Cross-cultural validation and reliability of the Korean version of the Haemophilia Activities List

To translate, culturally adapt, and evaluate the reliability and construct validity of the Korean version of the Haemophilia Activities List (HAL) in adult patients with hemophilia.

This cross-sectional validation study included adult patients with hemophilia A and B. The HAL was translated into Korean using a standardized forward–backward translation process according to international guidelines. The participants completed the Korean HAL, the EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), and the Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire. Internal consistency was assessed using Cronbach’s alpha, test–retest reliability was assessed using intraclass correlation coefficients (ICCs), and construct validity was assessed using Spearman’s correlation analysis.

A total of 87 adult patients completed the questionnaire. The mean age was 37 years (range, 18–62 years), and most participants had severe hemophilia. The Korean HAL demonstrated high internal consistency, with a Cronbach’s alpha coefficient of 0.97 for the total score and domain-specific values ranging from 0.78 to 0.95. The test–retest reliability was excellent, with an overall ICC of 0.95. Construct validity was supported by strong correlations between the HAL and EQ-5D-5L overall scores (r = 0.78, p < 0.01) and strong correlations with RAPID3 physical function scores (r = -0.82, p < 0.01).

The Korean version of the HAL demonstrated excellent reliability and good construct validity in adult patients with hemophilia. These findings support the use of the Korean HAL as a reliable and culturally appropriate patient-reported outcome measure to assess functional limitations in clinical practice and research.