Cross-cultural equivalence and psychometric properties of the Portuguese version of the Depressive Cognition Scale

There is a great need for researchers to have access to reliable and valid research instruments in their own language to measure a concept of interest or concern. Therefore, the purpose of this study was to determine semantic equivalency and psychometric properties of the Depressive Cognition Scale (DCS) in a Brazilian sample of diabetics. Back-translation and field testing methodology was used to determine the DCS semantic equivalency and psychometric properties. A convenience sample of 40 bilingual Brazilian adults was used to conduct the field testing of the scale. The findings suggested that the translation of the DCS was adequate and initial estimates of internal consistency and construct validity were adequate for both the DCS and its Portuguese version. Psychometric testing of the Portuguese language version of the DCS in this small sample appears to have sufficient reliability and validity for use in examining depressive cognitions in Brazilian adults. Further psychometric testing of the Portuguese version of the DCS in a larger Portuguese-speaking sample with diabetes is recommended.     

Cross-Cultural Translation and Adaptation to Brazilian Portuguese of the Paediatric Pain Profile in Children With Severe Cerebral Palsy

ContextPain is a prevalent symptom in children with severe cerebral palsy (CSCP), mainly as a result of the progression of muscle contractures, bone deformities, gastroesophageal reflux, and recurrent infections. Considering the lack of verbal communication in this population, both pain diagnosis and assessment of the analgesic treatment are often neglected. Although the Paediatric Pain Profile (PPP), an instrument with 20 items, is used to assess behavior indicative of pain in CSCP, it is not validated in Brazil.ObjectivesTo translate, adapt, and evaluate the psychometric properties of the PPP to Brazilian Portuguese.MethodsThe study was carried out at a philanthropic institution for CSCP and a university hospital. The sample of CSCP unable to communicate through speech or any device, their respective parents or primary caregivers, and health professionals were included. First, the instrument was translated and then back translated, and its clarity was evaluated by parents, primary caregivers, and professionals. The psychometric properties of the final version were evaluated for internal consistency (Cronbach's α) and stability (test-retest).ResultsForty-five children with a mean (SD) chronological age of 16 (8.69) years, 26 of whom were male, were included in the study. A total of 150 applications of PPP were carried out: 30 to assess clarity and 120 to assess the psychometric properties. Each item of the translated version showed a median between 3.00 and 4.00, considered to be clear and very clear, respectively. The internal consistency of the items was α = 0.864, with no significant difference between test and retest (P = 0.271).ConclusionThe adapted version of the PPP in Brazilian Portuguese demonstrated good internal consistency (similar to the original instrument) and stability over time, decisive for the next step of clinical validation for CSCP.     

Assessing health empowerment - Brazilian cross-cultural adaptation and validity testing of the health education impact questionnaire (heiQ) among people with chronic low back pain

BackgroundThere is no patient reported outcome measure available in Brazilian Portuguese to comprehensively assess outcomes following administration of patient education programs for people with chronic conditions.ObjectiveTo describe the cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the Health Education Impact Questionnaire (heiQ), a multidimensional questionnaire designed for the evaluation of patient education programs, which was tested in people with chronic low back pain (LBP).MethodsOne hundred thirty-seven individuals with non-specific chronic LBP (age: 38.7 ± 13.2) were enrolled in the study. The translation was performed according to international standards. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability, Cronbach’s α to assess internal consistency, Pearson rank correlation to compare the heiQ scales with comparator scales, and confirmatory factor analysis (CFA) for structural validity.ResultsThe test-retest analysis yielded ICC values ranging from 0.75 to 0.91. Cronbach’s alphas for the seven scales ranged from 0.70 to 0.89. Significant correlations between affective and general health constructs and the heiQ scales (72%) were observed. For the majority of the scales, the CFA fit statistics showed to be good to excellent.ConclusionOverall, the Brazilian Portuguese version of the heiQ showed acceptable reliability, internal consistency, construct validity, and structural validity in individuals with chronic LBP. The heiQ scales may serve as direct outcomes to assess education and self-management programs for the Brazilian Portuguese speaker population.     

