Objective
The Quality of Life for Eating Disorders questionnaire was translated into Hindi (QOL ED-H) using the forward-backward translation procedure for use with Indian females.
Method
A total of ninety-five females were recruited from two secondary schools and one tertiary college from Delhi, India. They were aged between 14 and 37 years, ranging from low to high socioeconomic status communities. A psychologist and teacher produced a preliminary Hindi version, which was back-translated by the psychologist and a journalist and any disparity was checked. The Hindi and English versions were administered one week apart to the same participants, the order being randomised.
Results
Repeated measures analysis revealed no significant differences in QOL ED scores (global and subscores) between the Hindi and English versions, when controlled for age.
Conclusion
The QOL ED-H can be used to assess eating and exercise disordered thinking, feeling, behaviours, psychological feelings and daily living in Indian females of all SES groups.
There is an increasing number of diagnosed eating disorder cases and more prevalent eating disorder symptomology among Asian female adolescents than in previous times (Lee, 1996). The Indian culture has held a stereotype that being ‘fat’ or ‘full-bodied’ signifies wealth, health and happiness. This may have been true in past generations and probably remains in smaller communities, however, urban communities in India have started to aspire to new body ideals and the concept of ‘slim is beautiful’ (Gandhi, Appaya, & Machado, 1991).
The inventories used to assess eating attitudes and behaviours have been under scrutiny when conducting research within Asian populations. Immigrants and people from the Asian continent, whose first language is not English, may have difficulty understanding eating disorder concepts. This was more evident with people from rural rather than urban communities as they scored higher on the EAT, implying more eating disorder attitudes, however this result is not supported by any past research, nor is there a rational explanation for this difference (Sjostedt, Schumaker, & Nathawat, 1998). This finding could be due to the inaccurate interpretation of the questions and lower levels of English proficiency rather than actual differences in eating attitudes, hence questioning whether the EAT is suitable for use in lower SES groups. Additionally, the scoring of tests is usually based on western norms, which may skew the interpretation of data (King & Bhugra, 1989). Nevertheless, EAT remains the most widely used inventory in most Asian studies.
Inventories may not reflect eating disorder symptomology that are typically present among people in Asian countries (Makino, Tsuboi, & Dennerstein, 2004). Research suggests different diagnostic criteria should be used for Indian girls, rather than the western population, as “fear of fatness” is not evident in Indian girls (Sjostedt et al., 1998 and Tareen et al., 2005).
Quality of life measures have become more popular with eating disorder research as we see the importance of evaluating well being and functioning in specific domains of life that may be affected by disordered eating or eating disorders (Engel, Adair, Las Hayas, & Abraham, 2009). Such studies have found that quality of life is poor with the presentation of eating disorder symptomology and changes in quality of life may be used to determine treatment effectiveness. Inventories such as EAT are useful to determine disordered eating attitudes and behaviours however quality of life measures determine the person’s own perception of their well being and daily functioning. There has not been a disease specific assessment available for the quality of life related to eating and exercise in the Hindi language, except for QOL ED-H. This questionnaire has been shown to correlate well, and over time, with other recognised eating disorder measures, such as, EAT and EDE (Abraham, Brown, Boyd, Luscombe, & Russell, 2006).
The aim of this study is to translate the Quality of Life: Eating Disorders in Hindi (QOL ED-H) for use within the Hindi speaking population and to ascertain whether the questionnaire is suitable for specific socioeconomic groups.
