Reconceptualising mindfulness in Cambodia: Khmer translation, cultural adaptation, and validation of the Southampton Mindfulness Questionnaire.

Objectives: Mindfulness is increasingly used in global mental health, yet its measurement tools are largely developed within Western cultural frameworks. This study aimed to (1) translate and culturally adapt the Southampton Mindfulness Questionnaire (SMQ) into Khmer, (2) evaluate its cultural integrity among Cambodian adults with physical disabilities, and (3) examine the psychometric properties and factor structure of the measure. Methods: The SMQ was translated using a standardised forward-backward translation process with expert panel review and cognitive interviewing. Exploratory (EFA) and Confirmatory Factor Analyses (CFA) were conducted on responses from 437 Cambodian participants with physical disabilities. Results: Following cultural adaptation, minor linguistic revisions were made to ensure conceptual equivalence. EFA and CFA supported a 14-item, six-factor structure comprising letting go, acceptance, non-judgement, cognitive-emotional reactivity, absence of aversion, and mindful observation. This structure demonstrated good model fit and internal consistency, diverging from the original Western single-factor model. Conclusion: This study provides a culturally adapted Khmer version of the SMQ with evidence of structural validity and internal consistency and offers evidence that the structure of mindfulness may vary across cultural contexts. The findings highlight the influence of Buddhist psychological concepts, particularly acceptance and reduced cognitive-emotional reactivity, in shaping the experience of mindfulness in Cambodia. The availability of this scale enables culturally grounded research and clinical practice and supports the development of contextually appropriate mindfulness-based interventions in low- and middle-income settings.