Tradução e adaptação transcultural da Composite Abuse Scale para o português brasileiro

OBJETIVO: Realizar a tradução e adaptação transcultural do inglês para o português brasileiro da Composite Abuse Scale, instrumento que identifica e quantifica a violência por parceiro íntimo. MÉTODOS: Este estudo baseia-se na execução rigorosa de seu protocolo, previamente publicado, e que consiste em dez etapas: (a) análise conceitual; (b) tradução duplo-cega; (c) comparação e primeira versão reconciliada das duas traduções; (d) retrotradução; (e) revisão da retrotradução feita pela desenvolvedora e segunda versão reconciliada; (f) revisão por comitê de especialistas (n = 6); (g) comparação das revisões por especialistas e terceira versão reconciliada; (h) entrevistas cognitivas com mulheres da Casa da Mulher Brasileira de Curitiba (n = 15); (i) avaliações das percepções das usuárias e reconciliação final; e (j) apresentação da versão final do questionário à desenvolvedora. RESULTADOS: A execução das 10 etapas do protocolo permitiu as equivalências idiomática, semântica, conceitual e experiencial da Composite Abuse Scale, incorporando sugestões e críticas dos diferentes participantes do processo, que incluíram desde a desenvolvedora, tradutores profissionais, pesquisadores especializados no tema, mulheres em situação de violência por parceiro íntimo e profissionais que as atendem. Especialistas e entrevistas cognitivas com mulheres foram fundamentais para garantir equivalências e facilitar a compreensão, incluindo: (1) adaptação do termo “relacionamento íntimo” para “relacionamento afetivo ou conjugal”; (2) substituição de ênclises por próclises em 20 itens; (3) adoção de linguagem de gênero neutro, permitindo sua utilização em relacionamentos hetero, bi e homoafetivos; (4) materialização de um instrumento de rigor científico e autoaplicável, que pode auxiliar as mulheres a visibilizarem as situações de abuso em seus relacionamentos. CONCLUSÕES: O processo de tradução e adaptação transcultural da Composite Abuse Scale resultou na Composite Abuse Scale Versão Português brasileiro, instrumento autoaplicável com 30 itens, capaz de identificar e quantificar a violência por parceiro íntimo, sua frequência, severidade e tipologias (violências física, emocional, assédio e grave combinada).OBJECTIVE: To perform the translation and cross-cultural adaptation from English into Brazilian Portuguese of the Composite Abuse Scale, an instrument that identifies and quantifies intimate partner violence. METHODS: This study is based on the strict implementation of its previously published protocol, which consists of ten steps: (a) conceptual analysis; (b) double-blind translation; (c) comparison and first reconciled version of the two translations; (d) back-translation; (e) review of the back-translation by the developer and second reconciled version; (f) expert committee review (n = 6); (g) comparison of expert reviews and third reconciled version; (h) cognitive interviews with women from the Casa da Mulher Brasileira in Curitiba (n = 15); (i) assessments of user perceptions and final reconciliation; and (j) submission of the final version of the questionnaire to the developer. RESULTS: The implementation of the 10 steps of the protocol allowed the idiomatic, semantic, conceptual and experiential equivalences of the Composite Abuse Scale, incorporating suggestions and criticisms from the different participants of the process. Participants included the developer, professional translators, researchers specialized on the subject, women in situation of intimate partner violence, and professionals who provide care to them. Experts and cognitive interviews with women were instrumental in ensuring equivalence, and facilitating the understanding, including: (1) adaptation of the term “intimate relation” to “affective or conjugal relation”; (2) substitution of enclisis for proclisis cases in 20 items; (3) adoption of gender-neutral language, allowing its use in heterosexual, bisexual, and same-sex relations; (4) materialization of an instrument of scientific rigor and self-applicable, which may help women to visualize the situations of abuse in their relations. CONCLUSIONS: The translation and cross-cultural adaptation process of the Composite Abuse Scale resulted in the Composite Abuse Scale Brazilian Portuguese Version, a 30-item self-applicable instrument, capable to identify and quantify intimate partner violence, its frequency, severity and typologies (physical, emotional, harassment and severe combined violence)

Women Teaching Women's Health: Issues in the Establishment of a Clinical Teaching Associate Program for the Well Woman Check

B1 - Research Book Chapter

Sustainability of identification and response to domestic violence in antenatal care: The SUSTAIN Study

This project set out to understand and support the integration of evidence-based, effective screening, risk assessment and first-line response to domestic violence (DV) into the complex system of antenatal care. It built on existing resources and research to focus on women assessed as currently in lower risk situations, who are often not in contact with DV services but attended health services for pregnancy

Translation and cross-cultural adaptation of the Composite Abuse Scale into Brazilian Portuguese

