Supplementary Material for: Validation of the Arabic version of the S3-non-invasive ventilation (S3-NIV) questionnaire in chronic respiratory disease

Background
Non-invasive ventilation (NIV) requires ongoing monitoring to ensure optimal therapeutic efficacy. The S3-non-invasive ventilation (S3-NIV) questionnaire was recently developed as a brief, repeatable, self-administered tool for the routine clinical evaluation of patients on long-term home NIV. This study aimed to produce an Arabic translation and cultural adaptation of the S3-NIV questionnaire and to assess its psychometric properties.
Methods
This was a descriptive, cross-sectional study involving patients with stable chronic respiratory disease treated with long-term home NIV. The Arabic version of the S3-NIV questionnaire was developed from the original French version through a standardized translation and back-translation process. The resulting instrument was evaluated for reliability and construct validity.
Results
A total of 150 patients were enrolled. The Arabic S3-NIV questionnaire demonstrated good internal consistency for the total score (Cronbach’s alpha = 0.76; 95% CI: 0.69–0.83) and for the "respiratory symptoms" domain (Cronbach’s alpha = 0.793; 95% CI: 0.728–0.858). The "sleep and side effects" domain showed lower reliability (Cronbach’s alpha = 0.573; 95% CI: 0.266–0.880). Both the total score and the two subscale scores showed weak negative correlations with the Epworth Sleepiness Scale (ESS), modified Medical Research Council (mMRC) scale, pain visual analogue scale (VAS), and fatigue VAS. Exploratory factor analysis (EFA) explained 54.6% of the total variance, supporting the internal structure of the Arabic version.
Conclusion
The Arabic version of the S3-NIV questionnaire demonstrates acceptable reliability and construct validity, particularly for the assessment of respiratory symptoms. It is a suitable tool for routine clinical use in Arabic-speaking patients receiving home NIV, although further refinement of the "sleep and side effects" subscale is recommended.

背景
无创通气（Non-invasive ventilation, NIV）需开展持续监测以保障最佳治疗效果。S3无创通气（S3-non-invasive ventilation, S3-NIV）问卷是近年研发的简短、可重复、自评式工具，用于长期家庭无创通气患者的常规临床评估。本研究旨在完成S3-NIV问卷的阿拉伯语翻译与文化调适，并评估其心理计量学特性。

方法
本研究为描述性横断面研究，纳入接受长期家庭无创通气治疗的稳定慢性呼吸系统疾病患者。S3-NIV问卷阿拉伯语版由原版法语版通过标准化翻译与回译流程研发，并对其信度与结构效度进行评估。

结果
共纳入150例患者。S3-NIV问卷阿拉伯语版的总得分（克朗巴赫α系数=0.76；95%置信区间：0.69–0.83）及“呼吸系统症状”维度（克朗巴赫α系数=0.793；95%置信区间：0.728–0.858）均表现出良好的内部一致性。“睡眠与不良反应”维度的信度相对较低（克朗巴赫α系数=0.573；95%置信区间：0.266–0.880）。总得分与两个分量表得分均与爱泼沃斯嗜睡量表（Epworth Sleepiness Scale, ESS）、改良版英国医学研究理事会（modified Medical Research Council, mMRC）量表、疼痛视觉模拟评分（visual analogue scale, VAS）及疲劳视觉模拟评分呈弱负相关。探索性因子分析（Exploratory factor analysis, EFA）可解释总方差的54.6%，验证了阿拉伯语版问卷的内部结构合理性。

结论
S3-NIV问卷阿拉伯语版具备可接受的信度与结构效度，尤其适用于呼吸系统症状的评估。尽管建议对“睡眠与不良反应”分量表进行进一步优化，但该问卷仍适合作为阿拉伯语人群家庭无创通气患者的常规临床评估工具。