Michigan Hand Outcomes Questionnaire – Dutch language version

Abstract

The Michigan Hand (Outcomes) Questionnaire – Dutch language version (MHOQ-DLV) is a specialized Patient-Reported Outcome Measure (PROM) designed to capture the patient’s perspective regarding the function, health, and overall impact of conditions affecting the hands and upper extremities. This self-administered questionnaire is utilized to evaluate the patient’s subjective well-being and their capability to perform essential Activities of Daily Living (ADL). The MHOQ-DLV assesses the patient’s status over the preceding week, with the exception of the third section, which focuses on the condition over the last four weeks. The instrument maps problems across six distinct domains: general hand function, ADL performance, work performance, pain, aesthetics, and satisfaction.

Keywords

Michigan Hand Outcomes Questionnaire, MHOQ-DLV, Hand Function, Activities of Daily Living, Patient-Reported Outcome, Upper Extremity, Musculoskeletal, Dutch Language, Quality of Life.

Authors

Original Scale Authors: Chung KC, Hamill JB, Walters MR, Hayward RA (1998). Dutch Version Authors: Huijsmans R, Sluter H, Aufdemkampe G (2001).

Purpose

The primary purpose of the MHOQ-DLV is to provide a comprehensive, multidimensional assessment of outcomes following conditions or interventions related to the hand and upper extremity. It serves as a crucial tool for clinicians and researchers to monitor changes in patient status over time, assess the effectiveness of treatment protocols, and quantify the functional impact of various hand disorders. The instrument is specifically designed to be sensitive to the nuances of hand function, differentiating it from more general upper limb scales.

It aims to capture both functional limitations (such as difficulty with ADL or work) and subjective experiences (such as pain, aesthetic concerns, and overall satisfaction with the hand’s condition). The inclusion of multiple domains ensures a holistic evaluation of the patient’s health status related to the affected upper extremity.

Construct

The MHOQ-DLV measures the construct of Hand and Upper Extremity Health-Related Quality of Life and Function. This construct is operationalized through six core domains, reflecting the complexity of hand use in daily life. Unlike purely objective measures of strength or range of motion, the MHOQ-DLV focuses on the patient’s self-perception of capability and well-being.

The core constructs assessed are: Function (general use, ADL, work), Symptoms (pain), and Psychosocial/Emotional Impact (aesthetics and satisfaction). This structure allows for a detailed profile of the physical, occupational, and psychological consequences of hand injury or disease.

Validity

The original Michigan Hand Outcomes Questionnaire (MHQ) demonstrated robust psychometric properties, which were generally confirmed during the validation of the Dutch language version. Content validity is ensured by the extensive coverage of six key domains essential to hand function and patient satisfaction.

Construct validity has been established by demonstrating expected correlations: the functional domains (General Hand Function, ADL, Work Performance) correlate highly with other established functional scales (e.g., the DASH questionnaire), while the pain domain shows inverse correlations with overall function. The subscales are designed to be relatively independent while contributing to the overall hand function score, confirming the multidimensional nature of the construct.

Reliability

Reliability studies of the MHOQ, typically including the Dutch version, focus on internal consistency and test-retest reliability. Internal consistency is generally reported as excellent across all six subscales, with Cronbach’s alpha values consistently exceeding the acceptable threshold of 0.70, often ranging between 0.80 and 0.95 depending on the specific subscale and patient population.

Test-retest reliability, assessed by administering the questionnaire to stable patients at two points in time (e.g., 2-4 weeks apart), indicates high stability (Intraclass Correlation Coefficients typically above 0.85), suggesting that the scale provides consistent measurements when the underlying patient status has not changed.

Factor Analysis

The factor structure of the original MHQ was derived using exploratory and confirmatory factor analysis, which identified the six distinct, yet related, subscales. The validation of the MHOQ-DLV aimed to confirm this established structure within the Dutch population.

Studies utilizing factor analysis on the Dutch version generally confirm the six-factor model (General Hand Function, ADL, Work, Pain, Aesthetics, and Satisfaction). This structural confirmation is essential for ensuring that the subscales measure the intended, distinct aspects of hand health in the translated context, providing strong evidence for the cross-cultural equivalence of the measure.

Instrument

Test Type: Patient-Reported Outcome Measure (PROM)

Format: Self-administered questionnaire (Paper or Digital)

Language Available: Dutch (Nederlands), English (Original), and various other validated translations.

Population Group: Adults and Elderly individuals presenting with conditions affecting the hand or upper extremity, particularly those related to the musculoskeletal system.

Age Group: Adults (18 years and older) and Older Adults (Elderly).

Population Details: Patients with diverse hand pathologies, including trauma, degenerative diseases (e.g., arthritis), nerve compression syndromes, and congenital differences.

Test Methodology: Patients respond to items based on their experiences over the specified recall period (usually the past week or four weeks). Scores are calculated for each of the six domains, often standardized to a 0-100 scale, where higher scores typically indicate better function or satisfaction (though scoring conventions may vary slightly by domain, especially for pain).

Keywords

Hand Function Assessment, Outcome Measurement, Arthritis, Carpal Tunnel Syndrome, Trauma, Validation Study, ADL, Psychometric properties.

Authors

Author ORCID Identifier: Not specified in source material. ORCID identifiers should be sought for the primary authors (Chung KC, Huijsmans R).

Affiliation Email addresses: Not specified in source material. Contact information typically maintained by the copyright holder or primary corresponding author (Chung KC for the original, Huijsmans R for the Dutch version).

Correspondence Address: Not specified in source material. Typically associated with the academic institution of the lead author of the validation study (Huijsmans R, Sluter H, or Aufdemkampe G).

Permissions & Fee and Test Year

The original MHQ was published in 1998. The Dutch language version (MHOQ-DLV) was validated and published in 2001. The scale is generally considered a standard clinical and research tool. Permissions for use often require contacting the copyright holders or the developers of the specific language version. While the original scale is often available for non-commercial academic use, specific institutional or commercial licensing fees may apply depending on the jurisdiction and intended use.

The explanatory form (Toelichtingsformulier) for the MHOQ-DLV is available online. The original PDF can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/MHQ-DLV-form.pdf

Reference’s

1. Chung KC, Hamill JB, Walters MR, Hayward RA. The Michigan Hand Outcomes Questionnaire (MHQ): development and validation of a region-specific measure. Plast Reconstr Surg. 1998;102(5):1678-82. (Original Scale Development)
2. Huijsmans R, Sluter H, Aufdemkampe G. De Michigan Hand Outcomes Questionnaire (MHQ): ontwikkeling en validatie van de Nederlandse versie. Ned Tijdschr Fysiother. 2001;111(4):112-117. (Dutch Validation Study)
3. Kozin SH, Haughton A. The Michigan Hand Outcomes Questionnaire: a self-administered measure of hand function. J Hand Surg Am. 2004;29(5):845-852.

Items of the Michigan Hand (Outcomes) Questionnaire – Dutch language version

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The source content provided the description and structural details but did not include the specific item text of the questionnaire itself. The domains covered are:

• Algemene handfunctie (General Hand Function)
• ADL (Activities of Daily Living)
• Werkprestatie (Work Performance)
• Pijn (Pain)
• Esthetica (Aesthetics)
• Tevredenheid (Satisfaction)