Translation of the short version of the Smartphone Addiction Scale into Brazilian Portuguese: cross-cultural adaptation and testing of measurement properties

BackgroundSmartphone use has been constantly increasing. Smartphone addiction can lead to changes in the emotional state and musculoskeletal system of users. To identify smartphone addicts, the Smartphone Addiction Scale-Short Version was developed; however, this scale has not been translated into Brazilian Portuguese and tested for its measurement properties.ObjectiveTo translate and cross-culturally adapt the Smartphone Addiction Scale-Short Version into Brazilian Portuguese; to assess the internal consistency, reliability and construct validity of the scale among university students.MethodsThe cross-cultural adaptation was performed following the guidelines for cross-cultural adaptation of self-report measures, and data were collected via online surveys administered to 59 university students over 18 years of age for test–retest. To test the measurement properties of the final version of the Smartphone Addiction Scale-Short Version, a convenience sample including 130 university students was used.ResultsThe Smartphone Addiction Scale-Short Version showed good reliability for test–retest scores (ICC_3,1 = 0.82; 95% CI = 0.70–0.89) and good internal consistency considering all 10 items (Cronbach's alpha = 0.95). The construct validity was calculated comparing the Smartphone Addiction Scale-Short Version score to data from a questionnaire prepared by the authors of this study, including frequency per day (r = 0.35; p < 0.001), leisure time on the smartphone (r = 0.33; p < 0.001), and time working on the smartphone (r = 0.18; p = 0.04) that were significantly positively associated with higher Smartphone Addiction Scale-Short Version scores. The results show a high prevalence of smartphone addiction among university students (33.1%).ConclusionIt can be concluded that the Brazilian Portuguese version of the Smartphone Addiction Scale-Short Version is a reliable and valid tool for screening smartphone addiction in university students.     

Translation,cross-cultural adaptation,and psychometric properties of the Brazilian Portuguese version of the DiAbeTes Education Questionnaire (DATE-Q)

BackgroundThe DiAbeTes Education Questionnaire (DATE-Q) is a self-administered tool developed to evaluate disease-related knowledge and to assess knowledge of five core components of rehabilitation programs: physical exercise, diet, psychosocial well-being, disease self-management, and complications.ObjectiveTo translate and cross-culturally adapt into Brazilian Portuguese, and to test the psychometric properties of the DATE-Q for its use in Brazil.MethodsThe process of translation and cross-cultural adaptation consisted of five steps: translation into Brazilian Portuguese, synthesis of translation, back translation, expert committee, and pilot test of pre-final version. The pre-final version was applied to a sample of 30 patients with diabetes. Psychometric properties (internal consistency, reliability, construct validity, and ceiling and floor effects) of the final version of the Brazilian Portuguese version of the DATE-Q were tested in a sample of 200 adults with diabetes.ResultsThere was no conceptual divergence between the original and the translated versions. Ten (50%) items of the DATE-Q were culturally adapted. Internal consistency (Cronbach’s alpha coefficient = 0.6), reliability (intraclass correlation coefficient = 0.5), and construct validity (correlation between Diabetes Knowledge Scales and DATE-Q total scores: ρ = 0.7; P < 0.001) were confirmed. Ceiling or floor effects were not identified. The highest scoring item was about healthy eating. The average time for completion of the DATE-Q was 5 min and 51 s, and the completion rate was 100% for all items.ConclusionThe Brazilian Portuguese version of the DATE-Q showed adequate psychometric properties, and results suggested that the tool can be used to assess disease-related knowledge in adults with diabetes in Brazil.     

Translation,cross-adaptation and measurement properties of the Brazilian version of the ACL-RSI Scale and ACL-QoL Questionnaire in patients with anterior cruciate ligament reconstruction

Background

Scales to assess the quality of life and return-to-sport after reconstruction of the anterior cruciate ligament (ACL) may help the clinical decision-making process.

Translation,cross-cultural adaptation to Brazilian- Portuguese and reliability analysis of the instrument Rapid Entire Body Assessment-REBA

Background:

Observational instruments, such as the Rapid Entire Body Assessment, quickly assess biomechanical risks present in the workplace. However, in order to use these instruments, it is necessary to conduct the translational/cross-cultural adaptation of the instrument and test its measurement properties.

Objectives:

To perform the translation and the cross-cultural adaptation to Brazilian-Portuguese and test the reliability of the REBA instrument.

