Cross-cultural Adaptation Study Research Articles

A psychometric study of validation and cross-cultural adaptation of the Holden Communication Scale for elderly with dementia in care homes

Purpose This paper aims to validate and adapt the Arabic version of Holden Communication Scale (HCS) for assessing communication skills among old people with dementia in care home. Design/methodology/approach A study involving 210 elderly residents from Jordanian care homes was conducted, where they completed the Arabic version of the HCS. Internal consistency and factor analysis techniques were precisely used to assess the scale's reliability. Additionally, cognitive function evaluation used the Arabic iteration of the Saint Louis University Mental Status (SLUMS) questionnaire, while communication skills were comprehensively appraised using the HCS. Findings The Arabic HCS has strong content validity, with a one-component structure accounting for 60% of the variation and a three-factor structure accounting for 77.2% of the variance. The original three-subgroup structure of the scale was recreated, and internal consistency varied from 0.85 to 0.87, indicating good reliability. Originality/value This study aimed to assess the reliability and validity of the Arabic version of the HCS among old people with dementia residing in care homes. The authors conducted examination of its psychometric properties within this unique population.

Spanish and Catalan Versions of the eHealth Literacy Questionnaire: Translation, Cross-Cultural Adaptation, and Validation Study.

The rise of digital health services, especially following the outbreak of COVID-19, has led to a need for health literacy policies that respond to people's needs.Spain is a country with a highly developed digital health infrastructure, but there are currently no tools available to measure digital health literacy fully. A well-thought-through questionnaire with strong psychometric properties such as the eHealth Literacy Questionnaire (eHLQ) is important to assess people's eHealth literacy levels, especially in the context of a fast-growing field such as digital health. This study aims to adapt the eHLQ and gather evidence of its psychometric quality in 2 of Spain's official languages: Spanish and Catalan. A systematic cultural adaptation process was followed. Data from Spanish-speaking (n=400) and Catalan-speaking (n=400) people were collected. Confirmatory factor analysis was used to confirm the previously established factor structure. For reliability, the Cronbach α and categorical ω were obtained for every subscale. Evidence of convergent and discriminant validity was provided through the correlation with the total score of the eHealth Literacy Scale. Evidence based on relations to other variables was evaluated by examining extreme values for educational level, socioeconomic level, and use of technology variables. Regarding the confirmatory factor analysis, the 7-factor correlated model and the 7 one-factor models had adequate goodness-of-fit indexes for both Spanish and Catalan. Moreover, measurement invariance was established between the Spanish and Catalan versions. Reliability estimates were considered adequate as all the scales in both versions had values of >0.80. For convergent and discriminant validity evidence, the eHealth Literacy Scale showed moderate correlation with eHLQ scales in both versions (Spanish: range 0.57-0.76 and P<.001; Catalan: range 0.41-0.64 and P<.001). According to the relationship with external variables, all the eHLQ scales in both languages could discriminate between the maximum and minimum categories in level of education, socioeconomic level, and level of technology use. The Spanish and Catalan versions of the eHLQ appear to be psychometrically sound questionnaires for assessing digital health literacy. They could both be useful tools in Spain and Catalonia for researchers, policy makers, and health service managers to explore people's needs, skills, and competencies and provide interesting insights into their interactions and engagement regarding their own experiences with digital health services, especially in the context of digital health growth in Spain.

Cultural adaptation and validation of the caring behaviors assessment tool into Spanish