Quality Assessment of Neonatal Pain Scales Translated and Validated to Brazilian Portuguese: A Systematic Review of Psychometric Properties

ObjectivesThe objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese and to verify the methodological quality of these translation, transcultural adaptations and validation.DesignThe present study is a systematic review. A systematic search in the literature included studies of development, validation, and transcultural adaptation of neonatal pain scales to Brazilian Portuguese. The instruments must have been developed for health care professionals to evaluate neonatal pain and stress in full-term and preterm newborns.Data SourcesThe search strategy was conducted in PubMed, Web of Science, Scopus, and Scielo databases following The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).Review /Analysis MethodsA total of 1,479 publications were identified and 5 fulfilled the inclusion criteria, with 4 instruments evaluated. For the methodological quality analysis of the measurement properties of the instruments the Consensus-based Standards for Health Measurement Instruments (COSMIN) Risk of Bias checklist was used. The psychometric properties verified were internal consistency, content validity, reliability, and construct validity.ResultsThree instruments reviewed were inadequate and one was doubtful.ConclusionsThe neonatal pain scales wich were cross culturally adapted to Brazilian Portuguese were shown to be of low methodological quality based on COSMIM checklist. Caution should be considered for clinical decisions about pain management judgment coming from these instruments.     

Brazilian versions of the Measure of Processes of Care-20 and Measure of Processes of Care-Service Providers: translation,cross-cultural adaptation and reliability

BackgroundThe Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries.ObjectivesTo translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency.Methodsthis study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil.ResultsTranslation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n = 107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n = 50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n = 92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n = 62).ConclusionThe Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care.     

Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR-Br): cross-cultural validation,reliability, and construct and structural validation

Purpose: This study aimed to culturally adapt and validate the Revised Fibromyalgia Impact Questionnaire (FIQR) to Brazilian Portuguese, by the use of analysis of internal consistency, reliability, and construct and structural validity.

Method: A total of 100 female patients with fibromyalgia participated in the validation process of the Brazilian Portuguese version of the FIQR (FIQR-Br).The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test–retest), Cronbach’s alpha for internal consistency, Pearson’s rank correlation for construct validity, and confirmatory factor analysis (CFA) for structural validity.

Results: It was verified excellent levels of reliability, with ICC greater than 0.75 for all questions and domains of the FIQR-Br. For internal consistency, alpha values greater than 0.70 for the items and domains of the questionnaire were observed. Moderate (0.40?r?r?>?0.70) correlations were observed for the scores of domains and total score between the FIQR-Br and FIQ-Br. The structure of the three domains of the FIQR-Br was confirmed by CFA.

Conclusions: The results of this study suggest that that the FIQR-Br is a reliable and valid instrument for assessing fibromyalgia-related impact, and supports its use in clinical settings and research. The structure of the three domains of the FIQR-Br was also confirmed.

• Implications for Rehabilitation

• Fibromyalgia is a chronic musculoskeletal disorder characterized by widespread and diffuse pain, fatigue, sleep disturbances, and depression. The disease significantly impairs patients’ quality of life and can be highly disabling.

• To be used in multicenter research efforts, the Revised Fibromyalgia Impact Questionnaire (FIQR) must be cross-culturally validated and psychometrically tested. This paper will make available a new version of the FIQR-Br since another version already exists, but there are concerns about its measurement properties.

• The availability of an instrument adapted to and validated for Brazilian Portuguese may make it possible to reliably verify the effects of rehabilitation programs on disability from fibromyalgia.

• The FIQR-Br showed results comparable with other versions of the FIQR in other languages, thereby enabling comparison of effects of rehabilitation interventions on disability from fibromyalgia conducted in Brazil with results of studies carried out in other parts of the world.

     

Cross‐Cultural Adaptation of the Quality of Diagnoses,Interventions and Outcomes (Q‐DIO) Instrument into Brazilian Portuguese

PURPOSE: To describe the cross‐cultural adaptation of the Quality of Diagnoses, Interventions and Outcomes instrument into Brazilian Portuguese. METHOD: This process entailed translation, synthesis, back‐translation, expert committee review, and pretesting. FINDINGS: Six items were altered in the Brazilian version, and the scoring system was changed from a five‐point to a three‐point Likert‐type scale. Pretesting was conducted on a sample of 40 randomly selected nursing records. Overall reliability as measured by Cronbach's alpha was 0.96. CONCLUSIONS: Adaptation resulted in a preliminary version of the instrument. IMPLICATIONS FOR NURSING PRACTICE: Assessment of the psychometric properties of the instrument in a larger sample of nursing records is required, and such a study is underway.     

