Translation, Cultural Adaptation, and Validation of the Duke Activity Status Index in the Hindi Language

BACKGROUND: The Duke Activity Status Index (DASI) is a validated questionnaire in English to assess the functional capacity (FC) of patients with cardiovascular disease (CVD). AIM: The aim of the study is to translate, cross-culturally adapt, and validate the DASI in Hindi. SETTINGS AND STUDY DESIGN: Observational validation study. METHODOLOGY: Different translators translated the DASI into Hindi and then back-translated it into English. Validation for feasibility and psychometric properties of translated questionnaire was done on 200 adults, Hindi-speaking patients with CVD, who were advised exercise testing by a cardiologist. STATISTICAL ANALYSIS: Internal consistency (Cronbach's α) and test–retest reliability (Pearson's correlation coefficient) were calculated. Construct (correlation with the Canadian Cardiovascular Society Classification [CCSC] for angina and exercise capacity with treadmill testing [TMT]) and content validity (time taken to fill the questionnaire, ease of understanding the questionnaire items, and comprehensibility) were calculated. P < 0.05 was considered significant. RESULTS: The Cronbach's α for internal consistency was 0.78, which indicates adequate relatedness among the items of questionnaire, and the test–retest reliability was 0.65 (P < 0.05). A significant correlation between CCSC (r = −0.60) and TMT (r = 0.56) was found. The median time taken by the respondents to fill the questionnaire was 4 min. Of all the respondents, 95.74% of the respondents agreed that the Hindi questionnaire was easy to comprehend and 97.87% patients correlated the translated items to their daily physical activity. CONCLUSIONS: The Hindi translated and culturally adapted version of the DASI is reliable, valid, and feasible to assess the FC in the Hindi-speaking CVD patients.