Translations of the Fibromyalgia
Impact  Questionnaire (FIQ) 

            Rivera J, Gonzalez T. The Fibromyalgia Impact Questionnaire: a validated Spanish version to assess the health status in women with fibromyalgia. Clin Exp Rheumatol 2004; 22(5):554-560.
 

            OBJECTIVE: To translate, adapt, validate and assess the sensitivity to change of a Spanish version of the Fibromyalgia Impact Questionnaire (FIQ-S). METHODS: The FIQ-S was adapted following the translation and back-translation methodology. Female patients with fibromyalgia (FM) were invited to participate. Reliability was analyzed by the Spearman correlation coefficient between test and retest. Internal consistency was checked by the Cronbach's alpha coefficient. Construct validity was analyzed comparing FIQ-S with: HAQ, FHAQ, SF-36, SCL90-R, and the visual analogue scale for pain. Sensitivity to change was assessed in an 8-week randomized trial of exercise therapy. Feasibility was analyzed by the time taken in completing the FIQ-S and the proportion of patients able to complete the questionnaire. RESULTS: Translation was concordant. Adaptation affected at 4 sub-items of physical function. One-hundred and two FM patients completed the protocol. Mean age was 48.7 years with a mean of 9.2 years of evolution. Test-retest correlations were between 0.61-0.85 (p < 0.0001). Internal consistency showed alpha = 0.82 for all items and alpha = 0.86 for the sub-items of physical function. Significant correlations (p < 0.0001) were found between the FIQ-S items and HAQ, FHAQ, SF-36 and SCL90-R. For patients treated with the exercise program, the pre-treatment FIQ-S score was 52.0 +/- 11.5 and the post-treatment score was 40.8 +/- 13.7 (p < 0.003). Mean time for completing FIQ-S was 3.3 minutes. In 4% of the patients external help was needed. CONCLUSION: The FIQ-S is a reliable, valid and responsive to changes questionnaire for measuring health status and physical function in Spanish speaking FM patients

            Bae SC, Lee JH. Cross-cultural adaptation and validation of the Korean fibromyalgia impact questionnaire in women patients with fibromyalgia for clinical research. Qual Life Res 2004; 13(4):857-861.
 

            OBJECTIVE:  Our aim was to translate and cross-culturally adapt the fibromyalgia impact questionnaire into Korean (KFIQ), and then evaluate its reliability and validity. The FIQ was translated into Korean by three translators and then independently translated back into English by three different translators. A total of 62 women patients with fibromyalgia (FM) were studied for the psychometric properties of the KFIQ. The mean age of the patients was 47.1 (25-73) years, and all were female. The mean KFIQ score was 48.3 (17-91), and the mean Korean health assessment questionnaire (KHAQ) score was 0.4 (0-1.7). The test-retest reliability of the KFIQ yielded an intraclass correlation coefficient of 0.85 (0.53-0.96). For the construct validity, the Spearman rank correlations of KFIQ with patient global assessments using visual analog scale (pain, 0.58; morning stiffness, 0.45; fatigue, 0.48; depression, 0.43; anxiety, 0.56; global well-being, 0.46; disease severity, 0.49; impact on life, 0.51), KHAQ (0.44), and tender points (0.60) were high and statistically significant. The KFIQ might be a reliable and valid instrument for measuring health status and physical functioning in Korean women patients with FM, but needs further study

            Sarzi-Puttini P, Atzeni F, Fiorini T, Panni B, Randisi G, Turiel M et al. Validation of an Italian version of the Fibromyalgia Impact Questionnaire (FIQ-I). Clin Exp Rheumatol 2003; 21(4):459-464.
 

