Cross-cultural translation and psychometric validation of the Arabic Intermittent Catheterization Adherence Scale...

Clean intermittent self-catheterization (CISC) is the reference treatment for neurogenic and non-neurogenic voiding dysfunction, yet adherence falls over time. The Intermittent Catheterization Adherence Scale (ICAS) measures this adherence, but no Arabic version has existed. We translated the ICAS into Modern Standard Arabic (MSA) and tested its psychometric properties in 84 Tunisian adults on CISC at 2 rehabilitation departments. Translation followed forward and back translation guidelines, with a 6-member expert committee and a pretest of 20 patients. We assessed content validity with the content validity index (CVI), structure with exploratory factor analysis (EFA), internal consistency with Cronbach's alpha, and 10-day test-retest reliability with the intraclass correlation coefficient (ICC). The mean total score was 3.12 ± 2.03 on the 0 to 8 scale, with no floor or ceiling effect. Content validity was strong (scale-level CVI by averaging 0.99). The correlation matrix was suitable for factor analysis (Kaiser-Meyer-Olkin 0.780; Bartlett p < 0.001). Parallel analysis supported a single factor explaining 40.1% of the variance, on which item 5 loaded weakly (0.25). Internal consistency was acceptable (alpha 0.75) and test-retest reliability excellent (single-measures ICC 0.97, 95% CI 0.95-0.98). Associations with clinical indicators were weak and non-significant. The Arabic ICAS reads best as a single-dimension screening measure for Tunisian patients and needs confirmation in larger, independent Arabic-speaking cohorts.