Search

Export Date: 18 October 2017 CODEN: ARUPB Correspondence Address: Cruz, E.B.; Escola Superior de Saúde, Instituto Politécnico de Setúbal, Campus do IPSPortugal; email: eduardo.cruz@ess.ips.pt References: Boonen, A., Braun, J., van der Horst Bruisma, I., The ASAS//WHO ICF core sets for ankylosing spondylitis: how to classify the impact of AS on functioning and health (2010) Ann Rheum Dis, 69, pp. 102-107; Kiltz, A., The ASAS Health Index (ASAS HI)-a new tool to assess the health status of patients with spondyloarthritis (2014) Clin Exp Rheumatol, 32, pp. S105-S108; Branco, J.C., Rodrigues, A.M., Gouveia, N., Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt-a national health survey (2016) RMD Open, 2; Ward, M.M., Health-related quality of life in ankylosing spondylitis: a survey of 175 patients (1999) Arthritis Care Res, 12 (4), pp. 247-255; van Echteld, I., Cieza, A., Boonen, A., Identification of the most common problems by patients with ankylosing spondylitis using the international classification of functioning, disabi-lity and health (2006) J Rheumatol, 33, pp. 2475-2483; Machado, P., Landewé, R., Braun, J., A stratified model for health outcomes in ankylosing spondylitis (2011) Ann Rheum Dis, 70, pp. 1758-1764; Kiltz, U., van der Heijde, D., Boonen, A., Development of a health index in patients with ankylosing spondylitis (ASAS HI): final result of a global initiative based on the ICF guided by ASAS (2015) Ann Rheum Dis, 74 (5), pp. 830-835; Gordeev, V.S., Maksymowych, W.P., Evers, S.M., Role of contextual factors in health-related quality of life in ankylosing spondylitis (2010) Ann Rheum Dis, 69, pp. 108-112; Kiltz, U., van der Heijde, D., Cieza, A., Developing and validating an index for measuring health in patients with ankylo-sing spondylitis (2011) Rheumatology, 50, pp. 894-898; Martins, A.C., Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work (2015) Work, 50 (4), pp. 585-593; Mokkink, L.B., Terwee, C.B., Patrick, D.L., The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study (2010) Qual Life Res, 19 (4), pp. 539-549; Beaton, D., Bombardier, C., Guillermin, F., Ferraz, M.B., (2002) Recommendations for the Cross-Cultural Adaptation of Health Status Measures, , Supported by the American Academy of Orthopaedic Surgeons, Institute for Work & Health, Revised March; Beaton, D.E., Bombardier, C., Guillemin, F., Ferraz, M.B., Guidelines for the process of cross-cultural adaptation of self-report measures (2000) Spine, 25, pp. 3186-3191; Guillemin, F., Bombardier, C., Beaton, D., Cross-cultural adaptation of health-related quality if life measures. literature review and proposed guidelines (1993) J Clin Epidemiol, 46 (12), pp. 1417-1432; Kiltz, U., van der Heijde, D., Bonnen, A., Measuring impairments of functioning and health in patents with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set. translation and cross-cultural adaptation into 15 languages RMD Open Objective: There is a lack of outcome measures to assess the impact of axial spondyloarthritis (axSpA) on health, function and quality of life. The Assessment of SpondyloArthritis International Society (ASAS) group developed the ASAS Health Index (ASAS-HI) and the ASAS Environmental Factors Item Set (ASAS-EF) to measure functioning and health across all aspects of health that are typically affected and relevant for patients with axSpA, based on the International Classification of Functioning, Disability and Health (ICF). The aim of this paper was to describe the translation and cross-cultural adaptation of both questionnaires into European Portuguese among patients with radiographic and non-radiographic axial SpA (nr-axSpA) and test the conceptual equivalence of the translated version in the Portuguese context. Material and Methods: The ASAS-HI and ASAS-EF were firstly translated into European Portuguese and then back-translated into English, following forward- -backward procedure. After the review of the Portuguese version by an expert committee, the field test with cognitive debriefing involved a sample of 10 axSpA patients with different gender, age, disease duration, and educational background. Results: Minor difficulties arose from the translation process of the ASAS-HI. The EF Item Set offered more difficulties indicating that concepts underlying the contextual factors may be more culture-dependent. A total of 10 patients with axSpA [8 males, mean age of 41.4 (±13.7)] participated in the field test. Cognitive debriefing showed that items of the ASAS-HI and EF Item Set of the Portuguese version are clear, relevant, understandable and easy to complete. As a result of cogni - tive debriefing, the wording of four items had to be changed to avoid misunderstandings or unintended interpretations, and a new response option "not applicable" was added to two items of the ASAS-HI to improve appropriateness. Conclusions: The resulting Portuguese version of the ASAS-HI and ASAS-EF showed acceptable linguistic validity and has potential for use in both clinical practice and research settings. Nevertheless, before European Portuguese versions can be fully implemented, its psychometric properties (validity and reliability) need to be evaluated. publishersversion published

NTRODUCTION:The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages.METHODS:Translation and cross-cultural adaptation has been carried out following the forward-backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included.RESULTS:The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option 'not applicable' was added to two items of the ASAS HI to improve appropriateness.DISCUSSION:This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.