Arabic Translation and Linguistic Validation of the English Version of the Preschool Children Quality of Life (TAPQOL) Questionnaire

Background: Health related quality of life (HRQOL) is an important measure of the health status of preschool children. The TAPQOL questionnaire was designed to measure HRQOL in preschool children aged 2 to 48 months and contains 43 questions distributed in 4 domains and 12 subdomains (scales). TAPQOL was developed originally in Dutch language and was translated in different languages including English, French, German, Brazilian Portuguese, Spanish, Chinese, Korean and Malay language. Till now there is no Arabic version of the TAPQOL questionnaire. Objective(s): This study aims to translate the English version of the TAPQOL questionnaire into Arabic language and qualitatively validate this Arabic translation to obtain an Arabic version of the TAPQOL Questionnaire that would be both semantically and culturally equivalent to the original. Methods: This study was conducted through 2 phases; translation and qualitative validation. Regarding translation phase, after evaluating the potential conceptual equivalence by the first and the second authors, the English TAPQOL questionnaire was translated into Arabic by independent forward-translation by three bilingual translators (the first author and 2 professional English-Arabic translators) and reconciliation (by the second author). Concerning qualitative validation, it was conducted in 2 stages: validation by a committee of 8 independent bilingual experts (face and content validity) then validation by cognitive debriefing (real-life face validity). The cognitive debriefing was carried out on 7 preschool children aged 2-48 months, through conducting a face-to-face interview with their mothers (the main caregiver) whose mother-tongue is the Egyptian Arabic language. Results: After the independent forward-translation by several translators, the reconciliator made the final decisions about the instrument translation, confirmed equivalence of the translated instrument with the originals, and selected the most appropriate wording for the final Arabic version to better reflect the Egyptian cultural meaning. However, the findings of the first stage of qualitative validation clearly indicated that the Arabic version of the TAPQOL was not suitable for use after the initial translation. The committee of experts asked for some modifications which consolidated the translated version of the questionnaire by means of equivalence in several areas: linguistic/semantical; idiomatic; cultural; conceptual; and experiential equivalence. After implementing those modifications, the cognitive debriefing yielded that there was no need to carry-out more modifications than those required by the validating experts. Conclusion: This Egyptian Arabic version of the TAPQOL has proven to be acceptable and culturally equivalent to its English version as its face and content validity was qualitatively confirmed. Future studies should complete the validation by extensive quantitative investigation of the psychometric properties of the Arabic version of TAPQOL questionnaire and compare them with those of the original version.