ABSTRACT OBJECTIVE To perform the translation and cross-cultural adaptation from English into Brazilian Portuguese of the Composite Abuse Scale, an instrument that identifies and quantifies intimate partner violence. METHODS This study is based on the strict implementation of its previously published protocol, which consists of ten steps: (a) conceptual analysis; (b) double-blind translation; (c) comparison and first reconciled version of the two translations; (d) back-translation; (e) review of the back-translation by the developer and second reconciled version; (f) expert committee review (n = 6); (g) comparison of expert reviews and third reconciled version; (h) cognitive interviews with women from the Casa da Mulher Brasileira in Curitiba (n = 15); (i) assessments of user perceptions and final reconciliation; and (j) submission of the final version of the questionnaire to the developer. RESULTS The implementation of the 10 steps of the protocol allowed the idiomatic, semantic, conceptual and experiential equivalences of the Composite Abuse Scale, incorporating suggestions and criticisms from the different participants of the process. Participants included the developer, professional translators, researchers specialized on the subject, women in situation of intimate partner violence, and professionals who provide care to them. Experts and cognitive interviews with women were instrumental in ensuring equivalence, and facilitating the understanding, including: (1) adaptation of the term “intimate relation” to “affective or conjugal relation”; (2) substitution of enclisis for proclisis cases in 20 items; (3) adoption of gender-neutral language, allowing its use in heterosexual, bisexual, and same-sex relations; (4) materialization of an instrument of scientific rigor and self-applicable, which may help women to visualize the situations of abuse in their relations. CONCLUSIONS The translation and cross-cultural adaptation process of the Composite Abuse Scale resulted in the Composite Abuse Scale Brazilian Portuguese Version, a 30-item self-applicable instrument, capable to identify and quantify intimate partner violence, its frequency, severity and typologies (physical, emotional, harassment and severe combined violence)

Matching depression management to severity prognosis in primary care: results of the Target-D randomised controlled trial.

BackgroundMental health treatment rates are increasing, but the burden of disease has not reduced. Tools to support efficient resource distribution are required.AimTo investigate whether a person-centred e-health (Target-D) platform matching depression care to symptom severity prognosis can improve depressive symptoms relative to usual care.Design and settingStratified individually randomised controlled trial in 14 general practices in Melbourne, Australia, from April 2016 to February 2019. In total, 1868 participants aged 18-65 years who had current depressive symptoms; internet access; no recent change to antidepressant; no current antipsychotic medication; and no current psychological therapy were randomised (1:1) via computer-generated allocation to intervention or usual care.MethodThe intervention was an e-health platform accessed in the GP waiting room, comprising symptom feedback, priority-setting, and prognosis-matched management options (online self-help, online guided psychological therapy, or nurse-led collaborative care). Management options were flexible, neither participants nor staff were blinded, and there were no substantive protocol deviations. The primary outcome was depressive symptom severity (9-item Patient Health Questionnaire [PHQ-9]) at 3 months.ResultsIn intention to treat analysis, estimated between- arm difference in mean PHQ-9 scores at 3 months was -0.88 (95% confidence interval [CI] = -1.45 to -0.31) favouring the intervention, and -0.59 at 12 months (95% CI = -1.18 to 0.01); standardised effect sizes of -0.16 (95% CI = -0.26 to -0.05) and -0.10 (95% CI = -0.21 to 0.002), respectively. No serious adverse events were reported.ConclusionMatching management to prognosis using a person-centred e-health platform improves depressive symptoms at 3 months compared to usual care and could feasibly be implemented at scale. Scope exists to enhance the uptake of management options

Economic evaluation of the Target-D platform to match depression management to severity prognosis in primary care: A within-trial cost-utility analysis.

BackgroundTarget-D, a new person-centred e-health platform matching depression care to symptom severity prognosis (minimal/mild, moderate or severe) has demonstrated greater improvement in depressive symptoms than usual care plus attention control. The aim of this study was to evaluate the cost-effectiveness of Target-D compared to usual care from a health sector and partial societal perspective across 3-month and 12-month follow-up.Methods and findingsA cost-utility analysis was conducted alongside the Target-D randomised controlled trial; which involved 1,868 participants attending 14 general practices in metropolitan Melbourne, Australia. Data on costs were collected using a resource use questionnaire administered concurrently with all other outcome measures at baseline, 3-month and 12-month follow-up. Intervention costs were assessed using financial records compiled during the trial. All costs were expressed in Australian dollars (A$) for the 2018-19 financial year. QALY outcomes were derived using the Assessment of Quality of Life-8D (AQoL-8D) questionnaire. On a per person basis, the Target-D intervention cost between$14 (minimal/mild prognostic group) and $676 (severe group). Health sector and societal costs were not significantly different between trial arms at both 3 and 12 months. Relative to a A$50,000 per QALY willingness-to-pay threshold, the probability of Target-D being cost-effective under a health sector perspective was 81% at 3 months and 96% at 12 months. From a societal perspective, the probability of cost-effectiveness was 30% at 3 months and 80% at 12 months.ConclusionsTarget-D is likely to represent good value for money for health care decision makers. Further evaluation of QALY outcomes should accompany any routine roll-out to assess comparability of results to those observed in the trial. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000537459)