients in each language. Semistructured interviews were conducted for patients to identify problems in understanding the translation versions to make appropriate corrections/modifications to the questionnaire. Results Pilot testing of English version of PATSAT-C33 and OUT-PATSAT7 did not pose any major difficulty leading to subsequent translation into both target languages (Hindi and Marathi). Reconciliated version of the translated questionnaires was arrived at after incorporating suggestions and proofreading by the EORTC translation group. Pilot testing of the reconciliated questionnaires (Hindi and Marathi) did not identify major problems in understanding, difficult/confusing words, or upsetting questions leading to the adoption of the reconciliated version as final translated questionnaire without further modifications. Conclusion The English version of PATSAT-C33 and OUT-PATSAT7 has been successfully translated into Hindi and Marathi languages using standardized EORTC methodology. Psychometric properties of the same are currently being tested for validation in a larger Indian cohort.

Psychometric properties of the knowledge and understanding questionnaire of the canadian assessment of physical literacy-2 in low-income brazilian children

This study aimed to translate and cross-culturally adapt the Physical Literacy Knowledge (PLK) questionnaire from Canadian Assessment of Physical Literacy-2 for Portuguese version, and to evaluate its psychometric properties (construct validation, content, composite reliability, measurement invariance) in low-income Brazilian children. The sample comprised of 562 children (247 girls), aged between 8.00 and 12.99 years-old (10.20±1.20 years), enrolled in the 12 public-school in Lagoa do Carro city, Pernambuco, Brazil. A translation and cross-cultural adaptation of the PLK questionnaire was carried out. Content validity was determined by calculating the content validity coefficient, which assesses the relevance, clarity and pertinence of total (CVCt) and each question individually (CVCi). The dimensional structure of the PLK and alternative models were considered with first and second order models. Internal consistency was assessed using composite reliability. Structural invariance (configural, metric, scalar and strict) between sexes was also assessed using a multigroup factor analysis. Content validity was considered acceptable, varying between 0.88 and 1.00 for CVCi, and 0.91, 0.94 and 0.99 for clarity, pertinence and relevance in the CVCt, respectively. Construct validity was considered adequate, with 3 dimensions and 9 items model being the most appropriate [χ²(df)=34.01(24); CFI=0.92; TLI=0.87; RMSEA=0.03; SRMR=0.04; 90%CIRMSEA=0.00-0.05]. The questionnaire was structurally invariant (all ΔCFI&lt;0.05). Based on the findings, the PLK questionnaire has adequate psychometric properties to assess the cognitive domain of Physical Literacy in low-income Brazilian children. Key-words: Physical Literacy; Cognition; Children; Psychometry; Child Development.

Translation of the MARS questionnaire into Romanian and the linguistic validation of the translated version

Abstract The purpose of this study is to describe the translation of the MARS questionnaire into Romanian and the linguistic validation and cultural adaptation of the translated version. The forward and backward translations of the MARS questionnaire were performed by blinded translators. Following the translation, a panel of specialists chose the final version and performed the necessary cultural adaptations. Although a seemingly simple questionnaire, the translation of MARS into Romanian involved a careful analysis of the items and the cultural adaptation of some in order to be used in the target language. Following the translation, the linguistic validation of the translation was performed in order to make any necessary adjustments for the final version. This paper presents the translation process of the MARS questionnaire and discusses all the difficulties encountered.

Urdu translation and cross-cultural validation of the stroke self-efficacy questionnaire

BackgroundThe Stroke Self-Efficacy Questionnaire (SSEQ) measures the self-confidence of the individual in functional activities after a stroke. The SSEQ is a self-report scale with 13 items that assess self-efficacy after a stroke in several functional domains.ObjectiveThe purpose was to translate the Stroke Self-Efficacy Questionnaire into Urdu Language and to find out the validity and reliability of Urdu SSEQ among stroke patients.MethodsThe cross-cultural validation study design was used. Following COSMIN guidelines, forward and backward translation protocols were adopted. After pilot testing on 10 stroke patients, the final Urdu version was drafted. A sample of 110 stroke patients was used to evaluate the validity and reliability of the SSEQ-U. Content and Concurrent validity were determined. The intraclass correlation coefficient and Cronbach’s alpha were used to measure internal consistency and test-retest reliability. Data analysis was performed using SPSS 25.ResultsThe final version was drafted after application on 10 stroke patients. Content validity was analyzed by a content validity index ranging from 0.87 to 1. The internal consistency was calculated by Cronbach’s alpha (α > 0.80). Test-retest reliability was determined by the Intra-class correlation coefficient (ICC2,1=0.956). Concurrent validity was determined by correlations with other scales by using the Spearman correlation coefficient; moderate to strong correlations (positive and negative) were found with the Functional Independence Measure (r = 0.76), Beck Depression Inventory (r=-0.54), Short Form of 12-item Scale (r = 0.68) and Fall Efficacy Scale (r = 0.82) with p < 0.05.ConclusionThe Urdu version was linguistically acceptable and accurate for stroke survivors for determining self-efficacy. It showed good content and concurrent validity, internal consistency and test-retest reliability.