The Persian Version of Community Integration Questionnaire in persons with multiple sclerosis: translation, reliability, validity, and factor analysis

Abstract

Purpose: To culturally translate and validate the Community Integration Questionnaire (CIQ) in persons with multiple sclerosis (MS). Methods: After a forward–backward translation, 105 persons with MS completed the Persian versions of the CIQ and MS Quality of Life (MSQOL) questionnaires in the first visit. The CIQ was re-administered to a sample of 45 persons with MS 7–10 days after the first session. Test–retest reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach’s α coefficient, respectively. Construct validity was assessed by measuring associations between subscales of the Persian CIQ (including Home Integration (HI), Social Integration (SI), and Productivity (P)) and MSQOL (including Physical and Mental Components). Dimensionality was assessed through two methods of corrected item-subscale correlation and factor analysis. Results: The acceptable level of test–retest reliability (ICC ≥0.70) was obtained for the Persian CIQ. However, Cronbach’s α coefficient of ≥0.70 was only seen for the HI. The correlations between the Persian CIQ and the Physical MSQOL were higher than those of Persian CIQ and the Mental MSQOL. The corrected item-subscale Spearman’s correlation coefficient of 0.40 was exceeded by most items of the HI and 2 items of P. A total of four factors were detected and similar to the results of item-subscale correlation, the most variability was seen for the items of SI which loaded on different factors. Conclusions: Persian CIQ seems to be a reliable and valid instrument for monitoring the level of community integration following rehabilitation in persons with MS. Some modifications need to be made in the SI of the Persian CIQ to improve extraction of information regarding community integration of persons with MS.

Implications for Rehabilitation

• The results on psychometric properties of the Persian Community Integration Questionnaire (CIQ) are comparable with the English and Spanish versions.

• Persian version of the CIQ appears to be a reliable and valid instrument to assess community integration in “clinical” and “research” settings of Persian-speaking Iranians with definite diagnosis of multiple sclerosis (MS).

Keywords::

• Community integration questionnaire
• multiple sclerosis
• Persian version
• psychometric properties

Acknowledgement

This study is part of M.Sc thesis of Mrs Fattahizadeh. Special thanks to Ahvaz Jundishapur University of Medical Sciences for the financial support (Master thesis grant no: pht-9008). Also, we thank Prof. Willer for permitting us to validate the Persian-version of this instrument in our country, Iran. Finally, we would like to thank the two anonymous reviewers (especially reviewer# 1) for providing us with constructive comments and suggestions.

Declaration of Interest: This work was supported by a Master thesis grant in Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. None of the authors have any financial or other interests relating to the manuscript to be submitted for publication in Disability & Rehabilitation.