Cross cultural adaptation and validation of the Arabic version of the Childhood Health Assessment Questionnaire for measuring functional status in children with juvenile idiopathic arthritis

Clin Exp Rheumatol. May-Jun 2003;21(3):387-93.


Objective: To cross culturally adapt the American-English version of the Childhood Health Assessment Questionnaire (CHAQ) and to evaluate the validity and reliability of the modified translated version on children with juvenile idiopathic arthritis (JIA).

Methods: A cohort of 62 children suffering from JIA (32 Egyptian, 30 Saudi Arabian) were recruited and asked to participate in the study. Two questions had been changed to suit the Arabic culture and to tackle some aspects that are more typical of the Arabic culture. After modification, translation and back translation of the questionnaire, it was administered to the selected patients as well as their parents and tested for internal consistency, reliability and construct validity by correlating the yield of the questionnaire with other disease activity parameters. The questionnaire was administered again after a one-week interval for evaluation of the reliability of this test. The modified questions were tested for their loyalty to the principal component and their correlation with that of the other unchanged items was compared.

Results: CHAQ proved to be valid in clinically discriminating between healthy subjects and patients with different patterns of JIA. Test-retest showed strong reliability with a high percentage of agreement and high kappa values. Internal consistency showed a high value for the standardized Cronbach's alpha (0.951), and this value did not show any significant change when any one of the items was eliminated. The modified questionnaire showed a strong and significant validity when its results were correlated with disease activity parameters.

Conclusion: The Arabic CHAQ is a reliable and valid instrument that can be administered to Arabic children suffering from JIA and to their parents, to evaluate the patients' functional disability. Its measurement properties were comparable to versions in other languages.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / epidemiology*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cross-Cultural Comparison*
  • Developing Countries
  • Egypt / epidemiology
  • Female
  • Health Status
  • Humans
  • Male
  • Probability
  • Quality of Life
  • Reproducibility of Results
  • Sampling Studies
  • Saudi Arabia / epidemiology
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Surveys and Questionnaires*
  • Translating