Cross-cultural Adaptation Research Articles

Validation of the Chinese version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' in family caregivers of elderly patients with cancer: A study protocol.

This study aims to translate the English version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' into Chinese and validate its psychometric properties in the family caregivers of elderly patients with cancer. A methodological study. Based on the Brislin translation model, the original scale will be translated and back-translated, the Delphi expert consultation method will be adopted for cross-cultural adaptation, and the pilot will be carried out in 20-30 family caregivers of elderly patients with cancer. Then, a dual-centre prospective study will be conducted by recruiting 371-542 family caregivers of elderly patients with cancer to validate the psychometric properties of the Chinese version of CAFCPCS. The scale's content validity will be evaluated using the Delphi expert inquiry method, and the face validity will be evaluated using a pre-experiment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to assess structural validity, while internal consistency reliability and split-half reliability will be used to assess reliability. Public involvement is of great significance for this study. Participants will be used in a pre-test to give feedback on whether the contents of the clinical pilot version of CAFCPCS after expert consultation can reflect real problems and whether the sentences can be well understood. Based on their opinions, the research group will further refine the scale.

Validation of the patient reported experiences and outcomes of safety in primary care compact Form Brazil.

To analyze the psychometric properties of the cross-culturally adapted version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) Compact Form Brazil. A methodological study was conducted with 281 adult Primary Health Care users. Data collection took place online. Confirmatory Factor Analysis (CFA) was used to evaluate the psychometric properties of the PREOS-PC after the process of cross-cultural adaptation to the Brazilian context. Internal consistency was evaluated through Cronbach's alpha coefficient (α) and McDonald's omega coefficient (ω). The sample consisted of 73.3% women. The mean age was 36.1 years (SD = 12.2). Of the 23 items of the PREOS-PC that were eligible for CFA, a model with four correlated domains and 16 items presented satisfactory fit indexes. The domains were Practice Activation (PrA) (four items), Patient Activation (PaA) (two items), Experiences of patient safety events (EPaS) (five items) and Outcomes of patient safety (OPaS) (six items). One domain (GPeS) presented one question with a 0 to 10 response scale and two open questions, which cannot be inserted in the CPA due to the nature of the items, but can be included in the application of the scale, being evaluated individually. In this factorial model, five items (EPaS2, EPaS3, EPaS4, EPaS5, EPaS6 and EPaS8) presented factor loadings ≤ 0.30. The α and ω values demonstrated good internal consistency for all domains of the PREOS-PC. The Brazilian version of the PREOS-PC Compact Form Brazil composed of four domains (PrA, PA, EPaS and OPaS) and 16 items presented evidence of validation of its psychometric properties and can be used to evaluate the experiences and results of patient safety in Primary Health Care in the Brazilian context.

Psychometric Features of the Arabic Version of the Children's Communication Checklist (CCC2).

The Children's Communication Checklist-Second Edition (CCC-2) uniquely assesses overlooked communication elements such as pragmatics and context use, which are rarely addressed by conventional language assessments. This study focuses on the psychometric assessment of the CCC-2's Arabic version, tailored to evaluate communication challenges in Arabic-speaking children. This study aims to validate the Arabic version of CCC-2 by testing its reliability and validity specifically for three higher-order constructs: Specific Language Impairment (SLI), Social Communication Disorder (SCD), and Impaired Behaviour within the Arabic-speaking population. A total of 121 participants in Saudi Arabia, showcasing diverse age and gender distributions, participated in the validation process. The study employed a Reflective-Reflective Higher-Order Construct (R-R HOC) model using partial least squares-structural equation modeling (PLS-SEM) to ensure content validity and cross-cultural adaptation of the translated items. Metrics such as Cronbach's alpha for reliability and Average Variance Extracted (AVE) for convergent validity were specifically examined. The study confirmed the reliability and validity of the Arabic CCC-2, demonstrating robust psychometric properties, with Cronbach's alpha and AVE scores indicating satisfactory reliability and convergent validity across constructs. Structural model evaluation further supported the strong interrelations among the constructs of SLI, SCD, and Impaired Behaviour. The results substantiate the Arabic CCC-2 as a reliable and valid tool for assessing communication challenges in Arabic-speaking children, particularly for diagnosing SLI, SCD, and Impaired Behaviour. The validated Arabic CCC-2 has significant potential for application in clinical and educational settings and suggests directions for future research to explore its utility further in diverse clinical populations.

