We adapted the English International Index of Erectile Function (IIEF) into Malay. This was difficult as many sex-related terms do not exist in colloquial Malay. In the pretest, there was no difficulty with comprehension and all subjects judged the Malay IIEF equivalent to the English IIEF. After slight modification, a final instrument was evaluated in two studies. Study A included 136 subjects. It showed that the instrument had good reliability and discriminant validity. The factor structure of the English IIEF was not reproducible. Study B included 26 ED subjects who underwent oral sildenafil therapy. The Malay IIEF was sensitive to treatment response. The area under the ROC curve of the Malay IIEF-5 was 0.86; the optimal cutoff score has a sensitivity of 85% and specificity of 75%. The results suggest that the Malay IIEF requires more work, but the Malay IIEF-5 has acceptable measurement properties to recommend its use in clinical practice and research.
Use of instruments or questionnaires in different cultural settings without proper validation can result in inaccurate results. Issues like reliability, validity, feasibility and acceptability should be considered in the use of an instrument. The study aims to determine the usefulness of the CIS-R Malay version in detecting common mental health problems specifically to establish the validity. The CIS-R instrument (PROQSY* format) was translated through the back translation process into Malay. Inter rater reliability was established for raters who were medical students. Cases and controls for the study were psychiatric in patients, out patient and relatives or friends accompanying the patients to the clinic or visiting the inpatients. The Malay version of CIS-R was administered to all cases and controls. All cases and controls involved in the study were rated by psychiatrists for psychiatric morbidity using the SCID as a guideline. Specificity and sensitivity of the CIS-R to the assessment by the psychiatrist were determined. The Malay version of CIS-R showed 100% sensitivity and 96.15% specificity at a cut off score of 9. The CIS-R can be a useful instrument for clinical and research use in the Malaysian population for diagnosing common mental disorders like depression and anxiety.
It has often been assumed that the translation of Greek medical books into Arabic was the main determinant in establishing Islamic medicine. This assumption must be put into proper perspective. Because, it is certainly true that the Prophet Muhammad (s.a.w) inspired love and passion for learning and called upon mankind to develop their faculties and intellects. His teaching on medicine indicates that no student of history of Islamic medicine can ignore the importance of the Prophet’s sayings and practices in this regard. This leads us to accept the fact that the principles of medicine in Islam, as a whole, are deeply rooted in the Qur’an and Ahadith of the Prophet (s.a.w), although this Islamic medicine itself came into being, especially during the Abbasid period, as a result of the integration by Muslims of several older traditions of medicine, most importantly Greek.
Background: Up to date, there are handful questionnaires that have been validated in Bahasa Malaysia (BM). This study aimed to translate the Depression Anxiety Stress Scales 21-item (DASS-21) and measure its psychometric properties. Objectives: To determine the construct validity and acceptability of the DASS, BM. Methods: Two forward and backward translations were done in BM in accordance to guideline, and its validation was determined by using confirmatory factor analysis. A total of 263 subjects were selected by systematic random sampling to represent Malaysian population for reliability and validity purposes. Results: The BM DASS-21 had very good Cronbach’s alpha values of .84, .74 and .79, respectively, for depression, anxiety and stress. In addition, it had good factor loading values for most items (.39 to .73). Correlations among scales were between .54 and .68. Conclusions: BM DASS-21 is correctly and adequately translated to Bahasa Malaysia with high psychometric properties. Further studies are required to support these findings.
To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales.
Introduction: As eating disorders such as anorexia nervosa and others are generally becoming more prevalent, it is essential to have a culturally accepted and locally validated questionnaire that is able to detect abnormal eating habits. Objective: To translate the Eating Disorders Examination Questionnaire (EDE-Q) into Bahasa Malaysia (BM) and to determine the construct validity, reliability and other psychometric properties of the BM version. Method: Two parallel forward and backward translations were done in BM in accordance to guideline. Its validation was determined by using confirmatory factor analysis among 298 secondary school children. Results: The BM EDE-Q had very good internal consistency with global Cronbach’s alpha value of 0.879. For construct validity, majority of the items managed to produce values of more than 0.4 for confirmatory factor analysis with four unforced distinct factors detected. Conclusions: Analyses of reliability and validity of this BM version of EDE-Q yielded satisfactory results. The BM version produced in this study had good psychometric properties and it is applicable to the Malaysian population. Findings indicated that cultural factors in eating habits certainly influences the effort to adapt the questionnaire within a Malaysian setting.
