Cross-cultural adaptation of a brief outcome questionnaire for Spanish-speaking arthritis patients

OBJECTIVE. To cross-culturally adapt a brief self-assessment

questionnaire to measure outcome among English- or

Spanish-speaking patients with arthritis.


questionnaire containing the following items was translated to

Spanish: the 8 activities of daily living (ADL) question of

the Modified Health Assessment Questionnaire; a question

about the duration of morning stiffness; and a 10-point pain

scale. Equivalence to the original English, test-retest

reliability, and construct, criterion, and discriminant

validity were determined on a population of patients with 4

clinical centers.

RESULTS. English-Spanish equivalence and

test-retest reliability of the questionnaire were almost

perfect (intra-class correlation coefficients [ri] > or =

0.90 for each). Construct validity, measured by comparing

questionnaire scores with an occupational therapist’s

evaluation, was also near-perfect in both languages (ri =

0.93 for English and 0.89 for Spanish). Both versions of the

questionnaire correlated well with the physician-determined

Steinbrocker functional class, as well as with the amount of

pain, grip strength, and walking velocity. Patients with

systemic lupus erythematosus, rheumatoid arthritis,

osteoarthritis, and fibromyalgia differed significantly in

their pain:ADL ratios, in both languages.


items of the Spanish questionnaire that we have adapted are

equivalent to the original English versions. This

questionnaire is suitable for studying Spanish-speaking

subjects with arthritis in the US and elsewhere.

Escalante A, Galarza-Delgado D, Beardmore TD, Baethge BA,

Esquivel-Valerio J, Marines AL, Mingrone M

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