Urdu translation, cultural adaptation, and psychometric validation of the ENRICH Marital Satisfaction Scale for men with sexual dysfunction in Pakistan.

INTRODUCTION: Marital satisfaction is a key determinant of psychological well-being; however, no validated Urdu version of ENRICH Marital Satisfaction Scale (EMSS) previously existed for Pakistani clinical populations. This study aimed to translate, culturally, and psychometrically validate an Urdu version of the EMSS (EMSS-PK) for use among married men with sexual dysfunction in Pakistan.

METHODS: A cross-sectional psychometric validation study was conducted between September 2024 and June 2025 in Karachi, Pakistan. One hundred and fifty married Pakistani men aged 25-40 years presenting with sexual dysfunction were recruited from outpatient psychiatry, psychology, and urology clinics. The EMSS was subjected to five-step forward-backward translation, expert panel review, and pilot testing. Psychometric analysis included exploratory factor analysis (EFA; principal component extraction, varimax rotation), Cronbach's α for internal consistency, Pearson correlation for test-retest reliability, and Kaiser-Meyer-Olkin (KMO) and Bartlett's test for sampling adequacy. Data were analyzed using SPSS version 29.0. Ethical approval was obtained. Written informed consent was obtained from all participants. The primary outcomes were internal consistency (Cronbach's α), test-retest reliability (Pearson r), and construct validity assessed through EFA.

RESULTS: The EMSS-PK demonstrated good internal consistency (Cronbach's α = 0.75) and strong test-retest reliability (r = 0.90, P < .001). KMO = 0.79 and Bartlett's test of sphericity (χ2 (105) = 816.20, P < .001) confirmed sampling adequacy. EFA identified a six-factor solution communication, conflict resolution, affection, sexual relationship, financial management, and relationship ideals accounting for 69.4% of total variance, consistent with the original EMSS theoretical framework. Cultural adaptation involved minor surface-level wording modifications to ensure conceptual equivalence without altering item meaning.

DISCUSSION: The EMSS-PK provides clinicians, psychotherapists, marital counselors, and researchers with a standardized, culturally appropriate instrument for the integrated assessment of marital satisfaction and sexual health in Urdu-speaking Pakistani populations. Strengths include a rigorous five-step translation methodology, expert panel review incorporating a religious scholar, pilot testing, and comprehensive psychometric evaluation. Limitations include a convenience sample restricted to married men with sexual dysfunction from a single city, a cross-sectional design, potential social desirability bias, and the absence of confirmatory factor analysis and inter-rater reliability (ICC) assessment; generalizability to women and community-based populations requires further study. Overall, the EMSS-PK shows preliminary evidence of validity, reliability, and cultural sensitivity for measuring marital satisfaction in Urdu-speaking Pakistani populations. It is among the first Urdu marital satisfaction scales to undergo initial psychometric evaluation can advance marital counseling, sexual health intervention, and research in South Asian contexts.