Introduction: There is an appealing need to have a validated Bahasa Malaysia (BM) questionnaire that is able to gauge stress coping styles among Malaysian population. A culturally accepted questionnaire will generate further research in the aspect of stress coping patterns in the Malaysia population. Objective: To translate the Coping Inventory for Stressful Situations (CISS) questionnaire into BM and to determine the construct validity, reliability and other psychometric properties of the translated BM version of the English CISS 48-item. Method: Two parallel forward and backward translations were done in BM in accordance to guideline and its validation was determined by using confirmatory factor analysis among 200 Malaysian subjects. Results: The BM CISS had very good Cronbach’s alpha values, 0.91, 0.89 and 0.85 respectively for Task-, Emotional- and Avoidance-oriented. The overall Cronbach’s alpha was 0.91. It also had good factor loading for most of its items where 44 items out of 48 had Confirmatory Factor Analysis values of more than 4.0. Conclusions: BM CISS had been adequately and correctly translated into Bahasa Malaysia with high psychometric properties. Minimal readjustment may be required in a few of its items to obtain excellent results.
BACKGROUND:
Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics.
OBJECTIVES:
To validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI) in Malaysian patients who consult for dyspepsia.
METHODS:
The English version of the SF-NDI was culturally adapted locally and a Malay translation was developed using standard procedures. English and Malay versions of the SF-NDI were assessed against the SF-36 and the Leeds Dyspepsia Questionnaire (LDQ), examining internal consistency, test-retest reliability and construct validity.
RESULTS:
Pilot testing of the translated Malay and original English versions of the SF-NDI in twenty subjects did not identify any cross-cultural adaptation problems. 143 patients (86 English-speaking and 57 Malay speaking) with dyspepsia were interviewed and the overall response rate was 100% with nil missing data. The median total SF-NDI score for both languages were 72.5 and 60.0 respectively. Test-retest reliability was good with intraclass correlation coefficients of 0.90 (English) and 0.83 (Malay), while internal consistency of SF-NDI subscales revealed alpha values ranging from 0.83 - 0.88 (English) and 0.83 - 0.90 (Malay). In both languages, SF-NDI sub-scales and total score demonstrated lower values in patients with more severe symptoms and in patients with functional vs organic dyspepsia (known groups validity), although these were less marked in the Malay language version. There was moderate to good correlation (r = 0.3 - 0.6) between all SF-NDI sub-scales and various domains of the SF-36 (convergent validity).
CONCLUSION:
This study demonstrates that both English and Malay versions of the SF-NDI are reliable and probably valid instruments for measuring HRQoL in Malaysian patients with dyspepsia.
The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach's alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach's alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass orrelation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.
The purpose of the linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) was to produce a translated version in Malay language which was "conceptually equivalent" to the original U.S. English version for use in clinical practice and research.
Objective: Family Environment Scale (FES) is one of the most widely used instruments to measure many family aspects. Cross cultural adaptation of the original FES is essential prior to local utilization as different cultures percept their family environments differently. We attempted to translate the FES into the Bahasa Malaysia language for adolescents, evaluate its reliability using internal consistency and compare its results with the original
study. Methods: This is a cross-sectional study, involving adolescents aged 12-17 from four secondary schools. The adolescents were selected using quota sampling for different age, ethnic and academic performance. The study was divided into four phases, namely: i) translation of FES, ii) pilot test iii) internal consistency reliability test and iv) comparison of the study results with the original FES. Results: A total of 295 adolescents participated in this study. All of the reliability measurements generated (ranged between Cronbach’s alpha 0.10 - 0.70) were lower than those originally reported for this instrument (ranged between Cronbach’s alpha 0.61 -0.78). Five subscales in the Bahasa Malaysia version were found to be less than Cronbach’s alpha 0.5, which were below the acceptable level for practical or research use. There was considerable variation observed between the sample population of this study and that of the original study, which could be due to the social cultural differences. Conclusion: The Bahasa Malaysia version of FES requires further culturally
appropriate revision. A new measuring scale could also be devised to provide an accurate evaluation of the family environment as perceived by Malaysian adolescents, which has acceptable levels of reliability and validity.
