OBJECTIVES: EQ-5D is the most widely used health-related quality of life measurement worldwide. However, EQ-5D has been found to be deficient in capturing important health aspects in some chronic conditions. This research aims to translate and culturally adapt four bolt-ons (skin irritation, self-confidence, social relationships, and sleep) in Egypt. This is an imperative step for the quantitative investigation of the psychometric properties of the addition of these four Bolt-ons in Arabic speaking patients with chronic skin conditions.

METHODS: The approved English version of the EQ bolt-ons by EuroQol Research and Development were translated into Arabic following the EuroQol’s translation protocol. Two forward translations, then two backward translations were undertaken. A consensus version was achieved after each translation process. A sample of eight participants (healthy and patients) was used for cognitive debriefing of the translated version. The final version was achieved after the proofreading of the third consensus version by a native Arabic speaking linguist.

RESULTS: Both forward translators were largely consistent. Minor changes were made to the original version due to differences related to sentence structure and grammatical differences between English and Arabic languages. The most challenging words were descriptors of severity levels “severe” and “extreme” as their literal translation to Arabic would be confusing, hence an equivalent Arabic term for “extreme” was used instead. Cognitive debriefing showed that the wording of the four bolt-ons were understood as intended. However, most respondents (62.5%) encountered difficulties with describing differences between consecutive levels in self-confidence and social relationships dimensions. Also, 4 (50%) respondents found a relation between self-confidence and social relationships where problems in the former will negatively affect the latter.

CONCLUSIONS: Arabic translation and cultural adaptation of EQ Bolt-ons has resulted in an acceptable and comprehensible version that can be used in qualitative and quantitative studies for further evaluation in the target patient group.