BackgroundThe aim of the research was to translate, culturally adapt and validate the Caring Behaviors Assessment (CBA) tool in Spain, ensuring its appropriateness in the Spanish cultural context.MethodsThree-phase cross-cultural adaptation and validation study. Phase 1 involved the transculturation process, which included translation of the CBA tool from English to Spanish, back-translation, and refinement of the translated tool based on pilot testing and linguistic and cultural adjustments. Phase 2 involved training research assistants to ensure standardized administration of the instrument. Phase 3 involved administering the transculturally-adapted tool to a non-probabilistic sample of 402 adults who had been hospitalized within the previous 6 months. Statistical analyses were conducted to assess the consistency of the item-scale, demographic differences, validity of the tool, and the importance of various caring behaviors within the Spanish cultural context. R statistical software version 4.3.3 and psych package version 2.4.1 were used for statistical analyses.ResultsThe overall internal consistency of the CBA tool was high, indicating its reliability for assessing caring behaviors. The subscales within the instrument also demonstrated high internal consistency. Descriptive analysis revealed that Spanish participants prioritized technical and cognitive aspects of care over emotional and existential dimensions.ConclusionsThe new version of the tool proved to be valid, reliable and culturally situated, which will facilitate the provision of objective and reliable data on patients beliefs about what is essential in terms of care behaviors in Spain.

The Chinese translation and cross-cultural adaptation of PRISMA-7 questionnaire: an observational study to establish the accuracy, reliability and validity

BackgroundFrailty is a health condition linked to adverse health outcomes and lower life quality. The PRISMA-7, a 7-item questionnaire from the Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA), is a validated case-finding tool for frailty with good sensitivity and specificity. This study aimed to translate, culturally adapt, and validate the PRISMA-7 questionnaire for Chinese use.MethodsA prospective observational study with convenience sampling recruited bilingual adults aged 65 and over living in the community. The Functional Autonomy Measurement System (SMAF) was the gold standard benchmark. The English PRISMA-7 questionnaire was culturally adapted to Chinese using forward and backward translation. Intra- and inter-rater reliability were determined using the intraclass correlation coefficient (ICC). Face, content and criterion validity were determined. The Receiver Operator characteristic (ROC) curve determined the optimal cut-off score.ResultsOne-hundred-twenty participants (55 females and 65 males) were recruited. The Chinese PRISMA-7 questionnaire had excellent intra-rater and inter-rater reliability (ICC = 1.000). The rigorous forward and backward translation established the face and content validity. The moderately high correlations between the English PRISMA-7 with SMAF (r = − 0.655, p < 0.001) and Chinese PRISMA-7 with SMAF (r = − 0.653, p < 0.001) pairs established the criterion validity. An optimal cut-off score of three “Yes” responses was reported with 100% sensitivity and 85.3% specificity.ConclusionThis translation, cross-cultural adaptation, and validation study established the Chinese PRISMA-7 questionnaire. The preliminary results suggest adequate diagnostic test accuracy for frailty screening among the Chinese-literate community.

Cross-cultural adaptation of the Daily living self-efficacy scale into brazilian portuguese

To carry out the cross-cultural adaptation of the Daily Living Self-Efficacy Scale into Brazilian Portuguese. This is a methodological cross-cultural adaptation study. The following stages were followed: translation; synthesis of translations; back-translation; review by a committee of judges; and pre-test. The Concordance Index was used to analyze equivalence and the Content Validity Coefficient was calculated for clarity of language, practical pertinence and relevance; and Fleiss' Kappa for the theoretical dimension. The stages of translation, back-translation and review by the committee of judges showed brief modifications, aimed at grammatical changes, inversion of words, replacement of terms with synonyms, exclusion of words and inclusion of articles and prepositions. The analysis of equivalences between the judges resulted in a concordance rate of over 80%. The practical relevance and theoretical relevance obtained a Content Validity Coefficient of 0.99 and clarity of language of 0.88, while the theoretical dimensions had a Fleiss Kappa of over 0.80. A pre-test was carried out with 30 participants. The cross-cultural adaptation of the Daily Living Self-Efficacy Scale into Brazilian Portuguese allowed the instrument to be adapted to the Brazilian context, showing properties for measuring self-efficacy in the daily life of stroke survivors.

Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation.

The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease. The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase. An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach's α =0.889-0.981), and reliability was excellent (ICC = 0.854-0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752. DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.

