A Spanish translation of the Walking Impairment Questionnaire was validated for patients with peripheral arterial disease

OBJECTIVES: Walking impairment is a common manifestation of peripheral arterial disease (PAD). In this study we present evidence for the validity of our Spanish translation of the Walking Impairment Questionnaire (WIQ). METHODS: The WIQ was translated into Spanish by our team of researchers. Spanish-speaking patients in the Houston, TX, area completed Spanish versions of the WIQ and the SF-36. Evidence for convergent and discriminant validity of the WIQ was obtained from correlations between the WIQ and other measures. Spanish or English as the primary language defined language-speaking status. RESULTS: Among 403 patients, convergent validity evidence was strong for both English- and Spanish-speaking patients. For patients with PAD, the correlation between walking distance and physical functioning was 0.55 (P < .01) for English-speaking patients and 0.85 (P < .01) for Spanish-speaking patients. The correlations of walking impairment with emotional health measures ranged from 0.26 to 0.44 for English-speaking patients (P < .01) and from 0.34 to 0.78 for Spanish-speaking patients. CONCLUSIONS: The WIQ scores correlated well with SF-36 components for both English- and Spanish-speaking patients. Our findings suggested that our translation process did not limit our ability to capture good-quality data. Further research is needed to determine what specific items in the WIQ or the SF-36 questionnaire warrant restructuring to increase their validity for use in diverse populations.     

Using Qualitative Methods to Improve Questionnaires for Spanish Speakers: Assessing Face Validity of a Food Behavior Checklist

Development of outcome measures relevant to health nutrition behaviors requires a rigorous process of testing and revision. Whereas researchers often report performance of quantitative data collection to assess questionnaire validity and reliability, qualitative testing procedures are often overlooked. This report outlines a procedure for assessing face validity of a Spanish-language dietary assessment tool. Reviewing the literature produced no rigorously validated Spanish-language food behavior assessment tools for the US Department of Agriculture's food assistance and education programs. In response to this need, this study evaluated the face validity of a Spanish-language food behavior checklist adapted from a 16-item English version of a food behavior checklist shown to be valid and reliable for limited-resource English speakers. The English version was translated using rigorous methods involving initial translation by one party and creation of five possible versions. Photos were modified based on client input and new photos were taken as necessary. A sample of low-income, Spanish-speaking women completed cognitive interviews (n=20). Spanish translation experts (n=7) fluent in both languages and familiar with both cultures made minor modifications but essentially approved client preferences. The resulting checklist generated a readability score of 93, indicating low reading difficulty. The Spanish-language checklist has adequate face validity in the target population and is ready for further validation using convergent measures. At the conclusion of testing, this instrument may be used to evaluate nutrition education interventions in California. These qualitative procedures provide a framework for designing evaluation tools for low-literate audiences participating in the US Department of Agriculture food assistance and education programs.     

Diagnostic Accuracy of Spanish Language Depression-Screening Instruments

PURPOSE To make decisions about implementing systematic depression screening, primary care physicians who serve Spanish-speaking populations need to know whether Spanish language depression-screening instruments are accurate. We aimed to review systematically the evidence regarding diagnostic accuracy of depression-screening instruments in Spanish-speaking primary care populations.METHODS We searched PubMed, PsycINFO, CINAHL, EMBASE, and Cochrane Libraries from inception to May 28, 2008, for studies examining the diagnostic accuracy of Spanish language depression case-finding instrument(s) administered to primary-care outpatients. Two authors independently assessed studies for inclusion and quality.RESULTS Twelve studies met inclusion criteria. In general primary care screening, the Spanish language version of the Center for Epidemiologic Studies-Depression scale (CES-D) had sensitivities ranging from 76% to 92% and specificities ranging from 70% to 74%. We found no US study reporting the accuracy of the Primary Care Evaluation of Mental Disorders (PRIME-MD-9) or the Patient Health Questionnaire (PHQ-9) depression module in Spanish-speakers. One fair-quality European study and 1 poor-quality study conducted in Honduras found the 9-item PRIME-MD had sensitivities ranging from 72% to 77% and specificities ranging from 86% to 100%. The 2-item PRIME-MD was 92% sensitive, but only 44% specific for depression in 1 US study. In geriatric outpatients, the 15-item Spanish language version of the Geriatric Depression Scale (GDS) had sensitivities ranging from 76% to 82%, and specificities ranging from 64% to 98%. In postpartum women, the Spanish language version of the Edinburgh Postnatal Depression Scale (EPDS) was 72% to 89% sensitive and 86% to 95% specific for major depression (2 non-US studies). The Spanish language version of the Postpartum Depression Screening Scale (PDSS) was 78% sensitive and 85% specific for combined major/minor depression (1 US study).CONCLUSIONS For depression screening in Spanish-speaking outpatients, fair evidence supports the diagnostic accuracy of the CES-D and PRIME-MD-9 in general primary care, the GDS-15-Spanish for geriatric patients, and the Spanish language versions of the EPDS or PDSS for postpartum patients. The ultrashort 2-item version of PRIME-MD may lack specificity in US Spanish-speakers.     

