Brazilian Portuguese Version Research Articles

The Brazilian Portuguese version of the Exercise Adherence Rating Scale (EARS-Br) showed acceptable reliability, validity and responsiveness in chronic low back pain

BackgroundThis study aimed to adapt the Exercise Adherence Rating Scale (EARS) into Brazilian Portuguese and evaluate its measurement properties, given as reliability, validity, and responsiveness in patients with non-specific Chronic Low Back Pain (CLBP).MethodsA total of 108 patients with a mean age of 46.62 years (SD = 9.98) and CLBP participated in this longitudinal study. Participants were oriented on undertaking the prescribed exercises in the first session, and adherence behavior was assessed after 1 week, and finally reassessed after 2 weeks (test-retest reliability). Three weeks after the first assessment, they were invited again to full fill the EARS (responsiveness). The intraclass correlation coefficient (ICC2,1) and Cronbach’s α were used to assess test-retest reliability and internal consistency, respectively. Spearman’s correlation and confirmatory factor analysis (CFA) were used to assess construct validity, and the Receiver operating characteristic curve and area under the curve (AUC) were used to analyze responsiveness.ResultsThe one-factor EARS-Br (adherence behavior) structure with 6 items showed acceptable fit indexes (comparative fit index and goodness of fit index> 0.90 and root-mean-square error of approximation< 0.08). The EARS-Br scale showed acceptable internal consistency (α = 0.88) and excellent reliability (ICC = 0.91 [95% CI 0.86–0.94]). Mild to moderate correlations were observed between EARS-Br total score vs. disability, pain catastrophizing, depression/anxiety, fear-avoidance and pain intensity. A Minimally Important Change (MIC) of 5.5 in the EARS-Br total score was considered as a meaningful change in the adherence behavior (AUC = 0.82). Moderate accuracy (AUC = 0.89) was obtained for a 17/24 total EARS cutoff score after home exercise was prescribed. The sensitivity and specificity were also acceptable (greater than 80%).ConclusionOur results demonstrated acceptable EARS-Br reliability, validity, and responsiveness for patients with CLBP. A final score of 17/24 on EARS after the prescription of home-exercise could be used as a cut-off for an acceptable adherence behavior associated with improvement in patient outcomes.

Brief Resilience Scale (BRS) Portuguese Version: validity and metrics for the older adult population

Objective This study aims to analyze the psychometric properties of the new Brazilian-Portuguese version of the Brief Resilience Scale (B-BRS) in older adults. Method A sample of 1251 participants (54.20% women; M = 68.02 years, SD = 6.52) completed the B-BRS and seven scales on successful aging and mental health. Confirmatory factor analysis was used to study the B-BRS dimensionality. Convergent and divergent validity was analyzed by means of examining the relationships of B-BRS with scales on successful aging and mental health. Results The results supported the unidimensionality of the B-BRS after controlling for wording method, as well as satisfactory reliability (ω = .79). B-BRS structure remained invariant across education level and income groups. B-BRS scores positively correlated with successful aging factors and negatively with psychopathology symptoms. Conclusion To conclude, our findings provide some evidence on the reliability and validity of the B-BRS, as well as its validation for use in the senior population.

Translation and Validation of the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) to the Brazilian Context: An Instrument Focusing on Arrhythmia Symptoms.

Introduction The wide variety of symptoms in patients with cardiac arrhythmias can affect daily living activities. The evaluation of symptoms with patient-reported outcome measures (PROMs), with validated instruments, can provide information that contributes to clinical decisions and treatment. In Brazil, however, there is no available scale that evaluates symptoms in different types of arrhythmias. Purpose This study aimed to translate the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia symptom scale (ASTA-symptom scale) and then validate the questionnaire in terms of Brazilian culture. Method The methodological process of cultural adaptation used was based on international literature guidelines consisting of forward translation, synthesis, back translation, review by an expert committee, and pretest. Psychometric analyses were conducted with 140 patients. These included measuring internal consistency (Cronbach's alpha), construct validity with item-total correlations, and convergent construct validity with correlations with the quality of life questionnaire for patients with atrial fibrillation-version 2 (QVFA-v2). Usability and understandability were evaluated through the usability evaluation of instruments. Results The translation and adaptation processes were performed by obtaining the Brazilian Portuguese version of the original Swedish instrument. This version presented the internal consistency of items, evaluated through Cronbach's α (0.79). Construct validity was demonstrated by item-total correlations for the nine items, all except one reached the level of >0.30 (0.24). Convergent validity showed a high correlation with QVFA-v2 (0.89). As for the evaluation of usability and understanding, after two small suggested changes, no additional alterations were necessary. Conclusion The psychometric properties of the Brazilian version of ASTA-symptom scale evaluated in this study were satisfactory, and the scale was proved to be a valid and reliable tool to assess the symptom burden in patients with different forms of tachyarrhythmia. The ASTA-Br-symptom scale questionnaire can be an important addition to PROMs for patients with arrhythmias and could help healthcare professionals in decision-making.

