Transcultural Adaptation Research Articles

Transcultural adaptation and validation of the Moroccan Arabic dialect version of the Wexner incontinence score in patients with low anterior resection syndrome after rectal surgery

BackgroundBowel dysfunction symptoms such as stool clustering, urgency, incomplete voiding, and fecal incontinence are frequent after colorectal surgery and known as the low anterior resection syndrome. The Wexner score is the most widely used tool for fecal incontinence assessment. We aimed to translate and test the psychometric properties of the Moroccan Arabic dialect version of the Wexner questionnaire in patients with low anterior resection syndrome after rectal surgery. MethodsThe Wexner questionnaire was translated to Moroccan Arabic and administered to a group of 158 patients, among which a subgroup of 43 patients took the test for a second time to examine test-retest reliability. Cronbach alpha coefficient was used to determine internal consistency and correlation, and the European Organisation for the Research and Treatment of Cancer Quality of Life C30 and the low anterior resection syndrome questionnaires were assessed for convergent validity. Discriminant validity was demonstrated through the Wexner score ability to detect differences based on the patients' different clinical and pathological characteristics. ResultsOne hundred and fifty-eight patients completed the Moroccan Arabic dialect version of the Wexner score, which showed an excellent internal consistency with a Cronbach alpha score of 0.91. Test-retest reliability was established by a Bland-Altman plot with 95% limits of agreement. The score showed positive correlation to the low anterior resection syndrome score (r = 0.748; P < .001) and the European Organisation for the Research and Treatment of Cancer Quality of Life C30 diarrhea symptom scale (r = 0.519; P < .001). A negative correlation was also demonstrated for each one of the 5 European Organisation for the Research and Treatment of Cancer quality of life C30 functional scales, namely physical functioning (r = –0.217 ; P = .006), role functioning (r = –0.267; P = .001), emotional functioning (r = –0.266; P = .001), cognitive functioning (r = –0.283; P < .001), and social functioning (r = –0,283; P < .001). The Wexner score differed between patients according to tumor location, chemoradiotherapy, type of mesorectal excision, and anastomosis. ConclusionThe Moroccan Arabic dialect version of the Wexner score shows good psychometric properties and can be used for fecal incontinence assessment, particularly in colorectal cancer patients.

The Brazilian version of the DOS for the detection of orthorexia nervosa: transcultural adaptation and validation among dietitians and Nutrition college students.

Orthorexia nervosa has been receiving considerable attention and several tools have been developed to assess it, for instance, the "Düsseldorf Orthorexie Scale" (DOS). Such scale is a validated test to measure orthorexic eating behavior and it has shown good psychometric properties. Therefore, this study aimed to transculturally adapt and validate the Brazilian version of the DOS (DOS-BR). DOS-BR was obtained using the back-translation process after two reviews done by a focus group and after running a pilot-test (n = 64). A self-report questionnaire was administered to a sample of Brazilian dietitians and Nutrition college students (n = 486). To examine the factor structure of the DOS-BR, exploratory factor analysis and confirmatory factor analysis were conducted. The ordinal alpha was examined. Test-retest reliability was evaluated in a sub-sample (n = 159). Convergent validity was assessed by conducting correlation analyses between the DOS-BR and other theoretically related tools (EAT-26 and OCI-R) within the sub-sample. A three-factor structure was revealed for the DOS-BR properly fitted (KMO = 0.787). The test showed good internal consistency with an ordinal alpha of 0.795, and it also had excellent test-retest reliability of 0.776. DOS-BR median score was 17 (14-22) in Measurement 1 and 19 (17-22) in Measurement 2. The total score had a positive and moderate correlation with eating disorders symptoms (0.488) and a positive and weak correlation with obsessive-compulsive symptoms (0.224). The DOS-BR was culturally and psychometrically adequate for the samples of Brazilian Nutrition-related subjects. The tool is indicated as a reliable alternative to evaluate orthorexia nervosa in Brazilian scenery. Descriptive (cross-sectional) study, Level V.

Transcultural adaptation of the children's anxiety questionnaire in Brazil.

