Monika Bullinger

Adaptação do módulo genérico DISABKIDS® para crianças e adolescentes brasileiros com condições crônicas

OBJECTIVES: to describe the process of cultural adaptation to Brazil Generic Module DISABKIDS for Chronic Conditions (DCGM-37), a generic instrument for measuring the quality of life of children and adolescents with chronic conditions. METHODS: a cross-cutting methodological study was carried out in pediatric outpatients clinics in Brazil, covering 118 children/adolescents with asthma or diabetes and their parents or carers. Translation, back-translation and cultural adaptation were carried out to obtain conceptual and semantic equivalence at the level of individual items.Equivalence was measured statistically by describing the initial psychometric properties, using validity and reliability criteria. RESULTS: most of the items were considered relevant and 14 of them were modified following the semantic validation phase. Values for Cronbachs alpha were α=0.92 and α=0.93, for the version for children and adolescents and the version for parents and carers, respectively. Analysis of correlations between items and dimensions revealed a satisfactory degree of convergent and discriminant validity. CONCLUSIONS: the initial phase indicates that DISABKIDS module is a valid and reliable tool for measuring quality of life in a Brazilian context.

Tradução e adaptação cultural para o Brasil do DISABKIDS® Atopic Dermatitis Module (ADM)

The objective of this study was to translate and make the cultural adaptation of the Brazilian version of the DISABKIDS® Atopic Dermatitis Module (ADM), an instrument used to measure the health-related quality of life of children and adolescents with atopic dermatitis. The instrument has 12 items answered using a Likert scale, with two versions: self and proxy. The study counted with a sample of 18 Brazilian children and adolescents with atopic dermatitis, of ages ranging between 8 and 18 years, and their respective parents or caregivers. The process involved the following steps of translation-back translation and semantic evaluation. The former revealed good acceptance of the translated version of the instrument, which participants considered having items of easy understanding. After completing the process of validation in the country, the instrument will become available to Brazilian researchers to measure health-related quality of life, as well as to compare results from Brazil to that of other cultures in which the instrument has already been validated.O objetivo deste estudo foi traduzir e adaptar culturalmente para o Brasil o DISABKIDS® Atopic Dermatitis Module (ADM), instrumento para mensuracao de qualidade de vida relacionada a saude de criancas e adolescentes, com Dermatite Atopica. O instrumento possui 12 itens com respostas em escala do tipo Likert, com duas versoes, self e proxy. A pesquisa incluiu uma amostra de 18 criancas e adolescentes brasileiros com Dermatite Atopica, na faixa etaria de 8 a 18 anos, e seus respectivos pais ou cuidadores. O processo envolveu as fases de traducao-retrotraducao e validacao semântica. A validacao semântica mostrou boa aceitacao da versao traduzida do instrumento com facil compreensao de seus itens pelos participantes. Apos o termino de seu processo de validacao no pais, o instrumento podera ser utilizado por pesquisadores brasileiros para mensuracao de qualidade de vida relacionada a saude, bem como possibilitara comparacao entre resultados no Brasil com outras culturas nas quais o instrumento ja se encontra validado.

Análise psicométrica inicial da versão brasileira do DISABKIDS Atopic Dermatitis Module

OBJECTIVE To assess preliminary psychometric properties of the Brazilian Portuguese version of a questionnaire for measuring health-related quality of life in children and adolescents with atopic dermatitis. METHODS Cross-sectional study with a sample consisting of 52 children and adolescents aged 8 to 18 diagnosed with atopic dermatitis, and their parents or caregivers, selected at the dermatology department of a university hospital in the city of São Paulo, Southeast Brazil, in 2009. Construct validity, internal consistency and agreement between the responses of children and adolescents and their parents or caregivers were assessed in the Brazilian Portuguese version of the DISABKIDS-Atopic Dermatitis Module (ADM). RESULTS Adequate internal consistency was found with Cronbachs alpha coefficients of 0.7024/0.8124 and 0.7239/0.8604. The multitrait multimethod analysis for assessing convergent validity showed measures higher than 0.30 for all items. The analysis showed good discriminant validity. Agreement between child self-report and parent proxy-report was evaluated using intra-class correlation with measures impact and social stigma of disease of 0.8173 and 0.7629, respectively. CONCLUSIONS The study results showed that the DISABKIDS-ADM can be used by Brazilian researchers after its complete validation as it showed adequate preliminary psychometric properties and can be considered a valid, reliable instrument.OBJETIVO: Analisar as propriedades psicometricas iniciais da versao brasileira de instrumento de avaliacao da qualidade de vida relacionada a saude de criancas e adolescentes com dermatite atopica. METODOS: Estudo transversal realizado com amostra de 52 criancas e adolescentes, com idades entre oito e 18 anos, diagnosticados com dermatite atopica, e seus responsaveis, recrutados em servico de dermatologia de hospital universitario na cidade de Sao Paulo, SP, em 2009. Foram avaliadas a validade de construto, a confiabilidade de consistencia interna e a correlacao entre as respostas de criancas e adolescentes e seus responsaveis da versao brasileira do Atopic Dermatitis Module (DISABKIDS-ADM). RESULTADOS: A confiabilidade de consistencia interna foi satisfatoria, com coeficiente alfa de Cronbach aceitavel para as dimensoes constantes no instrumento (0,7024/0,8124 e 0,7239/0,8604). A analise multitraco-multimetodo para validade convergente mostrou valores maiores que 0,30 para todos os itens. Quanto a validade discriminante, a analise revelou resultados satisfatorios. A concordância entre as versoes self e proxy foi avaliada pelo coeficiente de correlacao intra-classe, com valores de 0,8173 para impacto e 0,7629 para estigma. CONCLUSOES: Diante dos resultados encontrados, considera-se que o instrumento DISABKIDS-ADM pode ser utilizado por pesquisadores brasileiros depois de finalizado seu processo de validacao, por seus resultados iniciais apontarem propriedades psicometricas satisfatorias, que permitem considera-lo um instrumento valido e confiavel.