Translation into Brazilian Portuguese and Cross-Cultural Adaptation of the NCCPC-PV for Pain Evaluation of Patients with Intellectual Disability to Communicate.

Objective To perform the translation and cross-cultural adaptation to Brazilian Portuguese of the Non-Communicating Children's Pain Checklist - Postoperative Version (NCCPC-PV) instrument, which assesses acute pain in individuals with severe intellectual disability (ID) who present great cognitive impairment and inability to communicate (CIIC). Method In the adaptation process, the original NCCPC-PV was translated, back-translated, its versions were discussed by a committee of experts, and the resulting tool was tested in 20 health professionals and 20 caregivers of CCIC patients regarding its semantic clarity. Results Data from the present study and its participants were analyzed and their results were described. Thus, “Lista de Verificação de Dor em Crianças Não Comunicantes – Versão Pós-operatória” (Br-NCCPC-PV) was obtained as the final version in Brazilian Portuguese. Conclusion After the present study, the Br-NCCPC-PV was considered adequate for use in the Brazilian population.

Effectiveness and Safety of Supervised Home-Based Physical Training in Patients With COPD on Long-term Home Oxygen Therapy: A Randomized Trial

Patients with COPD in advanced stages who need long-term home oxygen therapy (LTHOT) have difficulty participating in outpatient pulmonary rehabilitation (PR) programs. This difficulty is due to the severity of their disease, limitations involving transportation and mobility, high costs, and issues related to patients' safety and individual needs. Unsupervised home-based physical training (PT) is frequently used. The main objective of this study was to investigate the effectiveness of a supervised home-based PT program on exercise capacity and other outcomes in patients with COPD receiving LTHOT. In a randomized clinical trial, patients with COPD who were on LTHOT were allocated into two groups: the supervised physical training (PT) group, consisting of patients who received home-based supervised muscle strength and endurance training in twice-weekly 60-min sessions for 12weeks; and the unsupervised activity booklet group, consisting of patients who received a booklet advising them to perform exercise twice a week for 12weeks. All participants were assessed prior to and following the intervention in terms of exercise capacity (6-min step-test and the 1-min sit-to-stand test); dyspnea (Medical Research Council scale); fatigue (Brazilian Portuguese version of the Fatigue Severity Scale); and health status (COPD Assessment Test). A total of 44 patients were assessed (mean age, 70 ± 8 years; FEV1, 33 ± 14%predicted) (PT group, n= 22; booklet group, n= 22). Only the PT group patients presented significant improvement in the 6-min step-test (21 ± 9 vs14 ± 11; P= .001), Medical Research Council scale (3.3 ± 1.0 vs3.9 ± 0.9; P= .013), Brazilian Portuguese version of the Fatigue Severity Scale (5.0 ± 1.4 vs5.2 ± 1.3; P= .015), and COPD Assessment Test (21 ± 8 vs26 ± 6; P= .001). No adverse effects were observed. Supervised home-based PT was effective and safe in improving exercise capacity, dyspnea, fatigue, and health status in patients with COPD on LTHOT. Brazilian Registry of Clinical Trials; No.: RBR-535smn; URL: http://www.ensaiosclinicos.gov.br.

The Brazilian Portuguese version of the ICIQ-OABqol: cross-cultural adaptation and reliability.

