Tradução e validação do Spinal Cord Independence Measure versão IV para o português do Brasil

Abstract

Objective: This study aims to carry out the adaptation and cross-cultural validation of the SCIM IV assessment instrument in individuals with spinal cord injury. Methods: The process of cross-cultural adaptation took place in 7 stages: 1) initial translation, 2) committee composed of experts, 3) counter-translation, 4) synthesis of translations and linguistic analysis, 5) validation of the translation, 6) revision of the text and 7) test of the pre-final version of the SCIM IV questionnaire. For the psychometric evaluation, 100 individuals with spinal cord injuries were recruited. For the construct validity SCIM IV score was correlated with the score of the Functional Independence Measure (FIM). The exploratory factorial analysis was performed, the Kaiser-Meyer-Olkin index (KMO) was carried out to inform if the analysis is factored or not. For the criterion validity, the correlation of SCIM IV subscales with the motor FIM domains was performed. For internal consistency analysis, Cronbach's alpha was used. Reproducibility was analyzed through the Intraclass Correlation Coefficient (ICC), which analyzed intra and interobserver reliability. For responsiveness a measure was used that estimates the size of the effect denominated MRP. The correlation between the SCIM IV score and the AIS motor index was analyzed. The Pearson correlation coefficient was used to verify the correlations. Results: The instrument was not modified during the cross-cultural adaptation, with the same number of pages in portrait orientation, during the test of the pre-final version, health professionals did not report doubts. The correlation between a SCIM IV and a motor FIM, we obtained excellent ICC values (ρ = 0.86). The exploratory factorial analysis was calculated as appropriate (KMO = 0.87). In the validation of a criterion in the SCIM IV "self-care" and "mobility" subscales with the domains "selfcare", "mobility" and "locomotion" of the FIM we obtained an excellent agreement and the correlation between the subscale "respiration and sphincter control" from SCIM IV with the domain "control of sphincters" in the FIM, we obtained moderate agreement. As for Cronbach's alpha, the total SCIM IV result was considered within the expected (α = 0.91). A reliability analysis indicated good intra and inter-observer reproducibility. Responsiveness was low in chronic patients, but acute patients obtained a high responsiveness on the "self-care" subscale and moderate on the SCIM IV total. The correlation between an SCIM IV and the AIS motor index was considered moderate (ρ = 0.65). Conclusion: The cross-cultural adaptation of SCIM IV into Portuguese from Brazil, presented adequate psychometric indexes, guaranteeing the use of this instrument for the evaluation of functional independence in patients with spinal cord injury both clinical practice and research.

Validation of the Advanced Practice Nursing Competency Assessment Instrument in a hospital environment

“…The hypothesis was that the higher the score in the dimensions of the APNCAI -Brazilian version, the higher the score would be in the category "therapeutic interventions" of the AVE; and the evaluation of validity through the hypothesis test showed that the data obtained were significant, demonstrating that the more advanced practice skills the nurse has, the more skills related to therapeutic interventions he performs. This AVE category includes items that highlight the importance of evidence-based updating and the nurse's contribution to the nursing team, multidisciplinary team, and the patient (18) .…”

“…Those who accepted signed the Informed Consent Form, received the printed instruments, and delivered them completed to the researcher on the agreed day. The instruments used for the collection were: a personal and professional characterization form of the sample, the APNCAI -Brazilian version (15) , and the "therapeutic interventions" category of the Nurse Competence Scale (NCS) (18)…”

“…The NCS evaluated the construct validity through hypothesis testing (18) . Through 73 items distributed in seven categories, this scale aims to assess how often nurses use specific competencies.…”

“…The response scale for each item is of the Likert type with four points, ranging from 0 (does not apply to my practice) to 3 (used very often). Thus, the higher the score, the greater the frequency with which the professional uses that competence in their professional activities (18) .…”