Preliminary psycometric assessment of the Brazilian version of the DISABKIDS Atopic Dermatitis Module

OBJECTIVE To assess preliminary psychometric properties of the Brazilian Portuguese version of a questionnaire for measuring health-related quality of life in children and adolescents with atopic dermatitis. METHODS Cross-sectional study with a sample consisting of 52 children and adolescents aged 8 to 18 diagnosed with atopic dermatitis, and their parents or caregivers, selected at the dermatology department of a university hospital in the city of São Paulo, Southeast Brazil, in 2009. Construct validity, internal consistency and agreement between the responses of children and adolescents and their parents or caregivers were assessed in the Brazilian Portuguese version of the DISABKIDS-Atopic Dermatitis Module (ADM). RESULTS Adequate internal consistency was found with Cronbachs alpha coefficients of 0.7024/0.8124 and 0.7239/0.8604. The multitrait multimethod analysis for assessing convergent validity showed measures higher than 0.30 for all items. The analysis showed good discriminant validity. Agreement between child self-report and parent proxy-report was evaluated using intra-class correlation with measures impact and social stigma of disease of 0.8173 and 0.7629, respectively. CONCLUSIONS The study results showed that the DISABKIDS-ADM can be used by Brazilian researchers after its complete validation as it showed adequate preliminary psychometric properties and can be considered a valid, reliable instrument.OBJETIVO: Analisar as propriedades psicometricas iniciais da versao brasileira de instrumento de avaliacao da qualidade de vida relacionada a saude de criancas e adolescentes com dermatite atopica. METODOS: Estudo transversal realizado com amostra de 52 criancas e adolescentes, com idades entre oito e 18 anos, diagnosticados com dermatite atopica, e seus responsaveis, recrutados em servico de dermatologia de hospital universitario na cidade de Sao Paulo, SP, em 2009. Foram avaliadas a validade de construto, a confiabilidade de consistencia interna e a correlacao entre as respostas de criancas e adolescentes e seus responsaveis da versao brasileira do Atopic Dermatitis Module (DISABKIDS-ADM). RESULTADOS: A confiabilidade de consistencia interna foi satisfatoria, com coeficiente alfa de Cronbach aceitavel para as dimensoes constantes no instrumento (0,7024/0,8124 e 0,7239/0,8604). A analise multitraco-multimetodo para validade convergente mostrou valores maiores que 0,30 para todos os itens. Quanto a validade discriminante, a analise revelou resultados satisfatorios. A concordância entre as versoes self e proxy foi avaliada pelo coeficiente de correlacao intra-classe, com valores de 0,8173 para impacto e 0,7629 para estigma. CONCLUSOES: Diante dos resultados encontrados, considera-se que o instrumento DISABKIDS-ADM pode ser utilizado por pesquisadores brasileiros depois de finalizado seu processo de validacao, por seus resultados iniciais apontarem propriedades psicometricas satisfatorias, que permitem considera-lo um instrumento valido e confiavel.

Translation and cultural adaptation of the brazilian version of Disabkids® Atopic Dermatits Module (ADM)

