Publish in this journal
Journal Information
Vol. 18. Issue 4.
Pages 236-245 (April 2022)
Download PDF
More article options
Vol. 18. Issue 4.
Pages 236-245 (April 2022)
Original Article
Validation of a Spanish version of the Health Assessment Questionnaire-II to assess Mexican patients’ physical function with rheumatoid arthritis
Validación de una versión en español del Health Assessment Questionnaire-II para la evaluación de la capacidad funcional en pacientes mexicanos con artritis reumatoide
Gabriel Horta-Baas
Servicio de Reumatología, Hospital General Regional 1, Delegación Yucatán, Instituto Mexicano del Seguro Social, Mérida, Yucatán, Mexico
Article information
Full Text
Download PDF
Figures (1)
Tables (5)
Table 1. General characteristics of the study participants.
Table 2. Results of the confirmatory factor analysis and the exploratory factor analysis in the patients of sample 1.
Table 3. Correlation between the Health Assessment Questionnaire-II y Health Assessment Questionnaire-Disability Index scores with other clinical variables.
Table 4. Results of the fit of item response theory (IRT) models to the HAQ-II and comparison of their goodness-of-fit.
Table 5. Parameters estimated with the MGRM multidimensional graduated response model (MRGM), fit of the items and marginal reliability coefficient of the IRT.
Show moreShow less
Additional material (1)

To evaluate the validity, reliability, and performance of the Health Assessment Questionnaire-II (HAQ-II) Spanish version questionnaire to measure physical function.


A cross-sectional study of 496 patients with rheumatoid arthritis (RA), distributed in 2 samples. The construct validity was evaluated employing the confirmatory factor analysis (CFA) and the validity based on the relationship with other variables. Cronbach's alpha (α) and McDonald’s omega (ω) coefficient were used to determine reliability. Item performance was analysed by fitting different models of item response theory (IRT).


The one-factor model presented a poor fit in the CFA; an exploratory factor analysis (AFE) was carried out, which suggested a 2-factor structure. The CFA in the second sample confirmed that the second-order model had a good fit to the data. The general factor explained more than 70% of the variance. The reliability indices showed adequate internal consistency (α = .92–.95; ω = .88–.93). Ninety-three percent of the contrasting hypotheses about the relationship of the HAQ-II scores with other variables were confirmed, demonstrating their convergent, divergent, and known group validity. The multidimensional graduated response model was the one that best predicted person's interaction with the items.


The Spanish version of the HAQ-II presents adequate validity and reliability for measuring Mexican patients' physical function with RA.

Functional Status Assessment
Disability evaluation
Patient Reported Outcome Measures
Rheumatoid arthritis

Evaluar la validez de constructo, fiabilidad y el funcionamiento de los ítems de una versión en español del Health Assessment Questionnaire-II (HAQ-II) para medir la capacidad funcional.


Estudio transversal que incluyó 496 pacientes con artritis reumatoide, distribuidos en 2 muestras. La validez de constructo se evaluó mediante el análisis factorial confirmatorio y la validez basada en la relación con otras variables. Para determinar la fiabilidad se empleó el coeficiente alfa de Cronbach (α) y omega de McDonald (ω). El funcionamiento de los ítems se analizó mediante el ajuste a diferentes modelos de la teoría de respuesta al ítem.


El modelo de 1 factor presentó un mal ajuste en el análisis factorial confirmatorio; se realizó un análisis factorial exploratorio que sugirió una estructura de 2 factores. El análisis factorial confirmatorio en la segunda muestra confirmó que el modelo de segundo orden presentó un buen ajuste a los datos. El factor general explicó más del 70% de la varianza. Los índices de fiabilidad mostraron una adecuada consistencia interna (α = .92–.95; ω = .88–.93). El 93% de las hipótesis contrastadas sobre la relación de las puntuaciones del HAQ-II con otras variables se confirmaron, lo cual demuestra su validez convergente, divergente y de grupos conocidos. El modelo de respuesta graduada multidimensional fue el que mejor predijo la interacción de las personas con los ítems.


La versión en español del HAQ-II presenta una adecuada validez y fiabilidad para la medición de la capacidad funcional en pacientes mexicanos con artritis reumatoide.

Palabras clave:
Capacidad funcional
Evaluación de la discapacidad
Resultados reportados por el paciente
Artritis reumatoide


These are the options to access the full texts of the publication Reumatología Clínica (English Edition)
If you are member of Sociedad Española de Reumatología (SER) or the Colegio Mexicano de Reumatología (CMR):
Please go to the member area of SER or CMR and log in.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Reumatología Clínica (English Edition)

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Reumatología Clínica (English Edition)

Subscribe to our newsletter

Article options
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?