Translation, cross‐cultural adaptation and validation of Nepali version of Health Assessment Questionnaire‐Disability Index in rheumatoid arthritis patients from Nepal

Objective To translate, cross‐culturally adapt and validate the Health Assessment Questionnaire‐Disability Index (HAQ‐DI) in Nepali language (Nepali HAQ). Methods Translation was done fulfilling the methodological standards described by Beaton. Comprehensibility testing of the preliminary version was done in 50 rheumatoid arthritis (RA) patients, and a prefinal version was prepared after making changes in the original version to maintain the equivalence with the target version. Psychometric testing was done in another group of 127 rheumatoid patients to test for content validity and reliability. Construct validity was tested with visual analog score (VAS) and numeric rating scales (NRS) for pain and stiffness. Results Nepali HAQ was comprehensible in >95% of patients. Reliability testing showed an intraclass coefficient for overall Nepali HAQ of 0.76, ranging from 0.71 to 0.95. The internal consistency was acceptable with a Cronbach's alpha of .92. Construct validity was also acceptable with a moderate correlation between Nepali HAQ and VAS and NRS. Conclusions Nepali HAQ is a comprehensible, reliable and valid tool for evaluation of the functional status of Nepalese patients with RA and should be implemented in clinical care and research settings.