Translation, Cross-Cultural Adaptation, and Validation of Measurement Instruments: A Practical Guideline for Novice Researchers.

Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from "CINAHL with Full Text" (via EBSCO) and "MEDLINE with Full Text". A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines.

Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese.

Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators' committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.

Turnover Intention and Organizational Commitment of Primary Healthcare Nurses.

Turnover intention is a predictor of the decision to leave an organization, which, if carried out, affects the quality of care provided. There is an association between turnover intention and organizational commitment. The more committed nurses are to the unit in which they work, the more committed they become to the unit's organizational goals; thus, they tend to continue working for the organization. Aiming to assess the turnover intention and the organizational commitment of nurses in primary healthcare, we conducted a quantitative, observational, descriptive, and cross-sectional study. The Intention of Turnover Scale and the Organizational Commitment Scale were applied in a sample of 297 nurses. Data were analyzed based on descriptive statistics. About 92.8% of the nurses intend to stay at their current workplace and only 7.3% plan to leave soon, suggesting low turnover intention; 84.5% of the nurses are willing to make an effort beyond what is normal to help their organization succeed, and 88.7% feel really interested in the destiny of the organization, which shows high organizational commitment. Pearson's Coefficient revealed the existence of a significant negative correlation between the factors "Intention to leave" and "Committed to the organization" (r = -0.51, p < 0.01). These findings suggest that, when nurses are more committed to their work and to the organization, they display less intention to leave, keeping the teams committed and motivated towards the organizational goals Our findings may guide nurse managers and policy-makers to develop strategies that retain nurses in organizations, keeping them motivated and engaged, and focusing on higher organizational commitment due to the influence it may have on the turnover intention.

Influencing Factors of Nurses' Practice during the Bedside Handover: A Qualitative Evidence Synthesis Protocol.

Nursing Bedside Handover (NBH) is acknowledged as a nursing practice implemented at the patient's bedside to improve communication safety during the shift change, but it is vulnerable due to inconsistent application among nurses. This synthesis of qualitative evidence aims to review and synthesize the perceptions and experiences of nurses regarding the factors that, in their perspective, influence NBH practice. We will follow the thematic synthesis methodology of Thomas and Harden and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) Statement guidelines. A search will be conducted through the databases of MEDLINE, CINAHL, Web of Science, and Scopus, and we will follow the three-step search process to identify primary studies with qualitative or mixed-method research designs and projects of quality improvement. The screening and selection of the studies will be carried out by two independent reviewers. We will use the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to report the screening, search, and selection of studies. To assess its methodological quality, two reviewers will independently use the CASM Tool. The extracted data will be reviewed, categorized, and summarized in tabular and narrative formats. The findings obtained will allow us to inform future research and change management led by nurse managers.

Transcultural nursing leadership: A concept analysis.

Background: Globalisation, wars, competitiveness, and technological innovation have increased workplace diversity, requiring leaders to conduct multinational projects, lead people from different cultural backgrounds, and deliver appropriate services that meet the needs of clients from different cultures. Several concepts are interchangeably used to define and describe leadership in culturally-diverse work environments; one such concept is transcultural leadership. Because of nurses' global migration and care delivery to patients from different cultural backgrounds, this concept is of interest in the nursing field. While some nurses have been identified as transcultural leaders, no definition of transcultural nursing leadership has been found in the literature. Objective: This study aimed to develop an operational definition of transcultural nursing leadership. Design: A concept analysis was performed using Walker and Avant's method. Methods: A literature search was conducted using electronic databases, including CINAHL and MEDLINE, books, and encyclopaedias. Quantitative, qualitative, mixed- design studies and literature reviews; master's and doctoral theses; interviews; and text and opinion papers published in English, Spanish, or Portuguese that focused on leadership in multicultural work environments overall and in nursing in particular were included. To identify differences and similarities between the concepts, a Correspondence Factor Analysis with the support of the software IRaMuTeQ was undertaken. Results: A total of 45 documents with definitions or descriptions of the concepts was included, of which five were in the nursing area and 40 in other areas of study. The defining attribute of transcultural nursing leadership is guiding the delivery of culturally-congruent care. Its antecedents were culturally-diverse populations, multicultural nursing teams, and the need to prepare healthcare workers, administrators, academics, professors, researchers, and minorities for transcultural nursing. The consequences identified included culturally-congruent care for patients and optimal health outcomes for all populations. The identified attributes, antecedents, and consequences did not cover the complexity of a culturally-diverse nursing work environment. Thus, the antecedents, attributes, and consequences of transcultural leadership identified in the literature were considered and added. Conclusions: Transcultural nursing leadership is a concept grounded in nursing theory that has significant implications for nursing management, education, research, and policy. This holds great promise for advancing culturally-congruent care, addressing health disparities, and building highly inclusive and productive nursing teams in an increasingly diverse world.

Translation and Validation of the Individual Workload Perception Scale-Revised for Portuguese Nurses.

(1) Background: In Portugal, there is no scale to assess nurses' satisfaction with their workload. Therefore, this study aimed to culturally/linguistically adapt and validate the IWPS-R scale, with 29 items, to produce a Portuguese version. (2) Methods: A quantitative, descriptive and cross-sectional study was conducted in two phases: translation and adaptation of the IWPS-R into Portuguese, following the steps recommended by Beaton; and evaluation of its psychometric properties in a non-probability sample of 323 nurses working in a hospital centre of reference in Portugal. (3) Results: The final scale obtained a total explained variance of 62.3% and a KMO of 0.88. The reliability was assured through the determination of an internal consistency of 0.88. The construct validity was determined through confirmatory factor analysis. The factorial model presented a good quality fit (X2/df = 2.118; CFI = 0.925; GFI = 0.900; RMSEA = 0.059; p (RMSEA ≤ 0.05) = 0.041; RMR = 0.078; MECVI = 1.525; SRMR = 0.0631) with five factors. (4) Conclusions: The Individual Workload Perception Scale-Revised-Portuguese version (IWPS-R-PT) is a 21-item tool with five dimensions: Nurse Manager Support, Team Support, Workload, Organizational Resources and Intent to Stay. The IWPS-R-PT was found suitable for hospital-based nurses and may be useful in other settings where nurses work.

International Portuguese Nurse Leaders' Insights for Multicultural Nursing.

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. AIM: This study aimed to identify nurse managers' interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders' experience in international settings. METHODS: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. RESULTS: Nurse managers' interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients' worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories-transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. CONCLUSIONS: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.