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      Translation, cross-cultural adaptation and validation of the Brazilian version of the Nonarthritic Hip Score Translated title: Tradução, adaptação cultural e validação da versão brasileira do questionário Nonarthritic Hip Score

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          ABSTRACT

          CONTEXT AND OBJECTIVE:

          The Nonarthritic Hip Score (NAHS) is a clinical evaluation questionnaire that was developed in the English language to evaluate hip function in young and physically active patients. The aims of this study were to translate this questionnaire into the Brazilian Portuguese language, to adapt it to Brazilian culture and to validate it.

          DESIGN AND SETTING:

          Cohort study conducted between 2008 and 2010, at Universidade do Estado do Rio de Janeiro (UERJ).

          METHODS:

          Questions about physical activities and household chores were modified to better fit Brazilian culture. Reproducibility, internal consistency and validity (correlations with the Algofunctional Lequesne Index and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) were tested. The NAHS-Brazil, Lequesne and WOMAC questionnaires were applied to 64 young and physically active patients (mean age, 40.9 years; 31 women).

          RESULTS:

          The intraclass correlation coefficient (which measures reproducibility) was 0.837 (P < 0.001). Bland-Altman plots revealed a mean error in the difference between the two measurements of 0.42. The internal consistency was confirmed through a Cronbach alpha of 0.944. The validity between NAHS-Brazil and Lequesne and between NAHS-Brazil and WOMAC showed high correlations, r = 0.7340 and r = 0.9073, respectively. NAHS-Brazil showed good validity with no floor or ceiling effects.

          CONCLUSION:

          The NAHS was translated into the Brazilian Portuguese language and was cross-culturally adapted to Brazilian culture. It was shown to be a useful tool in clinical practice for assessing the quality of life of young and physically active patients with hip pain.

          RESUMO

          CONTEXTO E OBJETIVO:

          O Nonarthritic Hip Score (NAHS) é um questionário de avaliação clínica que foi desenvolvido na língua inglesa para avaliar a função do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir o questionário NAHS para a língua portuguesa do Brasil, adaptá-lo à cultura brasileira e validá-lo.

          TIPO DE ESTUDO E LOCAL:

          Estudo de coorte, realizado entre 2008 e 2010, na Universidade do Estado do Rio de Janeiro (UERJ).

          MÉTODOS:

          Questões sobre atividades físicas e tarefas domésticas foram modificadas para melhor adaptação à cultura brasileira. Reprodutibilidade, consistência interna e validade (correlação entre o Algofunctional Lequesne Index e o Western Ontario McMaster Universities Arthritis Index [WOMAC]) foram testadas. Os questionários NAHS-Brasil, Lequesne e WOMAC foram aplicados em 64 pacientes jovens e fisicamente ativos (média de idade, 40,9 anos; 31 mulheres).

          RESULTADOS:

          O coeficiente de correlação intraclasse que avalia reprodutibilidade mostrou valores de 0,837 (P < 0,001). O gráfico de Bland-Altman revelou um erro médio da diferença das duas medidas de 0,42. A consistência interna foi avaliada pelo alfa de Cronbach com valores de 0,944. A validade entre os questionários NAHS-Brasil/Lequesne e NAHS-Brasil/WOMAC mostraram alta correlação, r = 0,7340 e r = 0,9073; respectivamente. O NAHS-Brasil mostrou boa validade sem efeitos de chão ou de teto.

          CONCLUSÃO:

          O NAHS foi traduzido para a língua portuguesa do Brasil e adaptado para a cultura brasileira, mostrando ser uma ferramenta útil na prática clínica para avaliar a qualidade de vida de pacientes jovens e fisicamente ativos com dor no quadril.

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          Most cited references53

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          Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures

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            Quality criteria were proposed for measurement properties of health status questionnaires.

            Recently, an increasing number of systematic reviews have been published in which the measurement properties of health status questionnaires are compared. For a meaningful comparison, quality criteria for measurement properties are needed. Our aim was to develop quality criteria for design, methods, and outcomes of studies on the development and evaluation of health status questionnaires. Quality criteria for content validity, internal consistency, criterion validity, construct validity, reproducibility, longitudinal validity, responsiveness, floor and ceiling effects, and interpretability were derived from existing guidelines and consensus within our research group. For each measurement property a criterion was defined for a positive, negative, or indeterminate rating, depending on the design, methods, and outcomes of the validation study. Our criteria make a substantial contribution toward defining explicit quality criteria for measurement properties of health status questionnaires. Our criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies. The future challenge will be to refine and complete the criteria and to reach broad consensus, especially on quality criteria for good measurement properties.
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              Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines

              Clinicians and researchers without a suitable health-related quality of life (HRQOL) measure in their own language have two choices: (1) to develop a new measure, or (2) to modify a measure previously validated in another language, known as a cross-cultural adaptation process. We propose a set of standardized guidelines for this process based on previous research in psychology and sociology and on published methodological frameworks. These guidelines include recommendations for obtaining semantic, idiomatic, experiential and conceptual equivalence in translation by using back-translation techniques and committee review, pre-testing techniques and re-examining the weight of scores. We applied these guidelines to 17 cross-cultural adaptation of HRQOL measures identified through a comprehensive literature review. The reporting standards varied across studies but agreement between raters in their ratings of the studies was substantial to almost perfect (weighted kappa = 0.66-0.93) suggesting that the guidelines are easy to apply. Further research is necessary in order to delineate essential versus optional steps in the adaptation process.
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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                01 August 2013
                2013
                : 131
                : 4
                : 244-251
                Affiliations
                [I ] originalMSc. Physiotherapist, Department of Surgical Specialties, Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, Brazil.
                [II ] originalPhysiotherapist, Laboratory of Biomechanics and Motor Behavior, Instituto de Educação Física e do Desporto (IEFD), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
                [III ] originalPhD. Associate Professor, Department of Anatomy, Instituto de Biologia (IB), Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropédica, Brazil.
                [IV ] originalMD, PhD. Associate Professor, Department of Rheumatology, Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, Brazil.
                [V ] originalMD, PhD. Associate Professor, Department of Orthopedics, Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, Brazil.
                Author notes
                [Address for correspondence: ] Letícia Nunes Carreras Del Castillo. Departamento de Fisioterapia, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro. Av. Marechal Rondon, 381. São Francisco Xavier (RJ) - Brasil. CEP 20950-003. Tel. (+55 21) 2234-3015. E-mail: leticia.castillo@ 123456terra.com.br

                Conflict of interest: None

                Article
                10.1590/1516-3180.2013.1314487
                10871827
                24141295
                aebc4f2b-b917-43dd-8a5e-324372525578

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 07 March 2012
                : 25 July 2012
                : 01 October 2012
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 31, Pages: 08
                Categories
                Original Article

                questionnaires,quality of life,translations,reproducibility of results,hip,questionários,qualidade de vida,traduções,reprodutibilidade dos testes,quadril

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