[Construction of measurement instruments in the area of health]. / Construção de instrumentos de medida na área da saúde.

Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.

Construção de instrumentos de medida na área da saúde / Construction of measurement instruments in the area of health

Instrumentos de medida são partes integrantes da prática clínica, da avaliação em saúde e de pesquisas. Esses instrumentos só são úteis e capazes de apresentar resultados cientificamente robustos quando são desenvolvidos de maneira apropriada e quando apresentam boas qualidades psicométricas. A literatura aponta que, apesar do aumento significativo no número de escalas de avaliação, muitas não têm sido desenvolvidas e validadas adequadamente. O presente estudo teve como objetivos realizar uma revisão narrativa sobre o processo de elaboração de novos instrumentos e apresentar algumas ferramentas que podem ser utilizadas em algumas etapas do seu processo de desenvolvimento. As etapas descritas foram: I-Estabelecimento da estrutura conceitual e definição dos objetivos do instrumento e da população envolvida; II-Construção dos itens e das escalas de respostas; III-Seleção e organização dos itens e estruturação do instrumento; IV-Validade de conteúdo; e V-Pré-teste. Uma discussão breve sobre a avaliação das propriedades psicométricas foi incluída devido à importância que esta tem para que os instrumentos sejam aceitos e reconhecidos tanto no meio científico como no meio clínico.

Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.

Psychometric properties evaluation of a new ergonomics-related job factors questionnaire developed for nursing workers.

The objectives of this study were to develop a questionnaire that evaluates the perception of nursing workers to job factors that may contribute to musculoskeletal symptoms, and to evaluate its psychometric properties. Internationally recommended methodology was followed: construction of domains, items and the instrument as a whole, content validity, and pre-test. Psychometric properties were evaluated among 370 nursing workers. Construct validity was analyzed by the factorial analysis, known-groups technique, and convergent validity. Reliability was assessed through internal consistency and stability. Results indicated satisfactory fit indices during confirmatory factor analysis, significant difference (p < 0.01) between the responses of nursing and office workers, and moderate correlations between the new questionnaire and Numeric Pain Scale, SF-36 and WRFQ. Cronbach's alpha was close to 0.90 and ICC values ranged from 0.64 to 0.76. Therefore, results indicated that the new questionnaire had good psychometric properties for use in studies involving nursing workers.

The Pain Disability Questionnaire: a reliability and validity study.

The goal of this study was to translate and adapt The Pain Disability Questionnaire (PDQ) to Brazilian Portuguese, as well as to assess its psychometric properties and practicability. The following methodological steps were followed: translation, synthesis, back-translation, expert committee assessment and pre-test. The psychometric properties were assessed through the application of a questionnaire to 119 patients with chronic musculoskeletal disorders. The results indicated the reliability of the instrument, with a Cronbach's alpha coefficient of 0.86, and high stability in the test-retest. A moderate correlation was found between the PDQ scores and the numerical pain scale. Negative correlations were found between the Spitzer Quality of Life Index and the functional condition, psychosocial component and total PDQ score. Construct validity demonstrated significant difference in PDQ scores between symptomatic and asymptomatic individuals. The PDQ revealed fast application and easy understanding. The results indicated a successful cultural adaptation and reliable psychometric properties.

Musculoskeletal symptoms and workers' perception about job factors in a pulp and paper industry.

The study aimed to conduct a literature review as a step of the development of a new questionnaire about the nursing workers' perception of job factors that may lead to musculoskeletal symptoms. An information synthesis was achieved by collecting data from studies that fitted the search criteria. The results showed that despite the existence of several job factors related to musculoskeletal symptoms, no specific questionnaire that evaluates this relationship was found. Therefore, this literature review presents important topics for developing the first questionnaire to analyze work activities that may contribute to pain and discomfort among nursing personnel.

Job factors related to musculoskeletal symptoms among nursing personnel--a review.

