Cross-cultural translation and validation of the Chinese version Distress Tolerance Scale for adolescents with chronic physical disease.

INTRODUCTION: Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15-item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. METHODS: The 15-item English version DTS was translated into a Chinese version using the translation guidelines for cross-cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item-total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. RESULTS: The two-factor nine-item Chinese version DTS for Adolescents with CPD (C-DTS-A) was developed. Lower scores of the C-DTS-A were significantly associated with higher diabetes distress, poorer self-management, and worse glycaemic control; their correlation coefficients sequentially were -.40, .17 and -.23. Cronbach's α and the test-retest reliability of the two-factor C-DTS-A ranged from .81 to .87 and from .79 to .89, respectively. CONCLUSION: The two-factor nine-item C-DTS-A with good cross-cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD.

Turkish Cross-cultural Adaptation of the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS).

PURPOSE: The purpose of this study is to cross-culturally adapt the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) to Turkish and test its validity and reliability. DESIGN: This is a methodological study. METHODS: This study was conducted with 121 children aged 1 to 12 years who underwent ambulatory surgery. The data of the study were collected using a Descriptive Information Form, PHBQ-AS, and the Parents' Postoperative Pain Measure. Data analysis and evaluation were performed using factor analysis, Cronbach's α analysis, item-total score correlation analysis, content validity, construct validity, and concurrent validity. FINDINGS: PHBQ-AS showed a high level of internal consistency (Cronbach's α = 0.801). The item-total correlation values of PHBQ-AS were found to be 0.458 to 0.753. PHBQ-AS was determined to be a single-factor scale explaining 66% of the variance in the examined variable. PHBQ-AS and Parents' Postoperative Pain Measure scores were moderately correlated. CONCLUSIONS: The Turkish version of PHBQ-AS was highly valid and reliable for the Turkish population. A recommendation for health care professionals in Turkey is to use the PHBQ-AS scale to evaluate posthospitalization behavioral changes in children who are admitted for ambulatory surgery.

A Japanese translation of the Swedish Universities Scales of Personality.

Background: The Swedish Universities Scales of Personality (SSP) is a personality measurement tool with a short test battery of high psychometric quality, previously not availiable in Japanese. Methods: We translated the SSP into Japanese and administered it to 103 Japanese nationals. For 11 of the 13 SSP scales in the Japanese version of the SSP (SSP-J11), the Cronbach's alpha ranged from 0.50 to 0.82 with good internal scale reliability. Results: A principal factor analysis replicated the previous work by identifying the same three principal dimensions of Neuroticism, Aggression, and Extraversion factors. Conclusion: The resulting three-factor SSP-J11 shows acceptable reliability and should provide informative insights about personality traits in research and clinical practice in a Japanese context.

Migration-Related Stress Among Haitians: Cross-Cultural Translation of the Demands of Immigration Scale.

Background and Purpose: Although the Haitian population in the United States continues to grow, there is a lack of instruments in Haitian Creole to assess risk factors associated with poor mental health such as migration-related stress. This study described the translation of the Demands of Immigration Scale (DIS) and evaluated psychometric properties, meaning equivalence, and understandability of the Haitian Creole/English DIS. Methods: I applied the Functional Assessment of Chronic Illness Therapy translation procedures and recruited 76 first-generation Haitian immigrants to pilot test the DIS. Results: Reliability was strong (α > .93). Meaning equivalence was maintained (r = .979), 75% understood both DIS versions equally, and 80% rated the translation as excellent/good. The DIS significantly correlated with gender, income, age, age at migration, English fluency, and depression. Conclusions: The DIS can reliably identify immigration-related social determinants of mental health and is ready for use in Haitian Creole.

Electronic adaptation and danish cross-cultural translation of PEmb-QoL and VEINES-QoL/Sym for patients with venous thromboembolism.

