{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:05:58Z","timestamp":1792789558080,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"King Saud University","award":["ORF-2026-1997"],"award-info":[{"award-number":["ORF-2026-1997"]}],"id":[{"id":"https:\/\/ror.org\/02f81g417","id-type":"ROR","asserted-by":"crossref"}]},{"award":["ORF-2026-1997"],"award-info":[{"award-number":["ORF-2026-1997"]}],"id":[{"id":"https:\/\/ror.org\/02f81g417","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Chronic venous disease significantly impairs health-related quality of life (HRQoL). Although the Chronic Venous Insufficiency Questionnaire (CIVIQ-20) is widely used internationally, a validated Arabic version is lacking. The objectives of this study were to translate and culturally adapt the CIVIQ-20 into Arabic and to examine its reliability, construct, and discriminative validity in Arab patients with chronic venous disease. Methods: Following standardized guidelines, the CIVIQ-20 was translated and cross-culturally adapted. For psychometric evaluation, 139 participants with chronic venous disease were selected. They completed the Arabic version of Chronic Venous Insufficiency Questionnaire-20 (CIVIQ-20-Ar) and 36-Item Short Form Health Survey (SF-36). Psychometric evaluation included internal consistency (Cronbach\u2019s alpha) and test\u2013retest reliability using the two-way random intraclass correlation coefficient ICC (2,1). Minimal detectable change (MDC95) was assessed, along with both convergent validity (using the SF-36 as a comparator) and known-group validity (across CEAP severity stages), using seven predefined hypotheses. Results: The CIVIQ-20-Ar questionnaire had adequate internal consistency and very strong test\u2013retest reliability. As hypothesized, the CIVIQ-20-Ar subscales and global index demonstrated a moderate-to-strong correlation with the SF-36 summary and domain scores (r = \u22120.42 to \u22120.79, p &lt; 0.001), with the strongest correlation in the pain subscale (r = \u22120.79, p &lt; 0.001). Known-group validity was established by significant score discrimination across advancing Clinical\u2013Etiology\u2013Anatomy\u2013Pathophysiology (CEAP) severity stages (p &lt; 0.01). Conclusions: The CIVIQ-20-Ar Questionnaire has adequate psychometric properties. Therefore, vascular surgeons, phlebologists, and rehabilitation specialists can use the CIVIQ-20-Ar in routine clinical practice and research to evaluate health-related quality of life in the Arabic-speaking population with chronic venous disease.<\/jats:p>","DOI":"10.3390\/jcm15197558","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:10:54Z","timestamp":1790673054000},"page":"7558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-Cultural Adaptation and Psychometric Validation of the Arabic Chronic Venous Insufficiency Quality-of-Life Questionnaire (CIVIQ-20) in Saudi Arabia"],"prefix":"10.3390","volume":"15","author":[{"given":"May S.","family":"Alabdullateef","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5592-548X","authenticated-orcid":false,"given":"Rehab F. M.","family":"Gwada","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-4916","authenticated-orcid":false,"given":"Mohammed T. A.","family":"Omar","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"ref_1","first-page":"100538","article-title":"Chronic venous disease of the lower extremities: A state-of-the art review","volume":"2","author":"Attaran","year":"2023","journal-title":"J. Soc. Cardiovasc. Angiogr. Interv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e14405","DOI":"10.1111\/iwj.14405","article-title":"Chronic venous insufficiency and venous leg ulcers: Aetiology, on the pathophysiology-based treatment","volume":"21","author":"Krizanova","year":"2024","journal-title":"Int. Wound J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ortega, M.A., Fraile-Mart\u00ednez, O., Garc\u00eda-Montero, C., \u00c1lvarez-Mon, M.A., Chaowen, C., Ruiz-Grande, F., Pekarek, L., Monserrat, J., As\u00fansolo, A., and Garc\u00eda-Honduvilla, N. (2021). Understanding chronic venous disease: A critical overview of its pathophysiology and medical management. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153239"},{"key":"ref_4","first-page":"105","article-title":"Epidemiology of chronic venous disorders in geographically diverse populations: Results from the Vein Consult Program","volume":"31","author":"Rabe","year":"2012","journal-title":"Int. Angiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"225","DOI":"10.15537\/1658-3175.2823","article-title":"Prevalence of chronic venous insufficiency in the Saudi adult population","volume":"26","author":"Bawakid","year":"2005","journal-title":"Saudi Med. