Translation, Utilization, and Psychometric Properties of the Functional Health Pattern Assessment Screening Tool With Patients in Brazil

Abstract

PURPOSETo translate the Functional Health Pattern Assessment Screening Tool (FHPAST) into Portuguese and further test and refine its psychometric properties using data obtained from culturally diverse clinical populations with chronic illnesses.METHODA nurse expert in the language translated the FHPAST into Portuguese. The instrument was validated using the back‐translation technique, followed by the judgment of another doctorally prepared nurse before use in the clinical setting. The tool was administered to 99 patients hospitalized in six units of Hospital São Paulo (neurologic surgery, orthopedics, pneumology, cardiac surgery, urology and vascular surgery, and infectious/parasite diseases) and to 28 undergraduate nursing students from Federal University of Paraiba. The 127 questionnaires were computed and data analyzed by the authors jointly with the multicenter study coordinators, according to preestablished analysis techniques.FINDINGSThe small sample size made it possible to run only frequencies as well as sum scores for the total sample. Reliabilities on usable cases was .94. Nurses who applied the tool observed that these data, added to data collected in specific physical examination for each specialty, allowed them to establish some nursing diagnoses not previously identified with the specialty's own tool. Most patients needed help to understand the questions and fill in the form, given the large percentage of illiterate or low‐scholarship people in this population. Completion time was approximately 25 minutes. Nurses who cared for patients with vascular and urologic conditions believed that using the FHPAST with aged patients was not productive because of the patients' difficulty understanding some questions and decreased hearing acuity. These difficulties were not noted with younger patients, patients from other specialties, or the students.DISCUSSIONFHPAST was designed to be a reliable and valid instrument allowing nurses to obtain screening assessment data to generate potential clinical judgments, select nursing interventions, and identify patient outcomes. The FHPAST is a 58‐item, self‐completed assessment tool based on Gordon's 11 Functional Health Patterns. It can be used to screen functional health and related behaviors across clinical populations. To date, research conducted to establish the psychometric properties of the instrument has been based on data obtained from well young‐adult populations. There has been limited, if any, use of the tool with culturally diverse populations within an acute care setting.CONCLUSIONSThere were no problems related to the instrument translation and back‐translation process with respect to semantic equivalence. However, using the tool with different populations (patients and students) showed that changes are needed in the language of specific tool items for use with selected culturally diverse clinical populations.