AimTo describe the transcultural adaptation process of the Children's Anxiety Questionnaire (CAQ) for the Brazilian culture.DesignThis is a methodological study of cross‐cultural adaptation.MethodsStudy conducted in Brazil and Sweden involved the following steps: preparation, translation, synthesis of translations, back‐translation and review, and harmonization of the translations by a committee of 13 healthcare professionals using the content validity index (CVI). Cognitive debriefing, using children between 4–10 years old, was completed by 15 children to determine if the images corresponded with their meanings and 17 children to determine if they could understand the Global CAQ after listening.ResultsConvergences and discrepancies between the original instrument in Swedish, the English version and the Brazilian translation were compared. The process of culturally adapting the CAQ to Brazilian Portuguese was validated, as demonstrated by a satisfactory S‐CVI (0.94) among professionals and an agreement of 95% and above by children.

Psychometric properties of the Spanish version of a questionnaire to evaluate clinical simulation in Health Sciences degrees

ObjectiveTo determine the psychometric properties of the Spanish version of the Jeffries questionnaire to assess perception, satisfaction and learning results in Clinical Simulation (QJSC) for students of Health Science degrees. MethodFor the transcultural adaptation to the Spanish language of the QJSC questionnaire, the inverse method was applied with a back translation. Internal consistency analysis was performed to assess reliability, analysed with Cronbach's alpha, a value between 0.90 and 0.95 was considered acceptable. To establish the content validity, a factor analysis was performed, only items with factor saturations greater than 0.60 were considered for interpretation. Statistical analyses were performed with the SPSS 19 programme. The administration of the questionnaire was carried out in 10–12 clinical simulation training sessions according to the subject programme with 10–12 students per session, for high-fidelity clinical simulation between 2017 and 2018, in a sample of 443 undergraduate students of the Health Sciences degrees corresponding to Nursing, Nutrition and Dietetics, Medical Technology and Kinesiology in the Clinical Simulation Centres (CSC) of the Coquimbo region, La Serena, Chile ResultsThe internal consistency level for QJSC was Cronbach's Alpha = 0.963. The data fulfilled the Kaiser–Meyer–Olkin criteria for adequate sample MSA (measure of sampling adequacy) of 0.981 with an acceptable minimum of 0.500. The data also met the requirements of the Bartlett sphericity test (χ2 = 53971, df = 561, p < .0001). The questionnaire showed a factorial structure of two factors which were named Active-Participatory Learning and Perception of Autonomy in learning. ConclusionsIt was concluded that the evidence on the validity and reliability of the scores for the Spanish version of the QJSC indicates that it is an adequate tool to evaluate the perception, satisfaction and learning outcomes of students in this teaching and learning methodology.

Knowledge, Attitude, Access and Confidence in Evidence-based practice amongst French dental undergraduates: A transcultural adaptation and psychometrics analysis of French version of the KACE questionnaire.

The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated. Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively. 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score. This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.

Transcultural adaptation and validation of the methodology of the Community Oriented Programme for Control of Rheumatic Disease (COPCORD) in the indigenous Wayuu population. Venezuela

ObjectiveTo adapt cross-culturally and validate the COPCORD methodology in the indigenous Wayuu population of Zulia state, Venezuela. MethodologyA cross-sectional study was conducted on Wayuu indigenous people from the Mara and Guajira municipalities of the state of Zulia, Venezuela. The Venezuelan version of the COPCORD questionnaire was transculturally adapted and translated from Venezuelan Spanish to Wayuunaiki (Wayuu language). One hundred indigenous Wayuu, agreed to participate, they were administered the instrument, house by house, by health personnel, who were bilingual and previously trained. Positive COPCORD individuals were evaluated by rheumatologists. A descriptive analysis of variables was performed, Cronbach's alpha was measured, Spearman's correlation, screening test analysis (sensitivity, specificity, VPP and SVR +). Results66% were women, average age 41.4 years, 20% monolingual, 21% illiterate, 69% in a couple/married, 57% with informal work. Sixty-two percent reported pain, 56% with criteria of rheumatic diseases, the most frequent were: osteoarthritis (32.3%), mechanical lower back pain (13.9%), and regional rheumatic pain syndrome (12.3%). Five dimensions of the instrument presented Cronbach's alpha> .7. The sensitivity was 100% and specificity 11.1%, VPP 14.3%, SVR + 1.13%. ConclusionThe COPCORD is valid and useful as a screening tool for the detection of musculoskeletal complaints and rheumatic diseases in the indigenous Wayuu population.

