Translation, cultural adaptation, and psychometric validation of the Arabic version of the university of Washington quality-of-life questionnaire in Jordanian head-and-neck cancer patients.

Purpose: The University of Washington Quality of Life Questionnaire (UW-QoL v4) is widely used to assess health-related quality of life (HR-QoL) in patients with head and neck cancer (HNC). This study aimed to translate, culturally adapt, and validate an Arabic version of the UW-QoL v4 for use with Jordanian HNC patients. Methods: A two-phase cross-sectional study was conducted at King Hussein Cancer Centre. Phase one included forward and back translation by bilingual experts, expert panel review, and cognitive testing with Arabic-speaking participants to ensure linguistic and conceptual equivalence. Phase one participants were not included in phase two analyses. Phase two assessed the psychometric properties of the final Arabic version in 98 HNC patients from 118 consented participants. Internal consistency, two-item Spearman-Brown reliability, test-retest reliability using intraclass correlation coefficients, measurement error, exploratory structural validity using principal component analysis, floor/ceiling effects, and selected construct-validity hypotheses were evaluated. Statistical analyses followed COSMIN-informed recommendations and were conducted in R. Results: The Arabic UW-QoL v4 demonstrated good internal consistency: Cronbach's alpha = 0.89 for the total 12-item scale, Cronbach's alpha = 0.86 for the 10-item physical-function subscale, and Spearman-Brown = 0.86 for the two-item socio-emotional subscale. Test-retest reliability was excellent for the total score, ICC(A,1) = 0.95. Exploratory PCA supported a two-component solution, with the first two eigenvalues equal to 5.67 and 1.06. Floor effects ranged from 4.1% to 14.3%, whereas ceiling effects ranged from 26.5% to 50.0%. Associations between domain scores and patient-identified problems were in the expected negative direction (r = -0.45 to -0.30). Known-groups validity showed higher total scores in the early primary tumor stage (T1-2) than in the advanced primary tumor stage (T3-4), Mann-Whitney U test, p = 0.0025; rank-biserial correlation = 0.49. Conclusion: The Arabic version of the UW-QoL v4 is a reliable and culturally appropriate tool for assessing quality of life among Jordanian HNC patients. The findings provide initial evidence of structural and construct validity; further studies using externally validated comparators, broader clinical subgroups, and longitudinal designs are recommended.