Translation of established public health measurement instruments into Arabic and Dari (ENSURE) (English Version)

Findings for Multi-Item Scale Recommendations for Multi-Item Scale

Item 4 was tested systematically. For the other items, only spontaneous responses of the test persons are available, if at all.

Do the test persons differentiate between item 1 on living situation and item 4 on housing situation?

Five test persons selected the same scale item for items 1 and 4, two of whom were from Syria (SY04, SY05) and three from Afghanistan (DA01, DA04, DA05). The answers to the respective item-specific probing questions show that the two Arabic-speaking test persons, although they selected the same answer category, understood different things (living vs. housing situation) and understood both items correctly.

Of the three Dari-speaking test persons, two stated that they understood both items in the same way (DA04, DA05), while one saw a difference (DA01). The latter test person explained this by saying that, in her opinion, the first item was about her life situation, where she lived, who she lived with and how she was physically and mentally, whereas the last item was about how her life was. Both questions were somehow the same, but then not the same. This test person spoke fluent German. When asked whether the German translation "Wohnsituation" (living situation) corresponded to the wording in the question in the original language, she answered in the negative; she would have translated the original wording as "Lebenssituation im Gesamten" (living situation as a whole).

A similar minimal distinction that DA01 made between items 1 and 4 was also made by test person DA04, who had indicated that she understood both items in the same way. For her, both questions were very similar. Item 1 is about life as a whole, how one's (private) life is overall, and item 4 is about one's life situation, the circumstances of how one is currently living, and the needs one has in life.

For DA05, housing and living situation also have approximately the same meaning, because both times she compared her current life with her previous one. According to the interpreter, this is due to the translation, because living and dwelling are the same thing in Dari. There are no different words for "to be alive" and "to live somewhere. One can only understand such a question from the context.

Those Dari-speaking test persons who had given different information on both items, but who had summarized their entire life situation in the probing inquiry about item 4, indicated that they saw a difference between the two items. DA02 had understood the items to mean that the first referred to her past life, and the fourth referred to her current situation. Informed that both items referred to the present, DA02 changed her answer from scale point 2 to scale point 10, so that thereafter both items had the same answer category. During this interview, the interpreter also noted that the translations of both items were very similar and both referred to the life situation.

DA03 saw the difference between the items in the fact that item 1 referred to the life situation as a whole, including childhood, i.e. including one's entire life (response: scale point 6), while item 4 referred to the life situation, to the labor market, but also to the family situation (parents, spouse, children [response: scale point 4]). DA06 also stated that item 1 was about life in general (response: scale point 5) and item 4 was about the situation in which one lived (response: scale point 6).

In summary, it can be said that in the Dari-translation the word "living situation" does not seem to have been translated or understood correctly.

Other findings

The Arabic translation of the first item contained one word too many, which caused the sentence structure to be incorrect. This meant that the item as presented was incomprehensible to the test persons. To make it understandable, the interpreters read the item without the extra first word. The problem was that the words for "currently" from the introduction to the question and "all in all" from item 1 did not form a grammatically correct sentence structure. In addition, according to the interpreter, "all in all" is a formulation that must be connected with a context in Arabic in order to be understandable.

Introduction: No changes recommended.

Item 1: The wording of the item should be slightly adapted in Arabic to create a grammatically correct sentence structure and transition from the question introduction to the item.

Item 2: No changes recommended.

Response format: No changes recommended.