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101725","DOI":"10.1016\/j.jvsv.2023.101725","article-title":"A state-of-the-art review of quality-of-life assessment in venous disease","volume":"12","author":"Cleman","year":"2024","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jvsv.2014.08.005","article-title":"Health-related quality-of-life scales specific for chronic venous disorders of the lower limbs","volume":"3","author":"Launois","year":"2015","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_8","first-page":"1091","article-title":"Impact of chronic venous disease on quality of life: Results of Vein Alarm study","volume":"17","author":"Branisteanu","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e20210229","DOI":"10.1590\/1677-5449.202102292","article-title":"Reliability and validity of specific quality of life assessment questionnaires related to chronic venous insufficiency: A systematic review","volume":"21","author":"Almeida","year":"2022","journal-title":"J. Vasc. Bras."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ejvs.2021.12.024","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs","volume":"63","author":"Kakkos","year":"2022","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jvsv.2019.12.075","article-title":"The 2020 update of the CEAP classification system and reporting standards","volume":"8","author":"Lurie","year":"2020","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.jvsv.2014.09.003","article-title":"An overview of the most commonly used venous quality of life and clinical outcome measurements","volume":"3","author":"Catarinella","year":"2015","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_13","first-page":"152","article-title":"A quality of life tool kit in chronic venous disorders","volume":"21","author":"Launois","year":"2014","journal-title":"Phlebolymphology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/BF00439228","article-title":"Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ)","volume":"5","author":"Launois","year":"1996","journal-title":"Qual. Life Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1358\/mf.2002.24.7.696544","article-title":"Quality of life (Spain and France): Validation of the Chronic Venous Insufficiency Questionnaire (CIVIQ)","volume":"24","author":"Lozano","year":"2002","journal-title":"Methods Find. Exp. Clin. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.ejvs.2010.03.034","article-title":"International psychometric validation of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20)","volume":"40","author":"Launois","year":"2010","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1177\/0268355513479582","article-title":"Linguistic validation of the 20 item Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20)","volume":"29","author":"Launois","year":"2014","journal-title":"Phlebol. J. Venous Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.ejvs.2011.04.007","article-title":"Validation of the Chronic Venous Insufficiency Quality of Life Questionnaire in Dutch patients treated for varicose veins","volume":"42","author":"Biemans","year":"2011","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"292","DOI":"10.3325\/cmj.2017.58.292","article-title":"Validation of the Croatian version of CIVIQ quality of life questionnaire in patients with chronic venous disorders","volume":"58","year":"2017","journal-title":"Croat. Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1186\/s40064-016-2039-2","article-title":"Cross-cultural adaptation, reliability and validity of the Turkish version of the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20)","volume":"5","author":"Tonga","year":"2016","journal-title":"SpringerPlus"},{"key":"ref_21","first-page":"394","article-title":"Translation and validation of a quality of life questionnaire for chronic lower limb venous insufficiency into Greek","volume":"23","author":"Erevnidou","year":"2004","journal-title":"Int. Angiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s41687-023-00569-9","article-title":"German translation, cross-cultural adaption and validation of the Venous Clinical Severity and Venous Disability Scores","volume":"7","author":"Hofmann","year":"2023","journal-title":"J. Patient-Rep. Outcomes"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1007\/s11136-021-03010-0","article-title":"Patient-reported outcome measures in Arabic-speaking populations: A systematic review","volume":"31","author":"Alaqeel","year":"2022","journal-title":"Qual. Life Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","article-title":"COSMIN guideline for systematic reviews of patient-reported outcome measures","volume":"27","author":"Prinsen","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/0021-9681(87)90003-8","article-title":"Standards for validating health measures: Definition and content","volume":"40","author":"Ware","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1097\/00005650-199803000-00018","article-title":"Reliability of an Arabic version of the RAND-36 Health Survey and its equivalence to the US-English version","volume":"36","author":"Coons","year":"1998","journal-title":"Med. