Translation of the “F-Words Tools” into Brazilian Portuguese

Abstract

Introduction:

The International Classification of Functionality, Disability and Health (ICF) determines that for any health condition, functionality is the result of the multidirectional relationship between the positive aspects of the components of body structures and functions, activities, participation and contextual factors, encompassing personal and environmental factors.

Objective:

To translate and culturally adapt the “F-Words Tools” into Brazilian Portuguese.

Methods:

Permission to translate was granted by the authors. After reading and understanding the instruments, a researcher performed a non-certified translation into Brazilian Portuguese. Next, the back translation into English was done by a specialist in both languages without prior knowledge of the original versions. The result of the back translation was sent to the authors of the instrument for verification of semantics and content. Based on the authors' recommendations and the results of translation analyses, there was no need for cultural adaptation.

Results:

The back translation was approved by the authors, indicating that the Brazilian Portuguese version of all instruments was adequate. The translated titles are: Termo de Compromisso (Agreement), Colagem (Collage), Perfil (Profile) and Folha de Metas (Goal Sheet). The ICF framework was entitled: “The ICF model and My Favorite Words”. The material is available free of charge at the CanChild website.

Conclusion:

The translation into Brazilian Portuguese allows materials to be used in Brazil to disseminate the concepts of the ICF and the “F-words” in clinical and family settings.

Keywords:
Translation; International Classification of Functioning, Disability and Health; Child

Resumo

Introdução:

A Classificação Internacional de Funciona-lidade, Incapacidade e Saúde (CIF) determina que para qualquer condição de saúde, a funcionalidade é o resultado da relação multidirecional entre os aspectos positivos dos componentes de estruturas e funções do corpo, atividades, participação e fatores contextuais, que englobam os fatores pessoais e ambientais.

Objetivo:

Traduzir e adaptar culturalmente as “F-Words Tools” para o português brasileiro.

Métodos:

A tradução foi autorizada pelos autores. Após leitura e entendimento dos instrumentos, uma tradução livre para o português brasileiro foi realizada por uma pesquisadora. Posteriormente, realizou-se a retro-tradução para o inglês por um especialista em ambos os idiomas e sem conhecimento prévio das versões originais. O resultado da retro-tradução foi enviado aos autores do instrumento para verificação de semântica e de conteúdo.

Resultados:

A aprovação da retro-tradução foi obtida pelos autores, indicando que a versão em português brasileiro de todos os instrumentos estava adequada. Os títulos traduzidos são: Termo de Compromisso (Agreement), Colagem (Collage), Perfil (Profile) e Folha de Metas (Goal Sheet). O modelo da CIF intitulou-se: “O modelo da CIF e Minhas Palavras Favoritas”. O material está disponibilizado gratuitamente no site do CanChild. Não foi necessária adaptação cultural, segundo recomendação dos autores e o conteúdo dos instrumentos traduzidos.

Conclusão:

A tradução para o português brasileiro possibilita o uso desses materiais no Brasil, de modo a disseminar os conceitos da CIF e das “Minhas Palavras Favoritas” em âmbitos clínicos e familiares.

Palavras-chave:
Tradução; Classificação Internacional de Funcionalidade, Incapacidade e Saúde; Criança

Introduction

The International Classification of Functioning, Disability and Health (ICF), published in 2001 by the World Health Organization (WHO), determined that for any health condition, functionality is the result of the multidimensional relation between the positive aspects of the components of body structures and functions, activities, participation and contextual factors that encompass personal and environmental factors.¹ Thus, assessment instruments or tools that allow identifying and applying the concepts of functionality have been created and implemented over the years in order to favor practices based on a biopsychosocial approach.

In this respect, it is important for the family to be included in the care process,² as a facilitator and enhancer of relevant results focused on the needs of children and their families. Thus, family-centered care is based on the precept that children/adolescents and their families are active partners in the care process, building mutual power-sharing and decision-making relations based on real patient needs.³

The family-centered approach has shown to be critical in improving the quality of life of newborns, children and adolescents with disabilities,^4,5 as well as self-care and the knowledge of health status. In addition, families enrolled in this type of program exhibited a decline in stress, anxiety and depression.⁵

In order for this approach to be effectively implemented, quality instruments that help instruct families are needed.⁶ It is also important that these instruments consider the ICF domains, thereby allowing a biopsychosocial approach, with active participation by both patients and families. .