Cross-cultural adaptation, reliability, and validity study of the Turkish version of the “Spinal Cord Injury-Falls Concern Scale”

Purpose This study aims to conduct a Turkish validity and reliability study of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS). Methods The study involved 134 volunteer patients with spinal cord injury. Various validity analyses, including content validity analysis, Confirmatory Factor Analysis (CFA), Pearson product-moment correlation coefficient, and Cronbach’s alpha value based on a single application for reliability, were employed. The Falls Efficacy Scale-International (FES-I) was used for criterion validity. Results All the standardized regression coefficients for the single factor measurement model established with 16 items in the scale are above 0.84. The CFA model, also with a single factor and 16 items, yields the following fit indices: Root-Mean-Square Error of Approximation value of 0.15, Standardized Root Mean Residual Squares value of 0.06, Chi-square value of 2.20, and Comparative Fit Index and Non-Normed Fit Index values of 0.98. The scores they received from the SCI-FCS and the scores they received from the FES-I scale have a statistically significant positive correlation (p < 0.01). The test-retest reliability coefficient value is 0.81, and the Cronbach Alpha value is 0.97. Conclusion The Turkish version of the SCI-FCS is a valid and reliable tool for determining fall concerns for patients with spinal cord injury.

Unlocking the Hidden Dimensions of Cancer Care: Cross-Cultural Adaptation and Feasibility Study of ESAS-FS, Assessing Spiritual Pain and Financial Distress in a Spanish-speaking Population with Advanced Cancer

IntroductionSpiritual pain and financial distress are two important dimensions of cancer care that are often overlooked. Both dimensions can have a significant impact on the quality of life of patients with cancer and their families. MethodsThis study conducted a cross-cultural adaptation, feasibility study, and psychometric properties of the Edmonton Symptom Assessment System-Financial and Spiritual (ESAS-FS) in a Spanish-speaking population with advanced cancer. The ESAS-FS is a patient-reported outcome measure that assesses 12 symptoms, including spiritual pain and financial distress. ResultsIn the cross-cultural adaptation process, the terms “spiritual pain” and “financial distress” were refined to “sufrimiento espiritual” and “preocupación por asuntos económicos” respectively, with strong professional consensus and high patients’ acceptancy (relevant questions 80%, appropriate terms 91%). A cohort of 100 onco-hematologic patients revealed that 70% experienced spiritual pain (mean 2.9/10), while 49% reported financial distress (mean 2.2/10). Symptomatic analyses illustrated significant associations of spiritual pain with various symptoms like fatigue, drowsiness, and depression. Similarly, financial distress correlated notably with drowsiness, depression, and anxiety. Moreover, a distinct correlation was observed between spiritual pain and financial distress. ConclusionThe findings of this study suggest that the ESAS-FS is a valuable tool for assessing spiritual pain and financial distress in Spanish-speaking patients with advanced cancer. The tool can be used to identify patients who are experiencing these dimensions of distress and to provide them with appropriate care.

Brazilian version of the Pasero Opioid-Induced Sedation Scale: cross-cultural adaptation study

RESUMO Objetivo: Realizar adaptação transcultural da escala Pasero Opioid-Induced Sedation para o cenário brasileiro. Método: Estudo metodológico, utilizado referencial de Beaton, composto por seis fases: tradução, síntese das traduções, retradução, comitê de especialistas, pré-teste e envio dos instrumentos adaptados ao autor do instrumento original. Estudo foi realizado de abril a dezembro de 2021. A pesquisa desenvolveu-se em um hospital privado, localizado no município de São Paulo, nas unidades de internação e críticas adultos. Recebeu aprovação do comitê de ética. Resultados: Após as etapas de tradução, síntese de tradução e retrotradução a versão foi avaliada pelo comitê de especialistas, com duas rodadas para obtenção de valores aceitáveis de índice de validade de conteúdo acima de 0,80. Na fase de pré-teste a escala apresentou boa compreensão com score de 0,98. Conclusão: A escala foi adaptada para o contexto brasileiro, no entanto, novos estudos serão necessários para análises de evidências de validade e confiabilidade.

Brazilian version of the Pasero Opioid-Induced Sedation Scale: cross-cultural adaptation study.

