| Dear Editor,
The present letter is to concern the article written by Pourmomeny, et al.[1] First off, we acknowledge the efforts made by the editors of Iranian Journal of Nursing and Midwifery Research to help publish such an indicative article. However, there seem to be some points neglected by the authors.
Psychometrics plays a pivotal role in measuring health outcomes. Hence, depending on different cultures, resorting to scales requires their appropriate compatibility. Regarding this point, the study should have applied cross-cultural adaptation rather than cross-sectional design. A cross-cultural adaptation questionnaire comprises translation, adaptation, calculation of validity, reliability, and responsiveness.[2] However, translation process, validity assessment, and factor analysis seem to need clear explanation.
The translation process is conducted as follows:first, a professional bilingual translator translates English version of FLUTS-LF into Persian. Subsequently, another bilingual translator translates the translated version back into English. Second, the latter translation is juxtaposed with the original English version by the expert panel mentioned in the article. Then, the cultural and linguistic equivalence of all items are evaluated. Third, a pre-survey is performed among several women and based on their feedback modifications are conducted. Finally, a consensus on cultural equivalence is concluded.[3]
Content validity is a logical and orderly approach that must be carried out separately from the translation phase. This is calculated through modified KAPPA by means of qualitative and quantitative approaches. It is done in a way that the Persian version of the questionnaire is assessed at least by 10 specialists with adequate knowledge and experience in the field of urology and gastrointestinal tract. And, the specialists present their ideas for improving the quality of the scale as well as judging the existing items in terms of clarity and relevance.[4]
The results obtained from the confirmatory factor analysis show that the model fits. However, the results of this analysis are not illustrated through a figure to guide the researchers. Furthermore, factor loading, Average Variance Extracted (AVE), and Composite Reliability (CR) have not been calculated to verify convergent validity. Similarly, the AVE values to the squares of the correlation coefficients between factors have not been compared to verify the discriminant validity of the FLUTS-LF. In order to improve fitness of the model, we suggest the authors to examine the correction indices for the regression weights so as to determine which covariance is among indicators or factors |