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/21501378.2021.1940118","article-title":"Alpha, omega, and H internal consistency reliability estimates: Reviewing these options and when to use them","volume":"14","author":"Kalkbrenner","year":"2023","journal-title":"Couns. Outcome Res. Eval."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","article-title":"Quality criteria were proposed for measurement properties of health status questionnaires","volume":"60","author":"Terwee","year":"2007","journal-title":"J. Clin. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1097\/01.phm.0000176452.17771.20","article-title":"How to assess the reliability of measurements in rehabilitation","volume":"84","author":"Lexell","year":"2005","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2165\/00007256-199826040-00002","article-title":"Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine","volume":"26","author":"Atkinson","year":"1998","journal-title":"Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2310\/6640.2004.15377","article-title":"Getting more from the literature: Estimating the standard error of measurement from reliability studies","volume":"56","author":"Stratford","year":"2004","journal-title":"Physiother. Can."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1002\/nur.20199","article-title":"Is the CVI an acceptable indicator of content validity? Appraisal and recommendations","volume":"30","author":"Polit","year":"2007","journal-title":"Res. Nurs. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"49","DOI":"10.21315\/eimj2019.11.2.6","article-title":"ABC of content validation and Content Validity Index calculation","volume":"11","author":"Yusoff","year":"2019","journal-title":"Educ. Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/14653125221076142","article-title":"On correlation coefficients and their interpretation","volume":"49","author":"Papageorgiou","year":"2022","journal-title":"J. Orthod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1080\/09638288.2023.2207220","article-title":"Cross-cultural adaptation and validation of the Arabic version of McGill Quality of Life: Revised questionnaire in the patients with cancer","volume":"46","author":"Omar","year":"2024","journal-title":"Disabil. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"243","DOI":"10.23736\/S0394-9508.23.05666-8","article-title":"Adaptation of the CIVIQ-20 questionnaire as a measurement instrument on quality-of-life in chronic venous insufficiency patients in Jakarta, Indonesia","volume":"37","author":"Darwis","year":"2024","journal-title":"Chirurgia"},{"key":"ref_40","unstructured":"Zalta, E.N. (2018). Social Norms. The Stanford Encyclopedia of Philosophy, Metaphysics Research Lab, Stanford University."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1177\/13567667231152937","article-title":"Socio-cultural drivers of Saudi tourists\u2019 outbound destination decisions","volume":"30","author":"Madkhali","year":"2024","journal-title":"J. Vacat. Mark."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/S0895-4356(03)00084-2","article-title":"A comparison of two-time intervals for test-retest reliability of health status instruments","volume":"56","author":"Marx","year":"2003","journal-title":"J. Clin. Epidemiol."},{"key":"ref_43","unstructured":"Streiner, D.L., and Norman, G.R. (1995). Health Measurement Scales: A Practical Guide to Their Development and Use, Oxford University Press. [2nd ed.]."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.jclinepi.2010.02.006","article-title":"The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes","volume":"63","author":"Mokkink","year":"2010","journal-title":"J. Clin. Epidemiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1067\/mva.2003.168","article-title":"Quality of life in patients with chronic venous disease: San Diego population study","volume":"37","author":"Kaplan","year":"2003","journal-title":"J. Vasc. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7558\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:26:28Z","timestamp":1790828788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":45,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197558"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197558","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]}}}