Translation and content validation of the Geriatric Institutional Assessment Profile for Brazil

Souza e Silva, Magda Carla de Oliveira; Beleza, Cinara Maria Feitosa; Soares, Sônia Maria

doi:10.1590/0034-7167-2018-0602

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (suppl 2) • Nov 2019 • https://doi.org/10.1590/0034-7167-2018-0602 linkcopy

Translation and content validation of the Geriatric Institutional Assessment Profile for Brazil

La adaptación y validez de contenido a Brasil del Geriatric Institutional Assessment Profile

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: to describe the process of content adaptation and validation of the Geriatric Institutional Assessment Profile (GIAP) for nurses working in the health care for older adults in Brazilian hospitals.

Method: methodological study conducted in five stages: initial translation, synthesis of initial translation, back translation, evaluation by committee of judges, and pre-test for cultural adaptation of the instrument.

Results: the instrument evaluation had good agreement between the judges, with general content validity of 0.94. The items of the translated version evaluated as unsatisfactory by the judges were reformulated from the professionals’ considerations in each group. Thirty-one subjects participated in the study. They considered the instrument easy-to-understand and suggested minor adjustments in some items.

Conclusion: the content of the Brazilian version of the GIAP is considered adapted and validated, with potential use in hospital institutions. The next stage will be to submit the instrument to the evaluation process of its psychometric properties for use in Brazilian populations.

Descriptors
Translating; Validation Studies; Aged; Nursing; Cross-Cultural Comparison

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[TFN1] Note: LU - Little Unsatisfied; U - Unsatisfied; LS - Little Satisfied; S - Satisfied; VS - Very Satisfied; DNA - Does not apply; DNI - Does not interfere; L - Little; I - Interferes; V - Very; EI - Expressively interferes; DL - Daily; W - Weekly; M - Monthly; LM - Less than monthly; R - Rarely; NA - Not available; VV - Very vulnerable; V - Vulnerable; LV - Little vulnerable; NVV - Not very vulnerable; NV - Not vulnerable; SA - Strongly agree; A - Agree; NAND - Neither agree nor disagree; D - Disagree; SD - Strongly disagree.