ADAPTATION AND VALIDATION OF THE INDONESIAN VERSION OF THE HEALTH BELIEF MODEL INSTRUMENT FOR PARENTS

Children are a crucial population requiring COVID-19 vaccination. With the global rollout of COVID-19 vaccines, the increasing number of unvaccinated children and adolescents has raised concerns. To was translated, adapted, and validate the Health Belief Model instrument for parents of children aged 6–11 years regarding COVID-19 vaccination in the Indonesian language. Cross-cultural translation and adaptation were conducted according to international standards. The instrument testing process, according to Beaton et al., (2020), involves five stages: forward translation, synthesis of the translation results, back translation, review of the back translation, and readability testing. Respondents were purposively selected from the parents of children aged 6–11 years. Face and content validity were achieved for the Indonesian version of Health Belief Model for parents of children aged 6–11 years. The validity of each statement item was assessed using Pearson Correlation with a significance level of 0.05 and 193 respondents, resulting in an r table value of 0.1406. The constructs within the Health Belief Model were deemed valid based on the Pearson Correlation values, as the coefficient values were greater than the r-table value (r > 0.1406; p < 0.05). The constructs in the Health Belief Model were also reliable, with a Cronbach’s alpha value of 0.657. The culturally adapted Indonesian version of the Health Belief Model instrument for parents of children aged 6–11 years regarding COVID-19 vaccination is considered valid and reliable for use in research among the parent population of children aged 6–11 years in the context of COVID-19 vaccination.

Turkish cross-cultural adaptation of Pediatric Transition Experience Measure

Introduction and aim. The period immediately after leaving the hospital is known as the transition home, which presents a critical time for parents to take on all the responsibilities and care of a child without the support of the hospital environment. The purpose of this study is to culturally adapt the Pediatric Transition Experience Measure (P-TEM) instrument into Turkish and test its validity and reliability. Material and methods. We conducted this methodological study with parents of children who were discharged from the hospital between May 2021 and May 2022. We evaluated linguistic, content, construct, convergent validity, and internal consistency. Results. The P-TEM exhibited a two-factor structure and accounted for 65% of the overall variability. The internal consistency reliability for the transition preparation and transition support subdimensions was 0.779 and 0.793, respectively, while the total measure had a reliability of 0.831. The item-total correlations for the P-TEM ranged from 0.493 to 0.671. Parents who received the highest P-TEM scores experienced a 5.1-point improvement (95% confidence interval: 1.7 to 8.6) in their satisfaction with healthcare services, which was greater than that of parents who reported lower P-TEM scores. Conclusion. It is worth noting that the P-TEM has been validated and has high reliability in Türkiye.

Cross-cultural adaptation and psychometric validation of <i>The Continuous Traumatic Stress Response Scale</i>: Ukrainian version

