Validation of the Arabic version of the Health Assessment Questionnaire (HAQ) in patients with rheumatoid arthritis

Abstract

Several instruments for measuring functional status in rheumatic diseases have been developed and validated. However, none is as yet available in Arabic.

Objective: To translate the Health Assessment Questionnaire (HAQ) from English to Arabic and to test the metrological properties, reliability, and validity of the Arabic version.

Methods: The study included 41 consecutive patients seen at the outpatient rheumatology clinic of a large teaching hospital in Kuwait for rheumatoid arthritis meeting 1987 American College of Rheumatology criteria. The HAQ was translated from English to Arabic by three translators who were aware of the intended use of the questionnaire. The translated questionnaire was administered to each patient during two clinic visits seven to ten days apart. Test-retest reliability was assessed based on the intraclass correlation coefficient. Internal consistency of individual items with the overall score was assessed using Cronbach's alpha coefficient. Construct validity was evaluated by determining Spearman's correlation between the Arabic HAQ score and disease activity variables.

Results: There were 34 women and seven men, with a median age of 38 years and a median disease duration of 5.3 years. Test-retest reliability was 0.81, internal consistency was 0.93, and construct validity ranged from 0.5 (erythrocyte sedimentation rate) to 0.75 (pain).

Conclusion: The HAQ-A retains the characteristics of the original American version, and is a reliable and valid instrument for measuring functional disability in Arabic-speaking patients with rheumatoid arthritis.