The International Consultation on Incontinence Questionnaire Overactive Bladder Symptoms Quality of Life (ICIQ-OABqol) Module evaluates the quality of life of individuals with overactive bladder (OAB) symptoms, and its use in scientific studies and clinical practice is recommended by the International Continence Society. The aim was to conduct the cross-cultural adaptation and validation of the Brazilian Portuguese version of the ICIQ-OABqol (ICIQ-OABqol_portuguese) in individuals with OAB symptoms. An observational cross-sectional study was performed at the Clinical Physiotherapy of PUC MINAS in Belo Horizonte, MG, Brazil, between March 2017 and October 2018. The translation was previously carried out by the Mapi Research Institute. After receiving the translated questionnaire, the cross-cultural adaptation process was conducted as follows: (1) review by an expert committee (13 experts); (2) pre-test (n = 30); (3) cross-cultural adaptation; (4) validation of the ICIQ-OABqol_portuguese. We analyzed the intraexaminer reliability validation (n = 118) and internal consistency measurement (Cronbach's α coefficient), test-retest reliability (ICC) and correlation between the ICIQ-OAB and ICIQ-OABqol_portuguese questionnaires through Pearson's correlation coefficient and Bland-Altman scatter plot and concordance. Confirmatory factor analysis was used to confirm the domains of the instrument. The ICIQ-OABqol was cross-culturally adapted to Brazilian Portuguese and presented satisfactory internal consistency (α-Cronbach coefficient 0.88), adequate construct validity, strong reliability considering the test-retest with an interval of 19.68 (±6.98) days and moderate correlation with the ICIQ-OAB. The Brazilian Portuguese version of the ICIQ-OABqol shows satisfactory psychometric properties and can be used to evaluate the quality of life of individuals of both sexes with OAB symptoms.

Validation to Brazilian Portuguese of the Self-Care Inventory-revised for adults with type 2 diabetes.

Objective The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of SCI-R to adults with type 2 diabetes. Materials and methods The SCI-R is a 15-question survey that reflects how well patients with diabetes have adhered to treatment recommendations. A pretest (n = 40) was first performed to improve comprehension of the survey items. A final version was then self-administered in another 75 adults with type 2 diabetes to determine the survey's reliability and validity according to its association with HbA1c. Finally, we conducted a test-retest reliability analysis over three weeks to stabilize the sample and determine intra-observer variability. Results After the pretest phase, the final sample's (N = 75) mean age was 59.9 ± 7.5 years and mean HbA1c level was 8.6 ± 1.5% (70 ± 16.4 mmol/mol). The initial Cronbach's alpha was 0.61; however, further analysis showed that four items had low item correlation and were excluded from the final version, which increased the Cronbach's alpha to 0.63. In predictive validity analysis, HbA1c levels correlated significantly with total survey scores (r = -0.38, P = 0.001). The intra-class correlation coefficient between baseline and three-week scores was 0.93, which indicates high reproducibility. Conclusions The Brazilian Portuguese version of the SCI-R is a valid tool for measuring treatment adherence in adults with type 2 diabetes.

Validation of the Objective Structured Assessment of Technical Skill in Brasil.

The aim of this study was to perform a cross-cultural adaptation of the Objective Structured Assessment of Technical Skill (OSATS) tool into Brazilian Portuguese and to determine its reproducibility and validity in Brasil. A Brazilian Portuguese version of OSATS was created through a process of translation, back-translation, expert panel evaluation, pilot testing, and then its validation. For the construct and the concurrent validities, twelve participants were divided into a group of six experts and six novices, who had to perform tasks on a simulation model using human placentas. Each participant was filmed, and two blinded raters would then evaluate their performance using the traditional subjective method and then the Brazilian Portuguese version of OSATS. The Brazilian Portuguese version of OSATS had the face, content, construct, and concurrent validities achieved. The average experts' score and standard deviations were 34 and 0.894, respectively, for Judge 1 and 34.33 and 0.816 for Judge 2. In the case of novices, it was 13.33 and 2.388 for Judge 1 and 13.33 and 3.204 for Judge 2. The concordance between the judges was evident, with the Correlation Coefficient (Pearson) of 0.9944 with CI 95% between 0.9797 and 0.9985, with p < 10-10, evidencing the excellent reproducibility of the instrument. This preliminary study suggests that the Brazilian Portuguese version of OSATS can reliably and validly assess surgical skills in Brasil.

