# Validation of the Arabic Version of the Long-Term Conditions Questionnaire (LTCQ): A Study of Factor and Rasch Analyses

## TL;DR

This study validated an Arabic version of the Long-Term Conditions Questionnaire to assess chronic disease experiences in Jordan.

## Contribution

The study provides a culturally adapted and psychometrically validated Arabic LTCQ for chronic disease populations.

## Key findings

- EFA and CFA supported a two-factor structure: Empowerment and Functional Wellbeing, and Health-Related Psychosocial Distress.
- Rasch analysis confirmed ordered thresholds, good targeting, and no gender-based DIF after removing one item.
- The refined 19-item Arabic LTCQ showed strong reliability and validity for use in clinical and research settings.

## Abstract

Background: Patient-reported outcome measures (PROMs) are essential for capturing the lived experiences of individuals managing chronic diseases. However, few PROMs have been culturally adapted and validated for Arabic-speaking populations. Aim: This study aimed to translate, culturally adapt, and validate the Long-Term Conditions Questionnaire (LTCQ) for use among Arabic-speaking adults living with chronic diseases in Jordan. Methods: Following forward–backward translation and an expert review, a cross-sectional survey of 1057 adults with chronic illnesses was conducted. The psychometric evaluation involved exploratory and confirmatory factor analyses (EFA and CFA) and Rasch modelling. While the original LTCQ assumed a unidimensional structure, EFA and CFA supported a two-factor solution: Empowerment and Functional Wellbeing, and Health-Related Psychosocial Distress. Results: The Rasch analysis confirmed that the item response thresholds were ordered, with good item targeting, and no differential item functioning (DIF) by gender. The removal of one poorly performing item resulted in a refined 19-item scale with strong reliability and validity. Conclusions: The Arabic LTCQ demonstrated robust psychometric properties and cultural relevance, supporting its use in clinical care, research, and policy initiatives. Future work should examine longitudinal responsiveness and further validate the tool across diverse Arabic-speaking populations.