Development and preliminary validation of the Arabic Quality of Life During War Scale (AQOL-War)
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Mohamed Fakhry Hussein1, Yasmine Yousry Mohamed2, Basma Tolba3
1Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
Background:
War profoundly affects quality of life (QOL) by disrupting daily routines, damaging infrastructure, and creating fear and uncertainty. This study aimed to develop and preliminarily validate the Arabic Quality of Life During War Scale (AQOL-War).
Methods:
This cross-sectional study was conducted in Sudan during wartime from June 11 to September 10, 2024. Data were collected through an anonymous online survey and face-to-face interviews. Cronbach's alpha was used to measure the tool's internal consistency. We assessed face, content, concurrent, and structural validity, along with measurement invariance.
Results:
Among 635 participants, the mean age was 27.9 ± 9.1 years, 72.1% were females, 65.4% lived in urban areas, 67.1% lived in their own house, 71.5% were single, 70.1% had a university education, 71.7% were not currently employed, 19.2% were from Khartoum State, and 21.3% reported losing a family member during the recent war. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) of 0.889, and Bartlett's test was significant (χ² = 4965.76, p < 0.001). Three factors (environment and security, psychological health, and physical health) with eigenvalues > 1 were extracted with a cumulative variance explained of 41.8%. Confirmatory factor analysis showed satisfactory model fit (χ2 = 831.36, p < 0.001) with good fit indices [root mean square error of approximation (RMSEA) = 0.06, root mean square residual (RMR) = 0.04, comparative fit index (CFI) = 0.916, goodness of fit index (GFI) = 0.936, Tucker-Lewis Index (TLI) = 0.905, and non-normed fit index (NNFI) = 0.905]. The overall Cronbach's alpha for the quality-of-life tool was 0.93; values for "environment and security", "psychological health", and "physical health" were 0.94, 0.84, and 0.83, respectively.
Conclusions:
The AQOL-War demonstrated satisfactory preliminary validity, reliability, and configural and metric invariance. It may provide a contextually relevant measure for researchers and clinicians working with Arabic-speaking populations affected by war. Further cross-context replication and longitudinal evaluation are needed.