Method:

The procedures of translation and cross-cultural adaptation to Brazilian-Portuguese were conducted following proposed guidelines that involved translation, synthesis of translations, back translation, committee review and testing of the pre-final version. In addition, reliability and the intra- and inter-rater percent agreement were obtained with the Linear Weighted Kappa Coefficient that was associated with the 95% Confidence Interval and the cross tabulation 2×2.

Results

: The procedures for translation and adaptation were adequate and the necessary adjustments were conducted on the instrument. The intra- and inter-rater reliability showed values of 0.104 to 0.504, respectively, ranging from very poor to moderate. The percentage agreement values ranged from 5.66% to 69.81%. The percentage agreement was closer to 100% at the item ''upper arm'' (69.81%) for the Intra-rater 1 and at the items ''legs'' and ''upper arm'' for the Intra-rater 2 (62.26%).

Conclusions:

The processes of translation and cross-cultural adaptation were conducted on the REBA instrument and the Brazilian version of the instrument was obtained. However, despite the reliability of the tests used to correct the translated and adapted version, the reliability values are unacceptable according to the guidelines standard, indicating that the reliability must be re-evaluated. Therefore, caution in the interpretation of the biomechanical risks measured by this instrument should be taken.     

Post-COVID-19 functional status scale: Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version

BackgroundThe Post-COVID-19 Functional Status (PCFS) scale was created to assess the functional status of patients after hospital discharge due to COVID-19.ObjectiveTo perform cross-cultural adaptation of the PCFS Scale and Manual into Brazilian Portuguese and evaluate its measurement properties in patients post-COVID-19.MethodsFor the cross-cultural adaptation, independent translations and back-translations were performed. This was followed by a pre-test, with analysis of the Content Validity Index (CVI), and preparation of the final version, after evaluating the measurement properties. Spearman's correlation between the PCFS and the WHO Disability Classification Scheme (WHODAS 2.0) was used for convergent validity. Weighted Kappa (wκ) was used for test-retest and interobserver reliability for PCFS scores and Kappa (κ) for PCFS items. Internal consistency was assessed using Cronbach's alpha. Only patients with post-discharge COVID-19 were evaluated through video-conferencing platforms.ResultsThe CVI was 0.75–0.83 for comprehension and 0.83–0.84 for the language of the self-administered questionnaire and the structured interview version. For measurement properties, 63 patients were evaluated, 68% male, 51.50 (12.60) years, 12.28 (7.62) days of hospitalization. For the convergent validity, a strong correlation was found (r = 0.73; p<0.01). The test-retest (wκ=0.54) and interobserver (wκ=0.43) reliability was moderate and the item-by-item analyzes ranged from fair to substantial (κ=0.25–0.66) and weak to substantial (κ=0.07–0.79). Internal consistency was excellent (0.85).ConclusionThe final PCFS in Brazilian Portuguese showed adequate content validity, reliability, internal consistency, and convergent validity for the functional assessment of patients after hospital discharge due to COVID-19.     

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.     

Brazilian version of the OSTRC Questionnaire on health problems (OSTRC-BR): translation,cross-cultural adaptation and measurement properties

BackgroundThe Oslo Sports Trauma Research Center - Questionnaire on Health Problems (OSTRC-QHP) has been shown to be a valid and reliable questionnaire for monitoring athletes with acute, overuse, and illness problems.ObjectivesTo translate and cross-culturally adapt the OSTRC-QHP into Brazilian-Portuguese (OSTRC-BR), and investigate the measurement properties of this version.MethodsThe original (Norwegian) questionnaire was translated and culturally adapted following existing guidelines. Measurement properties of the OSTRC-BR were investigated in 134 athletes followed for 13 weeks. Reliability was analyzed via internal consistency and test-retest reliability. Responsiveness was assessed by effect size (ES) estimations, correlation of the OSTRC-BR severity score with the Global Perceived Effect scale (GPE) and the Numeric Pain Rating Scale (NPRS), and by the Receiver Operating Characteristic (ROC) Curve test based on the area under the curve (AUC).ResultsThe OSTRC-QHP has been translated and cross-culturally adapted successfully. The Cronbach's alpha was 0.93 (95% CI: 0.92, 0.94). Intrarater reliability (ICC_2,1) of 0.96 (95% CI: 0.94, 0.98) was classified as excellent. ES estimation showed large effects (1.14 to 1.39). OSTRC-BR correlation was moderate (0.58 to 0.72) with the GPE and substantial (0.84 to 0.89) with the NPRS. The AUC values were above 0.70 when analysing all types of health problems.ConclusionsThe OSTRC-BR presented adequate measurement properties. The OSTRC-BR is a valid, reliable, responsive, and, therefore, an adequate tool for monitoring Brazilian athletes from different sports during training and competitions.     