PURPOSE: Most patient-reported outcome (PROs) used in thrombosis research and clinical practice are delivered using technology like online questionnaires. However, only few have undergone formal electronic adaptation from paper to digital versions, threatening the validity and reliability of the PROs. The present study aimed to perform an electronic adaption and cross-cultural translation of two PROs measuring health-related quality of life in a Danish cohort of patients with venous thrombosis (VTE), specifically the VEINES-QoL/Sym questionnaire and the PEmb-QoL questionnaire. METHODS: The electronic adaption and cross-cultural translation processes followed the international guidelines recommended by ISPOR. The migration of the questionnaires from paper to electronic versions was conducted in the Research Electronic Data Capture (REDCap). Following approval of the electronically adapted and translated versions, a pretest of the questionnaires was performed by cognitive interviewing patients with VTE recruited from a hospital setting. RESULTS: Nine men and ten women between the age of 19 and 73 years participated in cognitive interviews. The questionnaires were successfully adapted from paper to electronic versions, and during the migration process only a few modifications to the content and format were made. Most comments were related to technicalities, e.g. touch functions and checkboxes. The cross-cultural translation of both questionnaires was satisfactory, as only minor rephrasing was required. CONCLUSIONS: The original and Danish version of VEINES-QoL/Sym and PEmb-QoL were successfully adapted into electronic versions and are ready to share for REDCap users. Furthermore, the Danish versions of the two questionnaires have shown satisfactory face validity.

Cross-cultural adaptation and validation of the positive and negative social exchange scale in older adults with disabilities in China.

PURPOSE: This study translated the Positive and Negative Social Exchange (PANSE) scale into Chinese, examined its psychometric characteristics, and explored its feasibility for use among older adults with disabilities from China. MATERIALS AND METHODS: A two-stage study procedure was employed. In the first stage, the English version of the PANSE scale was translated and cross-culturally adapted. In the second stage, the reliability and validity of the scale were assessed based on item-total correlation, internal consistency, test-retest reliability, content validity, structural validity, concurrent criterion validity, and known group validity. RESULTS: A total of 357 older adults with disabilities participated in the survey. The Chinese version of the PANSE scale consisted of two parts, the Positive Social Exchange Scale and the Negative Social Exchange Scale. Exploratory factor analysis extracted six communal factors. The cumulative contribution of the two parts of the scale was 69.90% and 77.88%, respectively. The item-total correlation was 0.353 to 0.802, the internal consistency of the PANSE was 0.653 to 0.886. The PANSE demonstrated good content validity and it was correlated with the SSRS scale. CONCLUSION: The Chinese version of the PANSE is a valid and reliable instrument for assessing social exchange in Chinese older adults with disabilities.Implication for rehabilitationDespite the growing number of older adults with disabilities being a concern in China, the lack of tools to measure the type of social support limits research related to the health status of these people.This study cross-culturally adapted, translated into Chinese and validated the Positive and Negative Social Exchange (PANSE) scale as the measurement tool to be used in the cultural context of China.The two subscales of PANSE were validated in the Chinese population of older adults with disabilities.The PANSE scale measures social exchange among older adults with disabilities in China, which can guide the development of interventions to address issues in the social exchange of these people.

[JAPANESE TRANSLATION AND LINGUISTIC VALIDATION OF THE RECAP OF ATOPIC ECZEMA (RECAP)].

BACKGROUND: The Recap of atopic eczema (RECAP), a new core outcome of the atopic dermatitis trial, was translated into Japanese and linguistically validated. METHODS: Translation into Japanese was accomplished according to the ISPOR (International Society for Pharmacoeconomics and Outcome Research) guidelines and the basic guidelines for scale translation. The translation process included two forward translations, reconciliation with native English speakers, third-party back translation, cognitive debriefing, review and harmonization by the original authors. Twenty-seven atopic dermatitis and pediatric specialists from 21 centers in Japan participated in the translation process. Cognitive debriefing was conducted through face-to-face interviews using a think-aloud method with the interview guide including questions about comprehensibility, relevance, comprehensiveness, recall period and suggested improvements, based on the COSMIN methodology. RESULTS: No linguistic or cultural problems were encountered in the translation into Japanese. Cognitive debriefings were conducted with 10 adult patients and 10 parents of pediatric patients. Some minor modifications were made following discussion and approval by the research team and the original authors. The Japanese version of RECAP was considered to be understandable, comprehensive and relevant for adult patients and families of pediatric patients. CONCLUSION: The Japanese version of the RECAP, which has been validated as linguistically equivalent to the original version, is now available. Further evaluation of the measurement properties is needed in the future.

CROSS-CULTURAL ADAPTATION AND LINGUISTIC VALIDATION OF THE TRANSLATED ARABIC REVISED BREASTFEEDING ATTRITION PREDICTION TOOL.

