Cross-Cultural Adaptation and Psychometric Validation of the WHOQOL-DIS for Arabic-speaking Individuals with Physical Disabilities

Background: An accurate assessment of quality of life (QoL) is crucial for identifying the needs of individuals with physical disabilities (IWPDs) and designing effective interventions. However, culturally and psychometrically validated tools for Arabic-speaking IWPDs are lacking. Objectives: This study aimed to cross-culturally adapt and validate the World Health Organization Quality of Life–Disabilities instrument (WHOQOL-DIS), which integrates the WHOQOL-BREF core items with the Disabilities module, for use among Arabic-speaking IWPDs. Methods: A total of 376 participants from diverse regions of Saudi Arabia were recruited and randomly allocated into two equal groups for exploratory and confirmatory factor analyses (EFA and CFA). Results: The final Arabic version of the WHOQOL-BREF retained its original four-domain structure—physical health, psychological, social relationships, and environment—explaining 65.36% of the total variance. Item 21 was removed because of its misalignment with prevailing cultural norms in Arab societies. Item 14 showed a relatively low factor loading and explained variance but was retained to preserve structural consistency. Future studies are encouraged to revisit its phrasing and cultural framing. The Disabilities module supported a three-factor structure—Discrimination, Autonomy, and Inclusion—explaining 73.08% of the total variance. All subscales demonstrated satisfactory reliability (Cronbach’s alpha ranging from 0.643 to 0.948). While the autonomy and facets showed strong convergent validity and internal consistency, the discrimination facet yielded an AVE below the recommended threshold of 0.50 (AVE = 0.388), indicating limited convergent validity. Nonetheless, its theoretical importance and acceptable internal consistency justified its retention. Future research should pursue culturally informed refinements to better capture discrimination-related experiences among Arabic-speaking IWPDs. Conclusions: The Arabic versions of the WHOQOL-BREF and the Disabilities module demonstrated robust psychometric properties, supporting their suitability for assessing the QoL of Arabic-speaking IWPDs. These culturally adapted instruments provide a solid foundation for research, clinical evaluation, and policy planning in Arabic-speaking populations. Keywords: Quality of life, Physical disability, WHOQOL-DIS, Arabic, Psychometric validation, Cultural adaptation.