Computerized adaptive testing of diabetes impact: A feasibility study of Hispanics and non-Hispanics in an active clinic population

Background Diabetes is a leading cause of death and disability in the US and is twice as common among Hispanic Americans as non-Hispanics. The societal costs of diabetes provide an impetus for developing tools that can improve patient care and delay or prevent diabetes complications.Methods We implemented a feasibility study of a Computerized Adaptive Test (CAT) to measure diabetes impact using a sample of 103 English- and 97 Spanish-speaking patients (mean age = 56.5, 66.5% female) in a community medical center with a high proportion of minority patients (28% African-American). The 37 items of the Diabetes Impact Survey were translated using forward–backward translation and cognitive debriefing. Participants were randomized to receive either the full-length tool or the Diabetes-CAT first, in the patient's native language.Results The number of items and the amount of time to complete the survey for the CAT was reduced to one-sixth the amount for the full-length tool in both languages, across disease severity. Confirmatory Factor Analysis confirmed that the Diabetes Impact Survey is unidimensional. The Diabetes-CAT demonstrated acceptable internal consistency reliability, construct validity, and discriminant validity in the overall sample, although subgroup analyses suggested that the English sample data evidenced higher levels of reliability and validity than the Spanish sample and issues with discriminant validity in the Spanish sample. Differential Item Function analysis revealed differences in responses tendencies by language group in 3 of the 37 items. Participant interviews suggested that the Spanish-speaking patients generally preferred the paper survey to the computer-assisted tool, and were twice as likely to experience difficulties understanding the items.Conclusions While the Diabetes-CAT demonstrated clear advantages in reducing respondent burden as compared to the full-length tool, simplifying the item bank will be necessary for enhancing the feasibility of the Diabetes-CAT for use with low literacy patients.     

Affordances in the Home Environment for Motor Development-Infant Scale,Spanish Translation

The home environment has a critical influence on an infant’s development and well-being. The Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) is an instrument that has been developed to assess the home environment. This article illustrates the translation, validation, and cultural adaptation process of the AHEMD-IS from English to Spanish. The AHEMD-IS underwent a comprehensive process involving a four-phase translation process: (1) Forward translation, (2) Semantic equivalence, (3) Content equivalence testing, and (4) Final version development. Steps 1 and 2 resulted in linguistic alterations from the initial translation to enhance clarity for general public understanding. In step 3, mothers reported that the instrument was clear and easy to complete. Step 4 involved a final review of the instrument. The final outcome is a validated instrument that may prove beneficial when evaluating the home environment with Spanish-speaking populations, particularly those of Mexican descent.     

Access to assistive technology (AT) information in Spanish on state and territory program websites: United States, 2018

BackgroundCompared to non-Hispanic white individuals, assistive technology (AT) utilization is lower among Hispanic individuals.^1–7 In the US, Spanish is the 2nd most frequently spoken language. Greater than one-fifth of Spanish-speaking households are limited English proficiencty (LEP) households (i.e., all individuals over age 14 in the household speak English less than "very well").⁸ Availability of AT materials in Spanish is one factor influencing knowledge about and utilization of AT among Spanish-speakers.ObjectiveTo examine the availability of Spanish-language AT information on state AT program websites and to assess the relationship between availability and state demographic and linguistic characteristics.MethodsIn 2018, we evaluated 56 state and territory AT program websites for the availability of AT information in Spanish. We calculated 4 measures (US Hispanic population in the state/territory; Hispanic individuals as a proportion of state population; overall Spanish-speaking households, and Spanish-speaking, limited English proficient households) from the 2016 American Community Survey and created ranked lists for each measure. Point biserial (r_pb) correlations were calculated to test associations between each measure and availability of AT information in Spanish on each program’s website.ResultsSixteen program websites (15 states, 1 territory) provided access to Spanish-language AT information. None of the 4 measures were strongly associated with this outcome (r_pb ranged from 0.30 to 0.42). For any of the 4 measures, no more than half of states in the top 10 ranks offered online access to AT information in Spanish.ConclusionsImproving the online availability of AT information in Spanish is necessary to increase equity in AT utilization among Spanish-speaking people with disabilities.     

