Pre-validation Study of the Brazilian Version of the Disruptions in Surgery Index (DiSI) as a Safety Tool in Cardiothoracic Surgery

Abstract

IntroductionMost risk stratification scores used in surgery do not include external and non-technical factors as predictors of morbidity and mortality.ObjectiveThe present study aimed to translate and adapt transculturally the Brazilian version of the Disruptions in Surgery Index (DiSI) questionnaire, which was developed to capture the self-perception of each member of the surgical team regarding the disruptions that may contribute to error and obstruction of safe surgical flow.MethodsA universalist approach was adopted to evaluate the conceptual equivalence of items and semantics, which included the following stages: (1) translation of the questionnaire into Portuguese; (2) back translation into English; (3) panel of experts to draft the preliminary version; and (4) pre-test for evaluation of verbal comprehension by the target population of 43 professionals working in cardiothoracic surgery.ResultsThe questionnaire was translated into Portuguese and its final version with 29 items obtained 89.6% approval from the panel of experts. The target population evaluated all items as easy to understand. The mean overall clarity and verbal comprehension observed in the pre-test reached 4.48 ± 0.16 out of the maximum value of 5 on the psychometric Likert scale.ConclusionBased on the methodology used, the experts' analysis and the results of the pre-test, it is concluded that the essential stages of translation and cross-cultural adaptation of DiSI to the Portuguese language were satisfactorily fulfilled in this study.

Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios — A Marker for Developing Functionally Efficient Teams

“…Based on our own experience and those of others ( 14 ) - ( 16 ) , we were concerned by the frequency and variety of potential disruptions occurring during cardiovascular operations, and their possible detrimental effect on safety and patient outcomes. We, therefore, designed a study that aims to evaluate the perceptions by members of a local cardiovascular surgery OR team of the various disruptive elements that might occur in the OR.…”

“…We, therefore, designed a study that aims to evaluate the perceptions by members of a local cardiovascular surgery OR team of the various disruptive elements that might occur in the OR. We used a previously validated instrument to assess such disruptions, namely the Disruptions in Surgery Index (DiSI), which we have started to revalidate through cross-cultural translation and adaptation into Portuguese in a previous study ( 16 ) . Thus, the secondary aim of this study was to provide further validation evidence for the use of DiSI in Brazilian cardiovascular ORs.…”