Cross-cultural translation, adaptation and validation of the Burnt Hand Outcome Tool (BHOT) from English to French Canadian

Abstract

Background: The Burnt Hand Outcome Tool (BHOT) is a comprehensive tool assessing the multiple impacts of hand burn injuries which makes it essential to burn care practice, but is currently only available in English.

Objectives: To create a French-Canadian cross-cultural adaptation of the BHOT and to assess its content and construct convergent validity.

Methods: The BHOT was translated and culturally adapted according to evidence-based principles for patient-reported outcome measures. The steps included translation to French (BHOT-F), backward translation, expert committee review, and cognitive debriefing with 5 adult participants. A pre-final version of the BHOT-F was then administered to 39 adult participants with hand burn injuries to assess construct convergent validity using the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Content validity was evaluated based on comments from the expert committee and participant burn survivors.

Results: The BHOT-F was modified during the adaption process to ensure its clarity. The Cronbach's alpha value of 0.935 demonstrates the excellent internal consistency of the BHOT-F. The BHOT-F and the QuickDASH were strongly correlated (p < 0.01). Content validity was deemed satisfactory and recommendations are reported for future research.

Conclusions: The BHOT-F demonstrates adequate clinimetric properties to be used in clinical practice.

Keywords: Burn injury; Burnt Hand Outcome Tool; Cultural adaptation; Hand function assessment; Patient Reported Outcome Measure (PROM); Psychometrics.