Association of insomnia with quality of life, work productivity, and activity impairment

Purpose  To assess the association of insomnia with health-related quality of life (HRQOL), work productivity, and activity impairment. Methods  Data were obtained from the 2005 US National Health and Wellness Survey. Subjects were assigned to the insomnia group (diagnosed insomnia experienced at least a few times a month) or the noninsomnia group (no insomnia or sleep symptoms). HRQOL was assessed using the short form 8 (SF-8) (mental and physical scores). The work productivity and activity impairment questionnaire (WPAI) assessed absenteeism (work time missed), presenteeism (impairment at work), work productivity loss (overall work impairment), and activity impairment. Linear regression models were used to control for potential confounders. Results  A total of 19,711 adults were evaluated (5,161 insomnia, 14,550 noninsomnia). Subjects in the insomnia group had significantly lower SF-8 physical (−5.40) and mental (−4.39) scores and greater activity impairment scores (+18.04) than subjects in the noninsomnia group (P < 0.01 for all). Employed subjects in the insomnia group had greater absenteeism (+6.27), presenteeism (+13.20), and work productivity loss (+10.33) scores than those in the noninsomnia group (P < 0.01 for all). Conclusions  Insomnia is significantly associated with poorer physical and mental quality of life and work productivity loss and activity impairment.     

Screening for abuse in Spanish-speaking women

BACKGROUND: Domestic violence is a major personal and public health concern affecting women of all walks of life. Physicians have reported the need for screening instruments to help recognize abuse; several have been validated in English. No screening tools thus far have been validated in other languages. METHODS: We translated a previously validated tool, the Woman Abuse Screening Tool (WAST), into Spanish. To assess for validity, we compared responses of Spanish-speaking abused and nonabused respondents drawn from a community health center and a battered women's shelter. There were 27 women in the abused group and 34 women in the nonabused comparison group. RESULTS: The scale was found to be reliable with a Cronbach alpha of 0.91. The mean WAST Spanish scores were significantly different between the two groups, indicating this tool would be a valid screening instrument. A short form using the two most reliable questions was developed as a more rapid screening tool for office use, achieving a specificity of 94% and a sensitivity of 89%. CONCLUSIONS: The Spanish version of the WAST successfully discriminated between Spanish-speaking nonabused and abused women. The short form might help physicians reliably screen for abuse in Spanish-speaking women.     

Translation validation of a new back pain screening questionnaire (the STarT Back Screening Tool) in French

Background

Low back pain (LBP) is a major public health problem and the identification of individuals at risk of persistent LBP poses substantial challenges to clinical management. The STarT Back questionnaire is a validated nine-item patient self-report questionnaire that classifies patients with LBP at low, medium or high-risk of poor prognosis for persistent non-specific LBP. The objective of this study was to translate and cross-culturally adapt the English version of the STarT Back questionnaire into French.

Methods

The translation was performed using best practice translation guidelines. The following phases were performed: contact with the STarT Back questionnaire developers, initial translations (English into French), synthesis, back translations, expert committee review, test of the pre-final version on 44 individuals with LBP, final version.

Results

The linguistic translation required minor semantic alterations. The participants interviewed indicated that all items of the questionnaire were globally clear and comprehensible. However, 6 subjects (14%) wondered if two questions were related to back pain or general health. After discussion within the expert committee and with the developer of the STarT Back tool, it was decided to modify the questionnaire and to add a reference to back pain in these two questions.

Conclusions

The French version of the STarT Back questionnaire has been shown to be comprehensible and adapted to the French speaking general population. Investigations are now required to test the psychometric properties (reliability, internal and external validity, responsiveness) of this translated version of the questionnaire.     

