Table 3 Example of the key issues raised in the process of the finalization of the sleep-related impairments item banks

Tested Item stem

English version:

Arabic version:

I had difficulty waking up

كنت أجد صعوبةً في الاستيقاظ

Item responses and score

1 = Not at all

2 = A little bit

3 = Somewhat

4 = Quite a bit

5 = Very much

1 = ليس على الإطلاق

2 = مرات قليلة

3 = نوعاً ما

4 = غالبا

5 = كثيراً جداً

LC Response

The participants suggest revising the item from “كنت أجد صعوبة في الاستيقاظ” to “كنت أجد صعوبة في الاستيقاظ من النوم”

The difference is adding “from sleeping” at the end of the item this made the sentence more understandable

FACIT and MSS Response

Based on the participant suggestion the LC agrees with the change, but note that no participant had any issue with the test version translation. MSS agreed one can only “wake-up” from sleep. However, some dialects do not use the current word in spoken language. “from sleep” clarifies the meaning in the case of those with lower education levels who may not recognize the current term

Post Test Final

I had difficulty waking up

كنت أجد صعوبةً في الاستيقاظ من النوم