Semantic equivalence in Brazilian Portuguese translation of the Trinity Amputation and Prosthesis Experience Scales—Revised

The Trinity Amputation and Prosthesis Experience Scales-Revised assesses adjustment to amputation and to using a prosthesis and considers psychosocial adjustment, activity restriction, satisfaction with the prosthesis, and other aspects related to health and physical activities, including residual and phantom limb pain. The aim of this study was to assess the semantic equivalence of the Trinity Amputation and Prosthesis Experience Scales-Revised when translated into Brazilian Portuguese. Qualitative study. The process was conducted in five stages: translation of the questionnaire into Brazilian Portuguese; development of a first consensual version in Brazilian Portuguese; appraisal of the translation by an expert committee; back-translation; and semantics assessment of the instrument. For semantic evaluation, the translated and adapted Brazilian Portuguese versions were applied to a convenience sample of 10 individuals. The translated instrument showed a high degree of comprehension within the target population, as it was observed all questions from Part I and II were score 4 or higher on an Ordinal Scale ranging from 0 to 5. The Brazilian version of Trinity Amputation and Prosthesis Experience Scales-Revised has a satisfactory verbal comprehension and is now ready for assessment of its psychometric properties. The process of semantic evaluation of the Brazilian version of the Trinity Amputation and Prosthesis Experience Scales-Revised makes available to health professionals and researchers who work with people with amputations initial information on cross-cultural adaptation and degree of comprehension of this scale.

Cross-Cultural Adaptation of the Communication Assessment Tool for Use in a Simulated Clinical Setting

Construct: The Communication Assessment Tool (CAT) is a 14-item instrument developed in English to assess medical trainees’ interpersonal communication skills from the patient’s perspective in clinical settings. Background: Using validated instruments and simulated patients constitutes good practice in assessing doctor-patient communication. The CAT was designed for use in real practice, but has not yet been applied to assessing OB-GYN residents’ delivery of bad news in Objective Structured Clinical Examination (OSCE) stations. This study aims to provide validity evidence for using the CAT to assess residents’ interpersonal communication skills under difficult circumstances in a simulated clinical setting in Brazil. Approach: Cross-cultural adaptation comprised translation into Portuguese, synthesis of translations, and back-translation. Next, a committee of 10 external and independent experts rated the items for linguistic equivalence and relevance to the overall scale. Researchers used the expert ratings to produce a preliminary Brazilian-Portuguese version. This version was applied by four simulated patients to assess 28 OB-GYN residents completing two, 10-minute OSCE stations focused on delivering bad news. Item and scale content validity indices and internal-consistency reliability were calculated. Simulated patients were interviewed to clarify any doubt regarding the content and usability of the tool and their response process. Findings: Thirteen of the 14 items in the Brazilian-Portuguese version were considered “equivalent” by at least 70% of the experts. All items were considered relevant by 100% of the experts. The Item Content Validity Index ranged from .9 to 1, and the Scale Content Validity Index was .99. The instrument showed good reliability for both scenarios (Cronbach’s alpha > .90). Simulated patients considered the CAT easy to understand and complete. Conclusions: This study provides validity evidence for using the Brazilian-Portuguese CAT in a simulated clinical environment to assess OB-GYN residents’ delivery of bad news. Based on this study’s findings, the OB-GYN Department organized an annual formative assessment for residents to improve their interpersonal communication skills. This version of the CAT may also be applicable to other specialties.

Measurement properties from the Brazilian Portuguese version of the QUIP-RS

Parkinson’s disease (PD) has numerous motor and non-motor symptoms. Among non-motor manifestations impulse control disorders (ICDs) stand out. ICDs include compulsions for gambling, shopping, eating, and sexual behavior, and “related disorders” such as hobbyism, simple motor activities, and dopamine dysregulation syndrome. There is no rating scale translated and adapted transculturally into Brazilian Portuguese language. Therefore, we cross-culturally adapted and investigated the measurement properties of the Brazilian version of the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS). Fifty-three patients participated in the study. Inter-evaluator and test–retest (patient and health professional) reliabilities (intraclass correlation coefficient) were all excellent (0.93, 0.93, and 0.99). The internal consistency was high (α = 0.92). The Minimal detectable change (MDC) value was 5.8 (patient) and 2.3 (health professional) points. There was a floor, but no ceiling, effect. In summary, the Brazilian version of the QUIP-RS has high reliability and content validity.