            OBJECTIVE: To validate a translated Italian version of the Fibromyalgia Impact Questionnaire (FIQ). METHODS: The Italian version of the FIQ was administered to 50 patients affected by fibromyalgia (FM) (48 patients filled out the questionnaire again 10 days later) together with the Italian version of the Stanford Health Assessment Questionnaire (HAQ), the Medical Outcomes Survey Short Form-36 (SF-36), and a tender point count (TPC) obtained by summing the score (0-3) of each tender point tested by thumb palpation. All patients were asked about the severity of pain today (10 cm visual analog scale) and the duration of symptoms. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha of reliability. Construct validity of the FIQ was evaluated by correlations between the HAQ and subscales of the SF-36 as well as the TPC. RESULTS: The mean duration of symptoms was 6.5 years and the mean age of the participants was 57.4 years. Test-retest reliability was between 0.74 and 0.95 for physical functioning as well as for the total FIQ and other components. Internal consistency was 0.90 for the overall FIQ. Significant correlations were obtained between the FIQ items, the HAQ and the SF-36. CONCLUSIONS: The Italian FIQ is a reliable and valid instrument for detecting and measuring functional disability and health status in Italian patients with FM

            Perrot S, Dumont D, Guillemin F, Pouchot J, Coste J. Quality of life in women with fibromyalgia syndrome: validation of the QIF, the French version of the fibromyalgia impact questionnaire. J Rheumatol 2003; 30(5):1054-1059.

OBJECTIVE: To validate a translated and adapted version of the Fibromyalgia Impact Questionnaire (FIQ) for use in French-speaking populations. METHODS: The FIQ was translated into French by 2 independent translators and then back-translated into English to assess the conceptual equivalence. The translated version was tested and adapted by an expert committee to obtain the Questionnaire de mesure d'Impact de la Fibromyalgie (QIF), the French version of the FIQ. We administered the QIF to 102 women with fibromyalgia (FM): 71 women who consulted once, and 31 women who were follow for 3 visits (D0, M1, and M3). The patients were also asked to answer 4 other questionnaires: the McGill Pain Questionnaire, the Medical Outcome Study Short Form-36 (SF-36), the short form of the Arthritis Impact Measurement Scale 2 (AIMS2), and the General Health Questionnaire (GHQ) (for psychiatric assessment). To ensure test-retest reliability, the patients were asked to complete the QIF 7 days after the first visit and to send it back to the investigators by mail. During each visit, all patients were asked about pain intensity. A tender point count was obtained by thumb palpation and the tenderness threshold of each specific point was assessed by a 4-point scale score to determine the global tender point index. RESULTS: No major cultural adaptation was needed to obtain the French version of the FIQ. Test-retest reliability coefficients (intraclass correlation coefficient) for each question ranged from 0.04 to 0.84. Two items from the QIF (number of days when the patient felt good and visual analog scale stiffness) did not reach significant levels of test-retest reliability. Internal validity was good. The QIF score correlated well with the SF-36 and AIMS2 scores. The psychological aspects of the QIF were well correlated with those of GHQ-28. None of the items from the McGill Pain Questionnaire was correlated with QIF items. Similarly the clinical data concerning pain assessment were not correlated with QIF items. CONCLUSIONS: QIF is a valid instrument for measuring functional disability and health status in French women with FM. Some of the items were of a limited reliability, perhaps due to the variability of the multiple aspects of this syndrome

            Kim YA, Lee SS, Park K. Validation of a Korean version of the Fibromyalgia Impact Questionnaire. J Korean Med Sci 2002; 17(2):220-224.
 

