Translation and Psychometric Characteristics of the Post-Liver Transplant Quality of Life Instrument to Persian for Liver Transplantation Recipients Publisher



Javaherian M ; Abazari N ; Nejatisafa AA ; Nasiritoosi M ; Jafarian A ; Soleimani M ; Moghadam BA
Source: Middle East Journal of Rehabilitation and Health Studies Published:2026

Abstract

Background: The Post-Liver Transplant Quality of Life (PLTQ) instrument is a specific, disease-based questionnaire to evaluate health-related quality of life (HRQOL) among liver transplantation (LTx) recipients. Objectives: This study focused on the translation, cross-cultural adaptation, and validation of the psychometric properties of the PLTQ questionnaire to provide the Persian version of the Post-Liver Transplant Quality of Life (PV-PLTQ) instrument. Methods: This investigation is a translation and cross-cultural adaptation study followed by evaluation of validity and reliability of PV-PLTQ. Between February and June 2021, a total of 175 LTx recipients completed the PV-PLTQ and Short-Form 36 (SF-36) questionnaires at the Liver Transplantation Research Center of Tehran University of Medical Sciences. Sixty-seven randomly selected patients were asked to complete the PV-PLTQ two to three months later. Face validity, content validity, acceptability, ceiling and floor effects, internal consistency, test–retest reliability, responsiveness to change, convergent validity, and minimal detectable change (MDC) were evaluated. Internal consistency was assessed using Cronbach’s alpha (≥ 0.7); test–retest reliability using ICC; and responsiveness using effect size (ES), mean difference (MD), and standardized mean difference (SMD). Convergent validity was tested using Spearman’s correlation due to nonlinear relationships. Results: The results of face validity, content validity, and missing data proportion indicated that the PV-PLTQ questionnaire is acceptable and easy to understand. Cronbach’s alpha coefficient for the PV-PLTQ questionnaire was 0.97. The results of test-retest reliability showed a moderate to good intraclass correlation coefficient from 0.6 to 0.86 (P < 0.05). PV-PLTQ also demonstrated strong responsiveness to HRQOL changes, with a very large effect size (Cohen’s d = 3.82; 95% CI: 2.51 - 5.11), indicating substantial improvement over time among participants who reported improvement by SF-36. The correlations between PV-PLTQ domains and physical (r = 0.65) and mental (r = 0.63) components of SF-36, calculated using Spearman’s correlation, presented good convergent validity (P < 0.05). No floor effect was observed. The amount of 0.9 was calculated as the MDC of the total PV-PLTQ score. Conclusions: The PV-PLTQ questionnaire is a valid, reliable, and responsive to change instrument to evaluate HRQOL in LTx recipients. © 2026 Brieflands. All rights reserved.