The study aimed to conduct a literature review as a step of the development of a new questionnaire about the nursing workers' perception of job factors that may lead to musculoskeletal symptoms. An information synthesis was achieved by collecting data from studies that fitted the search criteria. The results showed that despite the existence of several job factors related to musculoskeletal symptoms, no specific questionnaire that evaluates this relationship was found. Therefore, this literature review presents important topics for developing the first questionnaire to analyze work activities that may contribute to pain and discomfort among nursing personnel.

The Pain Disability Questionnaire: a reliability and validity study / The Pain Disability Questionnaire: um estudo de confiabilidade e validade / The Pain Disability Questionnaire: estudio de confiabilidad y validación

The goal of this study was to translate and adapt The Pain Disability Questionnaire (PDQ) to Brazilian Portuguese, as well as to assess its psychometric properties and practicability. The following methodological steps were followed: translation, synthesis, back-translation, expert committee assessment and pre-test. The psychometric properties were assessed through the application of a questionnaire to 119 patients with chronic musculoskeletal disorders. The results indicated the reliability of the instrument, with a Cronbach's alpha coefficient of 0.86, and high stability in the test-retest. A moderate correlation was found between the PDQ scores and the numerical pain scale. Negative correlations were found between the Spitzer Quality of Life Index and the functional condition, psychosocial component and total PDQ score. Construct validity demonstrated significant difference in PDQ scores between symptomatic and asymptomatic individuals. The PDQ revealed fast application and easy understanding. The results indicated a successful cultural adaptation and reliable psychometric properties.

O objetivo deste estudo foi traduzir e adaptar The Pain Disability Questionnaire (PDQ) para o português do Brasil, avaliar suas propriedades psicométricas e praticabilidade. Os seguintes passos metodológicos foram seguidos: tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste. As propriedades psicométricas foram avaliadas pela aplicação do questionário a 119 pacientes com lesões musculoesqueléticas crônicas. Os resultados indicaram a confiabilidade do instrumento com o coeficiente alfa de Cronbach de 0,86, e alta estabilidade na aplicação do teste-reteste. Uma correlação moderada foi encontrada entre os escores do PDQ e a escala numérica de dor. Correlações negativas foram encontradas entre o Spitzer Quality of Life Index e a condição funcional, componente psicossocial e escore total do PDQ. A validade de construto demonstrou diferença significativa nos escores do PDQ entre indivíduos sintomáticos e assintomáticos. O PDQ mostrou aplicação rápida e fácil entendimento. Os resultados indicaram sucesso na adaptação cultural e propriedades psicométricas confiáveis.

El objetivo de este estudio fue traducir y adaptar el Cuestionario The Pain Disability Questionnaire (PDQ) para el portugués de Brasil, evaluando sus propiedades psicométricas y la usabilidad. Fueron seguidos los siguientes pasos metodológicos: traducción, síntesis, retrotraducción, evaluación por un comité de expertos y realización de una prueba piloto. Las propiedades psicométricas fueron evaluadas por la aplicación del cuestionario en 119 pacientes con lesiones musculares. Los resultados indican la confiabilidad del instrumento con el coeficiente alfa de Cronbach de 0,86, y alta estabilidad en la prueba piloto. Una correlación moderada se encontró entre las puntuaciones de la PDQ y la escala numérica del dolor. Correlaciones negativas fueron observadas entre el Spitzer Quality of Life Index y la condición funcional, el componente psicosocial, y la puntuación total de la PDQ. La validez del constructo demostró una diferencia significativa en las puntuaciones del PDQ entre sujetos sintomáticos y asintomáticos. El PDQ demostró ser rápido y comprensible. Los resultados indicaron una exitosa adaptación cultural y propiedades psicométricas confiables.

[Content validity in the development and adaptation processes of measurement instruments]. / Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas.

This study sought to conduct a review of content validity, which is an important phase of processes of construction and adaptation of measurement instruments. Research of comprehensive literature was conducted by means of a review of national and international databases. Initially, a description of the conceptual basis and the measurement methods used in content validity was made, with emphasis on its application in the healthcare area. It was seen that controversy exists in the literature on the terminology and concept of content validity. The recommended procedures used to check content validity during the construction and adaptation processes of instruments were described, especially the judges' assessment, which can involve qualitative and quantitative procedures. The number, selection and qualification of these judges were also described. The different methods used to quantify the level of agreement among the experts were verified, mainly the Content Validity Index (CVI). This study described aspects of the content validity process, one of the procedures to be considered by healthcare researchers and professionals who are interested in using reliable and appropriate measurements and instruments scales for given population groups.

Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas / Content validity in the development and adaptation processes of measurement instruments

This study sought to conduct a review of content validity, which is an important phase of processes of construction and adaptation of measurement instruments. Research of comprehensive literature was conducted by means of a review of national and international databases. Initially, a description of the conceptual basis and the measurement methods used in content validity was made, with emphasis on its application in the healthcare area. It was seen that controversy exists in the literature on the terminology and concept of content validity. The recommended procedures used to check content validity during the construction and adaptation processes of instruments were described, especially the judges' assessment, which can involve qualitative and quantitative procedures. The number, selection and qualification of these judges were also described. The different methods used to quantify the level of agreement among the experts were verified, mainly the Content Validity Index (CVI). This study described aspects of the content validity process, one of the procedures to be considered by healthcare researchers and professionals who are interested in using reliable and appropriate measurements and instruments scales for given population groups.

Este estudo teve por objetivo realizar uma revisão sobre validade de conteúdo, fase importante nos processos de construção e adaptação de instrumentos de medida. Foi realizada pesquisa bibliográfica definida como integrativa, por meio de pesquisa a bases de dados nacionais e internacionais. Iniciou-se a descrição das bases conceituais e os métodos de medidas usados em validade de conteúdo, com ênfase na área da saúde. Verificou-se que existem controvérsias na literatura sobre a terminologia e o conceito da validade de conteúdo. Foram descritos os procedimentos recomendados para realizar a validade de conteúdo durante os processos de construção e de adaptação de instrumentos, particularmente a avaliação por juízes, o que pode envolver procedimentos qualitativos e quantitativos. Descreveu-se número, seleção e qualificação desses juízes. Os diferentes métodos para quantificar o grau de concordância entre os especialistas foram analisados, principalmente o Índice de Validade de Conteúdo (IVC). Este estudo descreveu aspectos do processo de realização da validade de conteúdo, um dos procedimentos a serem considerados por pesquisadores e profissionais da área de saúde preocupados em utilizarem medidas e instrumentos confiáveis e apropriados para determinada população.

Sintomas osteomusculares em trabalhadores daenfermagem: uma revisão integrativa / Musculoskeletal symptoms in nursing personnel: an integrativereview / Síntomas osteomusculares en trabajadores de enfermería: unarevisión integrativa

A ocorrência de distúrbios osteomusculares, seus fatores de risco e suas conseqüências têm sido preocupaçãode estudiosos da área de saúde ocupacional. Esta revisão integrativa teve por objetivo analisar os estudosrelacionados a sintomas osteomusculares em trabalhadores da enfermagem. Para o levantamento bibliográfico,optou-se pela busca de artigos em periódicos nacionais e internacionais, publicados em português e espanhol,no período de 1996 a 2007, disponíveis nas bases de dados pertencentes à Biblioteca Virtual em Saúde (BVS) -Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados da Enfermagem(BDENF), Scientific Electronic Library Online (SCIELO). Foram selecionados 15 artigos que foram analisados conforme autoria, ano de publicação, país, população, tipo de pesquisa, instrumento utilizado para coleta de dados, tempo de prevalência dos sintomas osteomusculares e os resultados encontrados. Verificou-se que aliteratura sobre o tema é escassa em países latino-americanos. Os estudos avaliaram diferentes categoriasprofissionais da enfermagem e os instrumentos de medidas utilizados eram diversificados, sendo alguns validados e outros não. Verificou-se uma variabilidade no tempo de prevalência de sintomas osteomusculares, assim como nas taxas encontradas. A diversidade nos procedimentos metodológicos dificulta a comparação entre as pesquisas.

