Original Article

Translation and psychometric evaluation of the Persian version of the Mini-International Classification of Function and disability-rating for limitations of activities and participation in psychological disorders

Abstract

Background & Aim: Patients with mental disorders frequently experience limitations in activity and social participation, potentially disrupting recovery and social reintegration. Accurate assessment of these limitations is essential for treatment planning and rehabilitation. This study aimed to determine the validity and reliability of the Persian version of the Mini-International Classification of Functioning and disability-rating for limitations of activities and participation in psychological disorders.
Methods & Materials: This methodological study was conducted in 2025 among patients discharged from the psychiatric wards. Following forward–backward translation, face and content validity were assessed by 11 experts. Construct validity was evaluated using Exploratory Factor Analysis, followed by Confirmatory Factor Analysis in 193 patients. Reliability was assessed using Cronbach's alpha and the Intraclass Correlation Coefficient.
Results: All items demonstrated satisfactory face and content validity, with no item removed. Content Validity Ratio values ranged from 0.63 to 1.00, while the overall Scale-level Content Validity Index was 0.88, indicating acceptable but slightly below-threshold content validity. Exploratory Factor Analysis identified a three-factor structure explaining 51.13% of the total variance. Confirmatory Factor Analysis showed acceptable model fit. Cronbach's alpha was 0.76 overall, and the Intraclass Correlation Coefficient for the total scale was 0.796, indicating satisfactory internal consistency and stability.
Conclusion: The Persian Mini-International Classification of Function and Disability Rating for limitations of Activities and Participation in Psychological disorders demonstrates acceptable face, content, and three-factor structural validity. However, the low internal consistency of the third factor and suboptimal Tucker–Lewis Index fit warrant caution in interpreting subscale scores.

