Cultural adaptation and validation of the Systemic Sclerosis Quality of Life questionnaire into Arabic language

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ORIGINAL ARTICLE

Cultural adaptation and validation of the Systemic Sclerosis Quality of Life questionnaire into Arabic language Samah M Alian 1 & Nagwa A Sherby 1 & Shymaa A Sarhan 1 Received: 11 May 2020 / Revised: 22 August 2020 / Accepted: 25 August 2020 # International League of Associations for Rheumatology (ILAR) 2020

Abstract Background and objectives Systemic sclerosis (SSc) is a chronic connective tissue disease affecting all quality of life (QoL) parameters. In addition to clinical assessment, QoL measures should be included in patient assessment. There is no Arabic tool specific for assessing QoL in Arabic SSc patients; therefore, this work was designed to translate the SScQoL questionnaire, culturally adapt and check its reliability and validity. Method Based on the principle of translation and cross-cultural adaptation in other language, the SScQoL questionnaire was translated into Arabic. Correlation of SScQoL scores for 50 patients with Short Form Health Survey (SF-36) scores has been tested for convergent validity and discriminate validity evaluated by stratifying clinical parameters of patients and disease subtypes. The intraclass correlation coffee (ICC) was used to assess reliability by interviewing patients twice 14 days apart. Results Correlations were present between SScQoL scores and physical and mental component scores of SF-36 questionnaire. We found strong negative correlation between the physical component of SF-36 and QoL function, QoL emotion, QoL total scores (r = − 0.654**, r = − 0.512**, r = − 0.540**) and moderate negative correlation present between SF-36 mental component and QoL function, QoL emotion, QoL social, and QoL total (r = − 0.314*, r = − 0.486**, r = − 0.357*, r = − 0.433*). Also, significant association (P < 0.05*) between scores of total QoL and visceral involvements (GIT involvement, pericardial effusion, and LVDD) was evident. The Arabic edition of SScQoL has a Cronbach’s alpha of 0.78. Conclusion The translated Arabic version is a valid and reliable tool to assess Egyptian SSc patients’ QoL. Key Points • The SScQoL questionnaire items have a convergent validity with physical and mental component scores of SF-36, and discriminant validity with visceral involvement. • The Arabic edition of SScQoL is reliable with a Cronbach’s alpha of 0.78.

Keywords Quality of life . Questionnaire . Systemic sclerosis . Validity

Introduction Systemic sclerosis (SSc) is a progressive multisystem disorder caused by disturbance of immunity, microvascular involvement, and skin and internal organ fibrosis, affecting quality of life [1]. SSC-related death rates are higher relative to the general population and in comparison with other connective * Shymaa A Sarhan [email protected] 1

Rheumatology and Rehabilitation Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

tissue diseases [2]. Progressive multiorgan impairment creates major functional disabilities (physical and psychosocial) leading to work, personal healthcare, and household task problems. Also, SSc sk