A hospital stay can leave a child frightened, uncertain, and separated from familiar routines. Clinicians tend to focus first on treatment, while needs such as feeling safe, understanding what is happening, staying connected to family, and having age-appropriate activities receive less systematic attention. 

In the absence of standardized and reliable tools to measure the needs of hospitalized Arabic-speaking children, a study involving Dr. Bahia Abdallah, associate professor and assistant dean at the Alice Ramez Chagoury School of Nursing and corresponding author, titled “Cross-cultural adaptation and initial validation of the Arabic needs of hospitalized children questionnaire,” and published in International Journal of Nursing Studies Advances, set out to translate and adapt the 16-item “Needs of Hospitalized Children Questionnaire” into Arabic. The translated version was administered through interviews with school-age children in medical and surgical units at the Children’s Hospitals in Cairo, Egypt, for validation.

The team followed international guidance through forward translation, expert reconciliation, back-translation, and cognitive review. Twenty children took part in preliminary testing, after which the final version was administered through interviews with  180 Arabic-speaking children aged seven to 12 who had spent at least 24 hours in medical or surgical wards.

One of the main challenges was preserving the meaning of the questionnaire rather than simply reproducing its wording, said Dr. Abdallah. The researchers had to ensure “conceptual rather than literal equivalence during translation” while maintaining the validity of the original instrument in an Arabic cultural context.

Recruiting children who were clinically able to participate also posed difficulties. The team addressed these challenges through the structured translation and cultural-adaptation process before testing the Arabic version’s psychometric properties in the 180 participants.

By adapting an established questionnaire instead of developing a new instrument from the ground up, explained Dr. Abdallah, the researchers could build on an existing theoretical foundation and previous psychometric evidence, while extending the questionnaire to Arabic-speaking children and making future cross-cultural comparisons more feasible. At the same time, she stressed that “translation does not replace validation.” A questionnaire that has already proved reliable in one language must still demonstrate that it is valid and reliable in the new population.

The Arabic version achieved a high overall internal-consistency score, indicating that the questions worked together reliably while avoiding redundancy. The researchers then explored how the questions grouped. Four categories emerged: caring, information, activities, and relationships.

The responses also reinforced the importance of security and human connection during hospitalization. Children placed particular value on knowing they were safe, having their family involved, and feeling that staff cared about them. Questions about machines, test results, and continuity with the same nurse or physician were less often rated as very important.

Given that this was an initial validation in one setting and relied on interviews conducted with mothers present, further testing in other countries and hospital environments would strengthen evidence for broader use.

Nevertheless, the adapted questionnaire gives care teams a practical starting point for conversations that children may otherwise find difficult to initiate. Used alongside clinical judgment, it could help hospitals plan care and resources around the child’s own experience.

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