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Recovering Quality of Life (ReQoL) scale: linguistic validation in Malayalam, an Indian language

Authors:
  • Black Country Healthcare NHS Foundation Trust, Wolverhampton

Abstract

Recovering Quality of Life (ReQoL) is a self-reported measure of quality of life of people with mental illness, with a potential for use as a patient rated outcome measure. ReQoL in English has been designed and validated in United Kingdom. This paper describes the process of translation and validation of ReQoL in Malayalam, a language of predominant South Indian usage, especially in the state of Kerala. This was done by a team of mental health professionals at the Institute for Mind and Brain, in Kerala. The process involved translation, back-translation and piloting with patients. The Malayalam version is considered to be a valid translation of the original scale in English.
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... 8 The brief 10-item ReQoL has been now translated into various Indian languages: Bengali, Gujarati, Hindi, Kannada, Malayalam, Marathi, Odia, Punjabi, and Tamil; and has been pilot tested in clinical settings. [9][10][11][12][13][14][15][16][17] Objective Objective of this project was to translate ReQoL-10 to Telugu and validate it linguistically for clinical use in patients with mental illness. ...
... 25 It has been already translated into many Indian languages. [9][10][11][12][13][14][15][16][17] As Telugu is one of the major languages used by a sizeable proportion of the Indian population and worldwide, it is essential that ReQoL-10 is available for the patients using Telugu as their first language. Following the translation process, ReQoL-10 scale in Telugu was found to be satisfactory, comprehensible, easy to use and was suitable across a range of mental health conditions as the pilot sample included anxiety, mood and psychotic disorders. ...
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Background: There is a dearth of scales in the Telugu language for assessing quality of life in persons with mental illness. Aim: It was intended to translate and linguistically validate Recovering Quality of Life 10 item version (ReQoL-10) in Telugu, a south Indian language; and to explore its acceptability among psychiatric patients. Methods: Translation of ReQoL-10 to Telugu was carried out by forward and backward translation, reconciliation, pilot testing and proofreading. Pilot testing involved psychiatric patients attending Government Hospital for Mental Care, Visakhapatnam. Results: The process of translation met with linguistic issues that were highlighted by the patients. These were addressed by modification based on patient's observations. A second pilot-testing was done to ensure the scale is easily comprehensible by the patients, specifically by those at a lower educational level. The participating patient population (n=20) with a mean age 33.5 ± 8.4 years, was diverse in their psychiatric diagnoses which included depression, mania, schizophrenia and obsessive compulsive disorder. Conclusion: ReQoL-10 in Telugu is a linguistically acceptable scale and can be used to assess the quality of life in individuals with mental illness.
... Recently, the ReQoL measures originally developed in English have been translated and linguistically validated in German using established methodology [16]. ReQoL measures are also available in other languages, such as Dutch [17], seven common Indian languages [18][19][20][21][22][23][24] and traditional Chinese [25]. ...
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Background The generic self-reported Recovering Quality of Life (ReQoL) measures were developed for measuring recovery-focused health-related quality of life (HrQoL) in persons with mental health conditions. The aim of this study was to assess the psychometric properties of the German version of the ReQoL measures in patients with affective disorders in Germany. Methods Data from a patient sub-sample in a randomized controlled trial have been used (N = 393). The internal consistency and the test–retest reliability of the ReQoL measures were assessed using Cronbach’s Alpha and the intra-class correlation coefficient (ICC). The concurrent validity and the known-group validity of the ReQoL measures were assessed using Pearson’s Correlation coefficient and Cohen’s d. The responsiveness was assessed using Glass' Δ and the standardized response mean (SRM). Results The reliability among the items of the ReQoL-20 was overall excellent. The ICC of the ReQoL-20 was r = 0.70, indicating moderate test–retest reliability. The concurrent validity of the ReQoL-20 with the clinical measure PHQ-9 was strong with a correlation coefficient of r = − 0.76. The known-group validity of the ReQoL-20 using PHQ-9 cut-off points was large with an effect size of d = 1.63. The ReQoL measures were sensitive to treatment response and remission of symptoms measured by the PHQ-9 with large effect sizes/SRM. Discussion The psychometric properties of the ReQoL measures for the assessment of patients with affective disorders were overall good. With the ReQoL, valid and reliable measures for the assessment of recovery-focused HrQoL for persons with affective disorders are available in German language.
... 3 The brief 10-item ReQoL has been translated and linguistically validated in various Indian languages: Bengali, Gujarati, Hindi, Odia, Kannada, Malayalam, Marathi, and Tamil. [4][5][6][7][8][9][10][11] Punjabi is an Indian language spoken by the people in Punjab states of India and Pakistan and many neighboring states. It is the ninth most widely spoken language in the world and is one of the most widely spoken languages in India. ...
