Turkish Adaptation and Content Validity Analysis of the Toileting Habit Profile Questionnaire – 2nd Revision Form (THPQ-R2)

Abstract

Objective: Sensory processing differences are an important contributor to toileting difficulties in children with functional defecation disorders (FDD). The Toileting Habit Profile Questionnaire–Revised 2 (THPQ-R2) assesses sensory-based toileting behaviors; however, a Turkish version is unavailable. This study aimed to translate the THPQ-R2 into Turkish, culturally adapt it, and evaluate its content validity. Materials and Methods: The THPQ-R2 was adapted into Turkish through a seven-step process including translation, synthesis, back-translation, expert review, and pretesting in accordance with international cross-cultural adaptation guidelines. An interdisciplinary expert panel evaluated item relevance and clarity. Content validity was assessed using the Item-Level Content Validity Index (I-CVI), Average Content Validity Index (Ave-CVI), and modified kappa coefficient (k*). Comprehensibility and usability were evaluated through caregiver pretesting. Results: The Turkish translation of the THPQ-R2 demonstrated strong semantic, conceptual, and cultural equivalence with the original instrument. Adaptations were made to enhance cultural and linguistic appropriateness. All items achieved excellent content validity (I-CVI=1.00, Ave-CVI=1.00, k*=1.00), with complete agreement among experts (100%). Pretesting indicated that the scale was understandable and feasible. Discussion: The Turkish THPQ-R2 demonstrated excellent content validity and was successfully adapted to the Turkish language and cultural context. Further studies are needed to evaluate psychometrics in larger samples.