Validation of the Brazilian Portuguese Version of the Reflux Finding Score

Laryngopharyngeal reflux (LPR) poses a diagnostic challenge. Clinical diagnosis, based on suggestive symptoms and laryngoscopic signs of inflammation, should be acceptable, as long as diligent differential diagnosis is sought. In order to minimize subjectivity, a number of diagnostic instruments have been proposed, being the most common the Reflux Symptom Index and the Reflux Finding Score (RFS). The latter has been translated into several languages including Portuguese, but it still has not been properly validated in this language. To validate the Brazilian Portuguese version of the RFS. For validity and internal consistency, 172 adults were studied (106 with LPR and 66 healthy controls). Flexible transnasal laryngoscopy images were randomly examined twice by each of the two experienced otolaryngologists with a 72-hour interval. Strict exclusion criteria were applied to avoid other possible known causes of chronic laryngitis. For assessment of reproducibility and temporal stability, a random sample of 108 subjects (53 patients and 55 controls) were tested and retested. A statistically significant difference was observed in the mean RFS between patients with LPR (10.26±3.58) and controls (5.52±1.34) (P < 0.001). The interclass correlation coefficient comparing test and retest for both raters was high (R1=0.956; R2= 0.948). The Brazilian Portuguese version of the RFS proved to be a reliable and reproducible instrument for the diagnosis of LPR with a sensitivity of 82.08%, a specificity of 93.94%, a positive predictive value of 95.60%, and a negative predictive value was 76.54%.

Translation, Cross-cultural Adaptation and Reliability of Brazilian portuguese version of the DRAM Questionnaire for Psychometric Evaluation in Low Back Pain.

Objective Based on studies regarding pain physiology and its relation to emotional distress conditions, psychological evaluation became essential to determine the most favorable patient profiles to distinct therapeutic approaches. The Distress Risk Assessment Method (DRAM) has been developed as a screening instrument for patients with lumbar pain, classifying them in subgroups as normal, at risk, distressed somatic and distressed depressive, based on the two components of DRAM scores (Modified Somatic Perception Questionnaire [MSPQ] and Zung questionnaires). The objective of the present study is to translate and culturally adapt the DRAM to the Brazilian Portuguese language, and to determine the reliability of the final version. Methods As proposed by the International Quality of Life Assessment (IQOLA) method, a Brazilian Portuguese version of the DRAM has been applied to a sample of 85 individuals from 3 participant centers. Results The results confirmed the reliability and reproducibility of the DRAM in its Brazilian Portuguese final version: Cronbach alpha of 0.815 (MSPQ) and 0.794 (Zung) and intraclass correlation coefficient (ICC) of 0.688 (MSPQ) and 0.659 (Zung). Conclusion The presented DRAM version in Brazilian Portuguese is reliable and is available to clinical practice use.

Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation.

Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). Questionnaire translation and cross-cultural adaptation study conducted at a public university. The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the -SEFIP-sport items and alternatives. The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

THE INFLAMMATORY BOWEL DISEASE-FATIGUE PATIENT SELF-ASSESSMENT SCALE: TRANSLATION, CROSS-CULTURAL ADAPTATION AND PSYCHOMETRIC PROPERTIES OF THE BRAZILIAN VERSION (IBD-F BRAZIL).

Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). A translated and culturally adapted, instrument with robust psychometric for measuring fatigue in Brazilian patients with IBD is needed. To translate and cross-culturally adapt the inflammatory Bowel Disease Fatigue Scale (IBD-F) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with IBD. Data from 123 patients with IBD were collected. In addition to IBD-F, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was used. The measurement properties tested were: internal consistency, reproducibility (reliability and agreement), construct validity, internal and external responsiveness, and ceiling and floor effects. The Brazilian-Portuguese version of the IBD-F showed excellent internal consistency (Cronbach's alpha of 0.95), excellent reproducibility (ICC=0.97) and a minimal detectable change of 6.0 points. The construct validity was demonstrated with a good correlation between the IBD-F and FACIT-F (r=- 0.46). Effect sizes used for measuring internal responsiveness were moderate among those with Crohn's (0.66) disease and low in patients with ulcerative colitis (0.24). The Brazilian-Portuguese version of the IBD-F presented with high external responsiveness for Crohn's disease (0.84) and with low external responsiveness for ulcerative colitis (0.33). The area under the curve considered for responsiveness was 0.84. Twenty-five percent of floor effects and no ceiling effect were recorded. The Brazilian-Portuguese version of IBD-F has adequate measurement properties and its use can be recommended in clinical practice and research.

Translation and preliminary validation of an ageism scale for dental students in Brazil (ASDS-Braz).

