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Project Title:Translation of established public health measurement instruments into Arabic and Dari (ENSURE) (English Version)
  1. General Information: *Note: The Dari and Arabic translation of the item was tested. This is an English translation of the original German source item.*
  2. Question Text: How is your health in general? Would you say it is…
    [Wie ist Ihr Gesundheitszustand im Allgemeinen? Würden Sie sagen, er ist ...]
  3. Answer Categories very poor [sehr schlecht]

    rather poor [eher schlecht]

    partly, partly [teils, teils]

    rather good [eher gut]

    very good [sehr gut]

    not specified [keine Angabe]


    1. Recommendations: Question: We recommend that Arabic language experts review the translation to see if the translation of the word for "state of health" could be interpreted differently in the Arabic-speaking countries.
      If this is not the case, we recommend adding an explanation to the question that clarifies whether the respondents should refer exclusively to their physical or also to their mental state in their answer.
      Response format: The Dari translation of the response categories should be corrected to correctly reflect the gradation between "very poor" and "rather poor."
  1. Cognitive Techniques:Information image/link to cognitive pretesting General Probing, Comprehension Probing, Specific Probing
  2. Findings for Question: What do test persons think of when they think of their "health in general"?

    Five of the six Arabic-speaking test persons from Syria referred exclusively to their physical state of health. Health status included whether one had (chronic) illnesses (SY03, SY05, SY06) or pain (SY03, SY04), needed surgery or had had surgery (SY04, SY06), or how one ate (SY02). Only one test person emphasized that physical and mental health should be used equally to assess overall health (SY01).

    In the case of the Arabic-speaking test persons from Iraq, on the other hand, all answers indicated that both physical and psychological aspects had been included in the state of health. Among the physical aspects that constitute good health, the absence of pain or not taking painkillers (IR06), the absence of high blood pressure (IR01, IR03), back problems (IR03, IR06), and diseases (IR04) were mentioned. One test person stated that she was perfectly healthy physically, but occasionally suffered from depression, which is why she chose "rather good" rather than "very good" (IR04). Several test persons related their physical and mental health status. One test person explained that she was single with several children, which was very stressful and therefore had a physical impact (IR02). Another test person explained that she had always been employed in Iraq. Since this was different in Germany, she suffered from high blood pressure (IR03). One test person explained that her health was impaired because the climate in Germany did not agree with her (IR06).

    Of the Dari-speaking test persons, three referred to both their physical and mental state, while two named only physical aspects and one test person referred only to their mental state. According to the test persons, physical aspects that constituted a good or bad state of health included illnesses of any kind (DA03) as well as complaints (DA05) or injuries (DA06). In addition, two test persons included aspects that were indirectly attributable to health status; these were fitness or exercise (DA01, DA03) and diet (DA03). One test person also stated that having a job was also important for achieving a good state of health (DA02).

    In summary, the test persons from Syria took a narrower view of the question and referred primarily to their physical state of health, while the test persons from Iraq and Afghanistan more frequently formed a holistic judgment of their physical and mental health. In addition, they also referred much more frequently to peripheral aspects that can influence health status but do not define it, such as sporting activities or having a job.

    Is general health declared as the test persons’ own perception or an attribution from outside (endogenous vs. exogenous)?

    In all cases, test persons referred to self-assessment of their health, even in cases where test persons mentioned contacts with doctors (SY03) or stays in hospitals (SY04).

    Other findings

    During one of the Dari interviews, the interpreter noticed that the top two response categories in the Dari translation were the same, both "very poor." The second category should read "rather poor". Only one test person from Afghanistan selected this category (DA02), which made the duplication noticeable; the other test persons did not notice this error.
  1. Question Topic: Public health/ Health impairments
  2. Construct: General health