Translation and validation of the Malay version of the Duruöz hand index in individuals with diabetic peripheral neuropathy

BACKGROUND: Diabetic Peripheral Neuropathy (DPN) is a prevalent complication of Type 2 Diabetes Mellitus (T2DM), leading to hand function impairments that affect daily activities and quality of life. Despite its significance, no culturally adapted tool exists for assessing hand-related activity limitations in the Malay-speaking population. This study aimed to translate, culturally adapt and validate the Duruöz Hand Index (DHI) for Malaysians with DPN.

METHODS: A cross-sectional study was conducted in two phases: (1) translation and cultural adaptation of the DHI into Malay and (2) evaluation of its psychometric properties. Content validity was assessed by a panel of nine experts using the Content Validity Index (CVI). Face validity was evaluated through a pilot test with 10 individuals with DPN. Internal consistency (Cronbach's alpha) and test-retest reliability (Intraclass Correlation Coefficient, ICC) were measured in 30 participants with DPN. Known-group validity was examined by comparing DPN participants with healthy individuals.

RESULTS: The content validity of the Malay-DHI was excellent and face validity confirmed that the Malay-DHI was clear and comprehensible. Internal consistency was strong across all categories (α = 0.84-0.97). Test-retest reliability demonstrated excellent stability (ICC = 0.996-1.000). Known-group validity showed a significant difference between individuals with DPN and healthy individuals (Z = -6.93, p < .001).

CONCLUSION: The Malay version of the DHI demonstrated strong validity and reliability, making it a culturally relevant and robust tool for assessing hand function in individuals with DPN. This tool may facilitate targeted rehabilitation interventions and improve clinical outcomes.