Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

Adaptación y validación del Voice Handicap Index y su versión abreviada al español rioplatense de Argentina

Objetivo: Este estudio tuvo como objetivo principal validar el Voice Handicap Index (VHI) y su versión abreviada (VHI-10) adaptados al español rioplatense de Argentina, con objetivos específicos centrados en evaluar su fiabilidad y validez. Metodología: La adaptación cultural incluyó técnicas de traducción directa, síntesis y retrotraducción, evaluación de la equivalencia semántica y aplicación a un grupo piloto. Para la validación se evaluó la fiabilidad de ambos índices adaptados mediante la consistencia interna (coeficiente alfa de Cronbach) y la estabilidad test-retest (prueba de Bland-Altman, CCI y r de Spearman). Además, se examinó la validez de criterio y de constructo. 213 sujetos participaron en la validación del índice adaptado de 30 ítems (123 disfónicos; 90 de control); 113, en la del índice abreviado (63 disfónicos; 50 de control). Resultados: Se constituyó el Índice de Desventaja Vocal (IDV) como la versión adaptada del VHI al español rioplatense de Argentina. Ambos índices demostraron excelente consistencia interna (IDV-30 α = 0,96; IDV-10 α = 0,92) y estabilidad y concordancia (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Se halló alta correlación entre los puntajes de ambos índices y la autoevaluación de la severidad de la disfonía de los participantes (r = 0,85). Ambos índices demostraron capacidad de diferenciar entre individuos con disfonía y sujetos sanos (p< 0,001). El análisis factorial reveló tres factores para el IDV-30 y un factor para el IDV-10. Conclusiones: El IDV-30 e IDV-10 presentan grados adecuados de fiabilidad y validez. Ambos pueden ser incluidos en protocolos de valoración de la función vocal por profesionales de Argentina.

Aim: This study aimed to validate the Voice Handicap Index (VHI) and its abbreviated version (VHI-10) adapted into Rioplatense Spanish from Argentina, with specific goals centered on assessing their reliability and validity. Methods: Cultural adaptation involved direct translation, synthesis and back-translation techniques, followed by an assessment of semantic equivalence and application to a pilot group. For the validation process, the reliability of both adapted indices was assessed through measures of internal consistency (Cronbach's alpha coefficient) and test-retest stability (Bland-Altman test, ICC and Spearman's correlation coefficient). Additionally, we conducted analyses to asses criterion and construct validity. 213 subjects participated in the validation of the adapted 30-items index, (123 with dysphonia; 90 from control group); 113, in the abbreviated version (63 with dysphonia; 50 from control group). Results: The "Índice de Desventaja Vocal" (IDV) was established as the adapted version of the VHI into Rioplatense Spanish from Argentina. Both indeces exhibited excellent internal consistency (IDV-30 α = 0,96; IDV-10 α = 0,92) and satisfactory stability and agreement (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Regarding validity, a strong correlation was observed between the scores of both indeces and the participant's self-assessment of dysphonia degree (r = 0,85). Both indices effectively differentiated between individuals with dysphonia and healthy subjects (p< 0,001). Factor analysis revealed three factors for the IDV-30 and one factor for the IDV-10. Conclusion: The IDV-30 and IDV-10 demonstrate satisfactory levels of reliability and validity. Both indices can be incorporated into the assessment protocols for evaluating the vocal function by professionals in Argentina.

Translation and cultural adaptation of "Glasgow Children's Benefit Inventory" into Brazilian Portuguese

Abstract Objective Translate 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. Method This 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. Result The 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. Conclusion The 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 evidence 4.

Brazilian adaptation of the McLean Screening Instrument for Borderline Personality Disorder

Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach's alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians.

The Practice of Cross-Cultural Medical Services in the United States and Its Enlightenment to China / 中国医学伦理学

This paper collected and sorted out the cross-cultural medical practice in the top 20 US hospitals in 2019-2020 through web surveys, and summarized the concepts, featured projects and models of cross-cultural medical services in American hospitals. Generally, hospitals in the US advocate the service concept of "patient-centered", provide full-process services before, during and after the treatment, involving appointments, accommodation, transportation, language translation, medical process management, etc., and attach great importance to the role of culture factors in medical treatment and cross-cultural medical education and training for employees. On this basis, it is proposed that Chinese medical institutions should focus on the following aspects in the development of foreign-related medical services: conform to international medical service concepts and standards, improve the cross-cultural medical competence of medical staff and other groups, explore cross-cultural medical service models with localized characteristics, and build the international image of the hospital with the construction of international environment.

Research on Cross-cultural Competence of Medical Staff and Its Cultivation Path / 中国医学伦理学

With the acceleration of globalization, the number of foreigners in China is rising year by year, and their demand for medical treatment is also increasing. It is imperative to strengthen the supply of international professional medical services in China and improve the cross-cultural competence of medical staff. As the origin of cross-cultural medical competence research, the United States has accumulated rich theoretical and practical experience. By defining the concept and connotation of cross-cultural competence in the medical context and explaining its constituent elements, based on the experience of the United States and combined with the actual situation of China, this paper put forward that the cultivation path of cross-cultural competence of medical staff should be explored from the aspects of enhancing cross-cultural awareness of medical staff, strengthening cross-cultural medical competence training, and utilizing a variety of measures and tools.