Adapting and validating diagnostic tools aimed to evaluate the post-traumatic effects of war in low-income countries is essential for assessing needs and planning support programs. This paper will describe the process of cross-cultural adaptation and psychometric validation of the Continuous Traumatic Stress Response (CTSR) Scale for war-affected Ukraine. The study includes Phase 1, Translation and cross-cultural adaptation of the Scale, and Phase 2, Psychometric validation of the Scale. Cross-cultural adaptation goes through four stages: forward translation, expert panel review and back translation (n=3), pretesting and cognitive interviewing mental health professionals (n=8), and final version. Psychometric validation includes exploratory (n=200) and confirmatory (n=219) factor analyses, internal consistency, construct validity and test-retest reliability. Findings from the current research indicate that the components identified through factor analyses differed from those in the original questionnaire. While all original items in the questionnaire were retained, they merged into two new factors: “Exhaustion and Rage” and “Fear and Betrayal”. The results show that the overall Cronbach’s Alpha is .858, indicating a high level of internal consistency. Significant correlations exist between the total CTSR Scale score, the subscale scores, PTSD (PCL-5), moral injury (MISS-C-SF), depression (PHQ-9), and anxiety (GAD-7) symptoms, indicating construct validity. The findings demonstrate the test-retest reliability of the CTSR Scale and have practical implications for how it could be implemented in trauma-informed care. Disclosure Statement The authors reported no potential conflicts of interest. * Corresponding author: Larysa Zasiekina, 0000-0001-8456-0774zasyekina.larisa@vnu.edu.ua

Spanish translation, cross-cultural adaptation and validation of the ADTC scale (Atopic Dermatitis Control Tool)

Obtain a version to validate it in a population of adults with AD. 1) Translation into Spanish and cross-cultural adaptation of the questionnaire from the original version in English, through a seven-step process. 2) Evaluation of the unidimensionality of the resulting scale by means of an exploratory factor analysis (EFA), of its reliability by means of Cronbach's alpha coefficient, and of its validity by evaluating the correlation of its score with those of the POEM and DLQI questionnaires. (external reference criteria). The version resulting from the translation and cross-cultural adaptation process was well understood by the target population. The AFE of the 66 questionnaires documented the unidimensionality of the scale based on compliance with all the criteria used for its verification. Its reliability was excellent (Cronbach's Alpha: 0.917) and its score had a very high correlation with the external reference criteria (POEM: Spearman's Rho 0.85; p < 0.0001; DLQI Spearman's Rho = 0.81; p < 0 .0001). The version translated into Spanish and adapted for transculturation of the ADCT questionnaire has appropriate psychometric characteristics, which will contribute to optimizing the care processes of Spanish-speaking patients.

Assessment of physical literacy in 8- to 12-year-old Pakistani school children: reliability and cross-validation of the Canadian assessment of physical literacy-2 (CAPL-2) in South Punjab, Pakistan

BackgroundThe increasing prevalence of physical inactivity, declining fitness, and rising childhood obesity highlight the importance of physical literacy (PL), as a foundational component for fostering lifelong health and active lifestyle. This recognition necessitates the development of effective tools for PL assessment that are applicable across diverse cultural landscapes.AimThis study aimed to translate the Canadian Assessment of Physical Literacy-2 (CAPL-2) into Urdu and adapt it for the Pakistani cultural context, to assess PL among children aged 8–12 years in Pakistan.MethodThe Urdu version of CAPL-2 was administered among 1,360 children aged 8–12 from 87 higher secondary schools across three divisions in South Punjab province, Pakistan. Statistical analysis includes test-retest reliability and construct validity, employing confirmatory factor analysis to evaluate the tool’s performance both overall and within specific subdomains.ResultsThe Urdu version of CAPL-2 demonstrated strong content validity, with a Content Validity Ratio of 0.89. Confirmatory factor analysis supported the four-factor structure proposed by the original developers, evidenced by excellent model fit indices (GFI = 0.984, CFI = 0.979, TLI = 0.969, RMSEA = 0.041). High internal consistency was observed across all domains (α = 0.988 to 0.995), with significant correlations among most, excluding the Knowledge and Understanding domains. Notably, gender and age significantly influenced performance, with boys generally scoring higher than girls, with few exceptions.ConclusionThis study marks a significant step in the cross-cultural adaptation of PL assessment tools, successfully validating the CAPL-2 Urdu version for the Pakistani context for the first time. The findings affirm the tool’s suitability for assessing PL among Pakistani children, evidencing its validity and reliability across the Pakistani population.

