Cross-cultural adaptation and validation of the Michigan Hand Outcomes Questionnaire (MHQ) for Brazil: validation study

Sandra Mara Meireles,Mayara Lopes,Thelma Larocca Skare,Jamil Natour,Daniel Alberton Batista

doi:10.1590/1516-3180.2014.1326701

Abstract

CONTEXT AND OBJECTIVE: Rheumatoid arthritis is a chronic systemic disease that causes joint damage. A variety of methods have been used to evaluate the general health status of these patients but few have specifically evaluated the hands. The objective of this study was to translate, perform cultural adaptation and assess the validity of the Michigan Hand Outcomes Questionnaire for Brazil.DESIGN AND SETTING: Validation study conducted at a university hospital in Curitiba, Brazil.METHODS: Firstly, the questionnaire was translated into Brazilian Portuguese and back-translated into English. The Portuguese version was tested on 30 patients with rheumatoid arthritis and proved to be understandable and culturally adapted. After that, 30 patients with rheumatoid arthritis were evaluated three times. On the first occasion, two evaluators applied the questionnaire to check inter-rater reproducibility. After 15 days, one of the evaluators reassessed the patients to verify intra rater reproducibility. To check the construct validity at the first assessment, one of the evaluators also applied other similar instruments.RESULTS: There were strong inter and intra rater correlations in all the domains of the Michigan Hand Outcomes Questionnaire. Cronbach's alpha was higher than 0.90 for all the domains of the questionnaire, thus indicating excellent internal validity. Almost all domains of the questionnaire presented moderate or strong correlation with other instruments, thereby showing good construct validity.CONCLUSION: The Brazilian Portuguese version of the Michigan Hand Outcomes Questionnaire was translated and culturally adapted successfully, and it showed excellent internal consistency, reproducibility and construct validity.

Highlights

Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects all synovial joints, with progressive and irreversible joint destruction.[1]
The Michigan Hand Outcomes Questionnaire (MHQ) is a hand evaluation instrument that was conceived at the University of Michigan in 1998 using psychometric principles.[5]
Translation and cultural adaptation Two independent native speakers of Brazilian Portuguese who were fluent in English translated the original MHQ from English to Brazilian Portuguese in the manner recommended by Guillemin et al.[15] and by the guidelines of the American Academy of Orthopedic Surgeons Outcome Committee.[10]

Summary

Introduction

Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects all synovial joints, with progressive and irreversible joint destruction.[1]. The Michigan Hand Outcomes Questionnaire (MHQ) is a hand evaluation instrument that was conceived at the University of Michigan in 1998 using psychometric principles.[5] This is a self-administered instrument that has 37 items that evaluate six domains: overall hand function, activities of daily living, work performance, pain, esthetics and patient satisfaction with hand function. This instrument is intended for use among individuals with hand and wrist conditions and injuries, including arthritis. It takes nearly 15 minutes to complete and has been found to be valid and reliable for measuring hand function in RA patients.[4,5,6] The MHQ has been translated into other languages such as German,[7] Turkish[8] and Korean.[9]

Methods

Results

Conclusion