Translation, transcultural adaptation and validation of a scale of exposure to humanities among medical students

Abstract: Introduction: The humanities are associated with the improvement of medical students’ personal qualities. To date, there are no research instruments that quantify the exposure of medical students have to the humanities. Hence, the availability of a questionnaire with such characteristics in Brazilian Portuguese sets a precedent for the planning and implementation of educational strategies and policies addressing this topic. Objective: to translate and transculturally adapt the “HUMANITIES SCORE (LIFE EXPERIENCES + ATTITUDES) questionnaire, determine its validity and reliability, as well as identify the type of exposure to the humanities of the assessed population. Method: The original version of the questionnaire, written in English, was translated according to what is recommended by the specialized literature, with the addition of some activities in the humanities field, as per the original authors’ suggestion. The translated instrument underwent a pre-test with 31 medical students for semantic validation, followed by the application of its final version to 258 students. The exploratory and the confirmatory factorial analyses were applied to assess the instrument with its internal consistency was checked with Cronbach’s Alpha coefficient. Result: The final questionnaire was administered to the students to verify their type of exposure to the humanities. After the statistical tests were carried out, the final version of the instrument, named “Escala de Exposição às Humanidades” (EEH), included 17 items with Likert-scale responses with five options each, and obtained a Cronbach’s alpha of 0.689. The mean score of the students’ exposure was 1.72 ± 0.37, being influenced by the period at medical school, the number of volunteer social activity experiences, the participation in religious groups, the practice of meditation, and the involvement in political activities. Variables such as female gender, engagement in previous actions related to the humanities before starting medical school and in religious ceremonies positively influenced the students’ opinion about the importance of the humanities for the medical curriculum. Conclusion: The EEH demonstrated reliability in its structure and content, allowing correlations between the students’ exposure to humanities and their opinion about the importance of human sciences in the medical curriculum. It constitutes the first instrument that aims at measuring the humanities exposure rate in Brazil; however, further studies must be carried out, to better validate the instrument.

Translation, transcultural adaptation and validation of a scale of exposure to humanities among medical students

Abstract: Introduction: The humanities are associated with the improvement of medical students’ personal qualities. To date, there are no research instruments that quantify the exposure of medical students have to the humanities. Hence, the availability of a questionnaire with such characteristics in Brazilian Portuguese sets a precedent for the planning and implementation of educational strategies and policies addressing this topic. Objective: to translate and transculturally adapt the “HUMANITIES SCORE (LIFE EXPERIENCES + ATTITUDES) questionnaire, determine its validity and reliability, as well as identify the type of exposure to the humanities of the assessed population. Method: The original version of the questionnaire, written in English, was translated according to what is recommended by the specialized literature, with the addition of some activities in the humanities field, as per the original authors’ suggestion. The translated instrument underwent a pre-test with 31 medical students for semantic validation, followed by the application of its final version to 258 students. The exploratory and the confirmatory factorial analyses were applied to assess the instrument with its internal consistency was checked with Cronbach’s Alpha coefficient. Result: The final questionnaire was administered to the students to verify their type of exposure to the humanities. After the statistical tests were carried out, the final version of the instrument, named “Escala de Exposição às Humanidades” (EEH), included 17 items with Likert-scale responses with five options each, and obtained a Cronbach’s alpha of 0.689. The mean score of the students’ exposure was 1.72 ± 0.37, being influenced by the period at medical school, the number of volunteer social activity experiences, the participation in religious groups, the practice of meditation, and the involvement in political activities. Variables such as female gender, engagement in previous actions related to the humanities before starting medical school and in religious ceremonies positively influenced the students’ opinion about the importance of the humanities for the medical curriculum. Conclusion: The EEH demonstrated reliability in its structure and content, allowing correlations between the students’ exposure to humanities and their opinion about the importance of human sciences in the medical curriculum. It constitutes the first instrument that aims at measuring the humanities exposure rate in Brazil; however, further studies must be carried out, to better validate the instrument.