Unveiling the Lived Experiences of Western Indonesian Students in Javan Higher Education Institutions: A Phenomenological Exploration

This qualitative research embarks on an exploratory journey into the lived experiences of a specific group of students—young minds from western Indonesia who are embarking on an academic journey in the dynamic ecosystem of higher education institutions in Java. In the literature synthesis, it is clear that while the experiences of international students have been studied extensively, the experiences of certain subgroups within a country remain relatively unexplored. This phenomenological exploration of the life experiences of West Indonesian students in Javanese institutions not only enriches academic discourse but also informs practical strategies for enhancing the educational journey of these students. The study identified several major challenges faced by these students, including language barriers, misunderstanding of culture and social norms, variations in academic expectations, adaptation to local cuisine, and the formation of social networks. While these challenges were formidable, the narratives of these students also reveal their resilience and capacity for personal growth. These findings offer valuable insights that go beyond academia. Recommendations include establishing a standardized and accessible cultural orientation program, fostering a network of peer support, and recognizing the need for academic guidance tailored to the unique challenges facing Western Indonesian students. This research not only contributes to a deeper understanding of cross-cultural adaptation and personal growth but also has practical implications for policymakers and educational institutions.

Comparative Study on the Agglomeration Degree and Influencing Factors of the Urban Creative Class in the Central Area of the Yangtze River Delta

The creative class has become an important force in promoting sustainable urban development. Existing research has explored many factors for the agglomeration of the creative class, but there is still a lack of comparative studies from a heterogeneity perspective and on the design of cross-cultural adaptability factors, especially comparative studies across different regions in Chinese cities. This paper focuses on 27 central district cities in the Yangtze River Delta region of China, based on panel data from 2012 to 2019, and uses the location entropy method to measure the agglomeration degree of the creative class in different cities. Considering the cultural background of China, a model of influencing factors including five dimensions: economic foundation, living environment, cultural and educational environment, innovation environment, and ecological environment is constructed. The study finds: (1) The agglomeration degree of the creative class in the central urban cluster of the Yangtze River Delta is significantly higher than the peripheral level, forming an agglomeration distribution pattern led by Shanghai, with Nanjing, Hefei, Hangzhou, Suzhou, Ningbo, and other important node cities. The agglomeration degree of the creative class generally shows an upward trend. (2) The economic foundation, living environment, cultural and educational environment, innovation environment, and ecological environment all have a significant positive impact on the agglomeration of the creative class, among which the impact of the living environment, cultural and educational environment, and innovation environment is larger, while the economic foundation and ecological environment are relatively smaller. (3) There are differences in the influencing factors of the creative class agglomeration at the provincial levels of Jiangsu, Zhejiang, and Anhui in the Yangtze River Delta. Compared with the more core provinces of Jiangsu and Zhejiang, the cultural and educational environment and ecological environment have a more significant impact, while the relatively peripheral Anhui province is more dependent on the city’s openness and innovation environment factors. This study reveals the spatial distribution rules and influencing factors of the creative class in the central cities of the Yangtze River Delta, providing insights for coordinated and sustainable regional development.

Translation, cross-cultural adaptation, and psychometric evaluation of the brief illness perception questionnaire into Yoruba language among persons with chronic low back pain

BackgroundIllness perception may influence the coping behaviors of patients. There is a lack of tools to measure this construct among Yoruba speakers. Therefore, we translate, cross-culturally adapt and determine the reliability and the validity of the Yoruba version of the Brief Illness Perception Questionnaire (BIPQ-Y).MethodsThe translation and cross-cultural adaptation process was according to Beaton criteria. The psychometric testing of the BIPQ-Y was carried out among 28 consenting patients with low back pain attending a university teaching hospital, while only 10 of them participated in the reliability test. The convergent and discriminant validity of the BIPQ-Y was carried out using the Fear Avoidance Belief Questionnaire and Quadruple Visual Analogue scale. Confirmatory factor analysis was to assess construct validity.ResultsThe mean age of the respondents was 47 ± 15.3 years. The concurrent validity of the BIPQ-Y was excellent (r = 0.996) for the total score of BIPQ-Y while the internal consistency was moderate (α = 0.52). The test–retest of BIPQ-Y yielded excellent results with item intra-class correlation coefficient (ICC) ranging between 0.833 and 0.973 and an overall ICC of 0.889. For the confirmatory analysis of the BIPQ-Y, the factor loading for the eight items ranged from − 0.071 to 0.799 and the composite reliability was good with a score of 0.68.ConclusionThe BIPQ-Y demonstrated excellent psychometric properties that are satisfactory with standards, and it is recommended for assessing illness perceptions of patients with chronic low back pain among the Yoruba-speaking populations.

