Many of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaires is translated into standard Arabic. However, standard Arabic is not the language used for daily life communication in Arab countries where each country has its own local dialect. The aim of this study was to explore the understandability of the current standard Arabic version of the EORTC QLQ-C15-PAL by Egyptian advanced cancer patients with different educational levels.
The study included 100 adult patients with incurable cancer and different educational levels. Literate patients were asked to read the standard Arabic QLQ-C15-PAL questionnaire and to state whether or not they understand each of its 15 questions. For illiterate patients, the questions (as they are written without explanation) were read for them.
The median age of patients was 54 years (range: 27-78) and 56% were males. The education level was illiteracy in 49% of patients, less than high school in 18%, high school or equivalent in 18% and more than high school in 15%. The average number of questions understood by the whole group was 11 (range: 6 –15). Only 7 questions (1, 2, 5, 7, 10, 11 and 15) were understood by > 80% of patients. The average number of understood questions differed significantly according to the education level of patients (p < 0.001). The average number of understood questions was almost similar among illiterate patients and those with less than high school education with no significant difference between them (9.4 and 9.6, respectively; p = 0.814). Similarly, there was no significant difference in the average number of understood questions between high school and more than high school educated patients (13.8 and 14.5, respectively; p = 0.102).
The results suggest that the current standard Arabic translation of the EORTC QLQ-C15-PAL should only be used with patients with a high school level of education and above. There is a need to translate the EORTC QLQ-C15-PAL into “Egyptian” Arabic; otherwise, a vulnerable group of patients (illiterates and those with less than high school education) will not be included in studies using the EORTC QLQ-C15-PAL.
Clinical trial identification
Legal entity responsible for the study
Alexandria Faculty of Medicine, Alexandria Clinical Oncology Department.
Has not received any funding.
All authors have declared no conflicts of interest.