Cultural translation and Tunisian validation of the Drug Attitude Inventory (DAI-30) in outpatients with schizophrenia.

BACKGROUND: Non-adherence to treatment in patients with schizophrenia is associated with increased hospitalization, higher health care costs, and poorer long-term outcomes in terms of relapse rates. It is established that a negative drug attitude was a risk factor for non-adherence in long-term schizophrenia. The scale "Drug Attitude Inventory" is one of the scales designed to assess this concept. It has been translated and validated in different languages. However, its psychometric properties have not yet been studied in our sociocultural context. OBJECTIVES: The aims of this study were to translate into Tunisian Arabic dialect the scale "Drug Attitude Inventory" with 30 dichotomous items (DAI-30) and validate it in Tunisian sociocultural context in patients with schizophrenia. MATERIALS AND METHODS: This study was performed in 234 outpatients with schizophrenia, recruited through a random drawing. These patients are in remission and meet remission criteria proposed by "The Remission in schizophrenia Working Group". We recruited 30 patients for pretest and 204 patients for linguistic validation. Forward and backward translation of the DAI-30 was performed according to the protocol of the "MAPI Research Institute". This final version was submitted to 24 experts and followed by a pretest. Construct validity has been established by performing a principal component analysis factor on a sample of 204 patients. Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of Intra-Class Correlation coefficient (ICC). For the test-retest reliability evaluation, the "r" Pearson's coefficient was used between the DAI scores obtained in the initial evaluation and those obtained at 15 days. RESULTS: Regarding construct validity, factor analysis revealed seven factors that were responsible for 59.9% of the variance. The study of internal consistency between the 30 items was rated good (α=0.88). The test-retest reliability was satisfactory (r=0.99, p<10(-3)), as well as inter-rater reliability (ICC=0.99). CONCLUSION: In the Tunisian cultural context, the DAI-30 presented seven factors with good consistency and an inter-rater reliability.

Reliability and validity of the Arizona sexual experiences scale-Arabic version in Tunisian patients with schizophrenia.

BACKGROUND: Sexual dysfunction is frequent in patients with schizophrenia compared to the general population. Screening for this dysfunction seems essential, and a scale such as the Arizona Sexual Experience (ASEX) Scale may help practitioners. The aim of this study was to assess the validity of the Arabic version of the ASEX scale. METHOD: Arabic translation of the ASEX scale was obtained by the "forward/backward translation" method. Adaptations were made after a pre-test including ten outpatients with schizophrenia. For validation, one hundred outpatients with schizophrenia were recruited in the psychiatric department in Sousse (Tunisia) during a period of three months. Internal consistency was assessed by Cronbach alpha coefficient and test-retest was conducted by use of Pearson correlation. For factor analysis, principal components analysis and Varimax rotation were adopted. RESULTS: The study of internal consistency between the 5 Items was found to be good (α=0.82). The test-retest reliability was satisfactory (r=0.92, p<10(-3)). Regarding construct validity, factor analysis revealed one factor that was responsible for 83.7% of the variance. CONCLUSION: This study assessed the reliability and validity of the Arabic version of the ASEX scale. These findings demonstrate the highly acceptable psychometric properties of ASEX in patients with schizophrenia.