Cross-cultural adaptation and inter-rater reliability of the Swedish version of the Chelsea critical care assessment tool (CPAX-Swe) in critically ill patients

Abstract

Objectives: To translate and culturally adapt the Chelsea Critical Care Physical Assessment Tool into Swedish and to test the interrater reliability of the Swedish version in critically ill patients. Design: Observational study Methods: Translation and cross-cultural adaptation was performed in line with international recommendations, including forward and backward translation and expert round table discussions. The inter-rater reliability of the Chelsea Critical Care Physical Assessment Tool-Swedish was then explored in 50 critically ill adult patients, pragmatically recruited, in a University Hospital clinical setting. Reliability was calculated using intraclass correlation coefficient for aggregated scores and quadratic weighted Cohen's kappa analysis for individual items Results: The expert round table discussion group agreed that the translation was a satisfactory equivalent to the original version and applicable for use within the clinical setting. Reliability of aggregated scores and individual items were very good (intraclass correlation coefficient of 0.97 and quadric weighted kappa values ranging from 0.88 to 0.98). The measurement error for aggregated scores was low, with a standard error of measurement of 1.79, smallest detectable change of 4.95, and limits of agreement of 5.20 and-4.76. The percentage agreement for individual items ranged from 64% to 88%. Conclusion: The Chelsea Critical Care Physical Assessment Tool-Swedish was found applicable and appropriate for assessment of functioning in critically ill patients in an acute setting in Sweden, and it displayed high inter-rater reliability. This implies that the Swedish version can be used as assessment tool within intensive care and acute wards in Sweden.

German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability

“…The highest calculated SEM and SDC at ICU discharge were 0.688 and 1.89, respectively. These results are comparable to the Swedish CPAx with an ICCs of 0.97, SEM ¼ 1.79, and SDC ¼ 4.95 [34]. The slightly higher SDC is similar to our constructed limits of agreement.…”

“…Therefore, results about reliability should be interpreted with caution and measurement error might be slightly higher. Nevertheless, our results are very similar to the original and Swedish CPAx versions [10,34,36]. Additionally, it should be considered that, so far, interrater-reliability was only established by observation of the same physiotherapy treatment.…”

“…Discrepancies were solved by discussion within a multidisciplinary expert committee and verified with the original author to ensure a conceptually equivalent version. This approach has proved to be successful for the currently available Swedish and Danish CPAx translations [34,35]. Nevertheless, there are limitations to the German translation.…”

Reliability, Validity, and Cutoff Point of the Chinese Version of the Chelsea Critical Care Physical Assessment Tool in Critically Ill Patients

“…An inter-rater correlation coe cient > 0.7 indicates that the inter-rater reliability is good. The inter-rater correlation coe cient ranging from 0.8 to 0.9 indicates that the inter-rater reliability is high [14,[18][19][20]28] . In the present study, Cronbach's for CPAx-Chi was 0.939, and the inter-rater reliability of the CPAx-Chi score was 0.902 (p < 0.001).…”

“…CPAx not only includes physical function, mobility and grip strength, it also includes respiratory function and cough ability [11][12][13] . CPAx has been translated into several languages for use in the UK, Sweden, Denmark and other countries [14][15] . However, a Chinese version of CPAx, or the cutoff point of CPAx for the diagnosis of ICU-AW, is lacking.…”