Adaptation and Initial Validation of the Premature Infant Pain Profile–Revised (PIPP-R) in Brazil

BackgroundThe use of reliable pain assessment measures is essential for scoring and managing pain in infants. The Premature Infant Pain Profile (PIPP) is reliable and valid and has been recently revised. To adapt and validate the PIPP-R into Portuguese and to evaluate its psychometric properties are required to ensure maintenance of meaning and content.AimsThe aim of this study was to culturally adapt to Brazilian Portuguese and explore content validity and construct validity of the Premature Infant Pain Profile–Revised.DesignThis is a methodological study.Participants/SettingsTwo existing data sets of randomized clinical trials previously conducted were used to examine initial construct validity of the prefinal version of the Premature Infant Pain Profile–Revised.MethodsCross-cultural adaptation and validation occurred in four steps. Independent versions of the Premature Infant Pain Profile–Revised were produced, followed by the preparation of a synthetic version. Two back-translated versions were realized by professional translators. An expert committee evaluated idiomatic and semantic equivalence and clarity and relevance of the items. A content validity index was calculated. Finally, a consolidated prefinal version in Portuguese was then produced.ResultsNo difficulties in producing the material were reported. Semantic and idiomatic aspects were considered adequate, and content validity index was 1.0. Premature Infant Pain Profile and Premature Infant Pain Profile–Revised scores were highly correlated for pain after heel lancing and venipuncture (R² = 0.986, p < .001) and for pain associated with analgesic strategies (R² = 0.966-1.00, p < .001).ConclusionsThe Premature Infant Pain Profile–Revised was culturally adapted into Brazilian Portuguese. Appropriate content validity index was determined. Evidence of construct validity was also found. Future studies are warranted to explore the feasibility and other psychometric properties of using the Premature Infant Pain Profile–Revised translated and adapted into Brazilian Portuguese in the clinical setting.     

Translation,cross-cultural adaptation,and measurement properties of the psychosomatic questionnaire for children and adolescents with musculoskeletal pain into Brazilian-Portuguese

BackgroundPsychosomatic symptoms seem to influence both the onset and development of pain. There is lack of Brazilian-Portuguese questionnaires that measure psychosomatic symptoms in children and adolescents.ObjectiveTo translate and cross-culturally adapt the Psychosomatic Questionnaire for Children and Adolescents into Brazilian-Portuguese and English and test the measurement properties of the Brazilian-Portuguese version.MethodsThe translation and cross-cultural adaptation (from Dutch to Brazilian-Portuguese and English) followed six steps. Interviews were conducted in 33 Brazilian children and adolescents. We also recruited 107 children and adolescents with musculoskeletal pain from schools to test the measurement properties of the Brazilian-Portuguese version. The questionnaire was completed twice with a 7-day interval. Ceiling and floor effects, missing data, internal consistency, reliability, measurement error and construct validity were assessed.ResultsWe recruited 140 children and adolescents from public and private schools. During the cross-cultural adaptation process, no major difficulty answering and understanding the questionnaire were reported by children and adolescents. The questionnaire did not show ceiling or floor effects and had minimal missing data (0.37%). Internal consistency by the Cronbach's Alpha was 0.69. Test-retest reliability by the Intraclass Correlation Coefficient was 0.75 (95% CI: 0.64, 0.84). The smallest detectable change was 6.5 points out of 18 points. We observed a moderate correlation of 0.54 (p<0.01) with the Spence Children's Anxiety Scale, consistent with our a-priori hypothesis.ConclusionThe Brazilian-Portuguese version of the Psychosomatic Questionnaire for Children and Adolescents has acceptable measurement properties and is a good option for assessing psychosomatic symptoms in clinical practice and research.     

Psychometric Properties of the Knowledge,Attitude, and Practice Behavior of Oncology Nurses on Advance Care Planning Instrument

ObjectiveAdvance care planning has been practiced in Western countries for several years, but non-Western cultures face challenges in implementation. This study was dedicated to translating the instrument measure into Chinese, examining its psychometric qualities and exploring the relationships among knowledge, attitudes, and practicing behaviors in advance care planning among oncology nurses in China.Data SourcesThe research adopted a cross-sectional design from September 3 to October 5, 2021. After translation and cultural adaptation, oncology nurses (N = 249) were involved. The research used psychometric evaluation to verify that the content validity, structural validity, internal consistency, and test-retest reliability enhanced the analytical rigorous instrument.ConclusionThe translated and adapted instruments showed reasonable psychometric properties. The Chinese version of the KAB-ACP for oncology nurses is a consistent, valid, and reliable instrument for assessing knowledge, attitude, and practice behavior of Chinese-speaking nurses who work in advance care planning by researchers or clinicians.Implications for Nursing PracticeMeasures of oncology nurses’ knowledge, attitudes, and practice behaviors will allow for more targeted interventions that will improve end-of-life care outcomes.     

