Translation, Adaptation and Validation of the "Cultural and Psychosocial Influences on Disability (CUPID) Questionnaire" for Use in Brazil

Abstract

The paper describes the adaptation and testing of the Cultural and Psychosocial Influences on Disability Questionnaire for use in Portuguese. The cross-cultural adaptation followed the steps of translation, back-translation, evaluation of the translations by a committee of judges, and then piloting of the pre-final version. This was performed in a sample of 40 nursing staff from the Hospital at the University of São Paulo. Adjustments were made after review of the translations by the committee of judges (CVI≤ 80%). The pilot study was used to test whether questions could be satisfactorily understood and completed (≥ 85% of subjects). The Brazilian version of the Questionnaire is an adequate instrument for the ascertainment of occupational activities, psychosocial aspects of work, musculoskeletal symptoms and associated disabilities in nursing staff. The cultural adaptation of the CUPID differs from other studies of the same type which propose to investigate the psychometric properties of the questionnaires, because they were designed as a Likert scale (14)(15)(16)(17) . CUPID is an instrument whose answers mostly offer a qualitative perspective. On the other hand, the questionnaire is very extensive, which makes it difficult to immediately apply other possible techniques for content validation. Therefore, this publication intends to contribute to the understanding of the cultural adaptation of this type of instrument on workers' health, showing the steps followed for this purpose in detail. PurposeThe purpose was to evaluate a translation of the CUPID questionnaire into the Portuguese language spoken in Brazil, checking the accuracy of the translation, its content validity, and whether it could be clearly understood when piloted in a sample of nursing staff. MethodThe study is characterized as methodological (18) . The title of the CUPID Questionnaire in Portuguese is "Pesquisa Internacional sobre as Influências Físicas, Culturais e Psicossociais nos SintomasMusculoesqueléticos e Incapacidades Associadas". Procedures for adaptationAn adaptation of the CUPID questionnaire was performed, following the steps that are internationally recommended for translation, back-translation, evaluation of the translations by a judging committee, and then pilot testing of the pre-final version (18)(19)(20) . Forward translationThe CUPID questionnaire was translated from the original language -English -into the Portuguese Back-translationIndependent back-translation to English was carried out by an American bilingual translator, whose mother tongue was English as spoken in the UnitedStates. This version was evaluated and compared to the original in English to identify discrepancies. The questionnaire was then re-submitted to the general coordinator of the project, who suggested adjustments that would maintain the same meaning as the original idiom -English spoken in the United Kingdom. Judging committeeThe translated and back-translated versions of the questionnaire were submitted to a judging committee of specialists in its s...

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