title: Arabic version of Skindex-16: translation and cultural adaptation, with assessment of reliability and validity.
abstract: BACKGROUND
  Quality-of-life is increasingly recognized as an important measure in dermatology; however, most currently available dermatologic quality-of-life measures were originally created for the English language. Skindex-16 being one, is a self-administered questionnaire covering the symptoms, emotions and functioning aspects.
  
  
  OBJECTIVE
  Our aim was to translate into Arabic and culturally adapt Skindex-16 following the international guidelines for cross-cultural adaptation of health-related quality-of-life measures. Moreover, its validity and reliability would be assessed.
  
  
  METHODS
  Translation and transcultural adaptation of Skindex-16 were performed. Subsequently, a cross-sectional study was conducted where 678 persons (338 patients and 340 healthy people) responded to the Arabic version of Skindex-16. Evaluations of the semantic equivalence of back-translated items, reliability, construct validity, and content validity of the Arabic version were the main outcome measures.
  
  
  RESULTS
  Two problematic items as well as the introductory (header) statement required a second translation and back-translation to achieve satisfactory agreement with the original instrument. The final Arabic version of Skindex-16 was internally reliable (Cronbach's alpha-range for the scales 0.81-0.92). The instrument demonstrated both construct and content validity. As hypothesized, the scores for dermatologic patients were higher than those for healthy persons (mean 31.5 vs. 21.1, P < 0.001, respectively). Similarly, scores for patients with inflammatory dermatosis were higher than those for patients with isolated skin lesions (mean 32.99 vs. 25.3, P < 0.05), indicating a poorer quality-of-life. However, greater than 63% of the patients' responses to an open-ended question about their skin disease were addressed by items in the instrument.
  
  
  CONCLUSIONS
  We have developed a semantically equivalent translation with cultural adaptation of Skindex-16 into Arabic. The assessment of its measurement properties shows that it is quite reliable and a valid measure of the effects of skin diseases on the quality-of-life in Saudi patients.
authors.affiliation: Dermatology Department and Family Medicine Department, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid M
authors.initials: KM
authors.lastname: AlGhamdi
authors.forename: Sulaiman A
authors.initials: SA
authors.lastname: AlShammari
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D011788:Quality of Life; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000175:diagnosis*; D011795:Surveys and Questionnaires