Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 4;20(1):39.
doi: 10.1186/s12955-022-01943-9.

Cross-cultural adaptation of the Spanish MINICHAL instrument into English for use in the United Kingdom

Andrew N Jordan  1   2 , Christine Anning  3 , Lindsay Wilkes  3 , Claire Ball  3 , Nicola Pamphilon  3 , Christopher E Clark  4 , Nicholas G Bellenger  5   6 , Angela C Shore  3   5 , Andrew S P Sharp  5   6 , Jose M Valderas  5   4
Affiliations

Cross-cultural adaptation of the Spanish MINICHAL instrument into English for use in the United Kingdom

Andrew N Jordan et al. Health Qual Life Outcomes. .

Abstract

Background: Hypertension is a highly prevalent condition, with optimal treatment to BP targets conferring significant gains in terms of cardiovascular outcomes. Understanding why some patients do not achieve BP targets would be enhanced through greater understanding of their health-related quality of life (HRQoL). However, the only English language disease-specific instruments for measurement of HRQoL in hypertension have not been validated in accordance with accepted standards. It is proposed that the Spanish MINICHAL instrument for the assessment of HRQoL in hypertension could be translated, adapted and validated for use in the United Kingdom. The aim of the study was therefore to complete this process.

Methods: The MINICHAL authors were contacted and the original instrument obtained. This was then translated into English by two independent English-speakers, with these versions then reconciled, before back-translation and subsequent production of a 2nd reconciled version. Thereafter, a final version was produced after cognitive debriefing, for administration and psychometric analysis in the target population of patients living in the Exeter area (Southwest UK) aged 18-80 years with treatment-naïve grade II-III hypertension, before, during and after 18 weeks' intensive treatment.

Results: The English-language instrument was administered to 30 individuals (median age: 58.5 years, 53% male). Psychometric analysis demonstrated a floor effect, though no ceiling effect. Internal consistency for both state of mind (StM) and somatic manifestations (SM) dimensions of the instrument were acceptable (Cronbach's alpha = 0.81 and 0.75), as was test-retest reliability (ICC = 0.717 and 0.961) and construct validity, which was measured through co-administration with the EQ-5D-5L and Bulpitt-Fletcher instruments. No significant associations were found between scores and patient characteristics known to affect HRQoL. The EQ-5D-5L instrument found an improvement in HRQoL following treatment, with the StM and SM dimensions of the English language MINICHAL trending to support this (d = 0.32 and 0.02 respectively).

Conclusions: The present study details the successful English translation and validation of the MINICHAL instrument for use in individuals with hypertension. The data reported also supports an improvement in HRQoL with rapid treatment of grade II-III hypertension, a strategy which has been recommended by contemporaneous European guidelines. Trial registration ISRCTN registry number: 57475376 (assigned 25/06/2015).

Keywords: Adaptation; Hypertension; MINICHAL; Validation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Original MINICHAL instrument
Fig. 2
Fig. 2
English-language MINICHAL instrument
Fig. 3
Fig. 3
Correlation between the MINICHAL StM domain and EQ-5D-5L summary index. Rs = − 0.500, p < 0.0001
See this image and copyright information in PMC

References

    1. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–223. - PubMed
    1. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903–1913. - PubMed
    1. Falaschetti E, Mindell J, Knott C, Poulter N. Hypertension management in England: a serial cross-sectional study from 1994 to 2011. Lancet (London, England) 2014;383(9932):1912–1919. - PubMed
    1. Persu A, Jin Y, Baelen M, Vink E, Verloop WL, Schmidt B, et al. Eligibility for renal denervation: experience at 11 European expert centers. Hypertension (Dallas, Tex: 1979) 2014;63(6):1319–1325. - PubMed
    1. Tomaszewski M, White C, Patel P, Masca N, Damani R, Hepworth J, et al. High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis. Heart. 2014;100(11):855–861. doi: 10.1136/heartjnl-2013-305063. - DOI - PMC - PubMed

LinkOut - more resources