            OBJECTIVE: The aim of this study was to translate the Fibromyalgia Impact Questionnaire (FIQ) into Korean and to evaluate its reliability and validity for use with Korean-speaking patients with fibromyalgia (FM). After translating the FIQ into Korean, we administered it to 55 patients with FM (28 patients filled out the questionnaire again 7 days later) together with a Korean version of the Health Assessment Questionnaire (HAQ) and the Symptom Checklist-90-Revision (SCL-90-R). The tender-point count (TPC) was calculated from tender points identified by thumb palpation. In addition to sociodemographic characteristics, the severity of relevant current clinical symptoms, e.g., pain intensity, fatigue, and morning stiffness, were assessed by 10-cm visual analog scales (VAS). The test-retest reliability was between 0.466 and 0.780 (total 0.778). Cronbach's alpha was 0.800 for FIQ1 (the first assessment) and 0.857 for FIQ2 (the second assessment), indicating acceptable levels of internal consistency for both assessments. Significant correlations were obtained between the FIQ items, the HAQ, the severity of clinical symptoms, and the subscales of the SCL-90-R. In conclusion, the Korean version of the FIQ is a reliable and valid instrument for measuring health status and physical functioning in Korean patients with FM

            Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 2000; 20(1):9-12.

            OBJECTIVE: This study was undertaken to translate and adapt the Fibromyalgia Impact Questionnaire (FIQ) into the Turkish language and investigate its validity and reliability for Turkish female fibromyalgia (FM) patients. After translation into Turkish, we administered the FIQ and Health Assessment Questionnaire (HAQ) to 51 women with fibromyalgia. As well as sociodemographic characteristics, the severity of relevant clinical symptoms, e.g., pain intensity, fatigue, and sleep disturbance, were assessed by visual analog scales. A tender point score (TPS) was calculated from tender points conducted by thumb palpation. Test-retest reliability, internal consistency, and concurrent and construct validities of FIQ were evaluated. Test-retest reliability and internal consistency were good at 0.81 and 0.72, respectively. Correlation between FIQ and HAQ scores was 0.43, which was low but statistically significant. Significant moderate correlations were obtained between the FIQ items and severity of clinical symptoms (0.63-0.77)except TPS, 0.31. The FIQ is a reliable and valid instrument for measuring functional disability in Turkish female FM patients

            Offenbaecher M, Waltz M, Schoeps P. Validation of a German version of the Fibromyalgia Impact Questionnaire (FIQ-G). J Rheumatol 2000; 27(8):1984-1988.
 

            OBJECTIVE: To translate the Fibromyalgia Impact Questionnaire (FIQ) into German and to evaluate its reliability and validity for the use of German speaking patients with fibromyalgia (FM). METHODS: We administered the FIQ to 55 patients with FM (15 patients filled out the questionnaire 10 days later) together with German versions of the Stanford Health Assessment Questionnaire (HAQ), the Medical Outcomes Survey Short Form-36 (SF-36), and a tender point count (TPC). All patients were asked about the severity of pain today (10 cm visual analog scale) and the duration of symptoms. Tenderness thresholds were assessed by dolorimetry at all tender points with a Fisher dolorimeter and laboratory tests were obtained. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha of reliability. Construct validity of the FIQ was evaluated by correlating the HAQ and subscales of the SF-36 as well as the TPC and the tenderness thresholds. RESULTS: Mean age of participants was 54.3 years and mean duration of symptoms 9.5 years. Test-retest reliability was between 0.62 and 1 for the physical functioning as well as for the total FIQ and other components. Internal consistency was 0.92 for the overall FIQ. Significant correlations were obtained between the FIQ items, the HAQ, and the SF-36. CONCLUSION: The German FIQ is a reliable and valid instrument for measuring functional disability and health status in German patients with FM

            Buskila D, Neumann L. Assessing functional disability and health status of women with fibromyalgia: validation of a Hebrew version of the Fibromyalgia Impact Questionnaire. J Rheumatol 1996; 23(5):903-906.
 

