Psychometric validation and cultural adaptation of the Persian Galveston orientation and amnesia test and orientation-log for assessing traumatic brain injury

Post-traumatic amnesia (PTA) is a common symptom of acute traumatic brain injury (TBI). The Galveston Amnesia and Orientation Test (GOAT) and Orientation-Log (O-Log) are commonly used assessment tools to evaluate PTA following TBI. In this study, we aimed to validate the Persian versions of both scales. The forward-backward translation method was used, and a panel of experts, including three neuroscientists, one epidemiologist, and four lay experts with TBI experience, evaluated the scales. A total of 140 mild TBI patients aged 12 years and older were subsequently assessed with scales. Reliability was assessed using two approaches including Cronbach's Alpha and Intraclass Correlation Coefficient (ICC). The total ICCs were 0.870 (95% CI: 0.818-0.907) and 0.687 (95% CI: 0.564-0.776) for the GOAT and O-Log, respectively. The Cronbach's alpha values for the GOAT and O-Log were 0.64 and 0.75, respectively. A significant correlation was also found between the GOAT score and the O-Log (r = 0.729, p < 0.001). The Persian GOAT and O-Log were validated as reliable tools for monitoring TBI patients' orientation. The interviews revealed significant cultural considerations that must be considered when the scales are translated and validated to ensure their validity and reliability in diverse cultural contexts and prevent bias.