The occurrence of musculoskeletal disorders, their risk factors and its consequences have been of concern ofscholars in the area of occupational health. This integrative review aimed to examine studies related tomusculoskeletal symptoms in nursing personnel. It was decided to search for articles in national and internationaljournals, published in Portuguese and Spanish, from 1996 to 2007, available in databases belonging to theBiblioteca Virtual em Saúde (BVS) - Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS),Base de Dados da Enfermagem (BDENF), Scientific Electronic Library Online (SCIELO). A total of 15 articlesselected and analyzed according to the authors, publication year, country, population, type of survey, instrumentused for data collection, time of prevalence of musculoskeletal symptoms and the findings. It was found that theliterature on the topic is scarce in Latin American countries. The studies evaluated different professionalcategories of the nursing staff and the instruments used were varied, some of them were validated and others not. There was variability in the time of prevalence of musculoskeletal symptoms...

La ocurrencia de trastornos osteomusculares, sus factores de riesgo y sus consecuencias han sido preocupaciónde estudioso del área de la salud ocupacional. Esta revisión integrativa tuvo como objetivo analizar los estudiosrelacionados con los síntomas osteomusculares en trabajadores de enfermería. Para el análisis bibliográfico, seoptó por la búsqueda de artículos en periódicos nacionales e internacionales, publicados en portugués y español,en el período de 1996 a 2007, disponibles en las bases de datos pertenecientes a la Biblioteca Virtual em Saúde(BVS) - Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados daEnfermagem (BDENF), Scientific Electronic Library Online (SCIELO). Fueron seleccionados 15 artículos quefueron analizados considerando autores, año de publicación, país, población, tipo de encuesta, el instrumentoutilizado para la recogida de datos, el tiempo de la prevalencia de síntomas osteomusculares y los resultados. Severificó que la literatura sobre el tema es escasa en los países latino americanos. Los estudios evaluarondiferentes categorías profesionales de enfermería y los instrumentos de medida utilizados eran variados, algunoseran validados y otros no. Se verificó una variabilidad en el tiempo de prevalencia de síntomas osteomusculares,así como las tasas encontradas. La diversidad de procedimientos metodológicos dificulta la comparación entrelas investigaciones.

Development of a questionnaire to evaluate the usability of assessment instruments / Desenvolvimento de um questionário que avalia a praticabilidade de instrumentos de medidas / Desarrollo de un cuestionario que evalúa la factibilidad de instrumentos de medida

The aim of the present study was to develop a questionnaire to evaluate the usability of the Brazilian Portuguese version of the Job Factors Questionnaire. Content was validated using the recommended methodology: revision by an expert committee, and pretest. The usability instrument was applied to production and administrative workers in two metalworking industries. The expert committee’s suggestions were accepted, yielding a three-question questionnaire and a five-point Likert scale to evaluate the usability of assessment instruments. None of the 148 study participants encountered any difficulty during the pretest. The data collected showed that on average it took less than five minutes to answer the questionnaire, and the highest percentage score was for the option totally agree for all questions. The Instrument Usability Evaluation may be helpful to researchers concerned with data collection instrument quality.

O presente estudo teve por objetivo desenvolver um questionário para avaliar a praticabilidade da versão brasileira do Job Factors Questionnaire. A validação de conteúdo foi realizada seguindo a metodologia recomendada: revisão por um comitê de especialistas e pré-teste. O instrumento de praticabilidade foi aplicado em trabalhadores de produção e administração de duas indústrias metalúrgicas. As sugestões dos membros do comitê foram aceitas, resultando em um questionário composto por de três questões e uma escala tipo Likert de cinco pontos que avalia a praticabilidade de instrumentos de medidas. Dentre os 148 sujeitos que participaram do estudo, nenhum deles apresentou qualquer dificuldade durante o pré-teste. Os dados coletados mostraram que o tempo gasto de resposta era inferior a cinco minutos, e a porcentagem mais elevada foi para a opção concordo totalmente para todas as questões. O questionário Avaliação da Praticabilidade de Instrumentos poderá ser útil para pesquisadores preocupados com a qualidade de instrumentos utilizados para a coleta de dados.