Tradução para o português brasileiro e adaptação cultural da Definição de Pontuações de Componentes (Component Scores Definition) pertencentes ao Modified Barium Swallow Impairment Profile – MBSImP(™)

Translate into Brazilian Portuguese and culturally adapt the component scores definition from the Modified Barium Swallow Impairment Profile - MBSImP videofluoroscopy protocol. This study was conducted based on international guidelines for creation, translation and transcultural adaptation according to domestic publications for the validation of international speech-language pathology tests. A specialist committee was convened with two otorhinolaryngologists and three speech-language pathologists familiar with videofluoroscopy examinations. Translation into Brazilian Portuguese was carried out by two otorhinolaryngologists with subsequent back translation performed independently by two U.S.-born translators. The final Brazilian Portuguese version was written by speech-language pathologists after revision of translations and back translations resolved semantic, idiomatic, conceptual, linguistic and contextual inconsistencies. This version was tested by committee members, who assessed subjects with no disease, with head and neck cancer and with mild cognitive impairment. Translation of the component scores definition from MBSImP was performed independently and translators agreed on a final version. The MBSImP protocol was renamed "Martin-Harris scale for swallowing videofluoroscopy". Some terms were adapted for the final Brazilian Portuguese version. Use of the translated protocol did not reveal any deviations from the original. Translation of the MBSImP fragment into Brazilian Portuguese was consistent with the original version. Approval from specialist committee members refined the protocol adaptation, allowing precise concepts to be accurately translated.

Validation of the Chinese Version of the Quality of Dying and Death Questionnaire for Family Members of ICU Patients

ContextThe quality of end-of-life care services directly affects the end-of-life quality of life of patients and their families. At present, there are no standard tools in China for assessing the quality of dying and death (QODD) of critical intensive care unit (ICU) patients. ObjectivesThis study aimed to introduce the Chinese version of the QODD questionnaire for family members of ICU patients, after transcultural adaptation and validation, to provide an effective instrument for assessing the quality of end-of-life care of ICU patients in China, fill the gap in the evaluation of the quality of end-of-life care of critical ICU patients in China, and offer a theoretical basis and practical guidance during purposeful intervention. MethodsThis study involved the main adult caregivers or principal family members of 149 dying critically ill patients. The original QODD scale was translated using the double forward and backward method. Nine cultural adaptation experts adapted the Chinese version of the QODD scale for completion by family members of ICU patients. Then, we carried out content validity, structural validity, internal consistency, confirmatory factors, and item correlation analysis of the modified scale. ResultsThe Chinese version of the QODD for family members of ICU patients was developed after some items were deleted or modified. The content validity index was 0.93, indicating that all items were correlated with the measurement of death quality. The Kaiser-Meyer-Olkin value was 0.797, suggesting that the correlations between items were high. The Cronbach's α was 0.865, indicating good internal consistency. In confirmatory factor analysis, the fit indices were χ2 = 207.327, non-normed fit index = 0.916, root mean square error of approximation = 0.033, and comparative fit index = 0.93, indicating a good fit of the five-factor model of the Chinese version of the QODD questionnaire for family members of ICU patients. ConclusionThe Chinese version of the QODD questionnaire for family members of ICU patients is a reliable and effective instrument for evaluating the quality of death among patients who die in the ICU and can be applied to clinical practice and research.

VALIDATION OF THE INTERNATIONAL 7-ITEM FALLS EFFICACY SCALE IN PORTUGUESE COMMUNITY-DWELLING OLDER ADULTS

ABSTRACT Objective to determine the psychometric properties of the international 7-item Falls Efficacy Scale. Method a psychometric study. Convenience sample consisting of 170 older adults living in the Madeira Autonomous Region, Portugal. A two-part instrument was used (sociodemographic characterization and the Falls Efficacy Scale-International-Portugal). The starting point was the translation and transcultural adaptation already carried out for the Falls Efficacy Scale - International (16 items). Construct validity (factorial analysis and discriminant validity) and the reliability (Cronbach's α) of the 7-item scale were evaluated. Previous authorization was obtained from the Ethics Commission and from the people involved. Results in the exploratory factorial analysis, the International 7-item Falls Efficacy Scale presents an explained variance of 65.8%. The Spearman's correlation between the score obtained based on the 7 items and the score obtained based on the 16 items is significant and very strong (r=0.987, p&lt;0.0001). Internal consistency was 0.958. Conclusion the validity and reliability study of the International 7-item Falls Efficacy Scale revealed that it is an adequate scale for the evaluation of the fear of falling in the community-dwelling older adults.

Transcultural adaptation and validation of the Persian version of the Brief Emotional Intelligence Scale.

