National Early Warning Score 2: transcultural adaptation to Brazilian Portuguese

Abstract

Objective: Cross-cultural adaptation of the National Early Warning Score 2 to Brazilian Portuguese. Methods: A methodological study of a cross-cultural adaptation of a scale, based on the Beaton et al. framework, authorized by the Royal College of Physicians. Judges from nine Brazilian states, nurses and physicians evaluated the semantic, idiomatic, cultural, and conceptual equivalence between the original instrument and the translated versions. The nurses, working in inpatient or emergency units, conducted the pilot test, applying the final version to three case studies. Psychometric tests were used for data analysis: Content Validity Index (CVI), Kappa Coefficient, and Cronbach's Alpha. Results: The adaptation showed a mean CVI of 0.98 and perfect/almost perfect inter-rater agreement, with scores above 0.80. The consistency of the scale was 0.712. Conclusion: The process of cross-cultural adaptation of the scale to Brazilian Portuguese was successful, providing Brazilian professionals with an instrument aligned with patient safety.

Cross-cultural adaptation and validation of the Hamilton Early Warning Score for Brazil

“…In addition to the HEWS, the only early warning scale that was submitted to a methodological process of adaptation for Brazil was the National Early Warning Score 2 (NEWS 2) for use in adults (19) and the Brighton Pediatric Early Warning Score (BPEWS) for pediatric use (21) . When comparing the content validation results of the HEWS -Brazilian version and NEWS 2 scales, both scales obtained a good validity index, greater than 0.8, which demonstrates that these scales are clear and precise (20) .…”

“…It is recommended that tools and work strategies to be used based on scientific evidence to support health care and management (19) . However, in Brazilian practice, the use of clinical instruments can still be observed, in particular, the Early Warning Scores (EWS), translated literally and without prior validation for the target population in which it will be applied (1,20) .…”

Effect of the national early warning score on monitoring the vital signs of patients in the emergency room

“…Regarding the vital signs used by NEWS, we observed that the assessment of the level of consciousness is not yet a systematic practice incorporated into the assessment of physiological parameters in Brazilian hospitals. To use NEWS, the neurological assessment is performed using the acronym CVPU (confusion, verbal, pain, unresponsive), and a high agreement between participants (Kappa = 0.978) in the neurological assessment using this acronym was observed in a recent national study of cross-cultural adaptation of the National Early Warning Score 2 for Brazilian Portuguese, which may demonstrate that its use is simple and easy to understand in the application of the scale to the Brazilian context (14) .…”

Efeito do national early warning score no monitoramento dos sinais vitais de pacientes no pronto-socorro

“…Em relação aos sinais vitais utilizados pelo NEWS, nota-se que a avaliação do nível de consciência ainda não é uma prática sistematizada e incorporada na avaliação dos parâmetros fisiológicos nos hospitais brasileiros. Para utilizar o NEWS, a avaliação neurológica acontece por meio da sigla CVPU (confusion, verbal, pain, unresponsive), e foi observada, em um recente estudo nacional de adaptação transcultural do National Early Warning Score 2 para o português do Brasil, alta concordância entres os participantes (Kappa = 0,978) na avaliação neurológica por meio dessa sigla, o que pode demonstrar que sua utilização é simples e de fácil entendimento na aplicação da escala no contexto brasileiro (14) .…”