Assessing parental concerns in developmental dysplasia of the hip in early infancy: Validation of the Dutch Hip Worries Inventory

PURPOSE: The Hip Worries Inventory (HWI) is an 11-item questionnaire developed to assess parental concerns related to developmental dysplasia of the hip (DDH) in early infancy. This study aimed to translate the HWI into Dutch and evaluate its psychometric properties.

METHODS: The HWI was translated using a standardized forward-backward translation process. Psychometric evaluation followed COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and included assessments of readability, interpretability, responsiveness, reliability and content validity. Parents of infants aged 3-13 months diagnosed with DDH and managed with active surveillance or abduction bracing with a Pavlik harness were included.

RESULTS: The Dutch version of the HWI was completed by 59 parents prior to treatment and by 50 of them during treatment. In addition, 56 parents completed the questionnaire twice around their child's first birthday. The Dutch HWI demonstrated good readability (Flesch Reading Ease Score = 84.1) and adequate interpretability (mean score 21.53, standard deviation 6.11). Responsiveness was supported by confirmation of 89% of the predefined hypotheses. Internal consistency was good (Cronbach's α = 0.77-0.79) and test-retest reliability was excellent (Intraclass Correlation Coefficient = 0.95; 95% Confidence interval 0.91-0.97). Content validity assessment identified concerns regarding the relevance of items 3-6 for non-brace treatment, the sequencing of items, the use of negatively worded items and the absence of items addressing practical and informational needs.

CONCLUSIONS: The Dutch HWI is a promising instrument for assessing parental concerns related to DDH in early infancy. However, limitations in content validity highlight the need for refinement, incorporating input from parents, caregivers and healthcare professionals to enhance content validity and clinical applicability.