Background: Vertigo Symptom Scale (VSS) by Yardley et al. (1992) is one of the disease specific
questionnaires used widely in clinical settings. It is conducted in English and had been translated into six languages including Dutch, French, German, Spanish, Swedish, and Turkish. It has been acknowledged as a good subjective tool to determine the severity of balance disorders. Objective: To develop a valid Malay version of VSS (MVVSS) using appropriate translation methods and validation technique. Method: Forward and backward translation was performed by four professionals from different fields. The translated questionnaire was then assessed for its test reliability based on an experiment on 30 normal subjects. Further, to determine the cultural adaptation issues, the face validity of MVVSS was assessed from 32 normal subjects. They were asked to fill in the MVVSS questionnaire accordingly and give opinions regarding its language, understanding and overall format of questionnaire. Results: Final results of the translation process showed sufficient concurrence among the professionals involved. The reliability test among the normal subjects also showed a high Cronbach’s alpha value (0.90). The face validity method on 32 subjects (mean age of 29.9 ± 9.2 years) showed good feedbacks in terms of language, understanding and overall format of the MVVSS. Conclusion: The translation process was successful and the further validation showed an adequate face validity response. This suggests that our MVVSS has been culturally adapted and can be used in all Malay conversing patients.
To assess the cross-sectional construct validity of the Malay-translated and cross-culturally adapted FACT-H&N (v 4.0) for discriminative use in a sample of Malaysian oral cancer patients. A cross-sectional study of adults newly diagnosed with oral cancer. HRQOL data were collected using the FACT-H&N (v 4.0), a global question and a supplementary set of eight questions ('MAQ') obtained earlier in pilot work. Of the 76 participants (61.8% female; 23.7% younger than 50), most (96.1%) had oral squamous cell carcinoma; two-thirds were in Stages III or IV. At baseline, patients' mean FACT summary (FACT-G, FACT-H&N, FACT-H&N TOI, and FHNSI) and subscale (pwb, swb, ewb, fwb, and hnsc) scores were towards the higher end of the range. Equal proportions (36.8%) rated their overall HRQOL as 'good' or 'average'; fewer than one-quarter rated it as 'poor', and only two as 'very good'. All six FACT summary and most subscales had moderate-to-good internal consistency. For all summary scales, those with 'very poor/poor' self-rated HRQOL differed significantly from the 'good/very good' group. All FACT summary scales correlated strongly (r>0.75). Summary scales showed convergent validity (r>0.90) but little discriminant validity. The discriminant validity of the FHNSI improved with the addition of the MAQ. The FACT-H&N summary scales and most subscales demonstrated acceptable cross-sectional construct validity, reliability and discriminative ability, and thus appear appropriate for further use among Malaysian oral cancer patients.
The present study aimed to examine and compare results from two questionnaire pretesting methods (i.e., behavioral coding and cognitive interviewing) in order to assess systematic measurement bias in survey questions for adult smokers across six countries (USA, Australia, Uruguay, Mexico, Malaysia and Thailand). Protocol development and translation involved multiple bilingual partners in each linguistic/cultural group. The study was conducted with convenience samples of 20 adult smokers in each country. Behavioral coding and cognitive interviewing methods produced similar conclusions regarding measurement bias for some questions; however, cognitive interviewing was more likely to identify potential response errors than behavioral coding. Coordinated survey qualitative pretesting (or post-survey evaluation) is feasible across cultural groups, and can provide important information on comprehension and comparability. Cognitive interviewing appears a more robust technique than behavioral coding, although combinations of the two might be even better.
Background: The Malay short version of Depressive Anxiety and Stress Scale (DASS-21) has been widely used as a tool to measure psychological parameters in studies in Malaysia. The version has been found to be reliable for clinical and non-clinical populations. Objectives: To analyse and establish the psychometric properties of the Malay version of the DASS 42-item (BM DASS-42) among medical students. Methods: Concurrent forward and backward translations of original English DASS-42 were completed. Construct validity of the DASS-42 was established by looking at its exploratory factor analysis. Malay DASS-42 and Malay HADS were administered to a total of 411 medical students. Results: Reliability of DASS-
42 revealed excellent Cronbach’s alpha values of 0.94, 0.90 and 0.87 for depressive, anxiety and stress domains respectively. Construct validity yielded 38 items out of 42 items (90%) had good factor loadings of 0.4 and more. DASS and HADS were strongly correlated for both anxiety (r=0.87) and depression (r=0.68) domains. Conclusions: The BM DASS-42 had admirable psychometric properties among the tested population. Further studies are needed to verify these preliminary outcomes in other Malaysian subjects.
INTRODUCTION: The Three-Factor Eating Questionnaire was first constructed to measure eating behavior in an English population in the United States. It has been validated and translated for various populations in different languages. The aim of this article is to describe a systematic process for translating the questionnaire from English to Malay language.
METHODOLOGY: The report of the International Society for Pharmacoeconomics and Outcome Research (ISPOR) Task Force was used as the basis for the systematic translation process. The process began with preparation; followed by forward translation (2 independent translators), reconciliation, back translation (2 independent translators), back translation review, harmonization, cognitive debriefing, review of cognitive debriefing results and finalization, proofreading; and ended with the final report. Four independent Malay translators who fluent in English and reside in Malaysia were involved in the process. A team of health care researchers had assisted the review of the new translated questionnaires.