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The Recovering Quality of Life (ReQoL) scale, developed in the UK is an appropriate instrument for routine clinical use in mental health services. It has been translated to many languages in India and elsewhere. The translation and linguistic validation process of the ReQoL scale to Punjabi, an Indian language spoken in many Northern states of India, was undertaken by a team of mental health professionals at Post Graduate Institute of Medical Sciences, Rohtak, India. The standard process of translation and review was followed. A pilot study involving 10 patients with mental illness was conducted and their suggestions were incorporated in the translation process. The linguistic issues encountered during the process were addressed. The translated Punjabi version of ReQoL was considered acceptable by the patients and clinical team. It appears that ReQoL-10 in Punjabi can be used in the mental health services as an outcome instrument in psychiatric clinical practice and research.
... It has been pilot tested in clinical settings. [6][7][8][9][10][11][12] Objective of this project was to translate ReQoL to Gujarati and validate it linguistically for the clinical use in persons with mental illness. ...
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The Recovering Quality of Life (ReQoL) scale is a short scale for routine clinical use in mental health services. Its shorter 10-item version in English was translated and validated in Gujarati, an Indian language, spoken in the western state of Gujarat in India. The translation process involved following process: forward and back-translation, pilot-testing involving patients, review and reconciliation steps. The linguistic issues encountered during the translation process were addressed. The Gujarati version of ReQoL was considered linguistically acceptable for use in patients with mental illness. It is expected that ReQoL Gujarati version will add to QOL instruments in Gujarati language which can be used in routine clinical practice.
... 4,5 The brief 10item ReQoL has been translated to a few other major Indian languages and pilot tested with patients, establishing their linguistic validity. [6][7][8][9][10][11] We intended to translate ReQoL 10-item version to Bengali. ...
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Background: There is a need for a short quality of life measure for use in day to day psychiatric practice in Bengali language. We intended to translate Recovering Quality of Life (ReQoL) scale 10-item version to Bengali. Method: Translation and linguistic validation process used was suggested by Oxford University Innovation. It included forward translation, reconciliation, back translation, pilot study involving patients, discussion on the feedback from the patients, developing a consensus version and proof reading. Results: The emphasis during translation was on maintaining the conceptual and cultural appropriateness of the final version. The process involved many changes considering feedback from the patients during pilot testing. This led to the translated version being more appropriate and acceptable to patients with mental illness. Conclusion: The Bengali version of ReQoL-10 scale appears to be linguistically acceptable and is expected to be useful for Bengali speaking patients with mental illness.
... 9 The brief 10-item ReQoL has been now translated to Hindi, Odia, Tamil, Kannada and Malatyalam, which have been pilot tested for persons with mentally illness. [10][11][12][13][14] It was intended to undertake translation and linguistic validation process of ReQoL to Marathi language, to make it available for the clinical use for the persons with mental illness. ...
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The Recovering Quality of Life (ReQoL) scale was translated and validated in Marathi, one of the major Indian languages, by a team of mental health professionals at Datta Meghe Institute of Medical Sciences, India. The standard process of translation was followed which involved forward and back-translation, pilot-testing involving patients, review and reconciliation steps. The translated Marathi version of ReQoL was considered acceptable. The process of translation and the linguistic issues encountered during the process are discussed.
Article
Aim:This study aimed to examine the psychometric performance of the Recovering Quality of Life scale 10-item version (ReQoL-10) using a sample from a Singapore first-episode psychosis intervention program, to explore its clinical and sociodemographic correlates, and to discuss its utility as a patient-reported outcome measure (PROM). Methods: Sociodemographic data, duration of untreated psychosis (DUP), and diagnosis were collected from 300 participants. Clinical data, which included baseline and current scores on the Patient Health Questionnaire 9-item version, EuroQoL-5Dimension 3-level version, Positive and Negative Syndrome Scale, and Global Assessment of Functioning scale, were extracted. The ReQoL-10 was tested for structural validity, internal consistency, and construct validity, and a multiple linear regression determined if any of the baseline factors were statistically significant predictors of the total ReQoL-10 scores. Results:The mean (SD) total ReQoL-10 score of the sample was 27.8 (7.8). Confirmatory factor analysis confirmed the bifactor model structure of the ReQoL-10. The instrument demonstrated good internal consistency and adequate construct validity. Being older was associated with higher total ReQoL-10 scores, while being married, having a highest educational level of vocational/diploma, longer DUP, and a diagnosis of affective psychosis were associated with lower total ReQoL-10 scores. Conclusions:This study has validated the ReQoL-10 as suitable for routine use to measure recovery-specific quality of life in a psychiatric setting among patients with first-episode psychosis, and is a potential tool to initiate recovery conversations. As a PROM, it can facilitate shared decision making, inline with efforts to evaluate and improve quality of care.