Reliability and validity of the Chinese version of the functional status score for the ICU (FSS-ICU) after translation and cross-cultural adaptation

Purpose The Functional Status Score for the Intensive Care Unit (FSS-ICU) is designed to assess the physical functional status of patients in ICU settings. This study aimed to translate and culturally adapt the FSS-ICU for the Chinese context and to evaluate its reliability and validity. Methods Following Beaton’s translation model, the original FSS-ICU was subjected to forward translation, back-translation, and synthesis. After cultural adaptation and preliminary testing, the Chinese version of the FSS-ICU was established, and then two rehabilitation therapists assessed the functional status of 51 ICU patients using this scale, evaluating its reliability and validity. Results The Chinese version of the FSS-ICU exhibits excellent internal consistency with a Cronbach’s alpha coefficient of 0.934. The inter-rater and intra-rater correlation coefficients are 0.995 and 0.997, respectively. Both item-level and scale-level content validity indices are 1.00. The FSS-ICU demonstrates good convergent validity with other physical function assessment tools (Medical Research Council Sum-Score, grip strength, the Intensive Care Unit Mobility Scale), with |rs| values all above 0.5, and satisfactory discriminant validity with non-physical function assessment indicators (body mass index, blood glucose), with |rs| values all below 0.2. Additionally, it demonstrated no ceiling or floor effects. Conclusion The Chinese FSS-ICU, demonstrating strong reliability and validity, can serve as an effective assessment tool for physical function in ICU patients.

Polish Cultural Adaptation and Reliability of the Fugl-Meyer Assessment of Motor Performance and Sensory Assessment Scale in Stroke Patients.

Background and Purpose: The Fugl-Meyer Assessment of Motor Performance and Sensory Assessment Scale (FMA) is the most commonly used and recommended outcome measure for the sensorimotor impairment of the upper and lower limbs in stroke patients. The aim of this study was to perform cross-cultural translation and adaptation of the scale into Polish and to evaluate the FMA's reliability of motor performance and sensation of the upper and lower limb sections among ischemic stroke patients. Methods: The Polish version of the FMA (FMA-PL) was developed using a forward-backward translation performed by a group of experts and then evaluated by a panel of judges according to international guidelines. The study involved 86 patients (F = 30, M = 56, i.e., 35%; the average age of patients was 64 ± 12 years, 36 with right-sided stroke and 50 with left-sided stroke). The FMA-PL was carried out twice by two experienced neurological physiotherapists with a 2 h gap between assessments (test-retest and inter-rater). The reliability of the outcome measure was defined by calculating the intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and the minimum detectable change (MDC) were also calculated. The internal consistency of the test was determined by the Cronbach's alpha indicator. Results: Three domains were evaluated on the FMA-PL scale. From the whole test, results were obtained in the range of 12-124 points: 64 points for FMA-UE-PL 2, 34 points for FMA-LE-PL 4, and 24 points for FMA-S-PL 0. The ICC values were in the range of 0.99-1.00 for the total FMA-PL score and the results of each domain. The SEM and MDC for the entire FMA-PL calculated for test-retest measurements were 0.22 and 1.60, respectively. The SEM and MDC for the total FMA-PL score obtained during repeated measurements of the same investigator were 1.3 and 3.5 points, respectively. The Cronbach's alpha values calculated for the total FMA-PL, FMA-UE-PL, FMA-LE-PL, and FMA-S-PL items amounted to 0.938-0.939, 0.932-0.934, and 0.634-0.722, respectively. Conclusions: The Polish version of the FMA is a consistent and reliable outcome measure for the motor and sensory evaluation of the upper and lower limbs for patients in subacute and chronic stroke stages.