Este estudio tuvo como objetivo elaborar un cuestionario para evaluar la factibilidad de la versión brasileña del Job Factors Questionnaire. La validez del contenido fue realizada siguiendo la metodología recomendada: revisión por un comité de expertos, y prueba preliminar. El instrumento de factibilidad se aplicó a los trabajadores en la producción y la administración de dos industrias metalúrgica. Las sugerencias de los miembros del comité fueron aceptadas, lo que resulta en un cuestionario que consta de tres cuestiones y una escala Likert de cinco puntos que evalúa la factibilidad de los instrumentos de medida. Entre las 148 personas que participaron del estudio, ninguno presentó dificultades durante la prueba preliminar. Los datos recogidos han demostrado que el tiempo de respuesta fue de menos de cinco minutos, y el porcentaje fue mayor a la opción completamente de acuerdo a todas las cuestiones. El Cuestionario de Evaluación de Factibilidad puede ser útil a los investigadores preocupados por la calidad de instrumentos utilizados para recopilación de datos.

Adaptação cultural de instrumento que avalia atividades do trabalho e sua relação com sintomas osteomusculares / Adaptación cultural de un instrumento que evalúa actividades del trabajo y su relación con síntomas osteomusculares / Cross-cultural adaptation of an instrument to measure work-related activities that may contribute to osteomuscular symptoms

OBJETIVO: Traduzir e adaptar culturalmente o questionário Work-related activities that may contribute to job-related pain and/or injury para o português falado no Brasil e verificar a validade de conteúdo desta nova versão. MÉTODOS: A adaptação cultural seguiu normas internacionalmente aceitas com as etapas de tradução, síntese, retro-tradução, avaliação por um comitê de especialistas e pré-teste. Esta versão do instrumento foi aplicada em 40 trabalhadores. RESULTADOS: O procedimento de adaptação cultural foi realizado com sucesso. O comitê de especialistas verificou a validade de conteúdo e realizou algumas modificações. No pré-teste, 7,5 por cento dos indivíduos indicaram sugestões para um item do questionário e 17,5 por cento demonstraram dificuldades no entendimento da instrução. Informações adicionais foram incluídas para tornar o instrumento final mais compreensível. CONCLUSÕES: A versão brasileira deste instrumento foi obtida com sucesso.

OBJETIVO: Traducir y adaptar culturalmente el cuestionario Work-related activities that may contribute to job-related pain and/or injury al portugués hablado en el Brasil y verificar la validez de contenidos de esta nueva versión. MÉTODOS: La adaptación cultural siguió normas internacionalmente aceptadas con las etapas de traducción, síntesis, retro-traducción, evaluación por un comité de especialistas y pre test. Esta versión del instrumento fue aplicada a 40 trabajadores. RESULTADOS: El procedimiento de adaptación cultural fue realizado con éxito. El comité de especialistas verificó la validez de contenido y realizó algunas modificaciones. En el pre test, el 7,5 por ciento de los individuos indicaron sugerencias para un item del cuestionario y el 17,5 por ciento demostraron dificultades en el entendimiento de la instrucción. Las informaciones adicionales fueron incluidas para conseguir que el instrumento final sea más comprensible. CONCLUSIONES: La versión brasileña de este instrumento fue obtenida con éxito.

OBJECTIVE: To translate the Work-Related Activities Questionnaire into Brazilian Portuguese and to evaluate its cross-cultural adaptation among a sample of Brazilian workers. METHODS: International standard recommendations were followed to translate and back-translate the instrument, and to establish the cross-cultural adaptation of the instrument using content experts and pretest. A field testing of the instrument was conducted with 40 Brazilian workers. RESULTS: The procedure used to establish the cross-cultural adaptation of the instrument was found to be adequate. The panels of experts evaluated the initial content validity of the items of the instrument and suggested necessary revisions to achieve an acceptable content validity. In the pretest, 7.5 percent of individuals suggested changes in one of the items of the instrument. In addition, 17.5 percent of the individuals reported having difficulty understanding the instructions to complete the instrument. These findings led to further revision of the instrument. CONCLUSION: The Brazilian version of the instrument was adequately cross-culturally adapted and validated.