Evaluating the Reliability and Validity of the Arabic Version of the Parents Perceptions of Uncertainty Scale (A-PPUS) Nabeel Al-Yateem, RN, PhD a,b,c, ⁎, Maria Brenner, PhD, MSc, BSc, RCN, RGN, RNT d , Alaa Ahmad, RN, MQM, CPHQ, PDIC, CIC, EFQM e , Syed Azizur Rahman, Ph.D f a Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates b Sharjah Institute for Medical and Health Sciences Research (SIMHR), University of Sharjah, United Arab Emirates c Charles Stuart University, Faculty of Science, School of Nursing, Midwifery and Indigenous Health, Orange Campus, New South Wales, Australia d School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland e Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates f Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates abstract article info Article history: Received 15 December 2016 Revised 24 June 2017 Accepted 24 June 2017 Available online xxxx Background: Uncertainty often accompanies illness and may be a major aversive component of the patients' treat- ment process. There is evidence that parental uncertainty has a negative impact on their own and on their child's coping strategies and may affect family functioning. Key to the provision of competent care, to address uncertain- ty, is the use of an appropriate validated assessment tool to understand key parental concerns. The ‘Parent Per- ception of Uncertainty Scale’ (PPUS) has been widely used for this purpose. Aim: This study reports on the validity and reliability testing of the Arabic version of the Parents Perception of Un- certainty Scale (A-PPUS). Methods: The scale was translated to Arabic using the translation-back-translation method. Appropriate statisti- cal tests were performed including measurements of internal consistency, item to total scale correlation, and uni- variate and multivariate analyses. Results: The study included 240 parents of children with chronic illnesses. Cronbach's alpha coefficient of the whole scale was 0.93. All the items were positively correlated to the total score. The univariate and multivariate analysis supported the previous tests and the assertion that the Arabic version of the PPUS provided a relevant measure of the uncertainty level. Conclusion: This study has identified that the A-PPUS is a reliable tool for parent report of their uncertainty, in the UAE and Arabic population. © 2016 Elsevier Inc. All rights reserved. Introduction and Background Linguistically, uncertainty is the state of being unsure, not fully de- cided, or in doubt (Meriam-Webster, 2015). Uncertainty in illness, on the other hand, is the inability to comprehend illness-related events and their outcomes. Illness times are transitional in nature; illness can be unpredictable, variable in course of development and may involve complex treatment regimens, especially chronic illness. Therefore, un- certainty often accompanies illness and may be a major aversive com- ponent of the patients treatment process (Bailey et al., 2011; Mishel, 1983a,b; Mishel, 1988; Sajjadi, Rassouli, Abbaszadeh, Alavi Majd, & Zendehdel, 2014). Uncertainty in illness has been shown to have a negative impact on the life of adult patients (Bailey et al., 2010; Carroll & Arthur, 2010; Hagen et al., 2015; Mauro, 2010), parents of children who are unwell (He, You, Zheng, & Bi, 2016; Kerr & Haas, 2014; Lin, Yeh, & Mishel, 2010; Page et al., 2012; Stewart, Pyke-Grimm, & Kelly, 2012), and child and adolescent patients (Boyse, Gardner, Marvicsin, & Sandberg, 2014; Hommel et al., 2003; Ju et al., 2011; Van Pelt, Mullins, Carpentier, & Wolfe-Christensen, 2006). This uncertainty can be height- ened, and is associated with worse outcomes, in patients with chronic health conditions (Hoth et al., 2015). In fact, adapting to life during ill- ness and negotiating the associated uncertainty has been identified as a major concern for patients, something which was possibly a source of more stress than the illness itself (Perrett & Biley, 2013; Walsh & Hegarty, 2010). In adult patients, various negative consequences of increased uncer- tainty were reported in the literature, including: high levels of anxiety and distress (Carroll & Arthur, 2010; Mauro, 2010; Wolfe-Christensen, Journal of Pediatric Nursing 36 (2017) 179–185 ⁎ Corresponding author at: Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates. E-mail address: Nalyateem@sharjah.ac.ae (N. Al-Yateem). http://dx.doi.org/10.1016/j.pedn.2017.06.017 0882-5963/© 2016 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Journal of Pediatric Nursing