Validation and Cultural Adaptation of Persian Version of Multidimensional Health Assessment Questionnaire in Rheumatoid Arthritis Patients

Elham Aflaki; Faezeh Sehatpour; Sheida Banihashemi

doi:10.31138/mjr.130723.pvm

Validation and Cultural Adaptation of Persian Version of Multidimensional Health Assessment Questionnaire in Rheumatoid Arthritis Patients

Mediterr J Rheumatol. 2024 Jan 8;35(1):83-93. doi: 10.31138/mjr.130723.pvm. eCollection 2024 Mar.

Authors

Elham Aflaki¹, Faezeh Sehatpour², Sheida Banihashemi³

Affiliations

¹ Autoimmune Disease Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran.
² Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Background: Rheumatoid arthritis (RA) is a multidimensional disease. In addition to quantitative factors, qualitative factors play an important role in the progress and outcome of the diseases. One of the most effective methods of collecting qualitative information is questionnaires reported by patients. The data obtained from the questionnaires are as important as the clinical criteria. Multidimensional health assessment questionnaire (MDHAQ) is one of the latest questionnaires that provide useful information in a short time.

Objectives: To investigate the reliability and validity of the Persian form of MDAHAQ for the use of Iranian patients.

Method: Two groups of participants were selected for this study. The validity test group included 110 patients, and the reliability test group included 140 patients. Translation and adaption of MDHAQ were performed by using Guillemin guidelines. The reliability was tested by using test-retest and Cronbach's alpha for internal consistency. Persian version of the health assessment questionnaire (HAQ) was used for assessing the criterion validity. The correlation between the MDHAQ score and Disease Activity Score-28 (DAS28), Clinical Disease Activity Index (CDAI), and the Persian version of the health assessment questionnaire (HAQ) was evaluated using the Spearman coefficient. Discriminant validity was tested in groups of patients based on two varied disease activities based on CDAI and DAS28.

Results: Test-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.865(95% CI: 0.809, 0.904) for physical function and 0.786(95% CI: 0.698, 0.848) for psychological items. Cronbach's alpha was 0.885 and 0.705 for physical function and psychological dimensions respectively. The Persian version of the MDHAQ had a good to strong correlation with the Persian version of the HAQ (ranging from 0.604 to 0.962) and also with CDAI (ranging from 0.616 to 0.838) and a moderate correlation with DAS28 (ranging from 0.415 to 0.439).

Conclusion: The Persian form of MDHAQ is a reliable and valid instrument for the routine evaluation of RA patients in rheumatology clinics in Iranian RA patients.

Keywords: multidimensional health assessment questionnaire; reliability; rheumatoid arthritis; validity.