Ageism is a major barrier for age-appropriate care. The aim of this study was to translate and perform a preliminary validation of an ageism scale for dental students (ASDS) in Brazil (ASDS-Braz). The 27-item original ageism scale was translated from English into Brazilian Portuguese. A panel of five Brazilian dental educators revised the scale to establish content validity. The translated version was completed by 156 dental students in the Federal University of Pelotas in Brazil. Principal component analysis, internal consistency reliability and discriminant validity were estimated. All items in the Brazilian Portuguese version received a content validity index score ≥0.80 indicating that they were relevant to the topic. The principal component analysis produced a 12-item scale with three components that accounted for 51% of the overall variance. The first component contained six items associated with a negative view of older adults; the second component contained three items dealing with the complexity of providing care for older adults; and the third component contained three items associated with a positive view of older people. Discriminant validity did not show any differences related to demographic factors, the semester of studies and history of living with older people. The preliminary validation of the ASDS-Braz produced a 12-item scale with three components with acceptable validity and reliability. Future research in a larger, multi-institutional sample is now warranted.

Brazilian validation of the item banks on Sleep Disturbance and Wake Disturbance in the Patient-Reported Outcomes Measurement Information System (PROMIS)

This study aimed to validate the Brazilian version of the item banks for Sleep Disturbance and Wake Disturbance from the Patient-Reported Outcomes Measurement Information System (PROMIS). Validation of these item banks used classical test theory, item response theory, calibrations of items according to the gradual response model proposed by Samejima, and analysis of Differential Item Functioning (DIF), with a sample consisting of 627 participants over 18 years of age. As for data quality, there were no missing data, five items from the Sleep Disturbance bank and four items from the WE bank showed a floor effect, and none of the banks showed a ceiling effect. The two banks displayed excellent reliability with homogeneous scale and good temporal stability. With confirmatory factor analysis, using absolute and incremental goodness-of-fit indices, both banks displayed good fit, showing that the instruments are valid and sufficiently unidimensional. The calibration showed that the items' psychometric properties were satisfactory with good coverage of the sleep-wake construct. As for DIF, both the Sleep Disturbance and Wake Disturbance banks proved to be homogeneous for the different test groups. In conclusion, the version in Brazilian Portuguese for the item banks on Sleep Disturbance and Wake Disturbance in the PROMIS proved to be a reliable, precise, and valid instrument with robust psychometric analyses.

Narrative discourse of young and older brazilian adults associated with demographic factors.

1) Compare the discourse performance between young and older adults from the Brazilian Federal District (DF); 2) Compare the mean discourse performance of participants from the DF with the normative discourse of a population from a different region of the country; 3) Verify whether the variables age, educational level and socioeconomic status and scores on the cognitive, behavioral and functional screening tests were associated with discourse performance. A total of 60 healthy volunteers from the DF, 30 older adults and 30 young adults, were selected. Participants were divided into two subgroups according to educational level: low education and high education. The four narrative discourse subtests of the Montreal Communication Evaluation Battery, Brazilian Portuguese version (MAC-BR) were applied to the study sample. Discourse scores of the older adults were statistically higher than those of the young adults. The discourse scores in the high education group were also better than those in the low education group, with statistically significant difference observed in only one of the MAC-BR subtests. Discourse performance was associated with the sociodemographic variable and the scores on the cognitive and functional screening tests. The discourse performance of the DF sample differed from the national normative discourse with statistically significant difference. The discourse performance of older adults from the Brazilian Federal District differed from that of young adults from the same region, as well as from that of older adults from southern Brazil. Discourse performance was associated with several different variables.

Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil.

This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Internal construct validity of the Brazilian version of a tool for assessing the population's knowledge of human papillomavirus.

To verify the internal construct validity of the Brazilian Portuguese version of a tool for measuring the general population's knowledge of human papillomavirus (HPV). A cross-culturally adapted Brazilian Portuguese version of a measurement tool originally designed for English speaking populations was administered to 330 adults in Tubarão, Santa Catarina, Southern Brazil. After examining the overall suitability of the method, we performed investigations based on the item response theory and exploratory factor analysis. Ten of the 29 items presented a low contribution to the construct and were excluded from subsequent analysis. The factor analysis yielded three factors, which explained approximately 51% of the variance variability. A different arrangement from the original measurement tool was found: general HPV knowledge, with six items; HPV vaccination knowledge, with five items; HPV transmission and testing knowledge, with eight items. The Brazilian Portuguese version under study presented a different behavior from the original measurement tool, but proved to be a reliable and valid instrument in assessing the Brazilian population's knowledge about HPV.