Exploratory factor analytical study of depressive symptomatology: an Arab experience with a sample comprising college students, using the revised beck depression inventory

An understanding of the domains of depressive symptomatology could facilitate valid and interpretable comparisons across cultures. The objective of the present study was to assess the factor structure of the Beck Depression Inventory-II [BDI-II] in an Arab sample comprising college students, in comparison to the international data. Cross-sectional questionnaire survey of Arab college students in their classrooms over a 1-year period. Participants [n=624] who completed the questionnaire, which had been translated into Arabic, during the 2007-2008 academic session. Exploratory factor analysis was done by principal axis factoring with oblique rotation. Factor 1 consisted of psychological symptoms. Factor 2 mainly comprised somatic symptoms, but with some affective symptoms [loss of interest, irritability]. Factor 3 also belonged to a purely psychological domain, whereas factor 4 was another mixture of somatic and psychological symptoms [41.8% of variance explained]. Thus the four domains were as follows: cognitive I, somatic-affective I, cognitive II, and somatic-affective II. These domains were similar in construct to the original subscales on which the BDI-II was validated for students in North America. Our four-factor solution fulfilled the recommended criteria, namely, a strong first factor, simple structure [parsimony], and stable factors with construct meanings that are in line with theory. Our factor structure defined depression in a manner consistent with theory, in that sadness, self-dislike, and guilt feelings defined the cognitive domain. whereas irritability and changes in sleep pattern and appetite mostly defined the somatic-affective domain. The BDI-II has construct validity across cultures

Validity and reliability of the European Organization for Research and Treatment in Cancer Quality of Life Questionnaire [EORTC QLQ]: experience from Kuwait using a sample of women with breast cancer

Although the EORTC QLQ-C30 and its breast-specific module [BR-23] are widely used instruments, the few reports on their psychometric characteristics from Arab and neighboring countries involved limited analyses. Our objective was to assess the psychometric characteristics of both questionnaires using the responses of a larger sample of Arab women. Participants were consecutive clinic attendees at the Kuwait Cancer Control Center. The indices assessed were alpha coefficients, item-internal consistency [IIC], item-discriminant validity [IDV], and known-groups validity. The 348 women were aged 48.3 [10.3] years. The intra-class correlation for the test-retest statistic and the internal consistency values for the multi-item scales were >0.7 alpha. With the exception of the pain subscale, all items met the IIC criterion of >0.4 correlation with the corresponding scale. For IDV, the BR-23 performed better than the QLQ-C30. The scale scores discriminated between patients at different disease stages, and between sick and well populations. With the exception of the pain subscale, the Arabic version of the questionnaires is psychometrically sound

reliability and validity of the short version of the WHO quality of life instrument in an Arab general population

There is rising interest in quality of life [QOL] research in Arabian countries. The aim of this study was to assess in a nationwide sample of Kuwaiti subjects the reliability and validity of the World Health Organization Quality of Life [WHOQOL-BREF], a shorter version of the widely used QOL assessment instrument that comprises 26 items in the domains of physical health, psychological health, social relationships, and the environment. A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending large cooperative stores and municipal government offices in the six governorates completed the Arabic translation of the questionnaire. The indices assessed included test-retest reliability, internal consistency, item internal consistency [IIC], item discriminant validity [IDV], known-groups and construct validity. There were 3303 participants [44.8% males, 55.2% females, mean age 35.4 years, range 16 to 87 years]. The intra-class correlation for the test-retest statistic and the internal consistency values for the full questionnaire and the domains had a Cronbach's alpha >/= 0.7. Of the 24 items that constitute the domains, 21 met the IIC requirement of correlation >/= 0.4 with the corresponding domain, while 16 met the IDV criterion of having a higher correlation with their corresponding domain than other domains. Domain scores discriminated significantly between well and sick groups. In the factor analysis, four strong factors emerged with the same construct as in the WHO report. The Arabic translation of the WHOQOL-BREF has impressive reliability and validity indices. The poor IDV findings are due to the multidimensional nature of the questionnaire. The highly significant validity indices should reassure researchers that the questionnaire represents the same constructs across cultures. Negatively worded items possibly need refinement

Quality of life in people with epilepsy and their family caregivers: an Arab experience using the short version of the World Health Organization quality of life instrument

To assess the subjective quality of life [QOL] of Sudanese epilepsy patients with generalized tonic clonic seizures and their family caregivers, compared with the general population, and previous Sudanese data for chronic conditions, and to examine the predictors of QOL. This cross-sectional study using the World Health Organization's 26-item QOL instrument, was carried out from December 2005 to December 2006, on consecutive government hospital Neurology Clinic attendees and their family caregivers, who fulfilled the study's inclusion criteria, in the cities of Khartoum, Wad Medani, and Atbara, Sudan. There were 276 patients [56.5% male; mean age 29.5 years]. Patients' QOL scores were significantly lower [physical health domain [57.1%], psychological [60.1%], social relations [58.4%], environment [50.6%], and general facet [60.8%]], than the control group. They scored lower than the WHO 23-country patients for social relations and environment domains, and had lower environment domain scores than Sudanese diabetes patients. Caregivers had significantly higher scores [57.4 -73.7%] than patients and control group. Patients' higher QOL was associated with marriage, education, employment, no side effects and caregiver occupation. Caregivers had lower QOL if they were female, patients' own children, and less educated. The predictors of QOL included caregiver's proxy rating of the patient's QOL and drug side effects. Poor QOL in epilepsy reflects social underachievement, and calls for programs to remedy their psychosocial circumstance, and improve service provisions. Vulnerable caregivers need to be identified for assistance, to enhance their role