Background:Increasing the level of emotional intelligence (EI) is seen as a strategy for improving both relational quality and efficiency at work. As of today, there was no validated Persian brief instrument for evaluating EI. To fill this gap, this article was aimed to investigate the validity and reliability of the Persian version of the Brief Emotional Intelligence Scale (BEIS-10).Materials and Methods:A methodological cross-sectional study was conducted among 201 Persian-speaking individuals. These individuals were selected from different parts of Iran using the convenience sampling method. Translation of the BEIS-10 was conducted by employed forward–backward method. Internal consistency was evaluated by Cronbach's α, and for test–retest reliability, the intraclass correlation coefficient (ICC) was employed. The construct validity was investigated by confirmatory factor analysis (CFA).Results:The Persian version of BEIS-10 indicates a good test–retest reliability (ICC = 0.612, 95% confidence interval: 0.384 and 0.769) as well as internal consistency (Cronbach's alpha = 0.748, ranging from 0.359 to 0.868 for different domains). The construct validity was evaluated by CFA and five factors from ten items were confirmed and all goodness-of-fit-indices were in acceptable levels.Conclusion:The article concludes that the Persian version of BEIS-10 in five factors from ten items was a reliable and valid instrument for measuring EI in the general population. As well, the article was suggesting that the Persian version of BEIS-10 may stand as a suitable alternative to time-consuming tools for EI measurement since this scale appears to be time-saving and applicable to Iranian society.

TRANSLATION AND TRANSCULTURAL ADAPTATION OF THE PATIENT MEASURE OF SAFETY (PMOS) QUESTIONNAIRE TO BRAZILIAN PORTUGUESE

ABSTRACT Objective to translate and culturally adapt the Patient Measure of Safety questionnaire to Brazilian Portuguese. Method a transcultural adaptation study conducted in six stages: translation, synthesis, back-translation, review by experts committee, pre-test, and presentation of the documentation of the entire process to the authors of the instrument. Results in the initial translation and cultural adaptation stage, two versions of the questionnaire were generated. The divergences between both versions and other suggestions were discussed, and the decisions were made by consensus, thus creating a single version. In the back-translation stage, there were no significant differences between the versions and the original instrument. The assessment of the semantic, idiomatic, cultural and conceptual equivalences of the Patient Measure of Safety items was performed by a committee of experts from different Brazilian regions. The results of the content validity index were above 0.9 for most of the items. The pre-test was conducted with 30 patients. The mean time for the application of the questionnaire was 31.9 minutes. In relation to the understanding of the items by the patients, a regular or poor interpretation was identified only for 6 of the 44 items, which were modified. Conclusion the “Questionário de Avaliação da Segurança pelo Paciente”, name given to the translated and transculturally adapted version, resulted from a thoughtful process, presenting consistency in the equivalence of the translation and constituting an applicable instrument understood by the target population.

Transcultural Adaptation and Theoretical Models of Validation of the Spanish Version of the Self-Care of Heart Failure Index Version 6.2 (SCHFI v.6.2).

Background: Heart failure (HF) is a major and growing public health problem worldwide. Across the world, heart failure is associated with high mortality, high hospitalization rates, and poor quality of life. Self-care is defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiologic stability, the response to symptoms when they occur, and the ability to follow the treatment regimen and control symptoms. One instrument used to measure self-care is the Self Care of Heart Failure Index. Aim: The purpose of this study was to test the psychometric properties of the Spanish version of the Self Care of Heart Failure Index v.6.2 (SCHFI v.6.2). Methodology: Before testing its psychometric properties, the SCHFI v.6.2 was translated and adapted from its original English version into Spanish. Subsequently, we tested the instrument’s psychometric properties on a sample of 203 participants with HF. Descriptive statistics were used to analyze the sociodemographic and clinical variables, and to describe item responses. We tested the factorial validity of the SCHFI v.6.2 using confirmatory and exploratory factor analysis. Results: Confirmatory factor analysis (CFA) was performed using the our pre-existing models which resulted with poor fit indices. Thus, we performed exploratory factor analysis (EFA) on each of the SCHFI v.6.2 scales. Conclusion: The Spanish version of the SCHFI v.6.2. has good characteristics of factorial validity and can be used in clinical practice and research to measure self-care in patients with HF.

Measurement of the will to live in older adults: Transcultural adaptation, validity and reliability of the Will-to-Live Scale.

