Research Abstract
Background: The assessment of quality of life (QoL) has become increasingly important in the process of monitoring quality of care and improving services for people with skin diseases.
Objective: This study aimed to translate the Skindex-16, a skin-disease-specific, brief QoL questionnaire into Arabic and culturally adapt it to Egyptians and to evaluate its reliability and validity.
Methods: Translation and cultural adaption were performed following guidelines for cross-cultural adaption of health-related quality of life measures. Subsequently, the Egyptian Arabic version of Skindex-16 was administered to 500 consecutive dermatological patients and 500 healthy persons for verification of its reliability and validity.
Results: Three items of Skindex-16 required a second translation and back-translation to achieve satisfactory agreement with the original instrument. The instrument showed high internal consistency (Cronbach’s alpha range for the scales 0.79-0.95), indicating good reliability. Construct validity was indicated by higher scores for all patients than those for healthy persons (41.3±20.3 vs. 1.0±3.4 respectively, P 0.001), indicating a poorer QoL. In addition, patients with skin color change/ difficult concealment had significantly poorer QoL than those without skin color change (42.9±20.8 vs. 36.2±17.9 respectively; P = 0.003) or without difficult concealment (45.5±20.7 vs. 34.6±17.7 respectively; P 0.001). The majority (90%) of the patients’ responses to an open-ended question about their skin disease were addressed in Skindex-16, indicating content validity. Hyperpigmentation was the most frequently mentioned response that was not directly addressed by the items of the instrument.
Conclusion: The adapted and translated Egyptian Arabic version of Skindex-16 provides valid and reliable assessments of QoL in Egyptian patients with skin disease. We recommend adding questions, in the Arabic version of Skindex-16, addressing hyperpigmentation that was frequently mentioned by our patients.
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