Translation Using Collaborative Translation Protocols and Initial Validation of the Filipino Version of Stroke Specific Quality of Life Scale for Stroke Survivors

Angelica Marie V. Mandario, Gerald Neil SJ. Manalo, Marlo Eduardo M. Manalo, Jann Marielle M. Mangali, Erwin T. Manipol, Christine Beatrix Y. Manalo, Maria Minerva P. Calimag, Wennielyn F. Fajilan, Elenita C. Mendoza, John Dale V. Trogo, Johnny K. Lokin

Dec 2025 DOI 10.35460/2546-1621.2025-0094     Access   

Abstract

Introduction: Stroke is a significant public health burden in the Philippines, ranking among the leading causes of death and disability, yet a specific health-related quality of life (HRQOL) assessment tool tailored for Filipino stroke survivors is lacking. This study aimed to address this gap by translating the Stroke-Specific Quality of Life (SS-QOL) questionnaire into Filipino and subsequently validating this new version to provide a culturally relevant and reliable outcome measure for stroke patients in the country.

Methodology: A descriptive, cross-sectional design was utilized, involving the translation of the SS-QOL from English to Filipino through Collaborative Translation Protocols, which centered on group consensus. Three Filipino language experts rigorously evaluated the initial translation for linguistic and cultural appropriateness. To assess content and face validity, an expert committee of three neurology consultants provided ratings, which were analyzed using the item-level content validity index (i-CVI). Subsequently, a pilot testing phase was conducted with 10 stroke survivors recruited via purposeful sampling in Metro Manila to evaluate the SS-QOL-Filipino's clarity, layout, understandability and answerability, while also measuring the intraclass correlation coefficient (ICC) to assess consistency and agreement among items.

Results: The SS-QOL was successfully forward translated and refined through focused group discussions (FGD) with language experts. The translated questionnaire demonstrated high content validity, with all items achieving an i-CVI of 1.0 as rated by neurology experts. Face validity was also established, incorporating minor revisions based on expert feedback. Pilot testing yielded an average measures ICC of 0.761, indicating strong agreement, and responses on a 5-point Likert scale showed the questionnaire was easy-to-very-easy to understand and answer (mode ranging from 3-5).

Discussion: This study successfully developed a stroke-specific HRQOL tool for the Philippines, addressing a critical need for objective measures in patient-centered care. The use of Collaborative Translation Protocols ensured the questionnaire's conceptual, linguistic and cultural equivalence, incorporating nuances specific to the Filipino context in areas like eating habits, emotional expressions and technological terms. The high face and content validity, coupled with strong consistency and high understandability observed during pilot testing underscore the SS-QOL-Filipino's suitability for the target population, positioning it as a valuable instrument for both clinical practice and research.

Conclusion: The SS-QOL scale was successfully translated into Filipino using Collaborative Translation Protocols and rigorously validated. The SS-QOL-Filipino version demonstrates high content and face validity, strong consistency and excellent understandability and answerability, affirming its status as a reliable and appropriate outcome measure for assessing the QOL among stroke patients in Metro Manila.

Keywords: Stroke, collaborative translation protocols, quality of life, stroke specific quality of life scale, Filipino.

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