Perform a cross-cultural adaptation of the Pasero Opioid-induced Sedation Scale to the Brazilian setting. This is a methodological study using Beaton's framework, which consists in six stages: translation, synthesis of translations, re-translation, expert committee, pre-test, and sending the adapted version of the instrument to the author of the original. The study was carried out from April to December 2021. The research was conducted in a private hospitalin the city of São Paulo, in the adult hospitalization and critical care units. It was approved by the research ethics committee. After translation, translation synthesis and back-translation steps, the version was evaluated by the expert committee, requiring two rounds to obtain acceptable CVI values above 0.80. In the pre-test phase, the scale was well understood, with a CVI of 0.98. The scale was adapted for the Brazilian context; however, further studies will be needed to analyze validity and reliability evidence.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages.To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese.A translation, cross-cultural adaptation, and validation study conducted at Ceuma University.Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects.Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = -0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed.HASMID-10 has adequate measurement properties and may be used for Brazilians.

Translation and cultural adaptation of “Glasgow Children’s Benefit Inventory” into Brazilian Portuguese

ObjectiveTranslate and cross-culturally adapt into Brazilian Portuguese the Glasgow Children’s Benefit Inventory instrument used for the quality-of-life assessment after pediatric ENT interventions. MethodThis is a methodological study of translation and cross-cultural adaptation of the GCBI instrument following seven stages: 1) Translation of two versions by two independent translators, 2) Elaboration of a consensual synthetized version, 3) Assessment of the synthetized version by experts, 4) Assessment by the target audience, 5) Back-translation, 6) Pilot study and 7) Use of the instrument. The final version of the instrument was answered by a sample of 28 people responsible for children aged from 2 to 7 years, submitted to tonsillectomy between January 2019 and December 2021, in a public hospital in Porto Alegre. The collection considered patients with a minimum of 6-months and a maximum of 3-years of postoperative follow-up. ResultThe instrument final version was compared to the original version showing semantic equivalence, absence of consistent translation difficulties and appropriate cross-cultural adaptation, and well understood by the target audience. The application of the questionnaire in the sample showed a Cronbach alpha coefficient of 0.944 corresponding to a high degree of reliability of the instrument. ConclusionThe translation and cross-cultural adaptation showed semantic appropriateness and its use when assessing ENT postoperative results in a pediatric population showed high reliability of the instrument. Level of evidence4.

Transcultural Adaptation and Validation of the Turkish Version of the Breast Cancer Awareness Measure (BCAM) Questionnaire

Purpose: To analyze the validity and reliability of the Turkish version of the Breast Cancer Awareness Measure (BCAM-Tr).&#x0D; Material and Methods: This was cross-cultural adaptation and validation study. The study sample consisted of a total of 552 women who volunteered to participate in the study between December 2020 and November 2021. Data were collected using a descriptive characteristics form and the BCAM-Tr. The validity of the BCAM-Tr was tested with language validity, content validity, construct validity (first-level Confirmatory Factor Analysis and comparison of known groups) analyses. Reliability was evaluated by conducting test-retest analysis and internal consistency &#x0D; Results: The BCAM-Tr showed good test-retest reliability (Intraclass Correlation Coefficient=0.89) and internal consistency (Cronbach’s alpha=0.89). Cohen’s kappa coefficients indicated moderate to excellent agreement (0.55-0.96). Confirmatory factor analysis confirmed a two‐factor structure. Health professionals had higher correct response rates than women in the general population (p=0.0001), indicating good construct validity.&#x0D; Conclusion : The BCAM-Tr was shown to be valid and reliable for assessing breast cancer awareness in Turkish women.

Weinberger Adjustment Inventory Portuguese Version: A Study of Cross-Cultural Adaptation and Measurement Invariance

We examine the psychometric properties of the Weinberger Adjustment Inventory (WAI) from a modern psychometric perspective, including second-order models, better estimation of reliability, and measurement invariance, among a sample of young adults (N = 610, M = 21.33 years, SD = 3.09 years) from Portugal. Results indicated that only the four-factor intercorrelated confirmatory models of the WAI Distress and Restraint scales, and the two-factor intercorrelated confirmatory models of the WAI Defensiveness scales showed adequate fits. The WAI showed good reliability and distinctive correlates with other psychometric measures and criterion variables. Cross-gender measurement invariance was established. Our findings support the WAI as a valid and reliable measure.