Research on the Cross-Cultural Adaptation of Ethnic Minority College Students on Campus from an Acculturation Perspective

Research on the Cross-Cultural Adaptation of Ethnic Minority College Students on Campus from an Acculturation Perspective

Exploring the Mediating Effect of Self-Efficacy on the Relationship Between Cultural Intelligence and Life Satisfaction: A Study of Chinese Students in South Korea

With the acceleration of globalization, an increasing number of Chinese students are choosing to study in South Korea. However, cross-cultural adaptation poses a significant challenge for these students. In this context, cultural intelligence (CQ), the ability of individuals to adapt to diverse cultural environments, becomes particularly important. While existing research indicates that CQ plays a crucial role in cross-cultural interactions, its impact on life satisfaction and the underlying mechanisms remain underexplored. This study conducted a stratified sampling online survey targeting Chinese students in various regions of South Korea. The survey regions were geographically categorized as follows: the northern region, including Seoul and Gyeonggi-do; the central region, including Daegu and Gyeongbuk; and the eastern region, including Busan. This categorization encompassed a total of five cities, aiming to ensure the representativeness and diversity of the sample. Ultimately, 392 valid responses were obtained, and data processing and hypothesis testing were performed using SPSS 25.0. The research results indicate that CQ significantly and positively predicts life satisfaction among Chinese students in South Korea. Moreover, self-efficacy partially mediates the relationship between CQ and life satisfaction, with CQ enhancing life satisfaction by boosting self-efficacy. These findings not only enrich the theoretical foundation of cross-cultural adaptation but also deepen our understanding of the adaptation processes and related psychological mechanisms of Chinese students in South Korea. They provide a new perspective for improving the life satisfaction of Chinese students studying in South Korea.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the Exercise Therapy Burden Questionnaire for individuals with chronic diseases.

Chronic diseases, which caused 36 million deaths in 2008, are the most common cause of death worldwide. Exercise is one of the non-pharmacological treatment methods. Although exercise benefits are well known, more than half of the population does not exercise due to the burden of exercise. The objectives of the current study were to evaluate the Turkish version of the Exercise Therapy Burden Questionnaire (ETBQ-T) and to investigate its reliability and validity. A total of 100 participants (female: 69, male: 31) who were diagnosed with at least one chronic disease participated in the translation validity and reliability analysis of the study. Cross-cultural adaptation of the ETBQ-T was performed according to Beaton's guidelines. The ETBQ-T, the European Quality of Life 5 Dimensions (EQ-5D), pain, satisfaction, and self-efficacy were applied for convergent validity. The ETBQ-T was retested to examine its reliability after 7 days. The internal consistency and reliability were excellent (intraclass correlation coefficient=0.959; Cronbach's α=0.919). The standard error of measurement was reported as 5.35. The minimum detectable difference was also demonstrated at 1.35. The ETBQ-T had a good correlation with pain (r=0.545, p<0.001), satisfaction (r=-501, p<0.001), and self-efficacy (r=-0.579, p<0.001). However, the correlation of the ETBQ-T with EQ-5D (r=0.340, p=0.001) was weak. A factor was extracted, accounting for 58.289% of the total variation. There were no floor or ceiling effects. The ETBQ-T is a reliable and valid tool to evaluate the exercise burden in the Turkish population with chronic disease.

Cultural Adaptation and Validation of a Malay Version of the Craig Hospital Inventory of Environmental Factors (CHIEF) Among Older Adults in Malaysia.

