Arabic InCaSaQ: Translation and psychometric validation in a Tunisian population

Abstract

Objectives Patient satisfaction is an important patient-reported outcome in long-term intermittent catheterization. This study aimed to translate, cross-culturally adapt, and psychometrically validate the Intermittent Catheterization Satisfaction Questionnaire (InCaSaQ) for use in a Tunisian population.Methods The InCaSaQ was translated using a standardized forward-backward methodology and reviewed by a multidisciplinary expert committee to assess semantic and conceptual equivalence. The core questionnaire was formulated in Modern Standard Arabic, with a limited number of Tunisian Arabic explanatory terms added during cognitive pretesting in 20 patients to improve comprehension. The final culturally adapted version was administered to 80 adults performing clean intermittent self-catheterization; 98.8% had neurogenic bladder, and 95% used self-lubricated catheters requiring water addition. Psychometric evaluation, guided by COSMIN recommendations, included acceptability, internal consistency, test-retest reliability, principal component analysis, and Spearman’s rank correlations with the Arabic Intermittent Catheterisation Difficulty Questionnaire (ICDQ).Results The culturally adapted Arabic InCaSaQ showed satisfactory acceptability, with a mean completion time of 3 min 15 s and no missing InCaSaQ responses. The mean overall score was 2.35 ± 0.57 on the original 0–3 scale. Internal consistency was good (Cronbach’s α = 0.854), and test-retest reliability was excellent (ICC = 0.985). Principal component analysis identified two components explaining 64.72% of the total variance. The overall InCaSaQ score was negatively correlated with the total ICDQ score (Spearman’s ρ = −0.468, p < 0.001), and most content-category correlations with ICDQ dimensions were statistically significant.Conclusions The culturally adapted Arabic InCaSaQ demonstrated satisfactory acceptability, reliability, and validity in the Tunisian population studied. Additional cross-cultural adaptation and psychometric validation are required before its use in other Arabic-speaking populations and in patients with non-neurogenic urinary retention.