Development and preliminary validation of the Arabic Quality of Life During War Scale (AQOL-War)
13 affiliations
- 1Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
- 2Department of Family Health (Maternal and Child Health), High Institute of Public Health, Alexandria University, Alexandria, Egypt.
- 3Department of Neuropsychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- 4Department of Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt.
- 5Department of Applied Statistics and Econometrics, Faculty of Graduate Studies for Statistical Research, Cairo University, Giza, Egypt.
- 6Department of Geriatric Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- 7Department of Geriatric Medicine, Electricity Hospital, Cairo, Egypt.
- 8Faculty of Medicine, Alexandria University, Alexandria, Egypt.
- 9Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
- 10Department of Pharmaceutical Biotechnology, Al Mughtaribeen University, Sudan International University, Khartoum, Sudan.
- 11Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, Sudan.
- 12Ibrahim Malik Hospital, Port Sudan, Sudan.
- 13Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
Abstract
Background: War profoundly affects quality of life (QOL) by disrupting daily routines, damaging infrastructure, and creating fear and uncertainty. This study aimed to develop and preliminarily validate the Arabic Quality of Life During War Scale (AQOL-War). Methods: This cross-sectional study was conducted in Sudan during wartime from June 11 to September 10, 2024. Data were collected through an anonymous online survey and face-to-face interviews. Cronbach’s alpha was used to measure the tool’s internal consistency. We assessed face, content, concurrent, and structural validity, along with measurement invariance. Results: Among 635 participants, the mean age was 27.9 ± 9.1 years, 72.1% were females, 65.4% lived in urban areas, 67.1% lived in their own house, 71.5% were single, 70.1% had a university education, 71.7% were not currently employed, 19.2% were from Khartoum State, and 21.3% reported losing a family member during the recent war. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) of 0.889, and Bartlett’s test was significant (χ² = 4965.76, p < 0.001). Three factors (environment and security, psychological health, and physical health) with eigenvalues > 1 were extracted with a cumulative variance explained of 41.8%. Confirmatory factor analysis showed satisfactory model fit (χ2 = 831.36, p < 0.001) with good fit indices [root mean square error of approximation (RMSEA) = 0.06, root mean square residual (RMR) = 0.04, comparative fit index (CFI) = 0.916, goodness of fit index (GFI) = 0.936, Tucker-Lewis Index (TLI) = 0.905, and non-normed fit index (NNFI) = 0.905]. The overall Cronbach’s alpha for the quality-of-life tool was 0.93; values for “environment and security”, “psychological health”, and “physical health” were 0.94, 0.84, and 0.83, respectively. Conclusions: The AQOL-War demonstrated satisfactory preliminary validity, reliability, and configural and metric invariance. It may provide a contextually relevant measure for researchers and clinicians working with Arabic-speaking populations affected by war. Further cross-context replication and longitudinal evaluation are needed.
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BibTeX
@article{hussein2026development,
title = {{Development and preliminary validation of the Arabic Quality of Life During War Scale (AQOL-War)}},
author = {Mohamed Fakhry Hussein and Yasmine Yousry Mohamed and Basma Tolba and Suzan Abdel-Rahman and Mahmoud A Abdel-Fattah and Nesma Gamal Elsheikh and Nehal Elkholy and Assem Gebreal and Ayoub Ali Alshaikh and Alaa Yahia Fadle Modawy and Omelhassan Abdelgader Alawad and Randa Bushra Ibrahim Elbushra and Ramy Mohamed Ghazy},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0358784},
url = {https://doi.org/10.1371/journal.pone.0358784},
note = {CC BY},
}
RIS
TY - JOUR
TI - Development and preliminary validation of the Arabic Quality of Life During War Scale (AQOL-War)
AU - Mohamed Fakhry Hussein
AU - Yasmine Yousry Mohamed
AU - Basma Tolba
AU - Suzan Abdel-Rahman
AU - Mahmoud A Abdel-Fattah
AU - Nesma Gamal Elsheikh
AU - Nehal Elkholy
AU - Assem Gebreal
AU - Ayoub Ali Alshaikh
AU - Alaa Yahia Fadle Modawy
AU - Omelhassan Abdelgader Alawad
AU - Randa Bushra Ibrahim Elbushra
AU - Ramy Mohamed Ghazy
PY - 2026
DA - 2026/10/29
JO - PLOS One
DO - 10.1371/journal.pone.0358784
UR - https://doi.org/10.1371/journal.pone.0358784
AB - Background: War profoundly affects quality of life (QOL) by disrupting daily routines, damaging infrastructure, and creating fear and uncertainty. This study aimed to develop and preliminarily validate the Arabic Quality of Life During War Scale (AQOL-War). Methods: This cross-sectional study was conducted in Sudan during wartime from June 11 to September 10, 2024. Data were collected through an anonymous online survey and face-to-face interviews. Cronbach’s alpha was used to measure the tool’s internal consistency. We assessed face, content, concurrent, and structural validity, along with measurement invariance. Results: Among 635 participants, the mean age was 27.9 ± 9.1 years, 72.1% were females, 65.4% lived in urban areas, 67.1% lived in their own house, 71.5% were single, 70.1% had a university education, 71.7% were not currently employed, 19.2% were from Khartoum State, and 21.3% reported losing a family member during the recent war. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) of 0.889, and Bartlett’s test was significant (χ² = 4965.76, p < 0.001). Three factors (environment and security, psychological health, and physical health) with eigenvalues > 1 were extracted with a cumulative variance explained of 41.8%. Confirmatory factor analysis showed satisfactory model fit (χ2 = 831.36, p < 0.001) with good fit indices [root mean square error of approximation (RMSEA) = 0.06, root mean square residual (RMR) = 0.04, comparative fit index (CFI) = 0.916, goodness of fit index (GFI) = 0.936, Tucker-Lewis Index (TLI) = 0.905, and non-normed fit index (NNFI) = 0.905]. The overall Cronbach’s alpha for the quality-of-life tool was 0.93; values for “environment and security”, “psychological health”, and “physical health” were 0.94, 0.84, and 0.83, respectively. Conclusions: The AQOL-War demonstrated satisfactory preliminary validity, reliability, and configural and metric invariance. It may provide a contextually relevant measure for researchers and clinicians working with Arabic-speaking populations affected by war. Further cross-context replication and longitudinal evaluation are needed.
SN - 1932-6203
ER -