Influencing Factors of Cross-cultural Communication between Medical Professionals and Patients and Ways to Improve Competence / 中国医学伦理学

In order to build a global community of health for all, it is necessary to deeply understand the influencing factors of cross-cultural communication between medical professionals and patients. Factors such as different health beliefs, cultural values and communication mediators influence cross-cultural communication between medical professionals and patients, and then affect the medical satisfaction and treatment compliance. Medical education should adopt the learning concept of constructivism, advocate maintaining a humble cultural attitude, incorporate more patient perspectives and adopt cross-cultural teaching mode to improve the cross-cultural communication competence of medical students and medical staff, so as to establish a relationship based on communication and understanding.

Conductas sexuales de riesgo relacionadas con las infecciones de transmisión sexual en una comunidad shuar de Taisha, Ecuador

Objetivo: Describir conductas sexuales de riesgo relacionadas con las infecciones de transmisión sexual (ITS) en una comunidad shuar de Taisha, Ecuador. Metodología: Estudio descriptivo-transversal, con base en la teoría transcultural de Leininger. Participaron 215 adultos de ambos sexos, mayores de 18 años. Se utilizó un cuestionario validado por expertos, con método Delphi. El análisis relacional usó la prueba de X2. Resultados: De la muestra, 153 mujeres y 62 hombres, el 99.1 % se identificó como heterosexual; 79.1 % indicó que su actividad sexual se inició en la preadolescencia, siendo lo más frecuente de tipo genital; 16.3 % reveló haber presentado alguna vez una ITS; 29.3 % ha tenido relaciones sexuales bajo efecto del alcohol o sustancias afrodisíacas, de los que 6 % indicó utilizar preservativo. El 60 % respondió que no lo usa porque no sabe cómo y por sentir menos placer; 36.7 % refirió tener relaciones sexuales fortuitas y, en ellas, 73 % sin usar preservativo. No hubo asociación significativa entre las conductas sexuales y la edad de las personas. Conclusión: El escaso uso de preservativo, relaciones sexuales fortuitas sin protección, inicio temprano y actividad sexual bajo efecto alcohol o sustancias afrodisíacas resultaron ser prácticas de riesgo para contraer una infección de transmisión sexual en esta comunidad indígena. Se necesita tender puentes, desde el sistema de salud hasta las comunidades, para implementar programas de prevención, diagnóstico y tratamiento en estadios tempranos para detección, educación, apoyo y control. El modelo de enfermería transcultural y el trabajo interdisciplinario permiten conocer los principios, valores y cosmovisión de los integrantes de la comunidad.

Objetivo: Descrever os comportamentos sexuais de risco relacionados às doenças sexualmente transmissíveis (DST) em uma comunidade shuar em Taisha, Equador. Metodologia: Estudo descritivo-transversal, com base na teoria transcultural de Leininger. Participaram 215 adultos de ambos os sexos, com mais de 18 anos de idade. Foi utilizado um questionário validado por especialistas por meio do método Delphi. A análise relacional usou o teste X2. Resultados: Da amostra, 153 mulheres e 62 homens, 99,1 % se identificaram como heterossexuais; 79,1% indicaram que sua atividade sexual começou na pré-adolescência, mais frequentemente do tipo genital; 16,3 % revelaram já ter tido uma DST; 29,3 % tiveram relações sexuais sob o efeito de álcool, dos quais 6 % indicaram usar preservativo. Sessenta por cento disseram que não usam preservativos porque não sabem como usar e porque sentem menos prazer; 36,7 % relataram ter feito sexo casual, sendo 73 % deles sem usar preservativo. Não houve associação significativa entre o comportamento sexual e a idade. Conclusão: Constatou-se que o baixo uso de preservativos, o sexo casual desprotegido, o início precoce e a atividade sexual sob efeito do álcool ou substâncias afrodisíacas resultaram ser práticas de risco para contrair uma doença sexualmente transmissível nessa comunidade indígena. É necessário construir pontes entre o sistema de saúde e as comunidades para implementar programas de prevenção, diagnóstico e tratamento em estágios iniciais para detecção, educação, apoio e controle. O modelo de enfermagem transcultural e o trabalho interdisciplinar nos permitem conhecer os princípios, os valores e a visão de mundo dos membros da comunidade.