            OBJECTIVE. To validate a translated version of the Fibromyalgia Impact Questionnaire (FIQ) to be used by Hebrew speaking populations. METHODS. We administered the FIQ to 100 women with fibromyalgia (FM). The FIQ measures physical functioning, work status, depression, anxiety, sleep, pain, stiffness, fatigue, and well being. All patients were asked about the presence and severity (assessed by visual analog scale) of relevant FM symptoms (pain, fatigue, anxiety, etc.); a count of 18 tender points was conducted by thumb palpation, and tenderness thresholds were assessed by dolorimetry. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha coefficient of reliability. To assess content validity a cutoff criterion of > or = 25% impairment responses was set to indicate a valid item. Construct validity of the FIQ was evaluated by correlating the physical functioning score as well as the separate items with measures of symptom severity, count of tender points, and tenderness thresholds. RESULTS. Test-retest reliability was r = 0.96 for physical functioning, and 0.80-0.96 for other items of FIQ. Internal consistency was alpha = 0.93 at Time 1 and 0.86 at Time 2. Seventeen of 19 items of the FIQ met the > or = 25% criterion. Significant moderate to high correlations were obtained between the FIQ items and severity symptoms, point count, and tenderness threshold. CONCLUSION. The FIQ is a reliable and valid instrument for measuring functional disability and health status in Israeli women with FM

Hedin PJ, Hamne M, Burckhardt CS, Engstrom-Laurent A. The Fibromyalgia Impact Questionnaire, a Swedish translation of a new tool for evaluation of the fibromyalgia patient. Scand J Rheumatol 1995; 24(2):69-75.
 

Abstract: The American Fibromyalgia Impact Questionnaire (FIQ) was translated into Swedish. The FIQ is a brief 10-item self-administered instrument designed to evaluate the special problems bothering fibromyalgia patients. After the translation procedure, 73 Swedish women fibromyalgia patients answered the translated FIQ. The questionnaire was fast and simple to handle both for the patients and the investigators. There was a good level of correspondence between FIQ items and related items in the Health Assessment Questionnaire, the Nottingham Health Profile and the Psychological General Well-Being Index. There were no significant differences in a test-retest analysis. The study has provided evidence that the translated and slightly modified Swedish version of the American Fibromyalgia Impact Questionnaire has the validity and sensitivity to be able to function as a relevant and comprehensible tool to monitor FMS-patients

 Heymann RE, Helfenstein M, Feldman D. A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia. An analysis of outcome measures. Clin Exp Rheumatol 2001; 19(6):697-702.

OBJECTIVE: To study the efficacy and tolerability of amitriptyline and nortriptyline in a Brazilian population with fibromyalgia and to evaluate the instruments used to measure the efficacy of the treatment. METHODS: A total of 118 fibromyalgia patients were randomly assigned to 3 groups: amitriptyline (AM, n = 40), nortriptyline (NOR, n =38) and placebo (PL, n = 40), and were blindly given 25 mg at bedtime of the assigned treatment for 8 weeks. Clinical evaluation before and at the end of the study included the number of tender points (NTP), FIQ score (FIQ), and global improvement as reported by the patients on a verbal scale (VSGI). RESULTS: The 3 groups were comparable at baseline for all the parameters studied. After 8 weeks, the 3 groups improved in all parameters: (36.5% AM, 26.7% NOR and 24% PL patients improved on FIQ; 13.9% AM, 19.5% NOR and 8.57% PL patients improved on NTP; 86.5% AM, 72.2% NOR and 57.6% PL patients improved on VSGI). Only the AM group differed from the PL group on VSGI. Side effects were noted among the groups, but none were serious (16 in the AM group, 31 in the NOR group, and 25 in the PL group). CONCLUSION: All three groups improved after treatment. Only the patient's subjective global assessment of improvement differed between the AM patients and the PL group (p < or = 0.03). In fibromyalgia, placebo groups are important in drug trials. Different measures of therapeutic effect are not better than the patient's self assessment.