1. Kakaei H, Maleki F, Biderafsh A, Valizadeh R, Mansournia MA, Pakzad I, et al. High prevalence of mental disorders: A population-based cross-sectional study in the city of Ilam, Iran. Frontiers in Psychiatry. 2023; 14:1166692.
2. Bahrami M, Jalali A, Ayati A, Shafiee A, Alaedini F, Saadat S, et al. Epidemiology of mental health disorders in the citizens of Tehran: A report from Tehran Cohort Study. BMC Psychiatry. 2023;23(1):267.
3. Sanches SA, Swildens WE, van Busschbach JT, van Weeghel J. Identifying social participation subgroups of individuals with severe mental illnesses: A latent class analysis. Social Psychiatry and Psychiatric Epidemiology. 2019;54(9):1067-77.
4. Youn HM, Kang SH, Jang S-I, Park E-C. Association between social participation and mental health consultation in individuals with suicidal ideation: A cross-sectional study. BMC Psychiatry. 2020;20(1):305.
5. Jafari A, Tehrani H, Mansourian M, Nejatian M, Gholian-Aval M. Translation and localization of the Persian version of the diabetes distress scale among type 2 diabetes. Diabetology & Metabolic Syndrome. 2023;15(1):201.
6. Aasen J, Nilsson F, Sørensen T, Lien L, Leonhardt M. Barriers and facilitators to social participation in people with mental health and substance use disorders: a formative qualitative study. Advances in Dual Diagnosis. 2024;17(3):85-99.
7. Egger ST, Weniger G, Bobes J, Seifritz E, Vetter S. Exploring the factor structure of the Mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis. Revista de Psiquiatría y Salud Mental (English Edition). 2021;14(4):186-95.
8. Chan SKW, Mak WW. Social participation and recovery in people with mental illness: A systematic review. Social Psychiatry and Psychiatric Epidemiology. 2022;57(6):1075–1091.
9. Sanchez-Balsa A, Sobrido M. Effectiveness of interventions aimed at social participation in people with schizophrenia: systematic review. Cadernos Brasileiros de Terapia Ocupacional. 2023;31: e3299.
10. Fox V. An exploration of social participation for young adults following a first psychotic episode. Journal of Occupational Science. 2020;27(1):69-81.
11. Stithyudhakarn S, Uthis P, Nhat TV. Interventions to enhance mental health outcomes of persons with schizophrenia during the COVID-19 pandemic: A systematic review. Nursing Practice Today. 2025;12(3):237-258.
12. Amagai M, Suzuki M, Shibata F, Tsai J. Development of an instrument to measure self-efficacy for social participation of people with mental illness. Archives of Psychiatric Nursing. 2012;26(3):240-8.
13. Rogers ES, Millner UC, Ludlow L, Lord EM, Russinova Z. Development of a comprehensive inventory of community participation for individuals with psychiatric disabilities. Psychiatric Rehabilitation Journal. 2021 Mar;44(1):51-62.
14. World Health Organization. International Classification of Functioning, Disability and Health. Geneva: World Health Organization; 2001.
15. Linden M, Baron S, Muschalla B, Ostholt-Corsten M. Fähigkeitsbeeinträchtigungen bei psychischen Erkrankungen: Diagnostik, Therapie und sozialmedizinische Beurteilung in Anlehnung an das Mini-ICF-APP. Göttingen: Hogrefe; 2015.
16. Linden M, Baron S. The "Mini-ICF-Rating for Mental Disorders (Mini-ICF-P)": A short instrument for the assessment of disabilities in mental disorders. Rehabilitation. 2005; 44:144-51.
17. Chong SA, Vaingankar JA, Abdin E, Subramaniam M. Mental disorders: employment and work productivity in Singapore. Social Psychiatry and Psychiatric Epidemiology. 2013;48(1):117-23.
18. Molodynski A, Linden M, Juckel G, Yeeles K, Anderson C, Vazquez-Montes M, et al. The reliability, validity, and applicability of an English language version of the Mini-ICF-APP. Social Psychiatry and Psychiatric Epidemiology. 2013;48(8):1347-54.
19. Linden M, Keller L, Noack N, Muschalla B. Self-rating of capacity limitations in mental disorders: The Mini-ICF-APP-S. Praxis Klinische Verhaltensmedizin und Rehabilitation. 2018; 101:14-22.
20. Egger ST, Weniger G, Müller M, Bobes J, Seifritz E, Vetter S. Assessing the severity of functional impairment of psychiatric disorders: equipercentile linking the mini-ICF-APP and CGI. Health and Quality of Life Outcomes. 2019;17(1):174.
21. Üstün TB. Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0: World Health Organization; 2010.
22. Sadeghi N, Akbarfahimi M, Taghizadeh G. The Persian Version of “Meaningful Activity Participation Assessment” Questionnaire: Evaluation of Its Face and Content Validity in the Elderly. Function and Disability Journal. 2021;4(1):44.
23. Polit-O'Hara D, Yang FM. Measurement and the measurement of change: a primer for the health professions. Philadelphia: Wolters Kluwer; 2016.
24. Ebadi A, Zarshenas L, Rakhshan M, Zareiyan A, Sharifnia S, Mojahedi M. Principles of Scale Development in Health Science. 1st ed. Tehran: Jame-e-negar; 2017.
25. Rogers P. Best practices for your exploratory factor analysis: A factor tutorial. Revista de Administração Contemporânea. 2022;26(06):e210085.
26. Rossoni L, Engelbert R, Bellegard NL. Normal science and its tools: Reviewing the effects of exploratory factor analysis in management. Revista de Administração. 2016;51(2):198-211.
27. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis. 8th ed. Andover, UK: Cengage Learning; 2019.
28. Tavakol M, Wetzel A. Factor Analysis: A means for theory and instrument development in support of construct validity. International Journal of Medical Education. 2020; 11:245-7.
29. Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education. 2018;48(6):1273-96.
30. Wciórka J, Anczewska M, Jahołkowski P, Świtaj P. Psychometric evaluation of the Polish version of the MINI-ICF-APP – a concise measure of limitations on activity and restrictions on participation according to the ICF – in people with mental disorders. Advances in Psychiatry and Neurology. 2018;27(3):218–31.
31. Rak T, Wrześniowski S. Cronbach’s alpha-what makes it really good? Some advice for planning and criticizing psychological questionnaires. Przegląd Psychologiczny. 2023;66(4):151-67.
32. Rosburg T, Kunz R, Trezzini B, Schwegler U, Jeger J. The assessment of capacity limitations in psychiatric work disability evaluations by the social functioning scale, Mini-ICF-APP. BMC Psychiatry. 2021;21(1):480.
33. Burri M, Werk LP, Berchtold A, Pugliese M, Muschalla B. Mini-ICF-APP inter-rater reliability and development of capacity disorders over the course of a vocational training program—a longitudinal study. Journal of Psychosocial Rehabilitation and Mental Health. 2021 Aug;8(2):159-69.
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SectionOriginal Article(s)
Keywords
mental disorders; patients; psychometrics; social participation; psychometric properties
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How to Cite
1.
Ghaedi-Heidari F, Abbasi S, Irajpour A, Linden M, Taheri Z. Translation and psychometric evaluation of the Persian version of the Mini-International Classification of Function and disability-rating for limitations of activities and participation in psychological disorders. Nurs. pract. today. 2026;:X-X.