Objective: To describe risky sexual behaviours related to sexually transmitted infections (STIs) in a Shuar community of Taisha, Ecuador. Methodology: Descriptive-cross-sectional study, based on Leininger's cross-cultural theory. A total of 215 adults of both sexes over 18 years of age participated. A questionnaire validated by experts was used, with Delphi method. The relational analysis used the X2 test. Results: Of the sample, 153 women and 62 men, 99.1 % identified themselves as heterosexual; 79.1 % indicated that their sexual activity began in preadolescence, most frequently of the genital type; 16.3 % reported having ever had an STI; 29.3 % had had sexual relations while intoxicated, of which 6 % reported using a condom. The 60 % percent responded that they do not use condoms because they do not know how and because they feel less pleasure; 36.7 % reported having casual sex, 73 % of them without using a condom. There was no significant association between sexual behaviors and age. Conclusion: The scarce use of condoms, incidental unprotected sex, early onset and sexual activity under the influence of alcohol or aphrodisiac substances were found to be risk practices for contracting a sexually transmitted infection in this indigenous community. There is a need to build bridges from the health system to the communities to implement prevention, diagnosis and treatment programs in early stages for detection, education, support and control. The transcultural nursing model and the interdisciplinary work allow knowing the principles, values and cosmovision of the community members.

Consensus Auditory Perceptual Evaluation of Voice (CAPE-V): revisión sistemática de los métodos utilizados para su adaptación y validación

Introducción: CAPE-V es ampliamente utilizado para evaluación perceptual vocal y ha sido adaptado y validado en múltiples idiomas. A través de un análisis exhaustivo, este estudio buscó avanzar en establecer un estándar en el método utilizado para su adaptación y validación. Objetivo: Revisar los artículos publicados entre 2002 y 2022 que han adaptado y validado CAPE-V a distintos idiomas, para evaluar exhaustivamente la adaptación, metodología y estadísticas utilizadas. Métodos: Se realizó una revisión sistemática utilizando Scopus, Google Scholar y PubMed para identificar artículos que adaptaran y/o validaran CAPE-V entre 2002 y 2022. Se analizó el título y resumen para preseleccionar la muestra. Para evaluar el riesgo de sesgo de los estudios incluidos se analizó de forma crítica el texto completo. Resultados: La búsqueda inicial identificó 568 artículos. Al eliminar duplicados se revisaron 559 y 23 fueron preseleccionados. 12 se incluyeron finalmente y fueron analizados, considerando adaptación, metodología y análisis estadístico. Los resultados revelan que la adaptación y validación de CAPE-V a diversos idiomas es fundamental para garantizar mediciones precisas y confiables en diferentes poblaciones. Análisis y discusión: Existe heterogeneidad en la forma de realizar la adaptación y validación de CAPE-V. No obstante, todos los estudios tuvieron éxito en producir resultados válidos, subrayando la importancia de estos procesos para la práctica clínica. Conclusiones: Las adaptaciones y validaciones de CAPE-V se realizaron heterogéneamente por ausencia de un protocolo estándar. Es necesario generar orientaciones para realizar estos procesos por el aporte de esta escala a la clínica, asegurando calidad y confiabilidad de los resultados.

Introduction: CAPE-V is widely used for vocal perceptual evaluation and has been adapted and validated in multiple languages. Through an exhaustive analysis, this study sought to advance in establishing a standard in the method used in its adaptation and validation. Objective: To review articles published between 2002 and 2022 that have adapted and validated CAPE-V in different languages, to thoroughly evaluate the adaptation, methodology, and statistics used. Methods: A systematic review was conducted using Scopus, Google Scholar and PubMed to identify articles that adapted and/or validated CAPE-V between 2002 and 2022. The title and summary were analyzed to pre-select the sample. To evaluate the risk of bias of the included studies, the full text was critically analyzed. Results: The initial search identified 568 items. When duplicates were removed, 559 were reviewed and 23 were pre-selected. 12 were finally included and analyzed considering adaptation, methodology, and statistical analysis. The results show that the adaptation and validation of CAPE-V to different languages is essential to ensure accurate and reliable measurements in different populations. Analysis and discussion: There is heterogeneity in how CAPE-V is adapted and validated. However, all studies were successful in producing valid results, underlining the importance of these processes for clinical practice. Conclusions: Adaptations and validations of CAPE-V were performed heterogeneously due to the absence of a standard protocol. It is necessary to generate guidelines to perform these processes by providing this scale to the clinic, ensuring quality and reliability of results.

Cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for use on Brazilian adolescents

Abstract The present study aimed to perform the cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for native Brazilian Portuguese-speaking adolescents (DHLI-BrA). Cross-cultural adaptation consisted of the following steps: translation, assessment, and adjustments by the expert committee to ensure cultural equivalence; back-translation, and synthesis of back-translations. Cognitive testing was then performed in a pretest with adolescents using cognitive interviews with probing questions on the item's understanding interpretation and response options. Cronbach's alpha coefficient and McDonald's omega were used to estimate the instrument's reliability. Forty-two Brazilian adolescents participated in the study (mean age: 16.0 ± 2.0 years; range: 13 to 19 years). Items that were difficult to understand were adapted to the context of Brazilian adolescents. Cronbach's alpha coefficient and McDonald's omega for the 21 items of the DHLI-BrA were, respectively, 0.79 and 0.80. Cronbach's alpha coefficient for the subscales of the self-report instrument was 0.53-0.79 (range), demonstrating good reliability in the total instrument and moderate reliability in the subscales. This study provides the cross-cultural adapted version of the Digital Health Literacy Instrument (DHLI), which is an instrument for measuring digital Health literacy, for use in Brazilian adolescents (DHLI-BrA).

