Translation and validation of a patient satisfaction survey: the isiXhosa version

Background: Although the use of surveys has been supported for assessing understanding of health care service quality, it could also be argued that their main function is to quantify perceptions. The importance of assessing patient satisfaction in individuals’ own language has been highlighted in research. However, important culture-specific differences can be revealed during the adaptation process of a scale, and if not attended to can influence the validity of the scale. Objectives: The aim of this study was to assess the validity and reliability of the isiXhosa version of the Patient Survey for Quality of Care (PSQC) in primary health care (PHC) facilities in a selected district in the Western Cape, South Africa. Method: The PSQC was translated into isiXhosa by two independant translators and the translated back into English by a third translator. All three translators reviewed the back translation. Face and content validity of the scale were assessed. Fifteen isiXhosa-speaking clients with type 2 diabetes mellitus who had a mean age of 62.27 years (SD 10.33) and came from a randomly selected community health centre participated in the test-retest reliability. Results: Internal consistency of the scale was good (Cronbach alpha 0.70). Alpha values of individual items relating to quality of care as well as items flagged for inferior service quality were between 0.772 and 1.000, indicating good to high internal consistency. Conclusion: Results of this study indicated that the isiXhosa version of the PSQC was as reliable as the English version. It can be implemented at PHC level to assess isiXhosa-speaking patients’ satisfaction with health care services

Assessment of the face validity of two pain scales in Kenya: a validation study using cognitive interviewing

Background: Patients in sub-Saharan Africa commonly experience pain, which often is un-assessed and undertreated. One hindrance to routine pain assessment in these settings is the lack of a single-item pain rating scale validated for the particular context. The goal of this study was to examine the face validity and cultural acceptability of two single-item pain scales, the Numerical Rating Scale (NRS) and the Faces Pain Scale-Revised (FPS-R), in a population of patients on the medical, surgical, and pediatric wards of Moi Teaching and Referral Hospital in Kenya. Methods: Swahili versions of the NRS and FPS-R were developed by standard translation and back-translation. Cognitive interviews were performed with 15 patients at Moi Teaching and Referral Hospital in Eldoret, Kenya. Interview transcripts were analyzed on a question-by-question basis to identify major themes revealed through the cognitive interviewing process and to uncover any significant problems participants encountered with understanding and using the pain scales. Results: Cognitive interview analysis demonstrated that participants had good comprehension of both the NRS and the FPS-R and showed rational decision-making processes in choosing their responses. Participants felt that both scales were easy to use. The FPS-R was preferred almost unanimously to the NRS. Conclusions: The face validity and acceptability of the Swahili versions of the NRS and FPS-R has been demonstrated for use in Kenyan patients. The broader application of these scales should be evaluated and may benefit patients who currently suffer from pain

New version of the Pediatric Evaluation of Disability Inventory (PEDI-CAT): translation, cultural adaptation to Brazil and analyses of psychometric properties

BACKGROUND: The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), developed with innovative measurement methodologies, evaluates functioning of children and youth, from 0 to 21 years, with different health conditions. It is a revision of an earlier instrument (PEDI) that has been used in national and international clinical practice and research. It was felt to be necessary to make this new version (PEDI-CAT) available in Brazil. OBJECTIVES: Translate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties. METHOD: This methodological study was developed through the following stages: (1) translation, (2) synthesis, (3) back-translation, (4) revision by an expert committee, (5) testing of the pre-final version, and (6) evaluation of the psychometric properties. The 276 translated PEDI-CAT items were divided into three age groups (0-7, 8-14, and 15-21 years). RESULTS: The PEDI-CAT translation followed all six stages. The adaptations incorporated cultural and socioeconomic class specificities. The PEDI-CAT/Brazil showed good indices of inter-examiner (intraclass correlation coefficient-ICC=0.83-0.89) and test-retest (ICC=0.96-0.97) reliability, good internal consistency (0.99) and small standard error of measurement in all three age groups (0.12-0.17). Factor analyses grouped the items from the three functional skills domains into one factor, and items from the responsibility scale into three factors, supporting the adequacy of these factor solutions to the conceptual structure of the instrument and the developmental model. CONCLUSION: The PEDI-CAT/Brazil is a theoretically consistent, culturally appropriate, and reliable instrument. Its availability in Brazil will contribute to the evaluation and measurement of functional outcomes from clinical interventions, longitudinal follow-up, and rehabilitation research