Cross-Cultural Adaptation, Validity, and Reliability Study of Turkish Version of the International Hip Outcome Tool-33 (iHOT-33): A Pilot Study

Anketler hastalığın hikayesinde, fizik muayenede ve görüntüleme araçlarına bağlı olarak kalça patolojilerinin teşhisinde önemli rol oynamaktadırlar. Kalça patolojileri için farklı anketler vardır. Bu çalışmanın amacı, International Hip Outcome Tool (iHOT-33)’un Türkçe versiyonuna uyarlama, geçerlik ve güvenirliğini araştırmaktır. iHOT-33’ün Türkçe’ye çevirisi ve kültürel uygunluğu mevcut yönergeler izlenerek yapılmıştır. Bu çalışmaya düşük yaş ortalamasına ve yüksek fiziksel kapasiteye sahip 50 hasta katıldı. Ölçeğin güvenirliğini değerlendirmek için test-tekrar test ve iç tutarlık analizleri uygulandı. Test tekrar test analizi, sınıf içi korelasyon katsayısı (ICC) yöntemi ile analiz edildi. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 36 (SF-36) anketlerinin toplam puanları, iHOT-33’ün geçerliğini belirlemek için Pearson korelasyonu ile değerlendirildi. iHOT-33’ün yüksek düzeyde iç tutarlılığa sahip olduğu bulundu (Cronbach alfa 0.908). Test-tekrar test sonuçları yüksek korelasyon gösterdi (0.702-0.938 aralığında). Faktör analizi, ölçeğin dört faktörlü bir yapıya sahip olduğunu gösterdi. iHOT-33, WOMAC ve SF-36 ile iyi düzeyde korelasyona sahiptir (Pearson korelasyon katsayısı WOMAC ile -0.710, SF-36 ile -0.594). iHOT-33’ün Türkçe versiyonu geçerli ve güvenilirdir.

Patient Safety Culture Analysis in Dental Hospital Using Dental Office Survey on Patient Safety Culture Questionnaire: A Cross-cultural Adaptation and Validation Study.

The culture of safety and patient safety management in dental practice lags compared with medical practice. Hospitals strive to pursue quality and safety of healthcare services, with evidence of patient safety incidents in medical practice demonstrating the importance of promoting a safety culture. Measuring patient safety culture is a necessary first step to improving safety culture in clinical settings. As a hospital, dental hospital should improve the quality and culture of patient safety. Thus, our objective was to conduct a cross-cultural adaptation of a US measure of dental office patient safety culture for use in Indonesian dental hospitals. A cross-sectional study was conducted on 200 respondents at a dental hospital in Java, Indonesia. The first stage includes cultural adaptation and translation, followed by developing a questionnaire that was tested through expert agreement and analysis of validity and reliability using Spearman, Cronbach correlation coefficients, and correlation coefficients between classes. The Dental Office Survey on Patient Safety Culture consists of 58 items and 10 dimensions (overall perceptions of patient safety and quality, organizational learning, teamwork, staff training, work pressure and pace, management support for patient safety, office processes and standardization, communication about errors, communication openness, and patient care tracking/follow-up). A total of 200 respondents with a response rate of 61.5% and 77 invalid responses due to incomplete filling, so 123 respondents were analyzed. The validity test results on 38 question items from 10 dimensions, with a sign of 0.05%, 35 items are declared valid. The Indonesian version of the Dental Office Survey on Patient Safety Culture shows good validity and good reliability and has the potential to be used to evaluate patient safety culture in dental hospitals in Indonesia.