Among these instruments, the “F-Words for Childhood Disability” stands out. Created in 2012 by the CanChild team (McMaster University, Canada), this instrument aims to associate the ICF domains with the main areas of a disabled child’s and adolescent’s life⁷ in order to facilitate the biopsychosocial approach in clinical practice and the family context.

“F-Words”, initially translated into Brazilian Portuguese as “Minhas Palavras Favoritas” (My Favorite Words) by the Laboratory for Teaching and Research in Occupational Therapy in Childhood and Adolescence (LEPTOI),⁸ are a set of six words beginning with the letter F in its original English version, as follows: function/funcão, family/família, fitness/saúde, fun/diversão, friends/amigos and future/futuro. Each word is associated with the following ICF domains: function - activity; family - environmental factors; health - body structure and function; fun - personal factors; friends - participation; and future - encompassing all the components.

With a view to facilitating the practical application of My Favorite Words, the authors from CanChild, in partnership with the parents of disabled children, created the “F-Words Tools”. These consist of four instruments: F-Words Agreement, F-Words Collage, F-Words Profile and F-Words Goal Sheet.⁹ In addition to these instruments, a model characteristic of the ICF was created in association with My Favorite Words (F-Words Framework) in order to correlate the concepts and explain their relationships.

However, these materials, which are useful and well accepted, had not been translated into Brazilian Portuguese, hindering their use in Brazil. Although instruments that address ICF dimensions and include the family in the care process are being implemented in clinical practice and research, they need to be translated and adapted to different languages and countries.¹⁰ The process of translating instruments pertaining to the biopsychosocial aspects contained in the ICF provides greater dissemination of this knowledge to health professionals, researchers, families and patients with disability. However, few instruments that encompass these aspects have been translated into Brazilian Portuguese.¹⁰

As such, there was a need to translate and transculturally adapt these instruments. Use of these materials may further strengthen the biopsychosocial approach, which is growing in Brazil, and improve the functionality and well-being of people with disabilities. Thus, the aim of this study was to translate and transculturally adapt the “F-Words Tools” to Brazilian Portuguese.

Methods

The participants were a doctoral student in physiotherapy, and two professors with a PhD in physiotherapy, both native Portuguese speakers fluent in English. Translation and transcultural adaptation were authorized by the authors. The methodology followed their instructions and was based on the procedures described by Beaton et al.¹¹ and Guillemin et al.¹²

Non-certified translation into Brazilian Portuguese was performed by a native Portuguese-speaking researcher fluent in English. The translation was revised by another researcher, also a native Portuguese speaker fluent in English, who confirmed the translation. Next, the translated material was back translated into English by a specialist in both languages with no prior knowledge of the original English versions. The back translation result was sent to CanChild for the authors to determine the semantics and content and decide whether or not cultural adaptation was needed. This was deemed not to be necessary.

The F-Words Tools are described below:

F-Words Agreement

Instrument consisting of one page, with a space for a photograph of the child/adolescent and their name. The instrument contains an explanation for each of My Favorite Words, and invites the reader to put these ideas into practice, entering into an “agreement” between the child/adolescent, their family and the reader, who can be a therapist or teacher, for example.

F-Words Collage

Instrument consisting of one page and six spaces to add photographs of the child/adolescent for each of the My Favorite Words concepts. It helps the family and readers to observe and value all the areas of daily life of children/adolescents with disability, that is, to have a biopsychosocial perspective.

F-Words Profile

Instrument consisting of one page, with spaces for the child/adolescent’s photograph, name, date of birth, city of birth and language. For each of My Favorite Words, there are text boxes for the children/adolescents, their families, therapists or teachers to fill out, describing all the concepts addressed by My Favorite Words at the present time. Thus, the instrument creates a current profile of the child/adolescent, in order to value and identify what they are capable of doing.

F-Words Goal Sheet

Instrument consisting of one page, with a space for the child/adolescent’s name and date it was filled out. For each of My Favorite Words, there are text boxes for the goals one wishes to achieve, for each of the concepts. Thus, families, therapists and teachers are able to know the family’s and, especially the individual’s goals in order to address them specifically and directly.

