Revista do Colégio Brasileiro de Cirurgiões
https://revistadocbc.org.br/article/doi/10.1590/0100-6991e-2026002825
Revista do Colégio Brasileiro de Cirurgiões
Artigo Original

Tradução, adaptação transcultural e validação do questionário HerQLes em língua portuguesa

Translation, Cross-Cultural Adaptation, and Validation of the HerQLes Questionnaire into Portuguese

Jessica Zilberman Macret; Pedro Henrique Amaral; Eduardo Rullo Maranhão Dias; João Paulo Venâncio; Giovanna Zucchini Rondini; Sergio Roll

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Resumo

Introdução: A correção de hérnias ventrais é procedimento frequente em cirurgia geral, tradicionalmente avaliado por desfechos objetivos como complicações e recidivas. Entretanto, esses parâmetros não refletem plenamente a percepção do paciente. O HerQLes, questionário específico para hérnias ventrais, foi desenvolvido para mensurar impacto funcional, emocional e estético, mas não havia versão validada em português. Este estudo teve como objetivo traduzir, adaptar culturalmente e validar o HerQLes para o Brasil.

Métodos: Trata-se de estudo prospectivo, observacional, de coorte única, incluindo pacientes ≥18 anos submetidos à correção eletiva de hérnia ventral pela técnica de separação posterior de componentes (TAR). O HerQLes foi aplicado em cinco momentos: pré-operatório e 14 dias, 30 dias, 3 meses e 6 meses no pós-operatório. A tradução seguiu as diretrizes de Beaton e da ISPOR, com etapas de tradução, retrotradução, revisão por especialistas e pré-teste. As propriedades psicométricas foram avaliadas por consistência interna, efeito piso e teto, Teoria de Resposta ao Item, validade de constructo e responsividade.

Resultados: Foram incluídos 32 pacientes (idade mediana 58,5 anos, IMC 27,2 kg/m², tamanho médio da hérnia 9,1 cm). O HerQLes apresentou alta consistência interna em todos os momentos (α>0,80). O modelo Rasch demonstrou parâmetros adequados para a maioria dos itens, com correlação positiva entre itens e escore total. Observou-se melhora progressiva dos escores ao longo do seguimento: pré-operatório com grande impacto em dor e função; 14 dias com melhora discreta; redução acentuada aos 30 dias; e normalização em 96% dos pacientes aos 6 meses.

Conclusão: A versão brasileira do HerQLes mostrou-se válida, confiável e responsiva para avaliar qualidade de vida em pacientes com hérnia ventral, permitindo aplicação clínica e científica e comparabilidade internacional.

Palavras-chave

Hérnia ventral; Qualidade de vida; Questionário; HerQLes

Abstract

Introduction: Ventral hernia repair is one of the most commonly performed procedures in general surgery and has traditionally been evaluated using objective outcomes, such as postoperative complications and recurrence rates. However, these parameters do not fully reflect the patient’s perspective. The Hernia-Related Quality-of-Life Survey (HerQLes), a disease-specific questionnaire for ventral hernias, was developed to assess the functional, emotional, and aesthetic impact of the condition, but no validated Portuguese version was previously available. This study aimed to translate, cross-culturally adapt, and validate the HerQLes questionnaire for use in Brazil.

Methods: This prospective, observational, single-cohort study included patients aged ≥18 years who underwent elective ventral hernia repair using the posterior component separation technique with Transversus Abdominis Release (TAR). The HerQLes questionnaire was administered at five time points: preoperatively and at 14 days, 30 days, 3 months, and 6 months postoperatively. Translation followed the guidelines proposed by Beaton and the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), including forward translation, back-translation, expert committee review, and pretesting. Psychometric properties were assessed through internal consistency, floor and ceiling effects, Item Response Theory, construct validity, and responsiveness.

Results: Thirty-two patients were included (median age, 58.5 years. Body Mass Index (BMI), 27.2 kg/m². mean hernia size, 9.1 cm). The HerQLes demonstrated high internal consistency at all assessment time points (α > 0.80). Rasch model analysis showed adequate fit parameters for most questionnaire items, with positive correlations between individual items and the overall score. Progressive improvement in questionnaire scores was observed throughout follow-up: marked impairment in pain and functional domains preoperatively, modest improvement at 14 days, substantial improvement by 30 days, and normalization of scores in 96% of patients at six months.

Conclusion: The Brazilian Portuguese version of the HerQLes proved to be valid, reliable, and responsive for assessing quality of life in patients with ventral hernia, supporting its use in both clinical practice and research while enabling comparisons with international studies.

Keywords

Ventral hernia; Quality of life; Questionnaire; HerQLes

Referências

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Submetido em:
17/09/2025

Aceito em:
10/07/2026

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