Brazilian Portuguese version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability

Abstract

Background The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Methods Consecutive patients with headaches diagnosed by expert neurologists as per the International Classification of Headache Disorders were included. For the cross-cultural adaptation, 30 individuals answered the translated Headache Disability Inventory version. The internal consistency was evaluated, and the structural validity was assessed through exploratory factor analysis. For the construct validity assessment, 132 individuals answered the Headache Disability Inventory-Brazil, 12-item Short Form Survey (SF-12), and Headache Impact Test (HIT-6). After 1–3 weeks, 67 individuals again answered the Headache Disability Inventory-Brazil for the reliability assessment. The Pearson's correlation test, the intraclass correlation coefficient and the standard error of measurement were analyzed. Results The pre-stage version of the questionnaire was considered as the final version. The Headache Disability Inventory-Brazil had an internal consistency of 0.84 and consisted of a functional, emotional and social participation domain (factor loads > 0.3). The internal consistency ranged from 0.81 to 0.93 for each of the three domains. For the construct validity, the Headache Disability Inventory-Brazil presented moderate correlation with the SF-12 (r = −0.70, p < 0.05) and with the HIT-6 (r = 0.67, p ≤ 0.05). Its test-retest reliability was considered to be excellent (intraclass correlation coefficient = 0.95) and the standard error of measurement was 2.26 points. Conclusion The Headache Disability Inventory-Brazil was successfully translated and culturally adapted to the Brazilian population. It can be used for the impact assessment of primary and secondary headaches with validity and reliability equivalent to its original version.

Measurement properties of the Headache Impact Test (HIT‐6™ Brazil) in primary and secondary headaches

“…The construct of the original HIT‐6™ in English was validated online and contrasted to the 8‐Item Short‐Form Survey (SF‐8) questionnaire 8 . The Brazilian Portuguese version was also assessed in a self‐report form, compared to the SF‐12 questionnaire and with an additional impact instrument, the Brazilian Portuguese version of the HDI 19 . The original version had a moderate and negative correlation with the physical (−0.35) and mental (−0.31) scales of the SF‐8, 8 just as the Portuguese version in contrast with the SF‐12 total score.…”

“…In the two appointments, patients were asked about the frequency and intensity of headache during the last 30 days, in order to ensure the clinical stability of the sample. The following outcomes were used as a reference for the construct validity assessment: pain intensity (numeric visual scale, NVS), headache frequency within the last month, the SF‐12, 18 and the HDI‐Brazil questionnaires 19 …”

“…8 The Brazilian Portuguese version was also assessed in a self-report form, compared to the SF-12 questionnaire and with an additional impact instrument, the Brazilian Portuguese version of the HDI. 19 The original version had a moderate and negative correla- considered the most used instrument to evaluate the disability in migraine, presented also moderate correlation with the HIT-6™. 9 Our study also verified a moderate correlation between HIT-6™…”

“…The following outcomes were used as a reference for the construct validity assessment: pain intensity (numeric visual scale, NVS), headache frequency within the last month, the SF-12, 18 and the HDI-Brazil questionnaires. 19 The SF-12 17 questionnaire contains 12 questions regarding the self-perception of quality of life. The total score ranges from 37 to 123 points, and greater scores are related to a greater quality of life.…”

Patient-Reported Outcome Measurements in Temporomandibular Disorders and Headaches: Summary of Measurement Properties and Applicability

“…Method of administration: The HDI is a self-administered tool, but it could be administered by an interview [26,27].…”