The Will-to-Live Scale (WTLS) is used to measure the will to live in older adults; however, there is no Spanish version. The objective of the study was to translate the WTLS into Spanish, assess its internal structure, reliability, and the correlates between WTLS and life satisfaction, resilience, and depression in older Peruvian adults. The participants were 235 Peruvian older adults (M=72.69, SD=6.68), evaluated between March to May 2019, selected through non-probability sampling. The WTLS, the Satisfaction with Life Scale (SWLS), the Brief Resilient Coping Scale (BRCS) and the Patient Health Questionnaire-2 (PHQ-2) were administered. Data analysis included reliability by internal consistency and structural equation models, specifically confirmatory factor analysis (AFC), to test the one-dimensional solution of the WTLS and the convergent validity of the WTLS at the latent level, by specifying a four-factor model (will to live, life satisfaction, resilience and depression). Cronbach's alpha coefficient and the composite reliability index obtain values of .93 and .94, respectively. The one-dimensional structure of the WTLS was fitted to the data (χ2(5)=10,067, P=.073, CFI=.999, RMSEA=.066, SRMR=.014) and showed positive associations with the SWLS (ρ=.82), and BRCS (ρ=.86), as well as negative associations with the PHQ-2 (ρ=-.66). The WTLS in Spanish presents evidence of validity and reliability to measure the will to live in Peruvian older adults.

Roles for community health workers in diabetes prevention and management in low- and middle-income countries.

Diabetes prevalence is increasing worldwide, especially in low- and middle-income countries (LMIC), posing the need for improved detection and management strategies. Chronic disease models and lifestyle medicine provide structures for action. Community health workers (CHWs) can significantly contribute to chronic disease care if they are trained and integrated into low-resource health systems. Although most current CHWs worldwide are performing maternal/child health and infectious disease-related tasks, other programs involving CHWs for noncommunicable disease prevention and management are increasing. In this article, we discuss the advantages, challenges, and questions regarding possible roles assigned to CHWs in the prevention and management of diabetes. These roles include performing simple screening tests, implementing lifestyle/behavioral interventions, and connecting patients with alternatives to biomedicine. Specifically, CHWs can aid diabetes epidemiological surveillance by conducting risk score-based screening or capillary glucose testing, and they can facilitate diabetes self-management by delivering interventions described in the transcultural diabetes nutrition algorithm. Furthermore, while this role has not formally been assigned, CHWs can leverage their intimate knowledge of local practices to provide decision-making support to patients in environments with pluralistic health systems. Ethnocultural differences in CHW functions and transcultural adaptations of their roles in diabetes care should also be considered. In summary, CHWs can improve diabetes care by screening high-risk individuals and implementing lifestyle interventions, especially in LMIC.

CROSS-CULTURAL ADAPTATION OF THE POSITIVE MENTAL HEALTH QUESTIONNAIRE FOR NURSING STUDENTS IN THE BRAZILIAN CONTEXT

ABSTRACT Objective: to describe the cross-cultural adaptation process of the Positive Mental Health Questionnaire for undergraduate Nursing students, in the Brazilian context. Method: a psychometric study conducted in public universities in Rio de Janeiro/Brazil, between October 2019 and July 2020. The transcultural adaptation process encompassed the following stages: translation; reconciliation; back-translation; independent reviews by a committee of reviewers; pre-completion; completion; harmonization; formatting and review; cognitive test with 31 undergraduate Nursing students from two public universities; and analysis of the comments. Results: the process lasted approximately ten months, and the initial translations, carried out independently by two translators, achieved close versions; none of the translators reported difficulties in translating the meanings of the items. The Brazilian version of the instrument maintained conceptual, semantic, idiomatic, and experimental equivalences. The mean content validity ratio values for clarity, relevance, pertinence, and theoretical dimension were higher than established; the assessment by the target audience showed good understanding. Conclusion: the Positive Mental Health Questionnaire - Brazilian version showed equivalence with the original version, developed in Spain, and presented satisfactory evidence of content validity for use with undergraduate Nursing students in Brazil, being easy-to-understand by the target audience.