F-Words Framework

A one-page instrument with the same structure as the ICF model and the addition of My Favorite Words. It is an easy and visual means of correlating the ICF with My Favorite Words, thereby encouraging its use. There are two versions, which differ only in their graphic art, one designed for children and the other for adults. .

Results

The CanChild team approved the back translation, without the need for any change, indicating that the Brazilian Portuguese version of all the instruments and the ICF model with the F-Words was adequate. In addition, it indicated the nonnecessity of cultural adaptation. Examples of Brazilian Portuguese instruments are available on the same website.

The following titles were translated: Folha de Metas (Goal Sheet) (Figure 1), Perfil (Profile) (Figure 2), Colagem (Collage) (Figure 3) and Termo de Compromisso (Agreement) (Figure 4). ). The ICF model, entitled “The ICF model and My Favorite Words”, has a children’s and adult version (Figure 5). The material is available free of charge at the CanChild site⁸ and can be used by all professionals and families.

Figure 1
My Favorite Words Goals translated into Brazilian Portuguese and example.

Figure 2
My Favorite Words Profile translated into Brazilian Portuguese and example.

Figure 3
My Favorite Words Collage translated into Brazilian Portuguese and example.

Figure 4
My Favorite Words Agreement translated into Brazilian Portuguese and example.

Figure 5
The children´s (image on the left) and adult (image on the right) versions of “My Favorite Words” translated into Brazilian Portuguese.

Discussion

The aim of the present study was to translate and transculturally adapt the “F-Words Tools” to Brazilian Portuguese. The final version was approved by the authors and there was no need for transcultural adaptation, given that the instruments consist of elements applicable to both Brazilian and Canadian cultures, a consensus reached by both the authors of the original instrument and the translated version. In addition, examples of the Brazilian Portuguese instruments were presented, which are also available on the same site, in order to facilitate filling out the Portuguese versions. We underscore that there are also examples in the original English version, which prompted the publication of examples in Portuguese.

The translation into Brazilian Portuguese makes it possible to use these materials in Brazil and disseminate the ICF and “My Favorite Words” in clinical and family settings, facilitating its practical use. The systematic implementation of translated instruments allows their effective inclusion in clinical practice for professionals and the families of disabled children. In addition, specifically for this instrument, the use of “My Favorite Words” and their tools allows the families and children to be protagonists in understanding their health status and its impacts on different biopsychosocial settings, thereby contributing to mitigating any obstacles caused by a disability.

Moreover, using the approach based on this context facilitates assessments and interventions aimed at improving the quality of life of children and families, by identifying which environmental factors are acting as facilitators and barriers to participating in activities.¹³ Understanding this context allows more targeted actions based on broad perspectives of health status according to specific contexts.¹⁴ Thus, the implementation of materials such the My Favorite Words instrument could favor a family-centered approach. This practice considers the aims of the family in terms of clinical decisions and therapeutic conduct,¹⁵ given that the family environment may influence child development.^16-18

It is also important to underscore that the lack of instruments translated into Brazilian Portuguese that encompass the biopsychosocial aspects of the ICF is a gap in the literature, especially instruments that allow applying these aspects in clinical practice. Given that instruments that use a broad approach for the concept of health are increasingly recognized, it is essential that they be translated into the language of the country that uses them. In the case of Brazil, this allows their dynamic use by professionals and the families of children with some type of disability.

Conclusion

We conclude that these materials are appropriate and available for use in Brazil, and should be encouraged by clinicians and families alike, in order to favor the biopsychosocial development of children/adolescents with disabilities and improve their functionality. The use of these instruments may be an important ally in therapies and their availability free of charge, easy use and models containing examples facilitate their application in a heterogeneous developing country such as Brazil.

Acknowledgments

We are grateful to the CanChild team for their support and the opportunity to do these translations, especially Peter Rosenbaum, Rachel Teplicky, Andrea Cross, Bailey Featherston, Geil Astorga and Olaf Kraus de Camargo. We also thank FAPESP (Processes 2017/26847-0 and 2017/09653-8) for its financial support.

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Edited by

Associate editor:

Ana Paula Cunha Loureiro

Publication Dates

• Publication in this collection
  28 May 2021
• Date of issue
  2021

History

• Received
  18 Feb 2021
• Reviewed
  17 Mar 2021
• Accepted
  18 Mar 2021