Cross-cultural adaptation and measurement properties of the Brazilian Version of the Michigan Neuropathy Screening Instrument

Background

The Michigan Neuropathy Screening Instrument is an easy-to-use questionnaire aimed at screening and detecting diabetic polyneuropathy.

Measurement properties of the Brazilian Portuguese anterior cruciate ligament - return to sport after injury (ACL-RSI) scale short version after anterior cruciate ligament reconstruction

BackgroundHigher scores (closer to 100) on the Anterior Cruciate Ligament - Return to Sport after Injury (ACL-RSI) scale indicate better psychological readiness to return to sport after anterior cruciate ligament reconstruction (ACLR).ObjectivesTo verify the validity and reliability of the ACL-RSI-short version (ACL-RSI-SV) in Brazilian Portuguese in individuals who underwent ACLR.MethodsParticipants (n=168) answered the Brazilian versions of ACL-RSI, Tampa Scale for Kinesiophobia (TSK-17), and International Knee Documentation Committee (IKDC) to assess the convergent validity of the short version. Internal consistency was also verified through correlation between items. Scores of participants who did not return to sport, who returned at a lower level, and at the pre-injury level were compared to verify divergent validity. ACL-RSI was answered again after 5-8 days to verify test-retest reliability.ResultsACL-RSI-SV in Brazilian Portuguese showed good test-retest reliability (ICC_2.1 = 0.85, 95% CI: 0.76, 0.90) and acceptable internal consistency (Cronbach's alpha = 0.78). Standard error of measurement (SEM) and smallest detectable change (SDC) were 4.98 and 13.82. High positive correlation was found with the full version of the ACL-RSI (r=0.93, 95% CI: 0.91, 0.95), moderate positive correlation with the IKDC (r=0.52, 95% CI: 0.40, 0.62), and weak negative correlation with the TSK-17 (r = -0.45, 95% CI: -0.60, -0.28). It also presented good divergent validity to identify individuals who returned to sport.ConclusionACL-RSI-SV in Brazilian Portuguese is a consistent, valid, and reliable instrument to assess patients who have undergone ACLR, with good ability to identify those who return to sport.     

Psychometric evaluation of the Thai translation of the Diabetes Self-management Questionnaire in type 2 diabetes

ObjectivesTo explore the content validity and the internal consistency of the diabetes Self-management Questionnaire (DSMQ) for persons with T2DM in Thailand.MethodsDiabetes Self-management Questionnaire (DSMQ) was developed in English. The translation of DSMQ into Thai language was performed by native Thai translators. A panel of five experts in Thailand evaluated the translation. Content validity was quantified by the content validity index (CVI). A cross-sectional design was used to test internal consistency by calculating Cronbach’s alpha.ResultsThe DSMQ contains 16 items. There are eleven items (69%) which showed excellent CVI; two items (12.5%) showed good CVI and three items showed acceptable CVI. The average scale of CVI was 0.90. The internal consistency of the DSMQ was 0.73.ConclusionThe Thai version of DSMQ showed excellent content validity; good internal consistency. The instruments can be used among Thai adults with DM in future research studies.     

Health locus of control questionnaire for patients with chronic low back pain: psychometric properties of the Brazilian–Portuguese version