Translation,cross-cultural adaptation and validity of the Brazilian version of the Foot and Ankle Ability Measure questionnaire

Purpose: To translate and cross-culturally adapt the Foot and Ankle Ability Measure (FAAM) questionnaire and verify the psychometric properties of the Brazilian–Portuguese version of this instrument.

Methods: Analysis of validity was carried out by applying the Rasch model and evaluating correlations with the Short Form-36 (SF-36) Physical Function (PF) subscale. Test–retest reliability and internal consistency were analyzed with the intraclass correlation coefficient (ICC_2,1) and Cronbach’s alpha tests, respectively.

Results: Ninety subjects with various foot and ankle musculoskeletal disorders (age 37.05 SD 10.49 years) were included. The ICC_2,1 was 0.88 and 0.82 with Cronbach’s alphas of 0.93 and 0.90 for the “Activities of Daily Living” (ADL) and “Sports” subscales, respectively. Correlations with the SF-36 PF were 0.78 (p?95: 0.62–0.87) and 0.65 (p?95: 0.45–0.79) for the ADL and Sports subscales, respectively. Item reliability indices in Rasch analysis were 0.91 (ADL) and 0.84 (Sports). Three items from the ADL subscale (14.2%) did not match the expectations of the model. All items from the Sports subscale fit the model.

Conclusions: There is evidence of validity and reliability of the FAAM-Brazil. Rasch analysis indicated that three items of the ADL subscale did not fit the model in the sample studied.

• Implications for Rehabilitation

• Self-report questionnaires are commonly used in both clinical practice and research because of their ability to efficiently collect information. If the instrument is created properly, the information collected can be used to interpret the effect of clinical conditions on physical function.

• The Foot and Ankle Ability Measure (FAAM) is an evaluative instrument that assesses functional limitations for those with foot- and ankle-related disorders. It was translated into four languages and has evidence of validity, reliability, and responsiveness.

• Evidence of validity and reliability is provided for the FAAM-Brazil when applied to subjects with a wide range of foot and ankle musculoskeletal disorders.

     

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.     

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.     

Hand function and Disability of the Arm,Shoulder and Hand in Charcot-Marie-Tooth disease

Purpose. The aim of the present study was to examine hand function and disability in persons with Charcot-Marie-Tooth disease (CMT) and to evaluate the possible correlations between hand function and disability.

Methods. Nine male, 11 female (24–73 yrs) persons with CMT in northern Sweden and a matched control group of 18 men, 22 women (21–73 yrs) participated in the study. Measurements applied were tests of dexterity (Box and Block Test; Nine-Hole Peg test), grip strength (Grippit®), tactile gnosis (Shape Texture Identification test) and upper-limb disability (Disabilities of the Arm Shoulder and Hand questionnaire, DASH).

Results. Hand function in CMT was reduced (p < 0.001) to about 60% of normal, as indicated by each of the separate outcome measures as well as by a constructed summary index of hand function. DASH score median was 38.8 (range 0–66.7) and was clearly related to hand function (r = 0.64–0.83).

Conclusion. Reduced hand function in CMT was found at different dimensions according to the International Classification of Functioning, Disability and Health (ICF). We suggest that DASH can be used in persons with CMT, though clinicians should be aware that patients might score lower than expected, possibly because of a long process of adaptation when learning to live with a slowly progressive disease.     

