Elsevier

Journal of Hand Therapy

Volume 17, Issue 4, October–December 2004, Pages 417-423
Journal of Hand Therapy

Scientific/Clinical Article
Evaluation of the Chinese version of the Disability of the Arm, Shoulder and Hand (DASH-HKPWH): Cross-cultural adaptation process, internal consistency and reliability study

https://doi.org/10.1197/j.jht.2004.07.005Get rights and content

Abstract

The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives

This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method

Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results

Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion

The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Section snippets

New calculation for the DASH score

The main section of the DASH includes a 30-item scale according to the degree of difficulty and severity of pain in performing various activities during the week before completing the questionnaire. Items 1–21 and 29 relate to the level of difficulty in performing various physical activities. The severity of symptoms, including pain, tingling, weakness, and stiffness, are included in items 24–28. Items 22 and 23 relate to social activities, and item 30 asks about an individual's psychological

Cross-cultural adaptation

The synthesis of the forward translation of the questionnaire was produced with little difficulty, except when there were several items that required a longer discussion before achieving a consensus, such as item 20 (managing transportation needs) and the first item (using usual techniques) in both the DASH-W and DASH-SP modules. There were some discrepancies between the two back-translations because the two translators had different opinions regarding more colloquial language. For example, in

Discussion

The aim of the present study was to demonstrate the cross-cultural adaptation process and evaluate the face validity, internal consistency, and reliability of the DASH-HKPWH. Our study showed that this new questionnaire maintains the linguistic and cultural elements, as well as the internal consistency and reliability, of the original version.

When developing a scale, it is important to eliminate items that are repetitive or irrelevant to the body part being investigated or studied. Careful

Conclusion

The DASH-HKPWH is a self-administered questionnaire that can be used in clinical settings to subjectively identify any changes in symptoms by patients before commencing treatment. The application of the DASH and other relevant upper-extremity measuring instruments allows clinicians to understand their patients' conditions more clearly. The results suggest that the DASH-HKPWH is a reliable outcome measure for assessing patients with upper extremity disorders. To the best of our knowledge, this

Acknowledgment

The authors thank Drs. James Derrick and Lauren Pfister for their assistance with the translation and Professor Cindy Aun for proofreading of the manuscript. They also thank the expert committee for their valuable comments, and the staff and patients at the physiotherapy department of Prince of Wales Hospital, Hong Kong for their help with the cross-cultural adaptation study.

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