RESULTS: Majority of the TFEQ-R21 items were experiencing, conceptually and semantically equivalence between original English and translated English. However, certain phrase such as "feels like bottomless pit" was difficult to translate by forward translators. Cognitive debriefing was a very helpful process to ensure the TFEQ-R21 Malay version was appropriate in term of wording and culturally accepted. A total of four redundant comments in regards to response scale wording, word confusion and wording arrangement.
CONCLUSION: The systematic translation process is a way to reduce the linguistic discrepancies between the English and Malay language in order to promote equivalence and culturally adapted TFEQ-R21 questionnaire.
Introduction: None of the quantitative scale for public attitudes toward epilepsy was translated to Chinese language. This study aimed to translate and test the validity and reliability of a Chinese version of the Public Attitudes Toward Epilepsy (PATE) scale. Methods: The translation was performed according to standard principles and tested in 140 Chinese-speaking adults aged more than 18 years for psychometric validation. Results: The items in each domain had similar standard deviations (equal item variance), ranged from 0.85-0.95 in personal domain and 0.75-1.04 in general domain. The correlation between an item and its domain was 0.4 and above for all, and higher than the correlation with the other domain. Multitrait analysis showed the Chinese PATE had a similar variance, floor and ceiling effects, and relative relationship between the domains, as the original PATE. The Chinese PATE scale showed a similar correlation with almost all demographic variable except age. Item means were generally clustered in the factor analysis as hypothesized. The Cronbach’s α values was within acceptable range (0.773) in the personal domain and satisfactory range (0.693) in the general domain. Conclusion: The Chinese PATE scale is a validated and reliable translated version in measuring the public attitudes toward epilepsy.
Objective: To validate the Malay version of Berlin Questionnaire (BQ) as a tool to screen for patients at risk of obstructive sleep apnea (OSA) in primary care Background: Most patients with OSA are unrecognised and untreated. Thus, the BQ has been used as a tool to screen for patients at risk for OSA. However, this tool has not been validated in Malay version. Materials and Methods: A parallel back-to-back translation method was applied to produce the Malay version (Berlin-M). The Malay version was administered to 150 patients in a tertiary respiratory medical centre. Concurrent validity of the Berlin-M was determined using the Apnea Hypopnea Index (AHI) as the gold standard measure. The test-retest reliability and internal consistency of the Berlin-M were determined. Results: Most patients were males (64.0%) and majority of them were Malays (63.3%). Based on the sleep study test, 121 (84.0%) were classified as high risk while 23 (16.0%) as low risk using the Apnea Hypopnea Index (AHI) ≥5 as the cutoff point. The test–retest reliability Kappa value showed a good range between 0.864 – 1.000. The Cronbach’s alpha of BQ was 0.750 in category 1 and 0.888 in category 2. The sensitivity and specificity were 92% and 17% respectively. Conclusion: The BQ showed high sensitivity (92%) but low specificity (17%). Therefore, though the Berlin-M is useful as a screening tool, it is not a confirmatory diagnostic tool.
Introduction: Cognitive distortion seems to be a potential force in shaping criminals and antisocial behaviour within an individual. Unfortunately there is no valid Malay psychometric instrument available to measure cognitive distortion in Malaysian settings, especially in prisons. There is an urgent need to have a valid and reliable Malay psychometric instrument to assess the cognitive distortion among Malaysians. Therefore, the present study aimed to validate “How I Think” Questionnaire into the Malay language (henceforth, HIT-M). Methods: A cross-sectional study was conducted among inmates (n= 150) incarcerated within two prisons in Peninsular Malaysia. The validation study commenced with Forward-Backward translations and was followed by content and face validities. Later, construct validity was
performed via Exploratory Factor Analysis using Principal Component Analysis. Varimax rotation was applied in order to optimize the factor loadings on the extracted component. Finally, reliability testing was
performed to determine the internal consistency of the items which was done using Cronbach Alpha coefficient method (α). Findings: Initial factor loadings resulted in 11 factors with a total variance of 74.1%. Next, factor analysis was repeated by extracting the items into a four factor structure parallel to the theoretical construct. Items with factor loadings above 0.40 were retained as acceptable factor loadings. After considering factor loadings, item correlation and content of items, the final version of HIT-M consisted of 24 items. The internal consistency of HIT-M was 0.90 which was considered good. Conclusion: HIT-M is a valid and reliable psychometric instrument to measure and assess cognitive distortion among Malaysians.