Psychometric validation of a Saudi Arabian version of the sf-36v2 health survey and norm data for Saudi Arabia.

BACKGROUND: Adaptation of a patient-reported outcomes survey into a new language requires careful translation procedures as well as qualitative and quantitative psychometric testing. This study aimed to evaluate the basic psychometric properties of the new Saudi Arabian SF-36v2 and establish norm data for Saudi Arabia. METHODS: Translation and adaptation of the SF-36v2 used standard methodology. Psychometric validation included two stages: 1) A qualitative study (n = 100) explored the components of health and health-related quality of life considered important in Saudi Arabia and evaluated the content validity of the SF-36v2 in Saudi Arabia, and 2) A quantitative study (n = 6166) evaluated the basic psychometric properties of the Saudi SF-36v2 and established norm data for Saudi Arabia. Comparison with US general population data (n = 4040) evaluated differential item function (DIF) and cross-national differences. RESULTS: The qualitative study supported the content validity of the Saudi SF-36v2. Cognitive debriefing identified only few and minor problems. Psychometric analyses supported item convergence within scales and differentiation across scales of the SF-36v2. Scale level exploratory factor analyses did not support the typical distinction between physical health and mental health components. Internal consistency reliability was satisfactory for all scales except the social function scale (alpha = 0.67). Cross-national DIF was identified for 9 items. In the Saudi general population, the average vitality score was lower for women (- 2.71 points) compared to men. For men, older age groups scored lower on the physical function scale (- 3.31) and the physical health component (- 3.06). For women, older age groups scored lower on the role physical (- 3.72), bodily pain (- 3.66), and vitality (- 2.32) scales as well as the physical health component (- 3.52). Compared to the 2009 United States general population, and after adjusting for age, gender, and differential item function, persons in Saudi Arabia had lower average scores for the physical function (- 3.10), role physical (- 4.75), social function (- 4.23), role emotional (- 5.67), and mental health (- 4.82) scales, as well as the mental health component (- 4.57). CONCLUSION: This Saudi normative study of patient reported outcomes supported the validity and reliability of the new Saudi SF-36v2 and found cross-national differences with the USA.

Development of an Arabic inpatient satisfaction survey: application in acute medical rehabilitation setting in Saudi Arabia.

BACKGROUND: In the management of chronic disease, evidence suggests that satisfied patients exhibit more loyalty to treatment providers and greater adherence to treatment regimens. This is particularly so in the rehabilitation setting. We aimed to develop a reliable and valid Arabic-language survey to objectively measure inpatient satisfaction in medical rehabilitation settings in Saudi Arabia. METHODS: The King Fahad Medical City Rehabilitation Hospital Patient Satisfaction Survey (RH PSS) is a self-administered survey that addresses four domains of rehabilitation care: access, structure, process, and outcomes. The RH PSS was developed through four steps. Step 1: An item-generation process utilizing input from patients, rehabilitation professionals, and the relevant literature. Step 2: Individual interviews and focus groups, conducted for cognitive testing of the survey and to examine content validity. Step 3: Assessment of internal consistency and construct validity. Step 4: Survey implementation wherein factor analysis and reliability and validity testing were conducted. The survey was conducted at an acute inpatient medical rehabilitation hospital in Saudi Arabia. A total of 709 rehabilitation inpatients participated. RESULTS: The RH PSS demonstrated reasonable reliability and validity. Cronbach's alpha for all the RH PSS subscales ranged from 0.81 to 0.89, and 0.96 for the entire survey. Factor analysis showed good correlation of the 33 survey items and the subscales. The RH PSS demonstrated a good level of predictive validity through the high correlation between the global item "intent to recommend" and overall satisfaction (R2 = 0.786, adjusted R2 = 0.783, p = 0.01). CONCLUSIONS: The RH PSS is the first satisfaction survey with reported validity and reliability testing to address inpatient rehabilitation settings in Saudi Arabia. Further research involving multiple sites is recommended for nationwide validation.

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome.

OBJECTIVES: (1) Describe trends in time to rehabilitation admission and rehabilitation length of stay (LOS), (2) compare functional independence at discharge from rehabilitation between patients who arrived directly from acute care versus those from elsewhere and (3) identify independent predictors of functional outcomes following rehabilitation. SETTING: Traumatic brain injuries rehabilitation unit of King Fahad Medical City, Riyadh, Saudi Arabia. METHODS: We collected information on time from injury to rehabilitation admission, rehabilitation LOS, functional independence measure (FIM) score (admission and discharge) and demographic variables for 66 patients who arrived to rehabilitation from acute care and 142 patients who arrived from elsewhere. A mixed model analysis of variance measured change in FIM score between groups. Hierarchical regression was employed to investigate variables associated with FIM score at rehabilitation discharge. RESULTS: Patients arriving directly from acute care had a time from injury to rehabilitation admission 1/3 that of, and a higher discharge FIM score than, patients arriving from elsewhere. For the latter group, increasing time from injury to rehabilitation admission was associated with lower rehabilitation discharge FIM score. CONCLUSIONS: Reducing time from injury to rehabilitation admission and promoting enrolment to inpatient traumatic brain injury rehabilitation directly from acute care may improve functional outcome at discharge from rehabilitation.

Development of a rehabilitation goal menu for inpatients with neurological disorders: application in a Saudi Arabian context.

OBJECTIVE: To develop a rehabilitation goal menu based on understanding the specific goals that are important to neurological inpatients and that fall within commonly identified rehabilitation domains. DESIGN: Qualitative methods (semi-structured interview, focus groups) to develop a goal menu followed by cross-sectional study to measure participants' goal rankings. SETTING: Rehabilitation hospital in Saudi Arabia. SUBJECTS: A total of 130 participants with neurological injury. MAIN MEASURES: Participant rankings of rehabilitation goals and self-reported level of difficulty in areas such as mobility, self-care, accessibility, productivity, and leisure. RESULTS: A 10-item goal menu was developed based on initial focus groups, semi-structured interviews, and literature review. The overall highest ranked rehabilitation goal was Functional Mobility/Locomotion, followed by Self-Care and Religious/Life Philosophy. Self-reported level of difficulty with mobility was strongly associated with the ranking of Functional Mobility/Locomotion as a rehabilitation goal. However, there was little correspondence between reported difficulty and priority ranking of self-care. Subsequent factor analysis of detailed goal items suggest that the goal menu could be reduced to seven items. CONCLUSIONS: This study provided an understanding of which rehabilitation goals are important to Saudi clients with neurological disorders that could be used to facilitate their contribution to the goal-setting process.