Translation, cross-cultural adaptation, and validation of the Behavioral Activity Rating Scale (BARS) for the Brazilian population

Abstract

OBJECTIVE:Few instruments are available in Brazil to evaluate psychomotor activity in psychiatric emergency, clinical, and research settings. This study aimed to perform a cross-cultural adaptation of the behavioral activity rating scale (BARS) into Brazilian Portuguese and assess the psychometric properties of the scale. METHODS:An expert committee consensus conducted a translation and back-translation of the original scale, resulting in the BARS-BR. Four pairs of physicians applied the BARS-BR and the Sedation-Agitation Scale (SAS) to patients admitted in the psychiatry emergency room and patients in the psychiatric hospital wards. BARS-BR was compared to SAS, in order to assess the concurrent validity, and internal consistency was evaluated with the Bland-Altman technic. RESULTS:In the emergency room, the correlation coefficients between the first and second assessments were r = 0.997 and r = 1.0, respectively. In the hospital wards, the correlation coefficient between the pair of evaluators was r = 0.951. There was a strong correlation between the BARS-BR score of the first examiner and the SAS score of the second examiner (r = 0.903) and between the SAS score of the first examiner and the BARS-BR score of the second examiner (r = 0.893). CONCLUSION:The BARS-BR showed good psychometric properties, and we suggest its use because it is easy to assess changes in psychomotor activity. Further studies are suggested to evaluate the adoption and comprehension of the BARS-BR scale by all healthcare professionals.