Cross-cultural Adaptation of the Instrument Readiness for Hospital Discharge Scale - Adult Form

Objective: to perform the cross-cultural adaptation of the Readiness for Hospital Discharge Scale - (RHDS) Adult Form for use in Brazil. Method: a methodological study was conducted in 2015, in Brazil’s federal capital, following the eight stages scientifically established. Results: analysis proved the maintenance of semantic, idiomatic, cultural, and conceptual equivalences and kept both the face and content validity of the original version. The judging committee and the pre-test participants declared they understood the RHDS items and answer scale. Conclusion: the instrument is culturally adapted for Brazil and can be used as one of the stages for planning hospital discharge. Descriptors: Nursing Methodology Research; Transitional Care; Continuity of Patient Care; Patient-Centered Care; Patient Discharg

Transcultural adaptation to the Brazilian Portuguese of the Postpartum Bonding Questionnaire for assessing the postpartum bond between mother and baby

The establishment of the bond between mother and baby in the postpartum period is important for ensuring the physical and psychological health of both. This short communication reports the first phase of the cross-cultural translation and adaptation to the Brazilian context of the Postpartum Bonding Questionnaire (PBQ). Four aspects of equivalence between the original scale and the Portuguese version were evaluated: the conceptual, semantic, operational and item equivalences. Literature review, the study of PBQ history, translation, expert evaluation, back-translation and pretests involving 30 mothers with children aging up to 7 months using a primary healthcare unit were conducted. Each step demonstrated the need for adjustments, which were made during the adaptation process. At the end of the study, a version of PBQ in Brazilian Portuguese equivalent to the original one was obtained, offering promise for national studies on the mother-baby bond, and its influence on health, and for use in health services

The Maltese version of the DN4 questionnaire : initial validation to assess neuropathic pain in patients with chronic spinal or spinal-radicular pain

Background: Neuropathic pain is frequently encountered in patients with spinal and spinal-related pain which needs specific treatment. Therefore, the objective of this study was to do an initial linguistic translation and validation of the Maltese DN4 questionnaire to diagnose neuropathic pain in this population. Methods: The study was designed as a single-blinded, observational, prospective collected data and retrospective analysis. The English and French DN4 questionnaires underwent forward and backward translation, literal assessment and adaptation of the semantic equivalence into the Maltese language, followed by assessment of the Maltese DN4 during the initial patient assessment in patients who met the inclusion criteria. Results: The total Maltese DN4 score obtained a Cronbach’s alpha of 0.735 therefore having satisfactory internal consistency. Test-retest using the Intraclass Correlation Coefficient (95% CI) ranged from 0.975 to 0.991 (p=0.000), while inter-rater agreement using Intraclass Correlation Coefficient (95% CI) ranged from 0.986 to 0.995 (p=0.000). Test-retest reliability yielded an intraclass correlation coefficient (95% CI) ranging from 0.975 to 0.991 (p < 0.001), while inter-rater reliability yielded an intraclass correlation coefficient (95% CI) ranging from 0.986 to 0.995 (p < 0.001). Both the English and the Maltese DN4 questionnaires obtained the same sensitivity and specificity values of 0.422 and 0.941 respectively, and a positive likehood ratio of 7.153 and a negative likehood ratio of 0.614, at a cutoff score of 4. Conclusion: The results of this study support the transcultural internal consistency, inter-rater, test-retest reliability, validity of the Maltese DN4 questionnaire to differentiate between neuropathic and nociceptive pain in patients with chronic spinal and spinal-radicular pain. Therefore, this simple tool can be used both in daily clinical practice but also in the clinical research setting to quickly screen for neuropathic pain.peer-reviewe