Screening for domestic violence in a predominantly Hispanic clinical setting

BACKGROUND: Domestic violence is a public health problem that is common across ethnic groups. The utility of validated screening tools to detect abuse in diverse populations remains largely unknown. OBJECTIVE: The purpose of the study was to test the reliability and validity of a brief 4-question instrument, HITS, among predominantly Hispanic women. METHODS: We conducted a cross-sectional study in an urban clinical setting. Two hundred and two women completed HITS and two other previously validated tools, the Index of Spouse Abuse-Physical Scale (ISA-P) and the Woman Abuse Screening Tool (WAST). Instruments were prepared in English and translated to Spanish. Reliability and validity of HITS were compared with the ISA-P and WAST. Performance measures of HITS were compared with the ISA-P or WAST as a criterion standard. RESULTS: Cronbach's alphas were 0.76 and 0.61 for the English version and Spanish version of HITS, respectively. When administered first and analysed alone, the Spanish version of HITS had a reliability of 0.71. For both English and Spanish versions HITS was significantly correlated to ISA-P and WAST. The English HITS version had a sensitivity of 86% and a specificity of 99%. A cut-off score of 5.5 for Spanish HITS version achieved a sensitivity of 100% and a specificity of 86%. CONCLUSIONS: HITS demonstrated good reliability and validity with ISA-P in English speaking patients. The Spanish version of HITS showed moderate reliability and good validity with WAST in Spanish speaking patients. HITS may help physicians detect abuse in predominantly Hispanic clinical settings.     

An English/Spanish safety climate scale for construction workers

BACKGROUND: Workers in the construction trades experience high rates of traumatic injury. An increasing number of workers in this industry speak only Spanish, including members of construction trade unions. This brief communication reports a dual language safety climate scale developed during a larger training intervention study. METHODS: Construction workers in two unions self-completed a previously validated 6-item safety climate scale modified for the construction trades. A seventh item was developed midway through the study and incorporated into the version completed by half of the respondents. For one union with a sizeable number of Spanish-speaking members, a dual-language (Spanish/English) version was administered. Follow-up telephone interviews conducted 3 months after the self-completed survey also included the safety climate scale. RESULTS: Cronbach's coefficient alpha was 0.85 for the 6-item scale and 0.85 for the 7-item scale. Similar coefficient alpha scores were found for the subgroup of Spanish-speakers on the 6- and 7-item scales. Spanish speakers with low education were less likely to respond to the scale when self-completing but not when it was administered by telephone in Spanish. CONCLUSION: This safety climate scale elicits consistent and reliable response from unionized construction workers when administered in English or in Spanish. Spanish literacy may be a consideration for the use of this scale among foreign-born Hispanic workers.     

Development and Reliability Testing of Spanish Language and English Language Versions of the Multidimensional Task Ability Profile

Purpose The purpose of this study was to assess the: (1) test–retest reliability of the English and Spanish language versions of the Multidimensional Task Ability Profile (MTAP), (2) cross-cultural adaptation of the Spanish language version of the MTAP, and (3) practicality of both versions in terms of time required for administration. The MTAP is a patient-reported outcome measure of physical function that uses a combination of text and pictorial illustrations. Methods An observational study was conducted with a convenience sample of patients with musculoskeletal disorders from three outpatient physical rehabilitation centers. Participants (n = 110) completed the MTAP two times, whereby the second test was completed 24–72 h after the first test. Focus groups were conducted at the end of the study. Correlation analyses were used to assess test–retest reliability and qualitative analyses were used to assess cultural adaptation of the MTAP. Results The English and Spanish versions of the MTAP displayed good test–retest reliability (ICC 2,1 = 0.87–0.97, p < 0.05). Qualitative analyses demonstrated adequate cross-cultural adaptation of the Spanish language version of the instrument. Conclusions The findings of this study indicate that the MTAP has been adequately adapted from its original English version for use with Spanish-speaking individuals. The MTAP in its current form of 50 items is reliable when administered to individuals with musculoskeletal disorders in either English or Spanish.     

Measuring quality of life among cervical cancer survivors: preliminary assessment of instrumentation validity in a cross-cultural study