Background and Purpose: The diversity of populations across the globe and the need to better compare research findings make it imperative to validate research instruments across cultures. The purpose is to systematically describe the translation and the cross-cultural validation of the Revised-Breastfeeding Attrition Prediction Tool from English to Arabic. Methods: The process of cross-cultural validation included (a) translation and linguistic validation: forward- and back-translations; (b) expert evaluation using content validity index (CVI); (c) cognitive interviews (CIs), and (d) pilot testing with postpartum mothers. Results: The item-CVI scores ranged from .8 to 1.00 and the scale-CVI was .95. The CIs identified items that required modification. The reliability coefficient of the pilot-test was .83 and subscale reliabilities ranged from .31 to .93. Discussion: The translation process provided confirmation for the appropriateness of the translated tool to Arabic.

Cross-cultural translation and validation of the traumatic injuries distress scale - Spanish version.

PURPOSE: The Traumatic Injuries Distress Scale is a patient-reported measure capturing experiences of distress following non-catastrophic musculoskeletal injuries. The original English version has shown adequate accuracy for predicting recovery trajectories up to 12 months later. Herein we describe the translation of the English TIDS into the TIDS-Spanish. MATERIALS AND METHODS: The prototype version was developed through a two-step forwards-back translation involving four independent bilingual speakers. 73 participants (51% female, mean age 47 years, 32% acute) with musculoskeletal pain responded to the prototype through an online platform or in paper format through a single administration. A series of hypotheses including correlation with an external standard and factor structure were tested for both concurrent and factorial validity compared to those of the English version. RESULTS: Despite an overall higher mean TIDS score in the Spanish-speaking participants compared to the original English development cohort, all hypotheses for concurrent associations with external pain criteria were satisfied and the three-factor structure of the original was replicated in the new TIDS-Spanish (CFI = 0.97, TLI = 0.96, RMSEA = 0.05). CONCLUSION: While prospective data collection is needed to explore the equivalence in prognostic validity, all other analyses indicated psychometric equivalence of the new TIDS-Spanish with the original English version. Implications for RehabilitationThe Traumatic Injuries Distress Scale has previously shown prognostic validity for stratifying people with acute musculoskeletal injury into risk-recovery trajectories.A Spanish-translated version of the TIDS was developed and evaluated for psychometric equivalence with the original English version.Results indicate that we were successful in creating a conceptually and empirically equivalent version of the TIDS for use in Spanish-speaking populations.

[Balance Evaluation Systems Test: German translation, cultural adaptation and preliminary results on psychometric properties]. / Balance Evaluation Systems Test: deutsche Übersetzung, kulturelle Anpassung und erste Ergebnisse zu Gütekriterien.

BACKGROUND: The Balance Evaluation Systems Test (BESTest) evaluates balance ability and identifies affected systems associated with balance deficits. OBJECTIVE: The primary objective was the translation and cultural adaptation of the BESTest into German. Secondary objective was the preliminary evaluation of psychometric properties of the BESTest. METHOD: In accordance with international guidelines, the BESTest was translated and adapted by a 7-step process. To test the psychometric properties, persons with subjective or objective balance deficits were included. Internal consistency was evaluated by means of Cronbach's alpha. The criterion validity was tested by measuring the correlation with the Berg Balance Scale (BBS). Construct validity was examined using the Activities-Specific Balance Confidence (ABC-D) scale and the known groups methods (fallers versus non-fallers). RESULTS: A total of 27 subjects were included in the testing of the psychometric properties. Cronbach's alpha was 0.95 for the total scale. The correlation of BESTest scores with those of the BBS revealed a Spearmen's ρ of 0.84 (p < 0.001) and 0.61 (p < 0.001) with those of the ABC­D scale. Fallers and non-fallers showed a trend towards different BESTest scores (p = 0.057). DISCUSSION: This paper provides a German translation of the BESTest authorized by the developer. Our preliminary results confirm reliability and validity.

The Thai version of the Nijmegen questionnaire.