Resumo O estudo teve o objetivo de adaptar transculturalmente o Digital Health Literacy Instrument (DHLI) para adolescentes nativos do idioma português do Brasil (DHLI-BrA). O estudo de adaptação transcultural consistiu nas seguintes etapas: tradução, avaliação e adequação de equivalência cultural da tradução por comitê de especialistas; retrotradução e síntese das retrotraduções. Foi realizada a testagem cognitiva em pré-teste com adolescentes, utilizando-se entrevistas cognitivas com perguntas de sondagem sobre a compreensão e interpretação dos itens e opções de resposta. O alfa de Cronbach e ômega de McDonald's foram utilizados para estimar a confiabilidade do instrumento. Participaram do pré-teste 42 adolescentes brasileiros com média de idade de 16,0 ± 2,0 (variação de 13-19) anos. Os itens com dificuldade de compreensão foram adaptados ao contexto dos adolescentes brasileiros. O coeficiente alfa de Cronbach e o ômega de McDonald's, para os 21 itens do DHLI-BrA foi respectivamente, 0,79 e 0,80. O coeficiente alfa de Cronbach para as subescalas do instrumento de autorrelato foi de 0,53-0,79 (variação), demonstrando boa confiabilidade no instrumento total e confiabilidade moderada nas subescalas. Este estudo fornece a versão adaptada transculturalmente do Digital Health Literacy Instrument (DHLI), um instrumento de mensuração do letramento digital em saúde, para utilização em adolescentes brasileiros (DHLI-BrA).

Adaptation and validation of the Spanish version of the thyroid-cancer-specific Thyca-QoL scale: A cross-sectional study / Adaptación y validación de la versión en español de la escala thyroid-cancer-specific Thyca-QoL: Estudio de corte transversal

Introduction. Thyca-QoL is a specific instrument to assess QoL in thyroid cancer patients, but it is not validated in Spanish language. The aim was to assess the psychometric properties of the Thyca-QoL. Methods. This is a prospective cross-sectional study. The Thyca-QoL was translated and adapted to Spanish language. A psychometric validation using an exploratory principal axis factor analysis and confirmatory analysis, concurrent validation compared with EORTC QLQ-C30 and a test-retest reliability assessment was done. Results. A total of 296 patients were included. Exploratory factor analysis showed a seven-factor solution with good diagnostic tests results. Cronbach ́s alpha for the global scale was 0.86. The comparison between the Thyca-QoL and the EORTC QLQ-C30 demonstrated a high correlation (rho= 0.75) and coefficient for test-retest was 0.87. Discussion. The validation process followed all the methodological steps necessary to guarantee the performance of the instrument. The measurements of the internal validity, reliability, and reproducibility reached similar results as the original validation. The factor analysis showed a solution with seven factors that resembles the original results. Reproducibility was high for voice, sympathetic, sex, and chilliness domains and moderate for the others; the instrument had the ability to discriminate between clinical conditions. Conclusion. The spanish version of the thyroid-cancer-specific Thyca-QoL is a reliable and objective instrument to be used in clinical practice and for research objectives in Spanish speaking patients

Introducción. Thyca-QoL es un instrumento específico para evaluar la calidad de vida en pacientes con cáncer de tiroides, pero no está validado en idioma español. El objetivo de este estudio fue evaluar las propiedades psicométricas de Thyca-QoL. Métodos. Se hizo un estudio prospectivo transversal. El Thyca-QoL fue traducido y adaptado al idioma español. Se realizó una validación psicométrica mediante un análisis factorial exploratorio del eje principal y un análisis confirmatorio, una validación concurrente en comparación con EORTC QLQ-C30 y una evaluación de la fiabilidad test-retest. Resultados. Se incluyeron 296 pacientes. El análisis factorial exploratorio mostró una solución de siete factores con buenos resultados en las pruebas de diagnóstico. El alfa de Cronbach para la escala global fue de 0,86. La comparación entre Thyca-QoL y EORTC QLQ-C30 demostró una alta correlación (rho = 0,75) y el coeficiente para test-retest fue 0,87. Discusión. El proceso de validación siguió todos los pasos metodológicos necesarios para garantizar el desempeño del instrumento. Las medidas de validez interna, confiabilidad y reproducibilidad alcanzaron resultados similares a los de la validación original. El análisis factorial mostró una solución con siete factores que se asemeja a los resultados originales. La reproducibilidad fue alta para los dominios de voz, simpático, sexo y escalofríos y moderada para los demás; el instrumento tuvo la capacidad de discriminar entre condiciones clínicas.Conclusión. La versión en español de la escala thyroid-cancer-specific Thyca-QoL es un instrumento confiable y objetivo para ser utilizado en la práctica clínica y para objetivos de investigación en pacientes hispanohablantes

Escala de Influência Psicossocial da ingestão de Frutas, Verduras e Legumes do Adolescente: Adaptação e Validade Fatorial / Psychosocial Influence Scale of Fruit and Vegetable Consumption among Adolescents: Adaptation and Factorial Validity