The objective of this study was to translate and make the cultural adaptation of the Brazilian version of the DISABKIDS® Atopic Dermatitis Module (ADM), an instrument used to measure the health-related quality of life of children and adolescents with atopic dermatitis. The instrument has 12 items answered using a Likert scale, with two versions: self and proxy. The study counted with a sample of 18 Brazilian children and adolescents with atopic dermatitis, of ages ranging between 8 and 18 years, and their respective parents or caregivers. The process involved the following steps of translation-back translation and semantic evaluation. The former revealed good acceptance of the translated version of the instrument, which participants considered having items of easy understanding. After completing the process of validation in the country, the instrument will become available to Brazilian researchers to measure health-related quality of life, as well as to compare results from Brazil to that of other cultures in which the instrument has already been validated.O objetivo deste estudo foi traduzir e adaptar culturalmente para o Brasil o DISABKIDS® Atopic Dermatitis Module (ADM), instrumento para mensuracao de qualidade de vida relacionada a saude de criancas e adolescentes, com Dermatite Atopica. O instrumento possui 12 itens com respostas em escala do tipo Likert, com duas versoes, self e proxy. A pesquisa incluiu uma amostra de 18 criancas e adolescentes brasileiros com Dermatite Atopica, na faixa etaria de 8 a 18 anos, e seus respectivos pais ou cuidadores. O processo envolveu as fases de traducao-retrotraducao e validacao semântica. A validacao semântica mostrou boa aceitacao da versao traduzida do instrumento com facil compreensao de seus itens pelos participantes. Apos o termino de seu processo de validacao no pais, o instrumento podera ser utilizado por pesquisadores brasileiros para mensuracao de qualidade de vida relacionada a saude, bem como possibilitara comparacao entre resultados no Brasil com outras culturas nas quais o instrumento ja se encontra validado.

Adaptação cultural e propriedades psicométricas iniciais do instrumento DISABKIDS® – Cystic Fibrosis Module – versão brasileira

This study aimed to perform the cultural adaptation and describe the initial psychometric properties of the DISABKIDS®-Cystic Fibrosis Module instrument to measure health-related quality of life for children and adolescents and their parents/caregivers. Methodological study of sequential development, including 126 participants in four Brazilian states. Involved translation and back translation of items, semantic and conceptual equivalence, face validity and description of the initial psychometric properties related to the construct and reliability. For semantic equivalence of the adapted version, there were adjustments in the phrasing of an item. The instrument showed satisfactory internal consistency with Cronbachs alpha values between 0.70 and 0.85, convergent validity with correlation values above 0.40 in 85% of the items and divergent validity with scale fit higher than 75%. The Brazilian version of DISABKIDS® - CFM will certainly constitute a valid and reliable instrument for measuring the quality of life of Brazilian children and adolescents with cystic fibrosis.

Validity of the DISABKIDS® - Cystic Fibrosis Module for Brazilian children and adolescents

OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS® - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, São Paulo, Paraná, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS® - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS(r) - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, Sao Paulo, Parana, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS(r) - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.

Validade do instrumento DISABKIDS® - Módulo Fibrose Cística para crianças e adolescentes brasileiros

OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS® - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, São Paulo, Paraná, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS® - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS(r) - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, Sao Paulo, Parana, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS(r) - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.

Validez del instrumento DISABKIDS®- Módulo Fibrosis Cística para niños y adolescentes brasileños

OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS® - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, São Paulo, Paraná, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS® - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.OBJECTIVES: to validate the health-related quality of life measuring instrument DISABKIDS(r) - Cystic Fibrosis Module (self version) for Brazilian children and adolescents. METHOD: methodological study in which a sample of 113 participants (54 girls and 59 boys; mean age 11.91 years and SD=2.79) was considered, from four Brazilian states, Sao Paulo, Parana, Minas Gerais and the Federal District, 51 of whom participated in the pilot study and 62 in the field study. The answers to the questionnaire were analyzed, considering the frequency distributions with regard to the floor and ceiling effects, Cronbachs Alpha statistics, Pearsons Linear Correlation Coefficient, Mulitrait-Multimethod analysis and Confirmatory Factor Analysis according to Structural Equations Modeling. RESULTS: the instrument showed a high internal consistency coefficient (verified using Cronbachs Alpha) and construct validity, according to the Multitrait-Multimethod analysis. The DISABKIDS(r) - Cystic Fibrosis Module, self version, maintained the same factorial structure as in the originally proposed model. CONCLUSION: the instrument validation has been finished and indicates that the self version is validated for use in Brazil and can be included into the monitoring routine of this population.

Crianças e adolescentes em hemodiálise: atributos associados à qualidade de vida

Estudio de corte transversal, realizado en un Hospital docente, con una muestra de 735 internaciones, cuyo objetivo fue estimar la prevalencia y los factores asociados a la ocurrencia de incidentes relacionados a la medicacion, registrados en las historias clinicas de los pacientes hospitalizados en el Servicio de Cirugia, en el ano de 2010. Se realizo la categorizacion de los tipos de incidentes y fueron presentados la frecuencia absoluta y relativa, calculando la prevalencia y realizando el analisis multivariante. La prevalencia de los incidentes relacionados a la medicacion se estimo en 48,0% y fueron identificados como factores relacionados a la ocurrencia de estos incidentes: tiempo de la hospitalizacion igual o superior a cuatro dias, prescripcion de tres o mas medicamentos por dia y realizacion de la intervencion quirurgica. Se espera haber contribuido para que los profesionales y administradores del area puedan identificar situaciones de riesgo y revisar su actuacion.