da Mota Falcão Dircilene, Ciconelli Rozana Mesquita, Ferraz Marcos Bosi
Division of Rheumatology, Department of Medicine, University of São Paulo-UNIFESP, São Paulo, Brazil.
J Rheumatol. 2003 Feb;30(2):379-85.
To evaluate the methodological steps currently proposed in translation and cultural adaptation of quality of life questionnaires.
Fifty patients with rheumatoid arthritis were invited to participate. Two versions each of the Stanford Health Assessment Questionnaire (HAQ), the MOS 36 Item Short-Form Health Survey (SF-36), and the Arthritis Impact Measurement Scales 2 (AIMS-2) were administered: version 1 was a literal translation of the questionnaire; version 2 resulted from a process of translation and cultural adaptation following internationally accepted guidelines. For each patient we applied 2 questionnaires before and after consultation. The questionnaire, the order of administration, and the version were randomly assigned. The interviews were performed by a single interviewer. Several clinical and laboratory outcome measures were assessed simultaneously. Descriptive statistical analysis was used to characterize the data. Spearman and intraclass correlation coefficients were used to evaluate reliability and validity of each version of each questionnaire.
Patients' mean (SD) age was 47 (12) years and mean (SD) disease duration was 10 (7) years. The differences of the mean in the physical and affective AIMS-2 components between the literal and adapted versions (0.21 and 0.11, respectively) were similar to the differences in the intraobserver application of the same version of culturally adapted AIMS-2 components (0.03 and 0.20) (the component scores range from 0 to 10). The same results were observed when considering other components of AIMS and SF-36, as well as HAQ scores. Version 1 and 2 presented a similar clinically and statistically significant correlation with clinical and laboratory measures used in the validation process of the questionnaires.
The complex methodologies proposed in the translation and validation of the questionnaires should be carefully reevaluated. The simplification of this methodology should be studied.
评估目前在生活质量问卷的翻译和文化调适过程中所提出的方法步骤。
邀请50名类风湿性关节炎患者参与。对斯坦福健康评估问卷（HAQ）、医学结局研究简明健康调查（SF - 36）以及关节炎影响测量量表2（AIMS - 2）各发放两个版本：版本1为问卷的逐字翻译；版本2是按照国际公认指南进行翻译和文化调适后的版本。对于每位患者，在咨询前后各应用2份问卷。问卷、发放顺序及版本均随机分配。访谈由一名访谈者进行。同时评估了多项临床和实验室结局指标。采用描述性统计分析对数据进行特征描述。使用Spearman和组内相关系数评估各问卷每个版本的信度和效度。
患者的平均（标准差）年龄为47（12）岁，平均（标准差）病程为10（7）年。逐字翻译版和调适版AIMS - 2在身体和情感方面的平均差异（分别为0.21和0.11）与同一版本的文化调适后AIMS - 2在观察者内部应用时的差异（0.03和0.20）相似（各分量表得分范围为0至10）。在考虑AIMS和SF - 36的其他分量表以及HAQ得分时，也观察到了相同的结果。版本1和版本2在问卷效度验证过程中所使用的临床和实验室指标方面呈现出相似的临床及统计学显著相关性。
问卷翻译和效度验证中所提出的复杂方法应仔细重新评估。应研究简化该方法。