Purpose: The Nijmegen questionnaire is a screening tool for detecting hyperventilation syndrome. The present study aimed to cross-culturally adapt the questionnaire to Thai language and test its psychometric properties for screening hyperventilation syndrome, in which the prevalence is increasing due to the impacts of the COVID-19 pandemic.Design/methodology/approach: The Thai version of the Nijmegen questionnaire (NQ-TH) was generated following a cross-cultural adaptation guideline including initial translation, synthesis of forward translation, back translation, expert committee review, and prefinal testing. Fifty control participants and one-hundred patients with symptoms related to hyperventilation syndrome were enrolled in this study for the determination of psychometric properties. Content validity, construct validity, internal consistency reliability, and test-retest reliability of the NQ-TH were assessed. Its discriminant ability and cutoff point for screening hyperventilation syndrome were also revealed. Findings: The obtained IOC and disappeared floor and ceiling effects indicated excellent content validity of the questionnaire. There were significant correlations between the total scores of the NQ-TH and other questionnaires and recorded respiratory measurements obtained from the patients, i.e., SF-36-TH (r = -0.257), HADS-TH (r = 0.331), RR (r = 0.377), and BHT (r = -0.444). This supported the construct validity of the NQ-TH. An acceptable internal consistency was also observed (Cronbach's alpha = 0.789). Test-retest repeatability of the questionnaire was high (ICC = 0.90). Moreover, the NQ-TH reliability was also ensured by calculated MDC (2.68). The cutoff point of the NQ-TH was at 20 with 98% sensitivity and 94% specificity.Originality/value: The NQ-TH established by the present study is a valid and reliable tool for screening hyperventilation syndrome among Thais.

The Chinese Mandarin Version of the Esophageal-Atresia-Quality-of-Life Questionnaires for Children and Adolescents: Evaluation of Linguistic and Content Validity.

BACKGROUND: After repair of esophageal atresia (EA), children risk digestive and respiratory morbidity, but knowledge of their health-related quality of life (HRQOL) in China is lacking. The EA-QOL questionnaires were developed in Sweden and Germany to evaluate condition-specific HRQOL in children with EA aged 2-7 and 8-17. This study aimed to evaluate the linguistic and content validity of the Chinese Mandarin version of the EA-QOL questionnaires. METHODS: The procedure was conducted in compliance with international standards, including a forward-backward translation procedure, expert reviews, and cognitive debriefing interviews with 14 Chinese families of children with EA (parents of 8 children aged 2-7/6 children aged 8-17 and their parents). RESULTS: Following forward-backward translation, minor issues were identified and solved. In interviews, all participants rated all EA-QOL items easy to understand, none expressed negative emotions about them and most described them comprehensive and relevant for EA. Leading from cognitive debriefing, three EA-QOL items in the questionnaire version for children aged 2-7 and three EA-QOL items in the questionnaire version for children aged 8-17 were modified in the Chinese language to improve cultural appropriateness and/or clarity. CONCLUSION: The Chinese Mandarin version of the EA-QOL questionnaires achieved satisfactory linguistic and content validity. This can help increase focus of HRQOL in research and clinical practice of children with EA in China.

Cross-Cultural Translation and Application of the Lieberman-Brian Inclusion Rating Scale for PE in German-Speaking Countries.

Overcoming participation barriers of students with disabilities in physical education is of great importance and an internationally recognized goal. Research highlights that students with disabilities have mixed feelings about their inclusion experiences in physical education. Physical education teachers often do not feel prepared to appropriately support all students. In German-speaking countries in particular, there is a strong tradition of segregation, with varying interpretations of inclusion. In this light, an instrument to reliably assess the inclusive potential of physical education is needed, thereby providing data on the efficacy of teachers' practices. Such an assessment scale would be important to identify barriers to inclusive physical education while providing teachers with data that could potentially enhance the learning environment. The purpose of this study was to outline initial insights into the cross-cultural translation process of the Lieberman/Brian Inclusion Rating Scale for PE in German-speaking countries. The translation process followed suggestions for transcultural validation. Expert review was provided to check content and face validity. Major item challenges centered around paraeducators, gym management, and conceptual differences regarding physical education.

Cross-cultural adaptation and validation of the Amharic version of Roland Morris Disability Questionnaire in people with low back pain in Ethiopia.