Background With growing interest in cross-cultural and multicultural cancer-related quality of life studies, the need to assess reliability and validity of quality of life measures for linguistically and culturally diverse cancer survivors is pressing. Methods Reliability and validity of the English and Spanish versions of the Functional Assessment of Cancer Therapy (FACT)-G subscales were tested with a sample of English-speaking European American (n = 273) and ethnic minority American (n = 194), and Spanish-speaking Latina (n = 199) cervical cancer survivors in the U.S. Results Reliability coefficients (Cronbach’s alpha) were 0.76 or higher across ethnic/linguistic groups except for the emotional wellbeing subscale among Spanish-speaking Latinas (α = 0.64). Factor analyses demonstrated overall measurement equivalence across groups with some ethnic/linguistic variations: there were greater differences between linguistic groups than between ethnic groups. Additionally, the scale’s factor structure was less satisfactory for Spanish-speaking Latinas. The subscales had good concurrent validity with appropriate subscales of the Short Form (SF)-12 and Rand/SF-36 General Health subscale (Pearson’s r 0.53–0.66), suggesting each subscale was assessing its intended construct. Conclusion The overall psychometric properties of the FACT-G were cross-culturally equivalent. However, more validation studies are needed for non-English speaking populations particularly with emotional wellbeing. In addition, disaggregated analyses on linguistic groups are recommended unless cross-cultural equivalence is established. All participants in this study have provided written informed consent as required by the University of California at Los Angeles Institutional Review Board.     

Differential item functioning of the patient-reported outcomes information system (PROMIS<Superscript>®</Superscript>) pain interference item bank by language (Spanish versus English)

Background

About 70% of Latinos, 5 years old or older, in the United States speak Spanish at home. Measurement equivalence of the PROMIS^® pain interference (PI) item bank by language of administration (English versus Spanish) has not been evaluated.

Methods

A sample of 527 adult Spanish-speaking Latinos completed the Spanish version of the 41-item PROMIS^® pain interference item bank. We evaluate dimensionality, monotonicity and local independence of the Spanish-language items. Then we evaluate differential item functioning (DIF) using ordinal logistic regression with item response theory scores estimated from DIF-free “anchor” items.

Results

One of the 41 items in the Spanish version of the PROMIS^® PI item bank was identified as having significant uniform DIF.

Conclusions

English- and Spanish-speaking subjects with the same level of pain interference responded differently to 1 of the 41 items in the PROMIS^® PI item bank. This item was not retained due to proprietary issues. The original English language item parameters can be used when estimating PROMIS^® PI scores.

     

Validity of a job stressors measurement scale in nursing staff: the nursing stress scale]

BACKGROUND: The aim of this work was to determine the reliability and construct validity of a scale intended to measure job stressors to which hospital nursing staff may be exposed. SUBJECTS AND METHODS: The nursing stress scale contains 34 stressors. The scale's trans-cultural adaptation was carried out by means of the translation-back translation method. Validation was conducted on a random sample of 201 health professionals in a public hospital in Valencia. The reliability of the scale was assessed after its readministration on a sub-sample of 30 nursing professionals, with a 15 day interval. The construct validity was obtained through the correlation of the scale with another two scales: The 28 item version of Goldberg's General Health Questionnaire and 7 dimensions of the Health questionnaire SF-36. RESULTS: The scale in Spanish language contains 34 items after eliminating the first item from the original scale (N1: computer failure) and including a new item (E1: Frequent job interruptions). The distribution of scores obtained in the initial administration of the scale and fifteen days later do not differ statistically. The Cronbach's alfa coefficient is 0.92 for the total scale and in each of the sub-scales ranges between 0. 83 and 0.49. The correlation between the scale and the GHQ-28 items questionnaire is 0.34. For each one of the seven dimensions of the SF-36 questionnaire the correlations range between -0.21 and -0.31. CONCLUSION: The nursing stress scale is a useful instrument for measuring possible stressors in this collective. It has high internal consistency and construct validity, as does the original American version, however reliability is moderate.     

The effect of inadequate language translation on Hispanics' responses to health surveys.

Data bearing on the effect of language of the interview on Hispanics' responses to a health survey in which no back-translation was undertaken reveal both lower reliabilities and lower bivariate correlations among Hispanics interviewed in Spanish than among Hispanics interviewed in English. An independent back-translation aimed at creating an English version of the questionnaire that was linguistically equivalent to the Spanish version indicated several instances in which the Spanish version was unidiomatic. Differences between the Spanish and English version in the idiomatic quality of the interview items, while not affecting meaning, appear to have affected the seriousness with which the interview situation was perceived. These perceptions, in turn, appear to have led to the response discrepancies observed.     