Resumo Instrumentos para avaliar determinantes psicossociais da ingestão de frutas, verduras e legumes (FLV) de adolescentes são escassos, e há um instrumento - sem nome e validação - que investiga estes determinantes oriundos de teorias da psicologia social e direcionado à frequência de ingestão semanal de FLV de adolescentes. O objetivo foi apresentar o processo de adaptação e validação fatorial deste instrumento para ser aplicado em estudos na população brasileira. Realizou-se equivalência conceitual e de itens; equivalência semântica por tradutores e especialistas e semântica e operacional por entrevistas dirigidas com público-alvo. A versão final - denominada Escala de Influências Psicossociais da ingestão de Frutas, Verduras e Legumes de Adolescentes (PSI-FAVES) - foi testada com 429 estudantes (58% mulheres) utilizando confiabilidade por ômega de McDonald (ω) e Análise Fatorial Confirmatória (AFC) como métodos analíticos. A versão final demandou refinamento e o instrumento apresentou confiabilidade total adequada (ω=0,86) e bom ajuste dos dados ao modelo previamente conjecturado (CFI=0,955; TLI=0,951 e RMSEA (90%IC)=0,043 (0,038-0,049), sendo o primeiro instrumento sistematicamente validado para investigar determinantes psicossociais da ingestão de FLV de adolescentes.

Abstract Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.

Sleep disorders in university students during COVID-19: United States of America, Mexico and El Salvador / Trastornos del sueño en universitarios durante el COVID-19: Estados Unidos, México y El Salvador

Abstract Objective: The purpose of this cross-sectional study was to measure students' sleep disorders 12 months after the start of the COVID-19 pandemic. Materials and Methods: Data were collected from 693 students from three universities in El Salvador, Mexico, and the United States using the Student Health Behavior Inventory. Results: Sleep disorders were identified in the sample with those in the US reporting higher levels of sleep disorders and those in El Salvador reported the least. Differences were also observed by gender with females reporting more sleep disorders one year into the pandemic than males. Conclusions: The global pandemic related to COVID-19 has had a profound impact on the mental and physical wellbeing of students. Sudden changes in learning modalities, modifications to work schedules, and potential loss of loved ones have contributed to sleep disorders in this population group. Universities need to take steps to address the evolving needs of college students as they cope with this pandemic.

Resumen Objetivo: El propósito de este estudio transversal fue medir los trastornos de sueño de los estudiantes, 12 meses después del principio de la pandemia de COVID. Materiales y Métodos: Se recolectaron datos de 693 estudiantes de tres universidades en El Salvador, México y los Estados Unidos, utilizando el Inventario de Conducta de Salud del Estudiante. Resultados: Se identificaron síntomas de trastornos del sueño; los universitarios de EUA informaron niveles más altos de trastornos del sueño y los de El Salvador menos. También, se observaron diferencias por género, ya que las mujeres reportaron más trastornos del sueño un año después de la pandemia que los hombres. Conclusiones: La pandemia relacionada con COVID-19 ha tenido un profundo impacto en el bienestar mental y físico de los estudiantes. Los cambios repentinos en las modalidades de aprendizaje, las modificaciones en los horarios de trabajo y la posible pérdida de seres queridos han contribuido a los trastornos del sueño en este grupo poblacional. Las universidades deben tomar medidas para abordar las necesidades cambiantes de los estudiantes universitarios a raíz de la pandemia.

Brazilian Portuguese version of the Patient Scar Assessment Questionnaire / Validação da versão em português do Patient Scar Assessment Questionnaire

Introduction: Scars and their associated signs and symptoms have the potential to impact many aspects of health. Given the growing number of individuals with new scars, it is essential to have reliable, sensitive, and specific assessment tools that analyze the influence that scars can have on the quality of life. The objective is translate the Patient Scar Assessment Questionnaire (PSAQ) into Portuguese, adapt it to the Brazilian cultural context, and test its reproducibility, reliability, and validity. Methods: The questionnaire was applied to 121 individuals with post-surgical scars consecutively selected at a plastic surgery clinic from January 2015 to June 2016. The PSAQ consists of 39 questions divided into five subscales: appearance, symptoms, perception, satisfaction with appearance, and symptoms. Then its reproducibility, face, content, and construct validity were analyzed. Internal consistency was tested using Cronbach's alpha coefficient, and construct validation was performed by correlating the translated instrument with the QualiFibro and Patient and Observer Scar Assessment Scale (POSAS) questionnaires. Results: Analysis of the internal consistency of the PSAQ subscales obtained values >0.70 in all domains, showing good internal consistency. Reproducibility was demonstrated using Pearson's correlation and the Bland-Altman method, and the outcomes showed good reproducibility. In construct validation, a significant correlation was observed in all PSAQ domains with POSAS and QualiFibro. Conclusion: The PSAQ was translated into Portuguese and adapted to Brazilian culture, reproducible and presenting face, content, and construct validity.

