Cross-cultural adaptation and validation of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire's Arabic version

Abstract

Health-related quality of life (HRQOL) assessment is considered among the most relevant outcome measures following conservative and surgical interventions for various spinal conditions. Several questions are available to evaluate HRQOL in these conditions. A more recent Italian Spine Youth Quality of Life (ISYQOL) questionnaire was developed for this purpose and showed high validity in measuring HRQOL. To translate and adapt the ISYQOL questionnaire into Arabic language (ISYQOL-Ar) and evaluate its validity and reliability, and to correlate it with the validated revised Scoliosis Research Society (SRS-22r)'s Arabic questionnaire in a cross-sectional multicenter study. The ISYQOL was translated, back-translated, and reviewed by an expert committee. Reliability assessment for the questionnaire domains was performed using Cronbach's alpha. For construct validation, the Pearson's correlation coefficient was used. A total of 115 patients were enrolled in the study and completed the ISYQOL-Ar and Arabic SRS-22r questionnaires. A total of 72 patients (63%) completed the first set of questionnaires, and 2 weeks later, 63 patients (55%) completed both sets of questionnaires, with 15.8 a mean age, 39.5° mean Cobb angle of 88.9% females. ISYQOL-Ar showed excellent validity, good reliability, and internal consistency for spine health and brace wear, with Cronbach's alpha > 0.6, similar to SRS-22r in the same cohort. The correlation was significant between ISYQOL-Ar and Arabic SRS-22r (Pearson's coefficient = 0.708, P < .001). The ISYQOL-Ar questionnaire is a reliable and valid outcome measure for the assessment of young patients with spinal deformity among the Arabic-speaking population.

Cross-Cultural Adaptation and Psychometric Properties of the Traditional Chinese Version of the Italian Spine Youth Quality of Life (ISYQOL) Questionnaire

“…Additionally, ISYQOL-TC demonstrated excellent test-retest reliability for both the spine health and brace domains (all ICC values > 0.94) among participants with or without bracing. Canadian-French, Persian, and Polish versions of ISYQOL also showed excellent test-retest reliability (ICC > 0.9) [14,18,26], while the simplified Chinese and Arabic versions displayed moderate test-retest reliability (ICC > 0.7) [17,19].…”

“…In addition to overcoming the ceiling effect of SRS-22r [14,17,18,26], ISYQOL has other advantages. Compared to SRS-22r, ISYQOL has less questions, which allows users to complete the questionnaire in less than 10 min.…”

“…Researchers and clinicians can directly compare the ISYQOL results between bracers and non-bracers. Importantly, ISYQOL has demonstrated a smaller ceiling effect (<2.5%) for assessing the HRQOL of patients with AIS [14][15][16], as well as good internal consistency (Cronbach's alpha > 0.7) and test-retest reliability (ICC > 0.90) in various translated versions [14][15][16][17].…”

“…The original Italian questionnaire has been translated and cross-culturally validated in different languages (e.g., Arabic, Canadian-French, Chinese, English, and simplified Chinese [13,14,[16][17][18][19]). Although the simplified Chinese version has demonstrated good reliability and validity, the perceived meaning of wording by simplified Chinese users differs from traditional Chinese users due to cultural differences [20].…”

Arabic-Translated Versions of Patient-Reported Outcome Measures Utilized in Spine Research: A Review of Validated Studies

“…Low Back Pain Roland-Morris Disability Questionnaire RMDQ [19,24] Fear Avoidance Beliefs Questionnaire FABQ [20,27] Back Beliefs Questionnaire BBQ [26,28] Quebec Back Pain Disability Scale QBPDS [21] Oswestry Disability Index ODI [23] Japanese Orthopaedic Association Back Pain Evaluation Questionnaire JOA-BPEQ [29] STarT Back Tool SBT [32] Core Outcome Measures Index COMI [35] Bournemouth questionnaire BQ [36] Tampa Scale of Kinesiophobia TSK [37] Back Pain Attitudes Questionnaire Back-PAQ [41] Low Back Pain Knowledge Questionnaire LBP-KQ [42] Low Back Pain Treatment Beliefs Questionnaire LBP-TBQ [43] Functional Rating Index FRI [44] Orebo Musculoskeletal Pain Questionnaire OMPQ [46] Pain Self-Efficacy Questionnaire PSEQ [48] Neck Pain and Cervical Myelopathy Modified Japanese Orthopaedic Association Cervical Myelopathy Score mJOA-CMS [38,39] Neck Disability Index NDI [22] Copenhagen Neck Functional Disability Scale CNFDS [31] Spine Pain McGill Pain Questionnaire-Short Form MPQ-SF [30] Scoliosis Scoliosis Research Society Questionnaire-22 SRS-22 [25] Early Onset Scoliosis 24 Items Questionnaire EOS-24 [34] Italian Spine Youth Quality of Life ISYQOL [40] Scoliosis Research Society Questionnaire-30 SRS-30 [45] Spinal Cord Injury Patient Health Questionnaire-9 PHQ-9 [33] Neurogenic Bladder Symptoms Score-Short Form NBSS-SF [47] The results of the quality assessment of the CCA are summarized in Table 3. Most studies had good ratings in initial translation (83%), synthesis (77%), back translation (87%) and expert committee review (83%).…”