PURPOSE: Cross-culturally translate, adapt, and validate Roland Morris Disability Questionnaire (RMDQ) in Amharic language in Ethiopia. METHODS: The English version RMDQ was translated into Amharic and back-translated into English. An expert review committee reviewed the translations and created Amharic version of the RMDQ (RMDQ-Am). Pilot testing and cognitive debriefing of the RMDQ-Am were conducted with a sample of 20 individuals with LBP. The RMDQ-Am was administered to 240 individuals with LBP from three rehabilitation centers to determine its psychometric properties. Internal consistency of the tool was determined by Cronbach's alpha. Test-retest reliability was determined by the Intraclass correlation coefficient. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), and the Bland Altman Limit of Agreement (LOA) was also determined. The Short-Form Health Survey (SF-36) Bodily Pain and Physical Functioning subscales were used to assess convergent validity. Exploratory Factor Analysis (EFA) was used to determine the dimensionality of the tool. RESULTS: RMDQ-Am demonstrated good internal consistency (α = 0.88), excellent test-retest reliability (ICC = 0.91), SEM (1.64), MDC (3.55), and good LOA. There is a significant moderate correlation between RMDQ-Am and the Physical Functioning (Rho = -0.62, p < 0.01) and Bodily Pain (BP) (Rho = -0.41, p < 0.01) subscales of the SF-36. Exploratory Factor Analysis demonstrates that the Amharic version of RMDQ is a primary one and secondary four-factor model [The Kaiser Meyer Olkin = 0.877, X2 (df) =1413.278/190, p < 0.001]. CONCLUSION: RMDQ-Am is a reliable and valid tool that can be used in both clinical practice and research with the Ethiopian LBP population.IMPLICATION FOR REHABILITATIONDespite LBP being a concern in Ethiopia, the magnitude of disability related to this phenomenon is not studied in the country, mainly due to the absence of validated LBP specific patient-reported outcome measures such as the Roland Morris Disability Questionnaire (RMDQ).The RMDQ was successfully translated, adapted, and validated into the Amharic language and the Ethiopian context (RMDQ-Am).The RMDQ-Am is a reliable outcome measure among the Ethiopian population with LBP, as demonstrated by the good internal consistency (α = 0.88) and excellent test-retest reliability (ICC = 0.91).There is a moderate negative correlation between the RMDQ-Am and the Physical Functioning (Rho = -0.62, p < 0.01) and Bodily Pain (Rho = -0.41, p < 0.01) subscales of the SF-36.The RMDQ-Am can be used in clinical and research settings to measure LBP-related disability and its impact among individuals living with LBP in Ethiopia.

Systematic review of the use of translated patient-reported outcome measures in cancer trials.

BACKGROUND: Patient-reported outcomes (PROs) are used in clinical trials to assess the effectiveness and tolerability of interventions. Inclusion of participants from different ethnic backgrounds is essential for generalisability of cancer trial results. PRO data collection should include appropriately translated patient-reported outcome measures (PROMs) to minimise missing data and sample attrition. METHODS: Protocols and/or publications from cancer clinical trials using a PRO endpoint and registered on the National Institute for Health Research Portfolio were systematically reviewed for information on recruitment, inclusion of ethnicity data, and use of appropriately translated PROMs. Semi-structured interviews were conducted with key stakeholders to explore barriers and facilitators for optimal PRO trial design, diverse recruitment and reporting, and use of appropriately translated PROMs. RESULTS: Eighty-four trials met the inclusion criteria, only 14 (17%) (n = 4754) reported ethnic group data, and ethnic group recruitment was low, 611 (13%). Although 8 (57%) studies were multi-centred and multi-national, none reported using translated PROMs, although available for 7 (88%) of the studies. Interviews with 44 international stakeholders identified a number of perceived barriers to ethnically diverse recruitment including diverse participant engagement, relevance of ethnicity to research question, prominence of PROs, and need to minimise investigator burden. Stakeholders had differing opinions on the use of translated PROMs, the impact of trial designs, and recruitment strategies on diverse recruitment. Facilitators of inclusive research were described and examples of good practice identified. CONCLUSIONS: Greater transparency is required when PROs are used as primary or secondary outcomes in clinical trials. Protocols and publications should demonstrate that recruitment was accessible to diverse populations and facilitated by trial design, recruitment strategies, and appropriate PROM usage. The use of translated PROMs should be made explicit when used in cancer clinical trials.

Cross-cultural translation, adaptation, and validation of the Amharic version pain self-efficacy questionnaire in people with low back pain in Ethiopia.