Sustainability attitudes in nursing survey: A cross-cultural adaptation and validation study

Research aim: The aim of this study was to cross-culturally adapt the Sustainability Attitudes in Nursing Survey into Turkish and evaluate its validity and reliability among Turkish speaking nursing students. Methods: This methodological study was conducted with 400 nursing students, selected using a simple random sampling method from students studying at a state university in Turkey. Sociodemographic Characteristics Questionnaire and Sustainability Attitudes in Nursing Survey were used for data collection. The linguistic content validity analysis and Confirmatory Factor Analysis were performed to determine the validity of the survey. Test-retest reliability and Cronbach Alpha coefficient were determined for reliability of the survey. Findings: The Content Validity Index of the Turkish version of the Sustainability Attitudes in Nursing Survey was found to be 0.91. In the Confirmatory Factor Analysis, the survey was confirmed as a single-factor model. The Cronbach Alpha coefficient of the survey was determined to be 0.76 and the intra-class correlation was 0.81 as a result of the test-retest. Conclusions: The Turkish version of the survey has sufficient validity and reliability to evaluate sustainability attitudes of nursing students in the Turkish culture. It is recommended to conduct international comparative studies to identify nursing students’ sustainablity attitudes.

Cross-Cultural Adaptation and Reliability of the Toddler Sensory Profile 2 for Brazilian Children Aged 7 to 35Months.

To organize a cross-cultural adaptation study and analyze the reproducibility and test-retest reliability of a Brazilian version of the Toddler Sensory Profile 2 (TSP2Br) for children aged 7-35months. The English language version of the profile was translated and culturally adapted into Brazilian Portuguese, administered to 168 caregivers of toddlers aged 7-35months, and then re-administered to a portion of the sample (39 caregivers; 23%) for 7-14days for test-retest reliability. The internal consistency and test-retest reliability was analyzed using the Cronbach's alpha and kappa coefficient, respectively. As it is a norm-referenced standardized assessment, the cut-off scores used were 1.0 and 2.0 standard deviations above and below the mean for each group of items established as the preliminary cut-off scores for the Brazilian children. The TSP2Br showed good internal consistency (>0.70) when measured on the total scale; however, when it was analyzed for sensory areas, five to seven areas presented alpha values <.70. By quadrants, alpha was <.70, for all items. The test-retest values fell into the category of near-perfect agreement (.89-.97). The preliminary cut-off points of the Brazilian scores were distinct from those of the Americans. The TSP2Br showed preliminary reliability and validity in the identification of sensory processing problems in Brazilian children aged 7-35months; however, it would be necessary to increase the sample size to generalize our findings to the general Brazilian population.

Translation and cultural adaptation of the Short Version of the Reflux Symptom Score: Reflux Symptom Score-12 into Brazilian Portuguese.

To describe the process of translation into Brazilian Portuguese and cross-cultural adaptation of the French Reflux Symptom Score-12 questionnaire used for the diagnosis of laryngopharyngeal reflux. This was a cross-cultural translation and adaptation study of a health instrument, with a cross-sectional design. It was carried out in eight stages: translation from French into Brazilian Portuguese, cultural adaptation by a panel of experts, application of the first version (pilot test 1), adaptation by a panel of experts, application of the second version (pilot test 2), back translation, reviewing by a committee in conjunction with the author of the original instrument and, application of the final version. The Brazilian Portuguese versions of the questionnaire were applied to individuals with symptoms and signs of laryngopharyngeal reflux who underwent pHmetry and esophageal manometry at the study site. In pilot test 1, the first version of the RSS-12 in Brazilian Portuguese was applied to 30 patients. The patients had no difficulty to understand any of the 12 symptom items, but 15 patients (50%) had difficulty interpreting the symptom frequency score. After adapting the format of the frequency score, a version 2 of the RSS-12 in Brazilian Portuguese was applied to another 23 patients, who completed the questionnaire in full without any difficulty. Along with the review committee, the author of the original RSS-12 considered the version 2 to be adequate and did not propose any changes, so it was approved as the final version of the Brazilian Portuguese RSS-12. The Brazilian Portuguese version of the instrument, called Reflux Symptom Score-12 PT-BR, shows good understanding and linguistic, conceptual and content equivalence, in relation to the original Reflux Symptom Score-12.

Cross-Cultural Adaptation, Validity and Reliability Study of the Italian Version of the Back Pain Functional Scale

Cross-Cultural Adaptation, Validity and Reliability Study of the Italian Version of the Back Pain Functional Scale