Peer-reviewed article

Cross-cultural adaptation and initial validation of the Arabic needs of hospitalized children questionnaire.

Amel Abouelfettoh, Hoda Ahmed Mahmoud, Hoda Wahid Amer, Jehad O Halabi, Omayah Nassar et al. · 18 Jul 2026

Abstract

BACKGROUND: Hospitalization is a significant psychosocial event involving distress, anxiety, and loss of autonomy. It is essential to have standardized and reliable tools to measure a child's self-reported needs covering psychosocial, emotional, and physical domains. This ensures effective evidence-based practice and proper resource allocation. A major challenge in global health research is the scarcity of instruments that are both psychometrically robust and culturally suitable. METHODS: The study aims to translate and culturally adapt the Needs of Hospitalized Children Questionnaire into Arabic, following international consensus guidelines, and to validate the Arabic version. The original 16-item Needs of Hospitalized Children Questionnaire was developed to assess school-age children's self-reported perceptions of the importance and fulfillment of their needs during hospitalization, demonstrating strong psychometric properties. Arabic-speaking hospitalized school-age children in medical and surgical units at the Children's Hospital in Cairo, Egypt, were approached to participate. The translated Needs of Hospitalized Children Questionnaire was administered through interviews conducted by the research assistant in the presence of mothers. Exploratory factor analysis was performed on the 16-item Arabic version of the Needs of Hospitalized Children Questionnaire, using the Kaiser-Meyer-Olkin measure to assess sampling adequacy. Principal Axis Factoring was also conducted. RESULTS: The translation process yielded a 16-item questionnaire with no items removed or changed, achieving good internal consistency (Cronbach's α = 0.83). Exploratory factor analysis confirmed the construct validity of the questionnaire, with data from 180 participants suitable for factor analysis (Kaiser-Meyer-Olkin = 0.81, significant Bartlett's test). The study revealed four distinct factors: Caring, Information, Activities, and Relationships, collectively explaining 43.10% of the variance. Each factor included items with strong loadings (≥ 0.40). The Caring factor explained the largest variance (16%), followed by Information needs (10.60%), Activities (8.70%), and Relationships (7.80%), with all factors demonstrating satisfactory internal consistency (0.82). CONCLUSION: This study provides evidence that the Arabic version of the Needs of Hospitalized Children questionnaire is a valid and reliable tool. The successful validation of the questionnaire is crucial for informing regional healthcare policies, establishing standardized assessment protocols, and ultimately enhancing child self-reported outcomes research and clinical practice among Arabic-speaking hospitalized children.