Development of a Spanish (Castillian) version of the Childhood Health Assessment Questionnaire. Measurement of health status in children with juvenile chronic arthritis

Objective To demonstrate that the Spanish (Castillian) version of the Child hood Health Assessment Questionnaire (cHAQ-S) is a valid and reliable instr ument for measuring the health status of children with juvenile chronic (or rheumatoid) arthritis (JCA) and is sensitive to change. Methods A conceptual translation of the original questionnaire into Spanish and two back-translations were performed. The cHAQ-S was completed by the parents of young children (aged 1 to 19 years) affected by JCA, and additio nally by those children aged over 9. A second cHAQ-S was administered at le ast 15 months after the first one. Results The cHAQ-S was administered to 79 parents of patients affected by J CA. The test-retest reliability was evaluated among 16 patients, and no sig nificant differences between the first and second administration were found (0.88 versus 0.84; p > 0.6; intraclass cor-relation coefficient R = 0.94). The Cronbach's alpha coefficient was 0.948 indicating an excellent interna l reliability with a mean correlation between the different components of t he questionnaire varying from 0.3557 to 0.7831. For the between-observer re liability, an intraclass correlation coefficient of 0.96 was obtained. Corr elations between DI (Disability Index) and several measures of disease acti vity were all statistically significant (Spearman's R ranged from 0.42 to 0 .87; p < 0.005). Patients who improved showed similar improvement in the DI (p = 0.015), while patients who worsened showed a worsening of the DI (p = 0.1) and patients whose condition was stable showed no change in DI (p = 0 .6). Conclusion The cHAQ-S is a feasible, reliable and valid instrument for the determination of the health status of Spanish children suffering from JCA. It is also sensitive to changes in the child's health status.