Introdução: Cicatrizes e seus sinais e sintomas associados têm potencial para impactar vários aspectos da saúde. Dado o número crescente de indivíduos que adquirem novas cicatrizes, é importante ter ferramentas de avaliação confiáveis, sensíveis e específicas que analisem a influência que as cicatrizes podem exercer sobre a qualidade de vida. O objetivo é traduzir o Patient Scar Assessment Questionnaire (PSAQ) para a língua portuguesa, adaptá-lo ao contexto cultural brasileiro e testar sua reprodutibilidade, confiabilidade e validade. Método: O questionário foi aplicado em 121 indivíduos portadores de cicatrizes pós-cirúrgicas selecionados consecutivamente em ambulatório de cirurgia plástica no período de janeiro de 2015 a junho de 2016. O PSAQ é constituído por 39 questões divididas em cinco subescalas: aparência, sintomas, percepção, satisfação com a aparência e com os sintomas. Foram analisados a reprodutibilidade, validade de face, conteúdo e construto. A consistência interna foi testada pelo alfa de Cronbach e a validação de construto foi realizada correlacionando o instrumento traduzido com os questionários QualiFibro e Patient and Observer Scar Assessment Scale (POSAS). Resultados: A análise da consistência interna das subescalas do PSAQ obteve valores maiores que 0,70 em todos os domínios, evidenciando uma boa consistência interna. A reprodutibilidade foi demonstrada através da correlação de Pearson e método de Bland-Altman, sendo observada boa reprodutibilidade. Na validação de construto observou-se correlação significativa entre todos os domínios do PSAQ com a POSAS e QualiFibro. Conclusão: O PSAQ foi traduzido para o português e adaptado à cultura brasileira, mostrando-se reprodutível e apresentando validade de face, conteúdo e construto.

Cultural adaptation and validation of the COPCORD questionnaire for the detection of rheumatic diseases in the indigenous Misak population

Introduction: The objective was to adapt and valídate in a culturally sensitive way the methodology of the community-oriented programme for the control of rheumatic diseases (COPCORD) in the indigenous Misak community of Colombia. Material and methods: A culturally sensitive validation of the COPCORD questionnaire in Spanish was carried out, translating into the nam trik wam language used by the Misak community of Guambia town. It was adapted to the context of this population and later a back-translation to Spanish was carried out. Finally, it was validated applying the survey with the support of bilingual translators. Participants with pain, stiffness or swelling in any joint in the previous 7 days and/or at any time in life were evaluated by physicians and physiotherapists and were then, upon confirming the diagnosis of a musculoskeletal disorder, subsequently examined by a rheumatologist. Results: In this population (n = 106), 58.5% were women with an average age of 45.5 years. In the last 7 days, 51 subjects (48.1%) reported having musculoskeletal pain and 7 (44.3%) reported pain at some time in their life. Of those who received treatment, 53.1% reported using traditional medicine, 34.4% homeopathic treatment, and 25% allopathic treatment. The COPCORD Misak demonstrated an adequate capacity to detect musculoskeletal disorders, with a sensitivity of 63.3% and a specificity of 80.3%, with a positive likelihood ratio of 3.2, and area under the curve of.71. Conclusion: The COPCORD methodology is a valid screening tool to detect musculoskeletal disorders in the Misak community.

Introducción: El objetivo fue adaptar y validar, de forma culturalmente sensible, la metodología del Programa orientado a la comunidad para el control de enfermedades reumáticas (COPCORD) en la comunidad indígena misak de Colombia. Material y métodos: Se realizó una validación culturalmente sensible del cuestionario Copcord en español, que se tradujo al nam trik wam, lengua usada por el pueblo misak del resguardo de Guambia. El cuestionario se adecuó al contexto de esta población y posteriormente se llevó a cabo una retrotraducción al español. Por último, se validó aplicando la encuesta con el apoyo de traductores bilingües. Los participantes con dolor, rigidez o hinchazón en cualquier articulación en los siete días previos, o en cualquier momento de la vida, fueron evaluados por médicos y fisioterapeutas. Al confirmarse el diagnóstico de una enfermedad musculoesquelética los participantes eran examinados por un reumatólogo. Resultados: De la población estudiada (n = 106) el 58,5% fueron mujeres, con una edad promedio de 45,4 arios. En los últimos siete días, 51 sujetos (48,1%) informaron tener dolor musculoesquelético y siete (44,3%) refirieron dolor en algún momento de su vida. Quienes recibieron tratamiento reportaron el uso de medicamentos tradicionales en un 53,1% de los casos, homeopáticos en el 34,4% y alopáticos en el 25%. El cuestionario COPCORD Misak demostró una adecuada capacidad para detectar los trastornos musculoesqueléticos, con una sensibilidad del 63,3%, una especificidad del 80,3%, una razón de verosimilitud positiva de 3,2 y un área bajo la curva de 0,71. Conclusión: La metodología COPCORD es una herramienta válida de cribado de enfermedades musculoesqueléticas en el pueblo misak.

