Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations

Abstract Background The HEAR-COMMAND Tool is a self-reported questionnaire designed to assess hearing, communication, and conversation functioning (aka negative: disability), based on the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss. This study...

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Main Authors: Razan Alfakir, Mahmoud Hammady, Tahereh Afghah, Mohamed Abd Al-Ghaffar, Mostafa Youssif
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:The Egyptian Journal of Otolaryngology
Subjects:
Online Access:https://doi.org/10.1186/s43163-025-00832-4
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author Razan Alfakir
Mahmoud Hammady
Tahereh Afghah
Mohamed Abd Al-Ghaffar
Mostafa Youssif
author_facet Razan Alfakir
Mahmoud Hammady
Tahereh Afghah
Mohamed Abd Al-Ghaffar
Mostafa Youssif
author_sort Razan Alfakir
collection DOAJ
description Abstract Background The HEAR-COMMAND Tool is a self-reported questionnaire designed to assess hearing, communication, and conversation functioning (aka negative: disability), based on the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss. This study aims to introduce the HEAR-COMMAND Tool – Arabic to healthcare professionals in Arabic-speaking regions. It will provide them with a reliable and culturally relevant instrument that aligns with the ICF framework. Grounded in ICF, this tool represents a significant advancement in hearing-related assessment within the Arab world. Methods The study was conducted in the Department of Otolaryngology-Head and Neck Surgery, Audio-vestibular Medicine Division at Sohag University Hospital, Sohag, Egypt. The translation process followed a rigorous, multi-step approach to ensure linguistic accuracy and cultural relevance. This process included forward translation, expert panel review, and back translation. Content validation of the initial (beta) version was performed to confirm the tool’s relevance and comprehensibility by collecting responses from 30 participants. After implementing the suggested revisions, the revised version was provided to another cohort of 52 participants, including individuals with mild to moderately severe hearing loss and those with normal hearing, to evaluate the tool’s reliability and validity. Statistical analyses were conducted to assess internal consistency and content validity, ensuring the tool’s robustness for use in Arabic-speaking populations. Results The content validity analysis of the HEAR-COMMAND Tool – Arabic demonstrated a strong prevalence of impairment related to auditory functions, with auditory perception (80%-100%), sound detection (80%-100%), and speech discrimination (80%-100%) being highly represented. The tool also effectively captured several moderate prevalence challenges (50%-79%), including attention, memory, emotional regulation, social participation, and communication difficulties. It emphasized the impact of social determinants and environmental factors, such as sound quality and infrastructure compatibility, in shaping communication outcomes. The reliability assessment showed high internal consistency (Cronbach’s alpha = 0.97). Conclusion The validation and reliability assessment revealed that the tool is a robust measure for self-reported hearing impairment and its associated daily functioning difficulties in the most populous country in the Arab Region. Additional validation of the tool through a multicenter study across other Arabic-speaking countries is strongly recommended.
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spelling doaj-art-e19c0dc865a74f22924f17fa361bfb082025-08-20T03:03:19ZengSpringerOpenThe Egyptian Journal of Otolaryngology2090-85392025-07-0141111210.1186/s43163-025-00832-4Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populationsRazan Alfakir0Mahmoud Hammady1Tahereh Afghah2Mohamed Abd Al-Ghaffar3Mostafa Youssif4ABILITY Research Lab, Department of Speech-Language and Hearing Sciences, Auburn UniversityDepartment of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division Hospital, Sohag UniversityResearch Department, Hörzentrum Oldenburg gGmbH and Cluster of Excellence Hearing4allDepartment of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division Hospital, Sohag UniversityDepartment of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division Hospital, Sohag UniversityAbstract Background The HEAR-COMMAND Tool is a self-reported questionnaire designed to assess hearing, communication, and conversation functioning (aka negative: disability), based on the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss. This study aims to introduce the HEAR-COMMAND Tool – Arabic to healthcare professionals in Arabic-speaking regions. It will provide them with a reliable and culturally relevant instrument that aligns with the ICF framework. Grounded in ICF, this tool represents a significant advancement in hearing-related assessment within the Arab world. Methods The study was conducted in the Department of Otolaryngology-Head and Neck Surgery, Audio-vestibular Medicine Division at Sohag University Hospital, Sohag, Egypt. The translation process followed a rigorous, multi-step approach to ensure linguistic accuracy and cultural relevance. This process included forward translation, expert panel review, and back translation. Content validation of the initial (beta) version was performed to confirm the tool’s relevance and comprehensibility by collecting responses from 30 participants. After implementing the suggested revisions, the revised version was provided to another cohort of 52 participants, including individuals with mild to moderately severe hearing loss and those with normal hearing, to evaluate the tool’s reliability and validity. Statistical analyses were conducted to assess internal consistency and content validity, ensuring the tool’s robustness for use in Arabic-speaking populations. Results The content validity analysis of the HEAR-COMMAND Tool – Arabic demonstrated a strong prevalence of impairment related to auditory functions, with auditory perception (80%-100%), sound detection (80%-100%), and speech discrimination (80%-100%) being highly represented. The tool also effectively captured several moderate prevalence challenges (50%-79%), including attention, memory, emotional regulation, social participation, and communication difficulties. It emphasized the impact of social determinants and environmental factors, such as sound quality and infrastructure compatibility, in shaping communication outcomes. The reliability assessment showed high internal consistency (Cronbach’s alpha = 0.97). Conclusion The validation and reliability assessment revealed that the tool is a robust measure for self-reported hearing impairment and its associated daily functioning difficulties in the most populous country in the Arab Region. Additional validation of the tool through a multicenter study across other Arabic-speaking countries is strongly recommended.https://doi.org/10.1186/s43163-025-00832-4Audiological RehabilitationEveryday FunctioningHearing LossInternational Classification of Functioning Disability and HealthPatient-Reported Outcome MeasuresHEAR-COMMAND Tool
spellingShingle Razan Alfakir
Mahmoud Hammady
Tahereh Afghah
Mohamed Abd Al-Ghaffar
Mostafa Youssif
Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
The Egyptian Journal of Otolaryngology
Audiological Rehabilitation
Everyday Functioning
Hearing Loss
International Classification of Functioning Disability and Health
Patient-Reported Outcome Measures
HEAR-COMMAND Tool
title Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
title_full Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
title_fullStr Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
title_full_unstemmed Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
title_short Translation, cultural adaptation, and validation of the HEAR-COMMAND Tool – Arabic: a self-rated ICF-based questionnaire for assessing hearing, communication, and conversation disability in Arabic-speaking populations
title_sort translation cultural adaptation and validation of the hear command tool arabic a self rated icf based questionnaire for assessing hearing communication and conversation disability in arabic speaking populations
topic Audiological Rehabilitation
Everyday Functioning
Hearing Loss
International Classification of Functioning Disability and Health
Patient-Reported Outcome Measures
HEAR-COMMAND Tool
url https://doi.org/10.1186/s43163-025-00832-4
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