Translation, adaptation and psychometric properties of the Arabic version of the numerical rating scale when used with children and adolescents

Abstract

Objective

The 0–10 Numerical Rating Scale (NRS-11) is widely used with Arabic-speaking pediatric populations. However, there is no data about its validity or reliability. Thus, the aims of this research were to translate the NRS-11 into Arabic and study its dimensionality and construct (convergent and discriminant) validity, and reliability.

Methods

A group of 190 Lebanese students between 8 and 18 years old participated. Participants were interviewed online and asked to imagine themselves in a hypothetical painful situation and rate the expected pain intensity using the NRS-11-Arabic and an Arabic version of the Visual Analogue Scale (VAS-Arabic). They were also requested to respond to the pediatric Arabic version of the Pain Catastrophizing Scale (PCS-Arabic). Data collection lasted for a month.

Results

Data showed that the NRS-11-Arabic and the VAS-Arabic scores measure the same common construct. In addition, they showed strong statistically significant correlations between NRS-11 and VAS (ranging from 0.83 for the whole sample and 0.83 and 0.84 for the 8–12-year-olds and the 13–18-year-olds, which support its construct validity). These correlations were higher than those between the NRS-11-Arabic and the PCS-Arabic, which support the discriminant validity of NRS-11-Arabic scores. Test-retest reliability was 0.86 for the whole sample, and 0.89 and 0.82 for the 8–12-year-olds and the 13–18-year-olds, respectively, which shows the reliability of the NRS-11-Arabic scores.

Conclusions

The data provide preliminary evidence of the unidimensionality, validity and reliability of the NRS-11-Arabic scores, thus supporting its use in clinical and research activities involving Arabic-speaking pediatric samples.

Keywords:

• Pain assessment
• pain intensity
• NRS-11
• young people
• translation
• Arabic
• validity
• reliability

Transparency

Declaration of funding

This study was supported, in part, by the Spanish Ministry of Economy, Industry and Competitiveness under Grants RTI2018-09870-B-I00; RED2018-102546-T, and the Spanish Ministry of Science and Innovation (MCIN/AEI/10.13039/501100011033 (PID2020-113869RA-I00)); the European Regional Development Fund (ERDF), the Government of Catalonia (AGAUR; 2017SGR-1321), Fundación Grünenthal, Universitat Rovira I Virgili (PFR program) and ICREA-Acadèmia.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

JF: Data collection, Data curation; Methodology; Software; Writing- Original draft preparation. ES-R: Data analysis; Writing – review & editing. PJF: Data analysis; Writing – review & editing. JM: Conceptualization; Methodology; Supervision; Writing – review & editing; Funding acquisition

All authors discussed the results and commented on the manuscript.

Acknowledgements

Authors would like to thank the participants, students from North College School in Zgharta Lebanon, and the Director and Principals. In particular, authors thank Mr. Maroun Ishak, who was instrumental in the data collection despite the difficulties of the pandemic. They are also grateful to Mr. Anthony Geagea, the engineer who volunteered to prepare the online survey, and offered the server one month for free.