Abstract
ABSTRACTBackgroundThe 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.ObjectivesTranslate and culturally adapt the PEDI-CAT to the Brazilian-Portuguese language and test its psychometric properties.MethodThis 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).ResultsThe 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.ConclusionThe 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.
Highlights
Procedures for the translation and cultural adaptation of foreign functional measures are applied in Brazil to provide professionals and services with standardized instruments that are often used in other countries and cited in the international literature[1,2,3,4,5,6,7,8]
This study describes the procedures used for translation and cultural adaptation of the Pediatric Evaluation of Disability Inventory (PEDI)-CAT into Brazilian Portuguese and tested its psychometric properties
Some differences in the versions analyzed by the expert committee during the PEDI-CAT translation process were observed and resolved using strategies such as addition, omission, or substitution of words and the provision of examples, in an attempt to reach semantic, conceptual, idiomatic, and experiential equivalence
Summary
Procedures for the translation and cultural adaptation of foreign functional measures are applied in Brazil to provide professionals and services with standardized instruments that are often used in other countries and cited in the international literature[1,2,3,4,5,6,7,8]. In the biopsychosocial model, functioning reflects the interaction between individuals with a health condition and the opportunities or barriers present in the setting in which they live, including internal (personal) and external (environmental) factors This interaction has a bidirectional influence on body structures and functions, activities and participation, which together represent the components of function. Engagement of the child (i.e., the apprentice) with his/her parents and family members (i.e., experts) in the daily routine provides a context that triggers a collaborative process in which the child is guided by the expert to become engaged and gradually take responsibility for the performance of activities and tasks, while the caregiver decreases the assistance given[17,18] This approach is used to guide the content and scoring criteria of the items on one of the PEDI‐CAT test scales (i.e., Responsibility)
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