Article
Zusammenfassung Ziel der Studie Ziel dieser Arbeit war es, den Selbstbeurteilungsfragebogen „Recovering Quality of Life (ReQoL)“ zur Messung der gesundheitsbezogenen Lebensqualität von Menschen mit psychischen Erkrankungen in die deutsche Sprache zu übersetzen. Methodik Die Übersetzung des Fragebogens in die deutsche Sprache erfolgte durch 2 voneinander unabhängige qualifizierte Übersetzer. Diskrepanzen in der Bedeutung und Terminologie wurden durch den Vergleich einer Rückübersetzung mit der Originalversion ermittelt. Die deutsche Übersetzung des Fragebogens wurde mit 5 Patienten mit psychischen Erkrankungen vorgetestet. Ergebnisse Die Übersetzung einiger englischer Formulierungen des Fragebogens in die deutsche Sprache gestaltete sich, hauptsächlich aufgrund sprachlicher und kultureller Unterschiede, schwierig. Durch eine Expertendiskussion der Übersetzung und einen Pretest mit psychisch erkrankten Patienten konnten geeignete Formulierungen gefunden werden. Schlussfolgerung Es liegt eine deutsche Version des Selbstbeurteilungsfragebogens ReQoL vor, um die gesundheitsbezogene Lebensqualität von Menschen mit psychischen Erkrankungen zu erfassen.
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The article describes the process of translation and linguistic validation of Recovering Quality of Life (ReQoL) scale in Odia an eastern Indian language. While there are a few generic quality of life measures for use in health related subjects, there is none specific for mental health available in Odia. ReQoL is translated to Odia to bridge this gap. The translation and linguistic validation process was guided by the suggested methodology for translation of scales which involved forward and back-translation, pilot-testing involving patients, review and reconciliation steps. There were no major concerns in the translation process; the translated scale in Odia was observed to be easily comprehensible by the patients and useful in the clinical scenario.
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Recovering Quality of Life (ReQoL) developed at the University of Sheffield is a brief instrument to assess the quality of life of persons with mental illness. It is available in two versions: a 10-item and a 20-item measure, ReQoL-10 and ReQoL-20 respectively. An attempt was made to translate ReQoL-10 to Kannada, a widely spoken language in South India. The translation followed the procedure suggested by Oxford University Innovation Translation and Linguistic Validation Process. Difference of opinions during the translation process and its resolution; description of patient population and results of pilot testing are reported here. The Kannada version of ReQoL was found to be linguistically equivalent to the original version of English. It was simple to use and comprehensible for the Kannada speaking people with mental illness. Validation of the measure to establish its psychometric properties in Kannada is recommended.
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The linguistic validation process of the Recovering Quality of Life (ReQoL) scale to the Indian language Tamil was undertaken by a team of mental health professionals at Schizophrenia Research Foundation, Chennai. The process involved the recommended forward and backward translation and review. A pilot testing was done involving Tamil speaking patients using the self-administered ReQoL. The translated Tamil version of ReQoL was considered acceptable. A detailed summary of the process is presented in the paper.
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The linguistic validation process of the Recovering Quality of Life (ReQoL) scale to Hindi, the national language of India, was undertaken by a team of mental health professionals at Post Graduate Institute of Medical Sciences, Rohtak, India. The standard process of translation and review was followed. The translated Hindi version of ReQoL was considered acceptable. The process of translation and the linguistic issues encountered during the process are discussed.
Article
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Background Outcome measures for mental health services need to adopt a service-user recovery focus. Aims To develop and validate a 10- and 20-item self-report recovery-focused quality of life outcome measure named Recovering Quality of Life (ReQoL). Method Qualitative methods for item development and initial testing, and quantitative methods for item reduction and scale construction were used. Data from >6500 service users were factor analysed and item response theory models employed to inform item selection. The measures were tested for reliability, validity and responsiveness. Results ReQoL-10 and ReQoL-20 contain positively and negatively worded items covering seven themes: activity, hope, belonging and relationships, self-perception, well-being, autonomy, and physical health. Both versions achieved acceptable internal consistency, test–retest reliability (>0.85), known-group differences, convergence with related measures, and were responsive over time (standardised response mean (SRM) > 0.4). They performed marginally better than the Short Warwick-Edinburgh Mental Well-being Scale and markedly better than the EQ-5D. Conclusions Both versions are appropriate for measuring service-user recovery-focused quality of life outcomes. Declaration of interest M.B. and J.Co. were members of the research group that developed the Clinical Outcomes in Routine Evaluation (CORE) outcome measures.