         Zijlstra TR, Taal E, van de Laar MA, Rasker JJ. Validation of a Dutch translation of the fibromyalgia impact questionnaire. Rheumatology (Oxford) 2007; 46(1): 131- 134

OBJECTIVE:. To validate a Dutch translation of the fibromyalgia impact questionnaire (FIQ). Materials and methods. Data were taken from two randomized clinical trials on Spa treatment and venlafaxine in fibromyalgia (FM). Participants completed the Dutch FIQ and a set of validated questionnaires for general health (RAND-36), depression (Beck depression inventory, BDI), pain (McGill pain questionnaire, MPQ) and fatigue (checklist individual strength, CIS). Internal consistency within the FIQ item 'physical functioning' was studied using Cronbach's alpha. Test-retest reliability was studied with intra-class-correlation (ICC) in a subsample of 76 control subjects over a 3 month period without specific intervention. Construct validity was evaluated by correlating the FIQ to other questionnaires. Sensitivity to change was studied using standardized response means (SRM). Results. The study sample consisted of 213 women and 11 men (mean age 47 yrs, mean disease duration 11 yrs). Cronbach's alpha for the item 'physical functioning' was 0.91, indicating high internal consistency. Test-retest reliability was acceptable, with ICC ranging from 0.45 for 'morning tiredness' to 0.71 for 'physical function'. FIQ correlated significantly with the RAND-36, with Spearman's rho ranging from -0.60 to -0.70 for items measuring the same concept. Similar patterns of correlation were seen with MPQ, BDI and CIS. Sensitivity to change was sufficient, with SRM after Spa treatment ranging from 0.3 for 'work days missed' to 0.9 for 'days felt good'. Similar SRM were found in the venlafaxine trial for patients reporting general improvement. Conclusion. The Dutch FIQ is a valid instrument for measuring health status in FM, showing sufficient reliability, construct validity and responsiveness.

       Poca-Dias V, Almirall-Bernabé A, Cuscó-Segarra A, García-Fructuoso FJ. Validación de la versión catalana del Fibromyalgia Impact Questionnaire. Reumatol Clin. 2006;2
(Espec Congr):63-4

      OBJECTIVE:To evaluate the reliability of the most up-to-date version of the Fibromyalgia Impact Questionnaire (FIQ) which has been adapted and translated into Catalan (C-FIQ) so that it may be used in Catalan-speaking areas. METHODS:The FIQ was designed to quantify the overall impact of FM on various dimensions (functionality, pain perception, stiffness and fatigue, sleep disorders, anxiety and capacity for work and housework). The FIQ is considered to be the “gold standard” for measuring the functional state of FM and for measuring the traditional therapeutic response. To date, it has been validated and translated into 11 languages. The original English version of the FIQ (1991) with its latest modifications (1997 and 2002) was translated into Catalan (C-FIQ) by an official K-level certified translator and translated back into English for greater reliability by another independent translator. Certain phrases were changed so that they better suited Catalan society today (age 49 ± 12). This questionnaire was completed by 100 women who had been diagnosed with Fibromyalgia according to ACR diagnostic criteria and for reliability analysis, the patients were asked to repeat the test after 7 days, something which 78 then did. In view of the lack of other comparative Catalan-validated tests, special attention was paid to the counting of tender points by applying the established pressure and to the determination of the pain threshold by means of an electronic algometer (Electronic Engineering Corporation ®). The patient had to express the exact moment when pressure became painful. Prior familiarisation tests were conducted with the method to avoid anticipation and exaggeration.Internal consistency was measured with Cronbach’s alpha coefficient (item valid for impact higher than or equal to 25% impairment), the test-retest by interpreting Spearman’s r coefficient, validity was measured using correlation coefficients (Pearson / Spearmen) and the severity of symptoms was measured by counting tender points and thresholds using dolorimetry.
RESULTS:Reliability of the test-retest was r=0.85 for physical functionality and remained between 0.52 and 0.97 for the remaining items. Internal consistency was alpha = 0.85 in the first test and 0.82 in the second. 16 of the 20 C-FIQ items met the 25% impact criterion. Correlation between C-FIQ items, symptom severity, number of tender points and pain threshold was moderate to high.
CONCLUSIONS:The C-FIQ is a valid and reliable instrument for measuring functional capacity and the perception of health in Catalan women with fibromyalgia.