Background and Purpose . Low back pain is common among Brazilians, especially affecting those who are working. Psychosocial factors, such as the health locus of control, are associated with low back pain prognoses. Although the multidimensional health locus of control questionnaire is widely employed in individuals with low back pain, a Brazilian–Portuguese version is not yet available. The aim of the present study was to translate and adapt the multidimensional health locus of control (MHLC) questionnaire, and to investigate its psychometric properties in a Brazilian population with non‐specific chronic low back pain. Method . Translation and adaptation of the questionnaire was carried out in the first phase of the study. In the second phase it was administered to Brazilians with non‐specific chronic low back pain to evaluate its intra‐examiner reliability (n = 20), concurrent validity, internal consistency (n = 40), and floor and ceiling effects. To evaluate concurrent validity the Brazilian–Portuguese version of the Roland–Morris disability questionnaire was used as the comparison. Results . The sub‐scales demonstrated good to excellent reliability with intra‐class coefficient (ICC) values of 0.75 for the external subscale (95% confidence interval (95% CI): 0.46–0.89), 0.87 for the internal sub‐scale (95% CI: 0.69–0.94) and 0.90 for the chance sub‐scale (95% CI: 0.77–0.96). For concurrent validity, the external and chance sub‐scales correlated positively with disability (Pearson's r = 0.58; p < 0.001 and Pearson's r = 0.35; p = 0.025), respectively, while the internal sub‐scale correlated negatively with disability (Pearson's r = ?0.33; p = 0.037). The questionnaire had acceptable internal consistency, with a Cronbach's alpha value of 0.65 (95% CI: 0.46–0.80) for external sub‐scale, 0.77 (95% CI: 0.64–0.87) for internal sub‐scale and 0.83 (95% CI: 0.73–0.90) for chance sub‐scale. Conclusions . The Brazilian–Portuguese version of the MHLC questionnaire has acceptable measurement properties similar to that observed with the original English language version. Copyright © 2008 John Wiley & Sons, Ltd.     

Translation and cross-cultural adaptation of the Brazilian version of the PM-Scale: A specific measure of participation after stroke

BackgroundThe PM-Scale was developed specifically to assess participation in individuals after stroke based on the concepts contained in the International Classification of Functioning, Disability and Health. However, this measure is only available in English and French.ObjectiveTo translate and cross-culturally adapt the PM-Scale to Brazilian Portuguese, followed by the validation and testing of reliability of the translated version.MethodsThe translation process followed standard guidelines. Preliminary test-retest reliability was determined using the intraclass correlation coefficient (ICC_2,1). The Rasch model was employed to analyse the validity, unidimensionality, invariance, and internal consistency of the Brazilian version of the PM-Scale.ResultsThe final translated version of the PM-Scale presented appropriate semantic, idiomatic, cultural, and conceptual equivalence. The preliminary analysis revealed excellent intra-observer and inter-observer reliability (ICC_2,1 = 0.91; 95%CI: 0.83, 0.95 and ICC_2,1 = 0.81; 95%CI: 0.64, 0.89, respectively). The analysis of the Rasch model revealed only one erratic item. An excellent overall fit was found for items (mean ± SD = 0.01 ± 1.02) and adequate fit was found for persons (mean ± SD = 1.16 ± 0.88). Internal consistency was considered adequate (person separation index = 1.77, reliability = 0.76). No significant invariance was found with regards to the personal characteristics of the sample (p > 0.05).ConclusionThe Brazilian version of the PM-Scale is a valid, unidimensional, linear, reliable scale for measuring participation in stroke survivors and can be administered in less than five minutes.     

The Italian version of the Sickness Impact Profile-Roland Scale for chronic pain: cross-cultural adaptation,reliability, validity and sensitivity to change

Purpose.?As no adapted form of the 23-item Sickness Impact Profile (SIP)-Roland Scale for patients with chronic pain has ever been validated in the Italian population, the aim of this study was to translate, culturally adapt and validate an Italian version.

Methods.?The development of the Italian version involved translation and back-translation, a final review by an expert committee and the testing of the pre-final version to establish its correspondence with the original. The psychometric testing included testing reliability by internal consistency (Cronbach's α) and test-retest repeatability (intraclass coefficient correlation; ICC), construct validity by comparison with an 11-point pain intensity numerical rating scale (NRS; Pearson's correlation) and the Short Form Health Survey (SF-36; Pearson's correlation) and sensitivity to change by calculating the minimum detectable change (MDC).

Results.?It took 3 months to obtain a shared version of the scale, which was administered to 243 subjects and proved to be satisfactorily acceptable. It had a high degree of internal consistency (α == 0.860) and test-retest reliability (ICC == 0.972). Construct validity testing revealed a moderate correlation with the NRS (r == 0.418), close correlations with the SF-36 physical subscales and moderate-poor correlations with the mental and social subscales; the MDC was 2.33.

Conclusions.?The SIP-Roland scale was successfully translated into Italian, showing satisfactory psychometric properties. The measure can be recommended for use in research and clinical practice to improve the assessment of physical dysfunction in subjects with chronic pain.     

