Original Article Published on 31 Jul, 2026

COVID-19 Quality of Life (CO-19_QoL) Questionnaire for Investigation of Health-Related Quality of Life of COVID-19 Patients in Selangor: A Translation and Validation Study

Validation of Malay CO-19_QoL Questionnaire
Vol. 21 No. 2 : 2026 (1020-1033)

Alia Daniella Abdul Halim Alia Daniella Abdul Halim
Maznah Dahlui Maznah Dahlui
Awang Bulgiba Awang Bulgiba
Amirah Azzeri Amirah Azzeri
Mahmoud Danaee Mahmoud Danaee

Abstract
The impact of Coronavirus Disease 2019 (COVID-19) on quality of life (QoL) appears to be substantially underestimated. In Malaysia, Selangor consistently ranked among the states with the highest reported COVID-19 cases. Generic QoL instruments typically assessed broad domains such as mental well-being, physical function, social function and pain, which can all be impacted by any disease. Hence, diseasespecific tools are more sensitive in detecting clinical changes or differentiating patients according to disease severity. This study aims to assess the validity and reliability of the Malay version of the COVID-19 Quality of Life (CO-19_QoL) questionnaire for the use in the Malaysian context. A cross-sectional study involving 330 adult COVID-19 patients was conducted in the state of Selangor. The questionnaire was translated and culturally adapted following International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines, including forward backward translation and expert review to ensure conceptual and linguistic equivalence. It demonstrated excellent content validity (Kappa > 0.8), confirming that the items are relevant to COVID-19 symptoms and accurately translated. Internal consistency was high (Cronbach’s alpha = 0.919), while test-retest showed excellent reliability [Intraclass Correlation Coefficient (ICC) = 0.896, p < 0.001]. Construct validity analyses identified a single 15-item domain to be reliable and valid to measure the QoL of COVID-19 patients. The CO-19_QoL is a promising new instrument for measuring disease-specific QoL. It is easy to use, acceptable to patients, and meets rigorous reliability and validity standards. Also, CO-19_QoL enables a more thorough evaluation of HRQoL among COVID-19 patients in Selangor when used together with a generic QoL instrument.
Keywords : COVID-19; health-related quality of life; quality of life; translation; validation,
Abstrak
Kesan Penyakit Koronavirus 2019 (COVID-19) terhadap kualiti hidup (QoL) masih sering dipandang remeh. Di Malaysia, Selangor merupakan antara negeri yang mencatatkan jumlah kes COVID-19 tertinggi. Instrumen ukuran generik lazimnya tidak memberi tumpuan khusus kepada kesan sesuatu penyakit, sebaliknya merangkumi dimensi QoL yang lebih luas seperti kesejahteraan mental, fungsi fizikal, fungsi sosial dan tahap kesakitan sebagai aspek yang boleh terjejas akibat pelbagai jenis penyakit. Oleh itu, instrumen khusus bagi sesuatu penyakit adalah lebih sensitif dalam mengenal pasti perubahan status klinikal atau membezakan pesakit berdasarkan tahap keterukan penyakit. Kajian ini bertujuan untuk menilai kesahan dan kebolehpercayaan versi Bahasa Melayu soal selidik COVID-19 Quality of Life (CO- 19_QoL) bagi kegunaan dalam konteks Malaysia. Kajian keratan rentas ini melibatkan 330 orang pesakit dewasa COVID-19 di Selangor. Soal selidik ini telah diterjemahkan dan diadaptasi mengikut kesesuaian budaya berdasarkan garis panduan International Society for Pharmacoeconomics and Outcomes Research (ISPOR), yang merangkumi proses terjemahan hadapan (forward translation), terjemahan balik (backward translation), serta semakan oleh panel pakar bagi memastikan kesetaraan konsep dan linguistik dengan versi asal. Hasil analisis menunjukkan kesahan kandungan yang sangat baik (Kappa > 0.8), membuktikan bahawa setiap item adalah relevan dengan simptom COVID-19 dan diterjemahkan dengan tepat. Pekali konsistensi dalaman (Cronbach’s alpha) adalah tinggi pada 0.919, manakala ujian ulangan (test-retest) menunjukkan kebolehpercayaan yang sangat baik ["Intraclass Correlation Coefficient" (ICC) = 0.896, p < 0.001]. Bagi kesahan konstruk, satu domain tunggal dengan 15 item didapati sah dan boleh dipercayai untuk mengukur QoL pesakit COVID-19. Instrumen CO-19_QoL ini mempunyai potensi besar sebagai alat pengukuran khusus penyakit yang mudah digunakan, diterima baik oleh pesakit dan memenuhi kriteria ketat dari segi kebolehpercayaan serta kesahan. Selain itu, penggunaan instrumen ini bersama ukuran QoL generik mampu memberikan analisis yang lebih menyeluruh terhadap HRQoL pesakit COVID-19 di Selangor
Kata Kunci : COVID-19; kualiti hidup; kualiti hidup berkaitan kesihatan; terjemahan; validasi,

Correspondance Address
*Correspondence: maznahd@ummc.edu.my


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