Abstract
BACKGROUND: Health-related quality of life instruments are typically developed and validated for use in developed countries by patients who can read and write. Little is known about the feasibility of using adaptations of validated instruments in situations where literacy rates are low. OBJECTIVE: We aimed to translate, culturally adapt, and test an oral version of Skindex-16 in Runyankore, the predominant language in Mbarara, Uganda, for use in dermatologic research. METHODS: Skindex-16 was forward- and back-translated to Runyankore. The Runyankore version was administered orally to 47 dermatology patients and 47 random hospital visitors. Additional questions regarding duration, dyspigmentation, concealment status of the skin problem, and overall quality of life effect were also asked. RESULTS: Oral delivery was feasible; ≤ 10 minutes per subject. High Cronbach α values (0.86, 0.88, and 0.85 for symptoms, emotions, and functioning subscales, respectively) demonstrated internal consistency reliability. As hypothesized, subjects with reported skin problems, dyspigmentation, and difficulty in concealment had higher mean Skindex scores. A total of 72.4% of responses to the open-ended question were addressed in Skindex-16, indicating content validity. CONCLUSION: The orally delivered Runyankore version of Skindex-16 is reliable, with construct and content validity, and feasible for use in dermatology research in Mbarara, Uganda. Orally administered quality of life instruments have potential for use in low literacy groups worldwide.