![]() ![]() The construct validity was tested during the first session when the Visual Analogue Scale (VAS) for hand pain, the Health Assessment Questionnaire (HAQ) 12 and the Disability of the Arm, Shoulder and Hand (DASH) questionnaire 13 were administered in addition to the CHFS.Īspects of quality of life have been evaluated in previous assessments of RA patients. The second interviews were performed 15 days after the first interview by one of the raters to evaluate the intraobserver reliability. For the first interview, the patients were interviewed twice by two raters to evaluate the interobserver reliability. These patients were interviewed three times. After this phase, another group of 30 patients was selected. The objective of this phase of the testing was to assess the questionnaire's cultural equivalence. The items that were not understood by 20% or more of the respondents were analyzed and modified by the committee, and the revised questionnaire was then administered to a new group of 30 patients. V1 of the questionnaire was administered to 30 patients. The present study was approved by the Ethics Committee of the Universidade Federal de S�o Paulo, and all of the patients signed a free, prior informed consent statement. The participants were consecutively selected at the outpatient clinics of the Division of Rheumatology at a university in São Paulo/Brazil. The exclusion criteria were the following: a range of motion restriction due to skin lesions or other autoimmune disorders the presence of a neurological disease the presence of another musculoskeletal disease in the upper limbs a previous surgery on the wrist or the hand trauma in the wrist or hand during the previous week and difficulty understanding the Portuguese language. 11 The subjects of the present study included RA patients of both sexes, who were aged between 18 and 60 years, with some impairment in the wrist or the hand. ![]() The RA patients were selected according to the American College of Rheumatology (ACR) criteria. Therefore, V1 ( Appendix 1) was accepted as the version for testing as the CHFS-Portuguese. ![]() This comparison demonstrated that there was a semantic equivalence between the two versions. These two versions were compared with the original questionnaire. This version was translated into French by two other translators who were not familiar with the original questionnaire. 5, 6 The resulting translations were analyzed by a committee that was comprised of a rheumatologist and a physical therapist, who constructed a consensus version in Portuguese (V1). The original CHFS was translated from French into Brazilian Portuguese by two independent translators, as recommended by Guillemin et al. The aim of the present study was to translate, to perform a cultural adaptation of and to test the reproducibility of the CHFS for Brazil. It is a valid and reliable scale that has been used in other languages and for other diseases. This questionnaire consists of 18 questions about common daily activities. 5- 7 The Cochin Hand Functional Scale (CHFS) is a scale that was initially developed in France to assess the level of functional disability in the hands of RA patients. 4, 5 Because of the large number of existing tools and to the growing effort to use internationally standardized measures, the cultural adaptation of questionnaires has been widely used by researchers who do not have an assessment tool in their own language. 2, 3 The impact of chronic diseases such as AR has led to the development of tools for evaluating the physical, mental and social well-being aspects of a patient's quality of life. 1 When the joints in the hands are affected, their functional ability is compromised because this disease affects the strength, dexterity and mobility of the fingers and the wrist. Rheumatoid arthritis (RA) is a chronic autoimmune, systemic and symmetric inflammatory disease that affects synovial joints and often affects small joints, such as those in the hands and feet.
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