Development of Bengali version of a questionnaire assessing impact of hyperuricemia on quality of life

Context: Hyperuricemia and gout has been found to be associated with reduced health-related quality of life (HRQoL); however, there is no available Bengali questionnaire assessing the same. Aims: We aimed to develop the Bengali version of a questionnaire and examine its cross-cultural adaptability considering linguistic equivalence. Settings and Design: A multicentric, mixed methods, cross-sectional study was conducted through consecutive sampling at the outpatients of three homeopathic hospitals in West Bengal. Subjects and Methods: The Bengali version of the questionnaire was produced by standardized forward-backward translations. Psychometric analysis was run to examine its factor structure, validity, and reliability. Statistical Analysis Used: Reliability was examined using internal consistency (n = 210). Construct validity was examined by exploratory factor analysis (n = 105) using principal component analysis (PCA; varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 105) was performed to verify the model fit. Results: The internal consistency (Cronbach's α =0.880; 95% confidence interval 0.855-0.902), test-retest reliability and concurrent validity of the questionnaire- all were within acceptable limits. The (Kaiser-Meyer-Olkin = 0.832) and Bartlett's test of sphericity (Chi-square: 1644.344 at df = 210, P < 0.001) both suggested adequacy of the sample. In factor analysis using varimax, all the items loaded above the prespecified value of 0.4 and identified 6 components, explaining 77% of the variation. One item revealed a negative variance; hence the whole component of 2 items was removed from further evaluation. The goodness-of-fit of the 5-components model in CFA was also acceptable (Comparative fit index = 0.702, tucker Lewis index = 0.641, Root Mean Square Error of Approximation = 0.156, and Standardized Root Mean Square Residual = 0.123). Conclusions: The developed Bengali version of the questionnaire consisting of 19 items and framed within 5 components, appeared to be a valid and reliable instrument measuring HRQoL in patients suffering from hyperuricemia.