The Craig Hospital Inventory of Environmental Factors (CHIEF) is a tool designed to assess and quantify the impact of environmental factors on an individual's functioning and social participation. In this study, we aim to culturally adapt the CHIEF from its original English version into the Malay language (M-CHIEF) and examine its validity and reliability among older adults in Malaysia. The original CHIEF was cross-culturally adapted into the Malay language following the published guidelines on cross-cultural adaptation of health questionnaires. Its content and convergent validity were assessed using the content validity index and correlation with participants' gait speed, respectively. The reliability of M-CHIEF was assessed for its internal consistency using Cronbach's coefficient alpha and Cohen's kappa and its test-retest reliability was assessed using intraclass correlation coefficients (ICCs). The M-CHIEF was rated with excellent content validity with a scale-level content validity index (S-CVI) of 0.86. Its internal consistency was demonstrated to be high with Cronbach's alpha of 0.84. The test-retest reliability at a two-week interval showed a stable score of the M-CHIEF and its subscales with an ICC value of 0.89. The M-CHIEF is deemed relevant for use among Malay speakers. It can function as an instrument to quantify the environmental barriers of an individual while considering broad environmental factors including policy, physical/ structural, work/school, attitude/support, and services/assistance.

Cross-cultural adaptation of the Arabic Version of the Disability Rating Scale among caregivers of patients with traumatic brain injury

Cross-cultural adaptation of the Arabic Version of the Disability Rating Scale among caregivers of patients with traumatic brain injury

Cross-Cultural Adaptation and Validation of an Attitude about Euthanasia Scale in Portuguese Older Adults with Mixed Anxiety-Depressive Disorder.

On 25 May 2023, the Portuguese parliament approved the decriminalisation of euthanasia for incurable illnesses. As the experiences of other countries show us, it will be a matter of time before mental disorders are addressed. Studying the phenomenon, particularly in vulnerable groups, in advance is essential for proper law drafting. Therefore, instruments that allow an objective assessment and comparison between groups must be available. This study aims to explore the validation of Faria's attitude about euthanasia scale in Portuguese older adults with mixed anxiety-depressive disorder. A sample of 114 older adults with mixed anxiety-depressive disorder collected by convenience in the Psychiatry Department of Senhora da Oliveira Hospital in Portugal was included. The pre-final version of the scale was tested in a small group with good results. The validity of the internal structure was analysed using exploratory factorial analysis. The internal consistency study verified reliability. For construct validity, we assessed the correlation with other validated scales measuring attitudes toward euthanasia, cognitive performance, personality and empathy. The attitude about euthanasia scale showed good internal consistency. One factor was retained in the principal component analysis. Significant correlations verified construct validity. The results support the scale's usefulness and validity. This study makes available a unique instrument to assess the overall tendency of the attitudes towards euthanasia from the European-Portuguese perspective, which can be used, for example, to compare Portuguese with Brazilian older adults suffering from the same disorder. Furthermore, the adapted scale paves the way for other cross-cultural translations, adaptations, validations, and comparative analyses.

Cross-cultural adaptation of National Early Warning Score 2 to Angolan Portuguese

ObjectiveTo make a cross-cultural adaptation of the National Early Warning Score 2 (NEWS 2) from English to Angolan Portuguese. MethodsA methodological research of cross-cultural adaptation was conducted, involving sequential stages of forward translation, translation synthesis, back-translation, and the application of the Delphi Panel methodology for analyzing semantic, idiomatic, experiential, and conceptual equivalence between the translated and the original versions. This process culminated in the development of a pre-final version, which subsequently underwent testing in a cohort of nurses (n = 37). The Intraclass Correlation Coefficient was calculated to assess inter-rater reliability of ratings. Cronbach's alpha was used for evaluating the internal consistency and reliability within the items of the NEWS 2 score. ResultsThe cross-cultural adaptation process allowed us to prepare the final version of this tool. The data collected during the testing phase facilitated the examination of inter-rater reliability of ratings and the internal consistency and reliability within the items of the NEWS2 score. The Intraclass Correlation Coefficient observed at this step was 0.992. The Cronbach's alpha was 0.993. ConclusionThe cross-cultural adaptation of the NEWS 2 scoring system to Angolan Portuguese was successful, providing healthcare professionals in Angola with the means to effectively use the tool.