Linguistic Validation and Cultural Adaptation of the Albanian Version of the Older People’s Quality of Life Questionnaire (AL-OPQOL-35)

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you very much for giving me the opportunity to review this work. I am adding some comments to facilitate understanding and value of it:

- Why were there three translations from English to Albanian and only one from Albanian to English? Two independent translations should have been done to check similarities and differences.
- No expert committee was included. This is essential for linguistic validation.
- Was the study of psychometric properties conducted with the same group used for the pilot comprehension and feasibility test?
- The methodology section does not explain which psychometric properties will be studied or which statistics will be used.
- Why is Cronbach's alpha calculated only for the entire questionnaire and not for each dimension?
- Is feasibility not studied either?
- Test-retest reliability?
- What are the KMO and Bartlett tests used for? Nothing is explained in the methodology section.
- The methodology should be explained more thoroughly and clearly.
- The discussion should be clearer and more extensive, identifying what sets this questionnaire apart and the differences and similarities with other cross-cultural adaptations.

Thank you very much.
Best regards,

Author Response

Responses to Reviewer 1

- Why were there three translations from English to Albanian and only one from Albanian to English? Two independent translations should have been done to check similarities and differences.

Information regarding this comment is addressed in lines 86-88. One of translators was mentioned as local coordinator.

Figure 1 is also updated.

- No expert committee was included. This is essential for linguistic validation.

Information regarding this comment is addressed in lines 76-77, 149-151, 217, 249.

- Was the study of psychometric properties conducted with the same group used for the pilot comprehension and feasibility test?

Information regarding this comment is in lines 94-96.

- The methodology section does not explain which psychometric properties will be studied or which statistics will be used.

Information regarding this comment is in lines 125-127.

 

- Why is Cronbach's alpha calculated only for the entire questionnaire and not for each dimension?

Information regarding this comment is addressed in lines 199-213. Table 3 was added.

- Is feasibility not studied either?

Information regarding this comment is addressed in lines 153-157, 188-190.

- Test-retest reliability?

Not included in this study

- What are the KMO and Bartlett tests used for? Nothing is explained in the methodology section.

Data on these tests was removed.

- The methodology should be explained more thoroughly and clearly.

Updated...

- The discussion should be clearer and more extensive, identifying what sets this questionnaire apart and the differences and similarities with other cross-cultural adaptations.

Information regarding this comment is addressed in lines 245-247.

Reviewer 2 Report

Comments and Suggestions for Authors

Introduction

• It is accurate and provides relevant information, offering an appropriate context for the current situation regarding aging and quality of life. However, it would be useful to identify the advantages of the OPQOL-35 over other questionnaires designed to assess quality of life in older adults.

Material and Methods

• Section 2 (Permission and Ethical Approval for Use of OPQOL-35) would be more correctly included as a subsection in the Materials and Methods section.
• It is correct to follow the recommendation of the “Mapi Research Trust manual” and identify the phases of the process; however, the Materials and Methods section should explain how these phases are carried out from a methodological point of view. This information has been provided in the Results section, together with the findings obtained, which is not correct. Please restructure the information.

Results

• For example, lines 82 to 88 should be included in the Materials and Methods section. Please do this for all phases of the manual.
• Similarly, items in the Albanian language should also be presented in English so that readers can get an idea of where conflicts arise among translation experts.
• Lines 110 to 114 are difficult for the reader to understand. I understand that they compared the Albanian version with the English version (translated from Albanian). This resulted in minimal differences. However, the repetitive language and structure make it difficult to understand.
• Similarly, the items in subsection 4.3. should be expressed in English in parentheses after their Albanian wording.
• As for subsection 4.3, there are several methodological errors:
• The Bartlett sphericity test obtains adequate values, as does Cronbach's alpha. However, the KMO is not adequate, as it does not exceed the reference value of 0.8. This may be primarily due to the fact that expert recommendations suggest that there should be 10 participants for each item contained in the questionnaire, whereas in this study the ratio is 1:1.
• Similarly, there are numerous cross-loadings and items without sufficient loadings to be related to a factor. I understand that this is all part of an initial approach, for future validation, which I encourage the authors to pursue, but they must explain these types of issues at the methodological and results level.

Discussion

• This section is not adequate. It does not compare the results with other previously made cultural adaptations in other languages, does not mention relevant literature, nor does it compare the results obtained, and it does not present any limitations...

Author Response

Responses to Reviewer 2

 

 

 

Introduction

• It is accurate and provides relevant information, offering an appropriate context for the current situation regarding aging and quality of life. However, it would be useful to identify the advantages of the OPQOL-35 over other questionnaires designed to assess quality of life in older adults.

Regarding this comment, information has been added to lines 46-47 and 55-58.

 

Material and Methods

• Section 2 (Permission and Ethical Approval for Use of OPQOL-35) would be more correctly included as a subsection in the Materials and Methods section.

Information regarding this comment is addressed in lines 69-72.

• It is correct to follow the recommendation of the “Mapi Research Trust manual” and identify the phases of the process; however, the Materials and Methods section should explain how these phases are carried out from a methodological point of view. This information has been provided in the Results section, together with the findings obtained, which is not correct. Please restructure the information.

Information regarding the methodology is addressed in lines 82-84, 86-88, 90-109, 111-115.

Information regarding the results is addressed in lines 130-217.

 

Results

• For example, lines 82 to 88 should be included in the Materials and Methods section. Please do this for all phases of the manual.

Information regarding this comment is addressed in lines 125-127.

 

• Similarly, items in the Albanian language should also be presented in English so that readers can get an idea of where conflicts arise among translation experts.

Information regarding this comment is addressed in lines 136-144 and 158-187 (text in red color).

• Lines 110 to 114 are difficult for the reader to understand. I understand that they compared the Albanian version with the English version (translated from Albanian). This resulted in minimal differences. However, the repetitive language and structure make it difficult to understand.

Information regarding this comment is addressed in lines 146-151.

• Similarly, the items in subsection 4.3. should be expressed in English in parentheses after their Albanian wording.

Information regarding this comment is addressed in lines 136-144 and 158-187 (text in red color).

As for subsection 4.3, there are several methodological errors:

• The Bartlett sphericity test obtains adequate values, as does Cronbach's alpha. However, the KMO is not adequate, as it does not exceed the reference value of 0.8. This may be primarily due to the fact that expert recommendations suggest that there should be 10 participants for each item contained in the questionnaire, whereas in this study the ratio is 1:1.

Data on these tests was removed.

• Similarly, there are numerous cross-loadings and items without sufficient loadings to be related to a factor. I understand that this is all part of an initial approach, for future validation, which I encourage the authors to pursue, but they must explain these types of issues at the methodological and results level.

Factor analysis removed

 

Discussion

• This section is not adequate. It does not compare the results with other previously made cultural adaptations in other languages, does not mention relevant literature, nor does it compare the results obtained, and it does not present any limitations...

Information regarding this comment is addressed in lines 245-247.

limitations of the study in lines 261-264.