Translation and validation of a questionnaire on the impact of strabismus on the quality of life of patients / Tradução e validação de um questionário sobre impacto na qualidade de vida em pacientes com estrabismo

ABSTRACT Objective: To translate and validate the Adult Strabismus Quality of Life Questionnaire into Brazilian Portuguese. Methods: A cross-sectional study for linguistic and cross-cultural validation of the Adult Strabismus Quality of Life Questionnaire in order to assess the quality of life in patients with strabismus. We have followed previous published guidelines on translation process to ensure the equivalence between the original and translated versions. The final version was applied in a pilot study to evaluate concordance and its reliability and reproducibility as a tool to be used in future studies. Results: The translation and counter translation processes of the Adult Strabismus Quality of Life Questionnaire were conducted according to preestablished protocols. The analysis of the results obtained in the test-retest application of the questionnaire in a sample of 30 participants revealed a correlation coefficient of 0.67, which was deemed satisfactory for the validation process of this tool. Conclusion: The Adult Strabismus Quality of Life Questionnaire was translated and validated according to preestablished protocols. The referred questionnaire has been used in studies worldwide, so this process will enable its application to better understand the impact of strabismus in patients' quality of life in the Brazilian population.

RESUMO Objetivo: Traduzir e validar o questionário Adult Strabismus Quality of Life Questionnaire (AS-20) para o português brasileiro. Métodos: Estudo transversal para validação linguística e transcultural do questionário Adult Strabismus Quality of Life Questionnaire (AS-20) para avaliação da qualidade de vida em pacientes com estrabismo. Foram seguidas as diretrizes já publicadas sobre o processo de tradução, para garantir a equivalência entre as versões original e traduzida. A versão final foi aplicada em um estudo-piloto para avaliar a concordância e sua confiabilidade e reprodutibilidade, como ferramenta a ser utilizada em estudos futuros. Resultados: Os processos de tradução e contratradução do questionário Adult Strabismus Quality of Life Questionnaire (AS-20) foram realizados de acordo com protocolos preestabelecidos. A análise dos resultados obtidos na aplicação teste-reteste do questionário em uma amostra de 30 participantes revelou coeficiente de correlação de 0,67, que foi considerado satisfatório para o processo de validação desse instrumento. Conclusão: O questionário Adult Strabismus Quality of Life Questionnaire (AS-20) foi traduzido e validado de acordo com protocolos preestabelecidos. O referido questionário vem sendo utilizado em estudos ao redor do mundo e, portanto, esse processo possibilitará sua aplicação para melhor compreensão do impacto do estrabismo na qualidade de vida dos pacientes da população brasileira.

Cross-cultural differences in beliefs about emotions: A comparison between Brazilian and British participants / Diferenças transculturais em crenças sobre emoções: uma comparação entre participantes brasileiros e britânicos

ABSTRACT Objective: Perfectionist beliefs about emotions impact the experience and expression of emotions, being linked to increased levels of depression and anxiety. Given the influence of culture in the representation and expression of emotion, it is possible that beliefs vary across countries, but few empirical studies have been conducted on the theme. This study aims to compare Brazilian and British samples regarding their beliefs about emotional experience and expression. Methods: The current study compared a total of 960 Brazilian and British participants, with the samples having a similar profile in terms of age, gender and ethnicity. Participants answered online the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Beliefs about Emotions Scale (BES). This study aims to compare Brazilian and British samples with regard to beliefs about emotional experience and expression. Results: Significant differences between samples were found for beliefs about emotions. As hypothesized, Brazilians scored lower on unhelpful beliefs about emotions, except for beliefs about experiencing negative feelings and emotional control. Differences in total BES scores remained even after the inclusion of depression and anxiety as covariates. Conclusions: Results suggest higher endorsement of perfectionist beliefs in a European versus a Latin American context, but highlight that this pattern depends on the specific beliefs being studied. These differences should be considered when working with people from different cultural backgrounds and developing cultural adaptations for clinical interventions and psychopathology models.

RESUMO Objetivo: Crenças perfeccionistas sobre emoções afetam a experiência e expressão de emoções, estando relacionadas a níveis aumentados de depressão e ansiedade. Dada a influência da cultura na representação e expressão de emoções, é possível que as crenças variem entre os países, mas poucos estudos empíricos foram realizados sobre o tema. Este estudo tem o objetivo de comparar amostras brasileiras e britânicas em relação às suas crenças sobre a experiência emocional e expressão. Métodos: O presente estudo comparou um total de 960 participantes brasileiros e britânicos, com as amostras tendo um perfil semelhante em termos de idade, gênero e etnia. Os participantes responderam on-line à Escala de Ansiedade Generalizada (GAD-7), ao Questionário de Saúde do Paciente (PHQ-9) e à Escala de Crenças sobre Emoções (BES). Resultados: Foram encontradas diferenças significativas entre as amostras em relação às crenças sobre emoções. Como hipotetizado, os brasileiros obtiveram pontuações mais baixas em crenças prejudiciais sobre emoções, exceto nas crenças sobre experienciar sentimentos negativos e controle emocional. As diferenças nos escores totais da BES permaneceram mesmo após a inclusão de depressão e ansiedade como covariáveis. Conclusões: Os resultados sugerem maior endosso de crenças perfeccionistas em um contexto europeu, em comparação com um contexto latino-americano, mas destacam que esse padrão depende das crenças específicas estudadas. Essas diferenças devem ser consideradas ao trabalhar com pessoas de diferentes origens culturais e no desenvolvimento de adaptações culturais para intervenções clínicas e modelos de psicopatologia.

