Cross-cultural adaptation and semantic validation of an instrument to identify palliative requirements in Portuguese

Santana, Marcella Tardeli Esteves Angioleti; Gómez-Batiste, Xavier; Silva, Lucia Marta Giunta da; Gutiérrez, Maria Gaby Rivero de

doi:10.31744/einstein_journal/2020AO5539

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ORIGINAL ARTICLE • Einstein (São Paulo) 18 • 2020 • https://doi.org/10.31744/einstein_journal/2020AO5539 copy

Cross-cultural adaptation and semantic validation of an instrument to identify palliative requirements in Portuguese

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To translate and make cross-cultural adaptation of NECPAL CCOMS-ICO^© tool to Portuguese, and to analyze its semantic validity.

Methods

A methodological research about NECPAL CCOMS-ICO^© tool cross-cultural adaptation, translated from Spanish into Portuguese and measurement of semantic validity. The cross-cultural adaptation process was conducted according to Beaton recommendations, including translation, translation synthesis, back-translation, and analysis of semantic, idiomatic, conceptual, and cultural equivalence of translated and back-translated tool versions, resulting in a pre-final version, which was submitted to a pre-test (n=35). Contend Validity Index was calculated to analyze semantic validity.

Results

Cross-cultural adaptation process allowed us to prepare the final version of this tool, which was named NECPAL-BR. Collected data from pre-testing step enabled the analysis of semantic validity. The Content Validity Index observed at this step was 0.94.

Conclusion

The semantic validity of the tool in its Portuguese version was confirmed; therefore, it may assist in screening chronic progressive disease patients, aiming to provide early palliative care. It may also be used to develop clinical and team performance indicators, and be employed as a care management tool designed to optimize resources.

Palliative care; Chronic disease; Patient identification systems; Patient care management; Surveys and questionnaires; Validation study

Stages	Actions
Translation	Performed by two independent translators who were native speakers of Portuguese and were fluent in Spanish, in which one of them was blinded to the study objectives (blind translation)
Synthesis of the translation	The investigators evaluated the translated versions to verify possible ambiguities or discrepancies in the translation process, and prepared a synthesis of the two versions
Back-translation	In this stage, the consensual version was back-translated into Spanish by two other translators, laypersons, with no clinical experience, blinded to the original instrument and to the study objectives; one of them was a native speaker of Spanish, besides having Portuguese proficiency
Committee of specialists	A committee of specialists analyzed all versions of the instrument as to semantic, idiomatic, conceptual, and cultural equivalence, based on the synthesis of the translations. A second round of evaluations was needed, which resulted in the pre-final version. At this stage, the content validity was also verified
Pre-test	Application of the pre-final version (n=35), in which the understanding of each item was assessed, that is, its semantic validity
Submission to the authors of the original text	Presentation of all reports to the authors of the original text. Approval of the final version

Item of the instrument	CVR as to relevance (content validity)	CVR as to comprehension (semantic validity)
1. Surprise question	0.94	0.91
2.1. Demand	1.00	0.74
2.2. Necessity	0.97	0.89
3.1. Nutritional decline	1.00	1.00
3.2.Functional decline	1.00	0.94
3.3. Cognitive decline	0.97	0.91
4. Severe dependence	1.00	0.97
5. Geriatric syndromes	1.00	1.00
6. Persistent symptoms	0.97	1.00
7.1. Emotional suffering or severe adaptive disorder	1.00	0.91
7.2. Severe social vulnerability	0.66	0.91
8. Multimorbidity	1.00	1.00
9. Use of resources	0.94	1.00
10. Specific indicators	1.00	1.00

Instituto Israelita de Ensino e Pesquisa Albert Einstein Avenida Albert Einstein, 627/701 , 05651-901 São Paulo - SP, Tel.: (55 11) 2151 0904 - São Paulo - SP - Brazil
E-mail: revista@einstein.br

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[1] Corresponding author: Marcella Tardeli Esteves Angioleti Santana Avenida do Oratório, 2.635, Apto. 74 T3 Parque São Lucas Zip code: 03221-100 – São Paulo, SP, Brazil Phone: (55 11) 9339-1397 E-mail: marcellatardeli@yahoo.com.br