Translation,cross-cultural adaptation and psychometric properties of the Back Beliefs Questionnaire in Modern Standard Arabic

Purpose To translate and cross-culturally adapt the Back Beliefs Questionnaire (BBQ) into modern standard Arabic and examine its validity, acceptability and reliability in Arabic-speaking patients with low back pain (LBP). Method The BBQ was forward, back-translated and reviewed by an expert committee. Seventeen bilingual patients completed Arabic and English BBQs. LBP patients (n?=?199) completed the Arabic BBQ. Sixty-four repeated it a week later, and 151 completed the Arabic Fear-avoidance Beliefs Questionnaire (FABQ). Results The expert committee followed advice from the developers to maintain Arabic equivalence of “back trouble(s)”. Patients found the questionnaire comprehensible and acceptable. Agreement between the English and Arabic versions of the BBQ was acceptable, ICC?= 0.65 (0.25–0.86). Most item-by-item agreement ranged from fair to moderate (K?=?0.12–0.54). Mean (SD) of BBQ, FABQ total, work and physical activity subscales were 25.31(6.13), 44.76(19.49), 21.17(10.10) and 13.95(6.65). The BBQ correlated with the FABQ at r?=??0.33, work subscale r?=??0.29 and physical activity r?=??0.30 (all p?α?=?0.73 indicated high internal consistency. Test–retest reliability was high, ICC?=?0.80 (0.68–0.87). Item-by-item agreement ranged from fair to acceptable (K?=?0.31–0.66). Conclusions The Arabic BBQ has good comprehensibility and acceptability, acceptable agreement with the English BBQ, high internal consistency and test–retest reliability. We recommend its use with Arabic-speaking LBP patient to determine their beliefs and attitudes about their back pain, as they have been shown to be important predictors of persistent LBP disability.

• Implications for Rehabilitation

• There are limited valid and reliable outcome measures for back pain in Arabic. The Back Beliefs Questionnaire (BBQ) is a tool that measures attitudes and beliefs about back pain.

• We recommend the use of our valid and reliable, translated and cross-culturally adapted tool with Arabic-speaking patients.

• The tool can measure attitudes and beliefs concerning the future consequences of LBP, with regards to recovery and return to work in this sample.

• Findings will improve back pain management options aimed at reducing back pain disability though challenging and modifying beliefs in the Middle East or with migrant populations in the West.

     

Translation,Transcultural Adaptation,and Validation of the Empathy,Spirituality, and Wellness in Medicine Scale to the Brazilian Portuguese Language

ABSTRACT

Construct: The Empathy, Spirituality, and Wellness in Medicine Scale (ESWIM) is a 43-item multidimensional scale developed to investigate different dimensions of physicians and medical students. Background: Medical education research requires the use of several different instruments with dozens of items that evaluate each construct separately, making their application slow and increasing the likelihood of students providing a large number of incomplete or missing responses. To provide an alternative measure, this study aims to translate, adapt, and validate the multidimensional ESWIM instrument for Brazilian medical students. This is a very promising instrument because it is multidimensional, relatively short, and cost free; it evaluates important constructs; and it has been explicitly designed for use in the medical context. Approach: The English-language instrument was translated and adapted into the Brazilian Portuguese language using standard procedures: translation, transcultural adaptation, and back-translation. ESWIM was administered to students in all years of the medical curriculum. A retest was given 45 days later to evaluate reliability. To assess validity, the questionnaire also included sociodemographic data, the Duke Religion Index, the Empathy Inventory, the brief version of the World Health Organization Quality of Life (WHOQOL-Bref), and the Oldenburg Burnout Inventory. Results: A total of 776 medical students (M age = 22.34 years, SD = 3.11) were assessed. The Brazilian Portuguese version of ESWIM showed good internal consistency for the factor of Empathy (α = 0.79-0.81) and borderline internal consistency for the other factors: Openness to Spirituality (α = 0.61–0.66), Wellness (α = 0.57–0.68), and Tolerance (α = 0.56–0.65). The principal component analysis revealed a four-factor structure; however, the confirmatory factor analysis showed a better fit for a three-factor structure. We found a significant positive correlation between ESWIM empathy and empathy measured by the Empathy Inventory (r = .444, p < .01), as well as negative correlations between ESWIM empathy and burnout (r = ?.145 to ?.224, p < .01). ESWIM openness to spirituality was also significantly correlated with different subscales of religiosity (r = .301–.417, p < .01), and ESWIM wellness was significantly correlated with the WHOQOL-Bref factors (r = .390–.673, p < .01). The test–retest reliability (applied to 83 students) was high for all factors except Tolerance. Conclusion: This study provides supportive evidence regarding the reliability and validity of ESWIM empathy scores. The ESWIM scale opens a new field of research in relation to openness to spirituality by introducing a scale that measures this openness attitude. Despite borderline internal consistency, ESWIM wellness was strongly associated with quality of life and had good test–retest reliability. Thus, ESWIM appears to be a valid option for evaluating these constructs in medical students.     

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.