BACKGROUND: The Pain Self-Efficacy Questionnaire (PSEQ) is a valid and reliable instrument that evaluates pain self-efficacy beliefs in people with pain conditions. However, it has not been validated and used in Ethiopia. We conducted this study to translate, adapt, and test the psychometric properties of the PSEQ in the Amharic language and Ethiopian context for its use with people experiencing low back pain (LBP). METHODS: The PSEQ was translated into Amharic and then back-translated into English. An expert review committee created a final Amharic version of the tool (PSEQ-Am), followed by pilot testing and cognitive debriefing with a sample of 20 people with LBP. The psychometric properties of the final version of PSEQ-Am were assessed in a sample of 240 people with LBP recruited from three rehabilitation centers in Ethiopia. Cronbach's alpha and Intra-class correlation coefficient were calculated to describe the reliability and internal consistency of the tool. The SF-36-Am bodily pain subscale was used to assess convergent validity. Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) were performed to determine the dimensionality of the instrument. RESULTS: PSEQ-Am demonstrated excellent test-retest reliability (ICC = 0.93) and internal consistency (Cronbach's alpha = 0.91). As hypothesized, the tool demonstrated a significant moderate correlation with the Bodily Pain subscale of the SF-36-Am (Rho = 0.51, p < 0.01). EFA analysis shows that the Amharic version of PSEQ is a dominant one factor and secondary two factor structure. CONCLUSION: This study shows that PSEQ-Am is a reliable and valid tool that can be used in both clinical practice and research in the Ethiopian low back pain population.

The German RECAP questionnaire: linguistic validation and cognitive debriefing in German adults with self-reported atopic eczema and parents of affected children.

BACKGROUND: Recap of atopic eczema (RECAP) is a patient-reported outcome measure (PROM) assessing eczema control. Long-term control of eczema is one of the four core outcome domains for atopic eczema trials. This instrument has been recently developed in the UK. OBJECTIVE: This study aimed to translate the English RECAP into German and test its content validity in a German population with self-reported atopic eczema. METHODS: A six-step procedure including two forward and one backward translations, two consensus decisions and an expert review was performed to obtain a German version of RECAP. We conducted semi-standardized cognitive interviews with adults with atopic eczema (n = 7) and parents having children affected by this disease (n = 5). A "think-aloud" method was used and aspects of comprehensibility, comprehensiveness and relevance according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were examined. Interviews were coded using qualitative content analysis. RESULTS: No particular linguistic problems were encountered during forward-backward translation. Minor wording changes were made as required. The title was adjusted to a more familiar German term of the disease (which is 'Neurodermitis'). The recall period was rephrased from 'over the last week' to 'over the last seven days' since there was a different cultural understanding of the time frame. Regarding content validity, the items of the German RECAP were considered to be comprehensible, comprehensive and relevant for the participants and parents of affected children. The participants understood the instruction and considered the one-week recall period and the response options as appropriate. CONCLUSIONS: A German version of RECAP that is linguistically equivalent to the original version is now available but further assessment of its measurement properties is needed.

Measurement Properties and Translation to Brazilian-Portuguese of the Challenge for Children and Adolescents with Cerebral Palsy.

Aims: Translate the Challenge assessment into Brazilian-Portuguese, determine its face validity, evaluate the reliability of the total score and score per item, investigate whether the child's gross motor level (classified by the Gross Motor Function Classification System-GMFCS) influences the reliability levels, and estimate responsiveness to change.Methods: The translation followed four stages: translation, synthesis, back-translation, and review. For face validity, ten physical therapists evaluated item relevance. Children and adolescents with cerebral palsy (n = 50, 5-18 years of age) GMFCS I and II were evaluated by two therapists for inter and intra-rater reliability. Thirty of these participants were recruited for the instrument's responsiveness evaluation and reassessed (n = 28) after three months of treatment. Minimal Detectable Change (MDC), and Minimal Clinically Important Difference (MCID) were estimated.Results: The back-translated version was similar to the English version. All test items were considered relevant by the physical therapists. Total score intra and inter-rater reliability were excellent for both GMFCS levels (ICC = 0.94-0.99). Items' intra- and inter- rater reliability varied from low to almost perfect (kw=-0.14-0.94). MDC90 and MDC95 values were 3.90-6.35 and 4.63-7.54, respectively. MCID values were 3.57-4.56.Conclusion: The translated version of the Challenge showed excellent face validity and reliability and was able to document longitudinal change.

Cross cultural adaptation, reliability, and validity of the Greek version of the Cumberland Ankle Instability Tool.