Transcultural adaptation of the filial responsibility interview schedule for Brazil

AIRES M., WEISSHEIMER A.‐M., ROSSET I., DE OLIVEIRA F. A., DE MORAIS E. P. & PASKULIN L. M. G. (2012) Transcultural adaptation of the filial responsibility interview schedule for Brazil. International Nursing Review 59 , 266–273 Background: In developed countries, filial responsibility in relation to caring for elderly parents has been systematically studied. In Brazil and other developing countries, however, it is a relatively new topic and has not yet been included in the research agenda on ageing. Objective: To describe the process of cross‐cultural adaptation of the qualitative phase of the filial responsibility interview schedule into Brazilian Portuguese. Methods: An expert committee of six team members participated in the study. In addition, individual interviews were held with 11 caregivers of older persons to evaluate the quality of the final Portuguese version of the schedule. The process included examining conceptual, item, semantic and operational equivalencies. Conceptual and item equivalencies were based on a literature review and on discussions with the expert committee. Semantic equivalence was attained through translation, back‐translation, expert committee evaluation and pre‐testing. The final version was pre‐tested in caregivers of older persons enrolled in the home care programme of a primary health care service in Southern Brazil. Results: Conceptual, item, semantic and operational equivalencies were attained. Through the interviews, responses to the open‐ended questions concerning filial responsibility in the care for elderly parents pertained to the following categories: possibility of institutionalization of elderly parents, caregiver expectations, difficulties in being a child caregiver and responsibility as a natural process. Conclusion: The Portuguese version presented good semantic equivalence and the results showed that the concepts and items are applicable to the Brazilian context.     

Cultural adaptation and validation of the instrument requirement for directed attention

The aim of this study is to translate and validate the instrument Requirement for Directed Attention (RDA), developed by Guirardello, into Brazilian culture. The instrument, comprised of 39 items, addresses situations in the work environment of critical care and medical-surgical units that demand the nurse's direct attention. The methodological approach consists of the following steps: (a) translation of the instrument to the Portuguese language; (b) back-translation; (c) committee review; and (d) pre-testing of the instrument's final version. The Portuguese language version was applied to 44 nurses. The data resulted in high internal consistency for the total of the items (alpha = 0.91), and for the domains: Physical Environment (alpha = 0.78), Psychological Envi-ronment (alpha = 0.85) and the Behavioral Environment (alpha = 0.80). Only the domain Information had a low value (a = 0.12). These results suggest that the Portuguese language version of the RDA can be used to evaluate the attention demands for the nurse.     

Translation and cross-cultural adaptation of the Charcot-Marie-Tooth disease Pediatric Scale to Brazilian Portuguese and determination of its measurement properties

BackgroundThe Charcot-Marie-Tooth disease Pediatric Scale (CMTPedS) has been used to measure aspects of disability in children with all types of Charcot-Marie-Tooth disease (CMT).ObjectiveTo translate and cross-culturally adapt the CMTPedS into Brazilian–Portuguese and determine its reliability and validity.MethodsThe translation and cross-cultural adaptation followed international guidelines recommendations. Twenty individuals with CMT were assessed. Two examiners assessed the participants for inter-rater reliability. Face validity was assessed by eight physical therapists that judged the relevance of each test item. The Bland-Altman analysis (bias) and standard error of measurement (SEM) complemented the analysis. Furthermore, intraclass correlation coefficients (ICC), weighted kappa (k), and internal consistency (Cronbach’s alpha) was determined.ResultsThe CMTPedS was successfully translated and cross-culturally adapted. Twenty children/youth were enrolled in the study. Of these, the majority (55%) were girls with a mean age of 13.9 (range: from 6 to 18) years. Regarding face validity, the CMTPedS-Br showed relevant items for assessing children and youth with CMT. The ICC for the total score showed excellent reliability (ICC_2.1 = 0.93, 95% CI = 0.84, 0.97). The most reliable items were grip, dorsiflexion and plantar flexion strength while the least reliable items were pinprick, vibration, and gait. The internal consistency was excellent (α = 0.96, 95% CI = 0.91, 0.99) and the agreement showed small variability (bias = 0.15, 95% CI= -4.28, 4.60).ConclusionThe CMTPedS-Br showed adequate reliability and face validity to measure disability in individuals with CMT. This tool will allow Brazil to be part of multicentered studies on such a rare but debilitating condition.