Validation of the Arabic Version of the Long-Term Conditions Questionnaire (LTCQ):A Study of Factor and Rasch Analyses

Abstract

Abstract: Background: Patient-reported outcome measures (PROMs) are essential for capturing the lived experiences of individuals managing chronic diseases. However, few PROMs have been culturally adapted and validated for Arabic-speaking populations. Aim This study aimed to translate, culturally adapt, and validate the Long-Term Conditions Questionnaire (LTCQ) for use among Arabic-speaking adults living with chronic diseases in Jordan. Methods Following forward-backward translation and ex-pert review, a cross-sectional survey of 1,057 adults with chronic illnesses was con-ducted. Psychometric evaluation involved exploratory and confirmatory factor analyses (EFA, CFA) and Rasch modeling. While the original LTCQ assumed a unidimensional structure, EFA and CFA supported a two-factor solution: Empowerment and Functional Wellbeing, and Health-Related Psychosocial Distress. Results Rasch analysis confirmed ordered thresholds, good item targeting, and no differential item functioning (DIF) by gender. Removal of one poorly performing item resulted in a refined 19-item scale with strong reliability and validity. Conclusion The Arabic LTCQ demonstrated robust psychometric properties and cultural relevance, supporting its use in clinical care, research, and policy initiatives. Future work should examine longitudinal responsiveness and further validate the tool across diverse Arabic-speaking populations