‘Think of All the Differences!’: Mixed Marriages in Transcultural Adaptations of Chaucer’s ‘Man of Law’s Tale’

Abstract At a historical moment in which we attempt to come to grips with the legacy of racial inequality, this essay considers two twenty-first-century adaptations of Chaucer’s ‘Man of Law’s Tale’, which respond to the xenophobic and imperialist ideology of the original by representing its noble white heroine as a black asylum seeker, and replacing the dynastic genealogy of Chaucer’s tale with a celebration of an inter-racial marriage that defies cultural norms. Chaucer’s text might not seem promising for modern adaptation: its passive heroine embodies the abstract principle of constancy, and the action of the tale serves an ideological purpose that seems, to modern eyes, to be profoundly and unpleasantly imperialist, xenophobic, and Islamophobic. And yet, the 2003 BBC adaptation made the work remarkably legible for a twenty-first-century audience, by highlighting, rather than suppressing, the tale’s concerns with issues of family, race, and religion, and by imagining its central heroine as a Nigerian Christian, fleeing religious persecution. These concerns with migration and racial and religious intolerance are developed brilliantly in Patience Agbabi’s Telling Tales, a poetic revision of Chaucer’s work as filtered through the lens of the television adaptation. In these texts, mixed marriages become a powerful tool with which to challenge the racist legacy of the past and to interrogate the relationship of the adaptation to its canonical forebears.

Measurement of the will to live in older adults: Transcultural adaptation, validity and reliability of the Will-to-Live Scale

ObjectiveThe Will-to-Live Scale (WTLS) is used to measure the will to live in older adults; however, there is no Spanish version. The objective of the study was to translate the WTLS into Spanish, assess its internal structure, reliability, and the correlates between WTLS and life satisfaction, resilience, and depression in older Peruvian adults. MethodThe participants were 235 Peruvian older adults (M = 72.69, SD = 6.68), evaluated between March to May 2019, selected through non-probability sampling. The WTLS, the Satisfaction with Life Scale (SWLS), the Brief Resilient Coping Scale (BRCS) and the Patient Health Questionnaire-2 (PHQ-2) were administered. Data analysis included reliability by internal consistency and structural equation models, specifically confirmatory factor analysis (AFC), to test the one-dimensional solution of the WTLS and the convergent validity of the WTLS at the latent level, by specifying a four-factor model (will to live, life satisfaction, resilience and depression). ResultsCronbach's alpha coefficient and the composite reliability index obtain values ​​of .93 and .94 respectively. The one-dimensional structure of the WTLS was fitted to the data (χ2 (5) = 10,067, p = .073, CFI = .999, RMSEA = .066, SRMR = .014) and showed positive associations with the SWLS (ρ = .82), and BRCS (ρ = .86), as well as negative associations with the PHQ-2 (ρ = −.66). ConclusionThe WTLS in Spanish presents evidence of validity and reliability to measure the will to live in Peruvian older adults.

Transcultural adaptation and validation of the Spanish version of the Identification of Functional Ankle Instability questionnaire (IdFAI-Sp)

Objective The study aim was to cross-culturally adapt the Identification of Functional Ankle Instability (IdFAI) into a Spanish-language version (IdFAI-Sp), which would then be validated and its psychometric properties evaluated for use in possible cases of ankle instability. Methods The cross-cultural adaptation was performed following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Pearson correlations were calculated to assess the convergent validity between IdFAI and the Cumberland Ankle Instability Tool. Cronbach’s alpha and test re-test reliability values were calculated and floor/ceiling effects analysed. Construct validity was assessed by confirmatory factor analysis (CFA). Results The study population was composed of 110 participants, with a mean age of 40.49 years (10.43) and of whom 62 (56.36%) were female. Good test-retest results were obtained, with an intraclass correlation coefficient of 0.85 (ICC2,1: 95% CI: 0.82 − 0.88). The structure matrix was examined by CFA, which revealed a three-factor solution that accounted for 79.89% of the variance. The IdFAI-Sp obtained an excellent fit (RMSEA 0.068, GFI 0.94, CFI 0.98 and NFI 0.97). Conclusions This study validates the IdFAI-Sp questionnaire, corroborating its value to researchers and medical professionals as a self-reported outcomes measure for use with a Spanish-speaking population. IMPLICATIONS FOR REHABILITATION The Spanish-language version of the Identification of Functional Ankle Instability questionnaire (IdFAI-Sp) is a valid and reliable tool. The IdFAI-Sp enables researchers and healthcare professionals to identify and classify chronic ankle instability among Spanish-speaking patients. Accordingly, it can be considered a useful clinical instrument. Aapplication of the questionnaire before and after treatment can reveal the patient’s degree of recovery over time.