Development and validation of a WHOQOL-BREF Taiwanese audio player-assisted interview version for the elderly who use a spoken dialect

A quality of life questionnaire is rarely adapted to an interview mode for people who mainly use spoken language in daily life. In Taiwan, the WHOQOL-BREF (Mandarin Chinese version) has been developed, as a self-administered questionnaire, but it cannot be applied to the majority of the elderly in Taiwan, who speak only Taiwanese (a dialect). This study adopted the audio player-assisted interview mode to develop a Taiwanese version of the WHOQOL-BREF specifically for Taiwanese-speaking elderly people, and followed with examinations of the reliability and validity of this version. Initially, the WHOQOL-BREF (English version) was translated into colloquial Taiwanese, and field tests confirmed the equivalence and appropriateness of the translation. A total of 228 Taiwanese-speaking elderly people were assessed using the Taiwanese interview version, of which 144 subjects were re-assessed two weeks later. Interviewers assessed each subject aided by an audio player on which all the translated WHOQOL-BREF contents were recorded. The Taiwanese interview version of the WHOQOL-BREF, except for the item related to dependence on medication, showed acceptable reliability (internal consistency, corrected item-domain correlation, and test–retest reliability) and validity (criterion-related, convergent, and discriminant validity). Confirmatory factor analyses supported the four-factor model of the Taiwanese interview version, providing evidence for construct validity. The results suggest that the Taiwanese audio player-assisted interview version of the WHOQOL-BREF was reliable and valid in assessing quality of life of elderly Taiwanese.     

Validity and reliability of the Spanish sign language version of the KIDSCREEN-27 health-related quality of life questionnaire for use in deaf children and adolescents

Objective

The aim of this paper was to test the validity and reliability of a Spanish sign language (SSL) adaptation of KIDSCREEN-27, a health-related quality of life (HRQoL) questionnaire for use in deaf children and adolescents.

Methods

We performed an observational cross-sectional study of 114 deaf children and adolescents aged 8 to 18 years old. The Spanish version of the KIDSCREEN-27 was adapted to SSL through the translation-back translation technique. The adapted questionnaire was then administered using a web tool to ensure complete access to study participants. Floor and ceiling effects were calculated. Structural and cultural validity were tested using exploratory and confirmatory factor analysis. Cronbach's α was used to assess internal consistency. The questionnaire was administered for a second time to the entire sample after 2 to 4 weeks (test-retest reliability).

Results

In the SSL version of the KIDSCREEN-27, as in the original Spanish scale, five dimensions explained 59% of the variance. None of the participants obtained the minimum or maximum scores on the scale (floor and ceiling effect, respectively). Confirmatory factor analysis showed the goodness-of-fit of the factor solution with five dimensions of the SSL version. The Cronbach's α of both the total scale and of each of the distinct dimensions was above 0.75. The intra-class correlation coefficient of the test-retest scale was considered acceptable in all the dimensions.

Conclusions

The reliability and validity of the SSL version of the KIDSCREEN-27 are similar to those of the original Spanish version, providing a new tool for measuring HRQoL in deaf children and adolescents.     

Cross-cultural Adaptation,Reliability, and Validity of the Work Role Functioning Questionnaire to Brazilian Portuguese

INTRODUCTION: The study objectives were to translate and adapt the Work Role Functioning Questionnaire (WRFQ) into the Brazilian Portuguese language and evaluate its reliability in patients experiencing musculoskeletal disorders. METHODS: The cross-cultural adaptation was performed according to the internationally recommended methodology, using the following guidelines: translation, back-translation, revision by a committee, and pretest. At first, the questionnaire was independently translated by two bilingual translators, who had Portuguese as their mother language. Subsequently, two other translators whose mother language was English did the back-translation. A committee composed of five specialists revised and compared the translations obtained, developing the final version for pretest application. The pretest was carried out with 30 patients experiencing musculoskeletal disorders. Psychometric properties were evaluated by administering the questionnaire to 105 subjects with musculoskeletal disorders and receiving physical therapy treatment. The reliability was estimated through stability and homogeneity assessment. The construct validity was tested comparing subjects experiencing musculoskeletal disorders to healthy workers. RESULTS: The results indicated good content validity and internal consistency (Cronbach alpha = 0.95). Cronbach alpha for each scale was >0.85, except for the social demand scale. The Intraclass Correlation Coefficient for the test-retest reliability was satisfactory for mental demands (ICC = 0.68) and excellent for the others (0.82-0.91). In relation to the construct validity, the mean score obtained for each scale was lower for physical, work scheduling, and output demands in the subjects with musculoskeletal disorders. There was a significant difference (p < 0.001) between the groups in comparison to work scheduling, physical, and output demands. CONCLUSIONS: The data showed that the cross-cultural adaptation process was successful and the adapted instrument demonstrated psychometric properties making it reliable to use in Brazilian culture.