This study aims to present the cross-cultural adaptation process of the Modified Dyspnea Index to the Brazilian culture and to investigate its content validity and reliability. This process included the steps of translation, back translation and review by two experts to assess semantic, conceptual, idiomatic, cultural and metabolic equivalence. The Index of Content Validity was used to evaluate the extent of inter-observer agreement. A Guide to implement the Modified Dyspnea Index was developed and validated. Two different professionals assessed the reliability of the Brazilian version of the Modified Dyspnea Index, according to the inter-observer equivalence criterion, with 31 patients, indicating a Kappa coefficient=0.960 (p<0.001). In conclusion, the Brazilian version of MDI presented evidence of interobserver equivalence when applied by different health professionals in the population of cardiac patients.
Adaptación cultural y análisis de la confiabilidad del instrumentoModified Dyspnea Index para la cultura brasileña Este estudio presenta el proceso de adaptación cultural del Modified Dyspnea Index para la cultura brasileña y la evaluación de su validad de contenido y confiabilidad. Este proceso incluyó las etapas de traducción, retrotraducción y evaluación de la equivalencia semántica, idiomática, conceptual, cultural/experimental y metabólica. El Índice de Validad de Contenido fue utilizado para evaluar la proporción de concordancia entre los jueces. Fue desarrollado y validado un guión para orientar la aplicación del Modified Dyspnea Index. Dos diferentes profesionales evaluaron la confiabilidad de la versión brasileña del Modified Dyspnea Index, de acuerdo con el criterio de la equivalencia interobservador, en 31 pacientes, apuntando para un coeficiente Kappa=0,960 (p<0,001).La versión brasileña del Modified Dyspnea Index presentó pruebas de equivalencia interobservador en una muestra de pacientes cardíacos. The study of dyspnea is complicated, due to the difficulties to precisely define the physical stimulus that triggers it. In an attempt to assess and quantify dyspnea more objectively, different instruments have been developed, including structured interviews, self-report questionnaires, visual analogue scales, which assess dyspnea in both qualitative and quantitative terms.Specifically in the context of cardiopulmonary diseases, dyspnea has been assessed using instruments that measure the intensity of the symptom: the Horizontal Visual Analogue Scale (HVAS) (4) , Borg Scale (5) , Modified Borg Scale (5) , and the Numeric Rating Scale (6) Profile (CLASP) (7) , Chronic Heart Failure Questionnairedyspnea subscale (CHQ-D) (8) ; the Oxygen Cost Diagram (OCD) (9) and the Baseline Dyspnea Index (BDI) (10) .In 1986, the Modified Dyspnea Index (MDI) was proposed, as an adaptation of the BDI, which incorporated additional criteria for evaluation of dyspnea, contributing to the greater accuracy of the measure (11) .The MDI was developed in English, focused on the North American culture, and has been applied ...