Objectives: This study's objective was to translate and cross-culturally adapt the Cumberland Ankle Instability Tool (CAIT) into the Greek language and to evaluate its psychometric properties.Methods: CAIT was translated and adapted into Greek according to official cross-cultural adaptation guidelines of self-reported measures. The Greek version of the CAIT (CAIT-GR) was tested for reliability (internal consistency, test-retest reliability), validity (discriminative and convergent validity) and floor-ceiling effects. Additionally, a cut-off value discriminating between stable and unstable ankles across healthy participants and participants with ankle complaints was calculated. A convenience sample of 123 Greek individuals was recruited, 43 of which had a history of at least one ankle sprain. All participants completed the final version of the CAIT-GR twice within 7-10 days. Participants with a history of ankle sprain also completed the Greek version of the Lower Extremity Functional Scale (LEFS) and the Visual Analogue Scale (VAS).Results: CAIT-GR mean scores were 26.9 ± 3.16 for participants without a history of ankle sprain and 20.6 ± 4.62 for the instability group. The cut-off value was at 24.5 points of the total CAIT score (range 0-30). CAIT-GR had a moderate correlation with VAS (0.54) and a high correlation with LEFS (0.735). Results indicated good discriminative validity, high internal consistency (Cronbach's alpha of 0.97) and excellent test-retest reliability (ICC2,1 = 0.97, 95%CI = 0.97-0.98). Neither a floor nor a ceiling effect was observed.Conclusions: The CAIT-GR questionnaire was found to be a reliable and valid measure for chronic ankle instability. It is therefore, available for use in future clinical research and practice.

Cross-cultural adaptation and validation of the universal Portuguese-version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F) / Adaptação transcultural e validação da versão portuguesa universal da Escala Avaliação Funcional Pediátrica de Terapia de Doença Crônica - Fadiga (pedsFACIT-F)

Abstract Objective: To cross-culturally adapt and validate the universal Portuguese version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F). Method: The universal Portuguese version of the pedsFACIT-F was cross-culturally adapted and validated in 323 children and adolescents aged 8-18 years, 173 healthy individuals, and 150 with chronic diseases (cancer, juvenile idiopathic arthritis, and diabetes). Reliability (internal consistency and test-retest reliability) was assessed. Item response theory model assumptions were evaluated using confirmatory and exploratory factor analyses. Items were calibrated using a graded response model. Differential item functioning was assessed regarding age, gender, and clinical condition (healthy vs. chronic diseases). Results: No major cultural adaptations were needed. Internal consistency (Cronbach's alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0.92) were good. CFA (CFI = 0.92, TLI = 0.90, RMSEA = 0.097) and CFE analysis confirmed sufficient unidimensionality. The data also fit the GRM and demonstrated good coverage of the fatigue construct (threshold parameters range: -1.42 to 4.56). No items demonstrated significant differential item functioning. Conclusion: The universal Portuguese version of the pedsFACIT-F provides a reliable, precise, and valid measure after being assessed by robust psychometric properties. Stability of the measurement properties of the pedsFACIT-F scale allows its use to assess fatigue in clinical research in Portuguese-speaking children and adolescents.

Resumo Objetivo: Adaptar transculturalmente e validar a versão portuguesa universal da escala Avaliação Funcional Pediátrica de Terapia de Doença Crônica - Fadiga (pedsFACIT-F). Método: A versão traduzida para o português universal e adaptada transculturalmente da escala pedsFACIT-F foi validada em 323 crianças (entre 8 e 18 anos), 173 saudáveis e 150 com doenças crônicas (câncer, artrite idiopática juvenil e diabetes). A confiabilidade foi avaliada pela consistência interna e confiabilidade teste-reteste. Os pressupostos do modelo da teoria da resposta ao item foram avaliados por meio da análise fatorial confirmatória e exploratória. Os itens foram calibrados segundo modelo de resposta gradual. O funcionamento diferencial do item foi examinado com respeito à idade, ao gênero e à condição de saúde (saudáveis versus doenças crônicas). Resultados: A adaptação cultural não apresentou dificuldades substantivas. A confiabilidade da consistência interna (alfa-Cronbach = 0,84) e do teste-reteste (correlação intraclasse = 0,92) foram adequadas. As análises da AFC (CFI = 0,92, TLI = 0,90, RMSEA = 0,097) e AFE confirmaram suficiente unidimensionalidade. O estudo de calibração demostrou bom ajuste do MRG e boa cobertura do construto fadiga (variação dos limiares das categorias de resposta: -1,42 a 4,56). Não foi verificada presença de funcionamento diferencial do item significante. Conclusão: A versão portuguesa universal da escala pedsFACIT-F é uma medida confiável, precisa e válida, verificada após análises de propriedades psicométricas robustas. A estabilidade das propriedades de medida da escala permite seu uso para avaliação de fadiga em estudos clínicos com crianças e adolescentes em países lusófonos.