Translation and cross-cultural adaptation of the Scleroderma Health Assessment Questionnaire to Brazilian Portuguese

Abstract

CONTEXT AND OBJECTIVE: Systemic sclerosis is an autoimmune disease characterized by abnormalities of vascularization that may cause fibrosis of the skin and other organs and lead to dysfunction. It is therefore essential to have tools capable of evaluating function in individuals with this condition. The aim of this study was to translate the Scleroderma Health Assessment Questionnaire (SHAQ) into Portuguese, adapt it to Brazilian culture and test its validity and reliability. DESIGN AND SETTING: The validation of SHAQ followed internationally accepted methodology, and was performed in university outpatient clinics. METHODS: SHAQ was translated into Portuguese and back-translated. In the cultural adaptation phase, it was applied to 20 outpatients. Items not understood by 20% of the patients were modified and applied to another 20 outpatients. Twenty patients were interviewed on two different occasions to determine the validity and reliability of the questionnaire: two interviewers on the first occasion and one interviewer 14 days later. To determine the external validity, comparisons were made with Health Assessment Questionnaire (HAQ), Disabilities of the Arm, Shoulder and Hand (DASH) and short form-36 (SF-36). RESULTS: In the interobserver evaluation, Pearson's correlation coefficient and the intraclass correlation coefficient were both 0.967. In the intraobserver evaluation, Pearson's correlation coefficient was 0.735 and the intraclass correlation coefficient was 0.687. Regarding external validity, SHAQ scores were statistically correlated with all measurements, except the general health domain of SF-36 and the work-related score (Q2) of DASH. CONCLUSION: The Brazilian version of SHAQ proved to be valid and reliable for assessing function in patients with diffuse systemic sclerosis. RESUMO CONTEXTO E OBJETIVO:A esclerose sistêmica (ES) é uma doença autoimune caracterizada por anormalidades da vascularização, que podem gerar fibrose da pele e outros órgãos, podendo levar a disfunção. Assim, torna-se imprescindível a elaboração de instrumentos capazes de avaliar a função de indivíduos com ES. O objetivo deste estudo foi traduzir para o português, adaptar à cultura brasileira e testar a validade e confiabilidade do Scleroderma Health Assessment Questionnaire (SHAQ). TIPO DE ESTUDO E LOCAL:A validação do SHAQ seguiu uma metodologia aceita internacionalmente, e foi realizada nos ambulatórios da universidade. MÉTODOS: Foi realizada tradução e contra-tradução do instrumento. Na fase de adaptação cultural, o SHAQ foi aplicado a 20 pacientes.

An Update of Outcome Measures in Systemic Sclerosis

“…Two versions of Brazilian Portuguese SHAQ have been developed (27,28). Both versions demonstrated validity and reliability for assessing function in patients with diffuse SSc.…”

“…Both versions demonstrated validity and reliability for assessing function in patients with diffuse SSc. The version by Orlandi et al has an interobserver ICC of 0.967 ( P < 0.001) and an intraobserver ICC of 0.687 ( P < 0.001) (27). The SHAQ scores had significant correlations ( r = −0.57 to −0.84; P < 0.05) with all SF‐36 domains except for the general health domain (27).…”

Recommendations for Assessment and Management of Health-Related Quality of Life in Patients with Mucopolysaccharidoses in Latin America

“…There are 20 questions in eight functional categories, which include activities such as dressing, getting up, eating, walking, personal care, reaching and grasping objects and usual activities. The questionnaire is available in Portuguese [34] and Spanish [35].…”

Efeitos da cinesioterapia sobre a força de preensão palmar e a qualidade de vida de um idoso longevo com esclerose sistêmica: relato de caso

“…A Esclerose Sistêmica (ES) é uma patologia crônica e autoimune do tecido conjuntivo caracterizada por anormalidades no sistema vascular, sistema imunológico e matriz extracelular. Histologicamente, ocorrem alterações na síntese do colágeno gerando o aumento do seu depósito e consequentes modificações tróficas na pele e em órgãos internos, acometendo, principalmente, pulmões, trato gastrointestinal, coração e rins 4,5 . A etiologia é desconhecida, no entanto, acreditase que exista um envolvimento importante do sistema imunológico.…”

“…A etiologia é desconhecida, no entanto, acreditase que exista um envolvimento importante do sistema imunológico. É mais prevalente em mulheres, atingindo, sobretudo, indivíduos na faixa etária entre 35 e 60 anos de idade, com incidência anual de, aproximadamente, 4 a 19 indivíduos por milhão de pessoas adultas e prognóstico de vida entre 5 e 10 anos após o diagnóstico clínico 4,[6][7][8] . As manifestações cutâneas (fibrose e calcinose), vasculares (fenômeno de Raynaud e úlceras isquêmicas) e viscerais (destacando-se hipomotilidade esofágica e intestinal, refluxo gastroesofágico, pneumopatia intersticial, hipertensão pulmonar, crise renal esclerodérmica, miocardioesclerose e arritmia cardíaca) são frequentes na ES 9 .…”