Content validity evidence of the Brazilian version of the Cognitive Symptom Checklist-Work-21 / Evidencia de validez de contenido de la versión brasileña del Cognitive Symptom Checklist-Work-21 / Evidências de validade de conteúdo da versão brasileira do Cognitive Symptom Checklist-Work-21

ABSTRACT Objective: to cross-culturally adapt and assess the content validity evidence of the Cognitive Symptom Checklist-Work-21 for the Brazilian context. Method: a psychometric study of cross-cultural adaptation, covering the stages of translation, reconciliation, back-translation, intercultural equivalence assessment and content validity evidence analysis, considering Content Validity Ratio parameters in breast cancer survivors. Results: the translations were equivalent to the original version. Colloquial expressions were modified, tense, verbal adjusted, and two items containing multiple commands were separated. The final version now contains 22 items, presenting semantic, conceptual, idiomatic and experimental equivalences. The pre-test indicated good understanding and ease in the response process. Conclusion: the final version was defined as "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", showing good linguistic equivalence and strong evidence of content validity in the Brazilian context.

RESUMEN Objetivo: realizar la adaptación transcultural y evaluar las evidencias de validez de contenido del Cognitive Symptom Checklist-Work-21 para el contexto brasileño. Método: estudio psicométrico de adaptación transcultural, abarcando las etapas de traducción, reconciliación, retrotraducción, evaluación de equivalencia intercultural y análisis de evidencias de validez de contenido, considerando parámetros de Content Validity Ratio en sobrevivientes de cáncer de mama. Resultados: las traducciones fueron equivalentes a la versión original. Se modificaron las expresiones coloquiales, se tensaron, se ajustaron las verbales y se separaron dos ítems que contenían múltiples comandos. La versión final ahora contiene 22 ítems, presentando equivalencia semántica, conceptual, idiomática y experimental. El pre-test indicó buena comprensión y facilidad en el proceso de respuesta. Conclusión: la versión final fue definida como "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", mostrando buena equivalencia lingüística y fuerte evidencia de validez de contenido en el contexto brasileño.

RESUMO Objetivo: realizar a adaptação transcultural e avaliar as evidências de validade de conteúdo do Cognitive Symptom Checklist-Work-21 para o contexto brasileiro. Método: estudo psicométrico de adaptação transcultural, abrangendo as etapas de tradução, reconciliação, retrotradução, avaliação de equivalência intercultural e análise das evidências de validade de conteúdo, considerando parâmetros de Content Validy Ratio em sobreviventes de câncer de mama. Resultados: as traduções demonstraram equivalência à versão original. Expressões coloquiais foram modificadas, o tempo verbal ajustado, e dois itens contendo múltiplos comandos foram separados. A versão final passou a conter 22 itens, apresentando equivalências semântica, conceitual, idiomática e experimental. Os valores de CVR mantiveram-se acima de 0,87. O pré-teste indicou boa compreensão e facilidade no processo de resposta. Conclusão: a versão final foi definida como "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", apresentando boa equivalência linguística e fortes evidências de validade de conteúdo no contexto brasileiro.

Brazilian Portuguese version and content validity of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the 'Patient Exercise Booklet' and the 'Personal Exercise Guide', to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents 'Patient Exercise Booklet' and 'Personal Exercise Guide' of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity.

Psychometric properties of the Brazilian version of the Big Five Inventory

Abstract Introduction There is growing interest in the fields of psychiatry and psychology in investigating the relationship between personality and psychopathology. The Big-5 is a model developed to investigate five personality dimensions: Extroversion, Agreeableness, Conscientiousness, Neuroticism, and Openness. In the present study, we describe the process of translation into Brazilian Portuguese and adaptation of a free tool to evaluate the Big-5 model: The Big-5 Inventory (BFI). The instrument has 44 items with a Likert response scale ranging from 1 to 5. Objectives To translate and adapt the BFI into Brazilian Portuguese. Methods The adaptation was conducted in the following steps: 1) Translation, 2) Evaluation Committee, 3) Back-translation, 4) Pilot study, 5) Evaluation Committee, and 6) Application. The sample comprised 490 participants from various regions of Brazil. The participants' ages ranged from 18 to 71 years, most of them had completed high school (62.9%), and the majority were women (75%). Results A model with the following fit indexes was found: χ2/df: 1.954; goodness fit index (GFI): 0.924; comparative fit index (CFI): 0.920; and root mean square error of approximation (RMSEA): 0.044. Conclusion The results are suggestive that the Brazilian version of this instrument has good psychometric properties and represent a cost-free option for investigating associations with the Big-5 in psychiatry.