Cross-cultural adaptation and validation of a Bengali Health Assessment Questionnaire for use in rheumatoid arthritis patients

Int J Rheum Dis. 2013 Aug;16(4):413-7. doi: 10.1111/1756-185X.12032. Epub 2013 Jan 22.


Aim: To translate and adapt the Health Assessment Questionnaire Disability Index (HAQ-DI) into Bengali (B-HAQ) for use in Bangladeshi populations and to test its reliability and validity in patients with rheumatoid arthritis (RA).

Method: The HAQ-DI was translated using rigorous forward-backward protocols and the translated version was subsequently cognitively pretested in a sample of 30 outpatients with RA. The pre-final version of the questionnaire was psychometrically tested for internal consistency and construct validity in a new sample of 100 consecutive RA outpatients.

Results: Ten questions were changed to suit the Bengali culture. Pretests showed that the items included in the B-HAQ were well understood by Bengali patients, while some of the original items were difficult to understand for a majority of patients. The resulting B-HAQ showed good internal consistency and construct validity in the psychometric validation study.

Conclusion: This study suggests that the B-HAQ is a reliable and valid instrument for measuring functional disability in a Bengali-speaking population with RA. Future studies should examine the test-retest reliability and responsiveness of the B-HAQ before it can be confidently recommended as an outcome measure in intervention studies.

Keywords: Health Assessment Questionnaire; cross-cultural translation; physical function; rheumatoid arthritis; validity.

Publication types

  • Validation Study

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / epidemiology*
  • Bangladesh / epidemiology
  • Cross-Cultural Comparison*
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Outcome Assessment*
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Translating*
  • Young Adult