Geriatric Institutional Assessment Profile (Brazilian version)
• As regards the hospital you work in, how satisfied are you with the following:
Individualized care provided by staff.	LU	U	LS	S	VS	DNA
Elderly patients receiving necessary care.	LU	U	LS	S	VS	DNA
The way the team addresses issues on geriatric care.	LU	U	LS	S	VS	DNA
The team's familiarity with the effects of aging on treatment.	LU	U	LS	S	VS	DNA
Aging being considered as a factor in planning and evaluation.	LU	U	LS	S	VS	DNA
Older adult patients receiving the information they need to make decisions about their care and treatment.	LU	U	LS	S	VS	DNA
Families receiving the information and support they need to help seniors in their families.	LU	U	LS	S	VS	DNA
Staff obtaining the information and data from patients' previous hospitalization.	LU	U	LS	S	VS	DNA
Continuous care between your institution and different health services.	LU	U	LS	S	VS	DNA
Adequate continuity between all hospital departments.	LU	U	LS	S	VS	DNA
• When making decisions elderly care, the following obstacles are encountered. To what extent does each one of them interfere with the care in your hospital?
Lack of knowledge/familiarity about care for the elderly.	DNI	L	I	V	EI	DNA
Lack of (or inadequate) written geriatric policies and procedures.	DNI	L	I	V	EI	DNA
Differences of opinion between professionals (between sectors) about common geriatric problems.	DNI	L	I	V	EI	DNA
Lack of specialized services for the elderly (such as oral care, podiatry).	DNI	L	I	V	EI	DNA
Lack of special equipment (e.g. raised toilet seats/special mattresses).	DNI	L	I	V	EI	DNA
Exclusion of nurses from the decisions of geriatric care.	DNI	L	I	V	EI	DNA
Economic pressure to limit the treatment or duration of stay.	DNI	L	I	V	EI	DNA
Lack of staff or time limitations.	DNI	L	I	V	EI	DNA
Communication difficulties with seniors and their families.	DNI	L	I	V	EI	DNA
Exclusion of the elderly from their own care decisions.	DNI	L	I	V	EI	DNA
Confusion about who is responsible for the appropriate decisions.	DNI	L	I	V	EI	DNA
• How often do you use these geriatric services?
Specialized nurse in geriatrics or geriatric nursing.	DL	W	M	LM	R	NA
Geriatrician.	DL	W	M	LM	R	NA
Geriatric social worker.	DL	W	M	LM	R	NA
Geriatric psychologists or psychiatrists.	DL	W	M	LM	R	NA
Patient transfers and internal geriatric services.	DL	W	M	LM	R	NA
Geriatric texts and magazines.	DL	W	M	LM	R	NA
Geriatric, conferences/workshops, regional or national.	DL	W	M	LM	R	NA
• How vulnerable do you feel with respect to legal responsibility for:
Development of pressure ulcers in the elderly.	VV	V	LV	NVV	NV	DNA
Elderly patients falling.	VV	V	LV	NVV	NV	DNA
Accusations of illegal restraints.	VV	V	LV	NVV	NV	DNA
Injuries resulting from use of restraining devices.	VV	V	LV	NVV	NV	DNA
Nosocomial infection from the use of a catheter.	VV	V	LV	NVV	NV	DNA
Lesions resulting from use of sedative medication.	VV	V	LV	NVV	NV	DNA
• Some older adults may exhibit disruptive behaviour. How often do elderly patients under your care: • To what extent does it disturb or bother you when elderly patients: [F - frequent (5 or more times per week); S - Sometimes (1-4 times a week); N - Never; DNA - Does Not Apply]
Get picky/demanding.			F	S	N	DNA
Get argumentative/critical.			F	S	N	DNA
Become uncooperative.			F	S	N	DNA
Request guarantees or reaffirmation/attention / assistance/support in decision-making.			F	S	N	DNA
Stay awake at night.			F	S	N	DNA
Wander about during the day.			F	S	N	DNA
Get confused or agitated.			F	S	N	DNA
• How strongly do you agree or disagree with the following statements about your hospital:
Doctors and administrators work together to resolve problems for elderly patients.	SA	A	NAND	D	SD	DNA
You are allowed to disagree with your supervisor about the care of seniors.	SA	A	NAND	D	SD	DNA
The employee's participation is sought in setting policies and guidelines for geriatric care.	SA	A	NAND	D	SD	DNA
Elderly patients are always treated with respect.	SA	A	NAND	D	SD	DNA
Qualified employees are involved in the decisions about geriatric care.	SA	A	NAND	D	SD	DNA
Personal growth is encouraged.	SA	A	NAND	D	SD	DNA
Rights of elderly patients are protected.	SA	A	NAND	D	SD	DNA
• How strongly you agree or disagree with the following statements:
The majority of pressure ulcers are preventable.		SA	A	NAND	D	SD
Pressure ulcers occur in about half of elderly hospital patients.		SA	A	NAND	D	SD
It is almost always possible to avoid skin lesions.		SA	A	NAND	D	SD
The heels are one of the regions most susceptible to skin breakdown in bedridden elderly patients.		SA	A	NAND	D	SD
Pressure ulcers can lead to osteomyelitis.		SA	A	NAND	D	SD
Regular massage of prominent bones can help reduce skin lesions.		SA	A	NAND	D	SD
The hospital appreciates the time spent with prevention of pressure ulcers.		SA	A	NAND	D	SD
I don't have time to do daily skin evaluations of my elderly patients.		SA	A	NAND	D	SD
Adequate nutrition is the most essential element to the prevention of skin lesions.		SA	A	NAND	D	SD
Sleeping problems in elderly hospital patients contribute negatively to the hospital's results.		SA	A	NAND	D	SD
Sedatives get rid of hallucinations and agitation in elderly patients with sleeping disorders.		SA	A	NAND	D	SD
The majority of sleeping problems in elderly patients requires the use of sedatives.		SA	A	NAND	D	SD
Sleeping problems should always be treated aggressively.		SA	A	NAND	D	SD
We do a good job identifying and preventing sleeping disorders.		SA	A	NAND	D	SD
The time spent in prevention of sleeping problems is valued in this hospital.		SA	A	NAND	D	SD
Without the aid of sedatives, I don't have time to help prevent sleeping problems.		SA	A	NAND	D	SD
The prevalence of incontinence in elderly patients is close to 20 percent.		SA	A	NAND	D	SD
Problems with urinary continence are a normal part of aging.		SA	A	NAND	D	SD
Kegel exercises are good for all types of incontinence.		SA	A	NAND	D	SD
Constipation can lead to urinary incontinence.		SA	A	NAND	D	SD
The hospital values the time spent managing urinary continence without the use of catheters or incontinence.		SA	A	NAND	D	SD
I try to avoid the use of long-term indwelling catheters in elderly patients, even if that means they occasionally wet themselves.		SA	A	NAND	D	SD
• How strongly you agree or disagree with the following statements:
We use adult incontinence clothing at night for most of our elderly patients		SA	A	NAND	D	SD
Urinary catheters are adequate in incontinence treatments as long as they are discontinued after 10 days		SA	A	NAND	D	SD
Reducing the use of catheters creates significant demands of the team's time		SA	A	NAND	D	SD
Permanent catheters are the principal cause of sepsis in older hospitalized adults.		SA	A	NAND	D	SD
Bed or chair restraints bring more security to confused elderly patients.		SA	A	NAND	D	SD
Nerve damage may result from the use of restraint devices.		SA	A	NAND	D	SD
Utilizing restraints often contributes to confusion of elderly patients.		SA	A	NAND	D	SD
I check on elderly patients at least once an hour.		SA	A	NAND	D	SD
When the use of mechanical restraints is decreased, the use of sedative drugs increases		SA	A	NAND	D	SD
In this hospital, all reasonable alternatives are attempted before restraining elderly patients.		SA	A	NAND	D	SD
Doctors need better guidelines to help determine what is appropriate care for the elderly.		SA	A	NAND	D	SD
Many elderly patients prefer to let their caretaker make the decision about the what the best treatment is.		SA	A	NAND	D	SD
My colleagues value my opinion about adequate care of elderly patients.		SA	A	NAND	D	SD