Translation and cultural adaptation of the hyperacusis handicap questionnaire to Brazilian Portuguese

Assis, Adriane da Silva; Lemos, Stela Maris Aguiar; Prabhu, Prashanth; Mancini, Patrícia Cotta

doi:10.1590/2317-1782/e20250057en

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Original Article • CoDAS 38 (1) • 2026 • https://doi.org/10.1590/2317-1782/e20250057en linkcopy

Translation and cultural adaptation of the hyperacusis handicap questionnaire to Brazilian Portuguese

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose To translate and culturally adapt the Hyperacusis Handicap Questionnaire (HHQ) to Brazilian Portuguese.

Methods The cultural adaptation followed the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines and included five stages: 1) translation of the questionnaire from English to Brazilian Portuguese (BP) by two bilingual translators; 2) synthesis of the translations into a consensus version; 3) back-translation into English by two professional translators; 4) development of the pre-final version of the HHQ in Brazilian Portuguese by a committee of experts; and 5) testing of the pre-final and adjusted pre-final versions with individuals from the target population.

Results No discrepancies were observed in the title, key responses, or questionnaire items throughout the translation process. In the pre-final version testing phase, more than 80% of participants understood the HHQ items in BP, demonstrating the effectiveness of the adaptation. However, four items were adjusted based on participants’ suggestions during the testing phase. Subsequently, the adjusted pre-final version was tested, with 100% of participants demonstrating comprehension of the items, confirming its appropriateness for the Brazilian population. During the linguistic equivalence assessment, none of the participants selected the "not applicable" option, further validating the relevance of the questions to the Brazilian context. Additionally, an introductory statement was added, providing detailed instructions on how to complete the questionnaire.

Conclusion The cultural adaptation of the HHQ to Brazilian Portuguese was completed, resulting in the final version titled Hyperacusis Handicap Questionnaire in Brazilian Portuguese (HHQ-BP). Validation of this version is currently in progress.

Keywords
Hyperacusis; Indicators of Quality of Life; Self-assessment; Surveys and Questionnaires; Translating; Speech, Language and Hearing Sciences

Gender	Stage T-V1						Stage T-V2
Gender	n	Mean (year)	SD	Median (year)	Min	Max	n	Mean (year)	SD	Median (year)	Min	Max
Female	26	44.0	14.8	48	20	65	24	37.4	18.4	35.5	20	69
Male	4	47.7	9.6	49	33	60	6	43.3	12.7	46.0	26	58
Total	30	44.5	14.3	48	20	65	30	38.6	15.9	36.5	20	69

Descriptive Statistics	Stage
Descriptive Statistics	T-V1	T-V2
n	30	30
Minimum	25	28
Maximum	30	30
Mean	29,0	29,1
1st Quartile	28	28
Median	29	29
3rd Quartile	30	30

Questions	T-V1 (n=30)		T-V2 (n=30)
Questions	Frequency	Percentage	Frequency	Percentage
Q1	26	86.6	30	100.0
Q2	30	100.0	30	100.0
Q3	30	100.0	30	100.0
Q4	25	83.3	30	100.0
Q5	30	100.0	30	100.0
Q6	30	100.0	30	100.0
Q7	30	100.0	30	100.0
Q8	27	90.0	30	100.0
Q9	30	100.0	30	100.0
Q10	30	100.0	30	100.0
Q11	30	100.0	30	100.0
Q12	26	86.6	30	100.0
Q13	30	100.0	30	100.0
Q14	30	100.0	30	100.0
Q15	30	100.0	30	100.0
Q16	30	100.0	30	100.0
Q17	30	100.0	30	100.0
Q18	30	100.0	30	100.0
Q19	30	100.0	30	100.0
Q20	30	100.0	30	100.0
Q21	30	100.0	30	100.0

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[1] Caption: T-V1 = pre-final version test; T-V2 = adjusted pre-final version test; n = number of participants; SD = standard deviation; Min = minimum value found; Max = maximum value found