Reliability and validity of the Arabic version of the PedsQL<sup>TM</sup> 4.0 generic ore scales and PedsQL<sup>TM</sup> 3.0 diabetes module

Abstract

Background: Health related quality of life (HRQOL) has become a field of extensive research involving children and adolescents with diabetes. There are no HRQOL instruments designed or adapted for the Arabic culture and language. The objectives of the study are to test the Arabic translated version of the PedsQLTM 4.0 Generic Core Scales (GCS) and the PedsQLTM 3.0 Diabetes Module (DM) in children and adolescents with type 1 diabetes (T1DM) in Kuwait and analyse their psychometric properties. Methods: After the process of translation, committee review and pre-testing (linguistic validation), 131 children and adolescents with and 104 without T1DM, with their parents completed the Arabic version of GCS. Those with T1DM completed the Arabic DM. Demographic and diabetes-related data were collected using specially designed questionnaires. Internal consistency was checked by Cronbach’s alpha coefficient. The intraclass correlations coefficient, celling and floor effects and construct validity were assessed to determine the psychometric properties of both instruments. Results: Cronbach’s alpha of the child self-report and parent proxy-report was greater than 0.70, for both instruments, indicating internal consistency reliability. Items of both instruments had minimal missing responses, and required a brief time (5 - 7 minutes) to finish indicating their feasibility. No floor effect was demonstrated. Ceiling effect ranged from 5.8% to 15.8%. The GCS distinguished between healthy and diabetic children. The intraclass correlation coefficient (ICC) between child self-report and parent proxy-report of GCS scores showed good to excellent agreement, p < 0.001. However, in the DM reports, the correlation was lower, but still significant. Girls reported lower HRQOL scores in worries and communication subscales of the diabetes module than boys, p < 0.05. Conclusions: The Arabic version of the PedsQL GCS and PedsQL DM showed sufficient feasibility, reliability and validity to be used for research purposes in public health setting for children 2 - 18 years old and their parents.