Tradução, adaptação cultural e validação da “COVID-19 - Impact on Quality of Life Scale (COV19-QoL)” para o contexto brasileiro

Abstract

INTRODUCTION: Coronavirus Diseases 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The main symptoms caused were fever, tiredness and dry cough, and in older people or with other health conditions, they have a greater risk of severity of the disease. In view of the above, the availability of an instrument that assesses the impact of COVID-19 on the quality of life (QoL) of Brazilians is extremely important. OBJECTIVE: Translate, culturally adapt and validate the “COVID-19 - Impact on Quality of Life Scale (COV19-QoL)” for the Brazilian context. METHOD: This is a methodological study, with the following steps: initial translation of the COV19-QoL into Brazilian Portuguese, synthesis of translations, back-translation of the scale into English, review by a committee composed of six experts, pre-testing of the version pre-final COV19-QoL, carried out with 40 participants and analysis of the internal consistency and construct validity of the adapted version of COV19-QoL. For this last stage, there were 128 participants, who responded to the following instruments: Sociodemographic characterization of the sample; adapted Brazilian version of COV19-QoL; Medical Outcomes Study 36- Item Short Form Health Survey (SF- 36) and the Depression, Anxiety and Stress Scale (DASS-21). All ethical precepts were respected. RESULTS: COV19-QoL was translated by two independent translators, after which the consensual version was established, which was back-translated by a third translator, who was unaware of the research objectives and had English as his native language. A review was then carried out by six experts, who assessed the scale's equivalences. The content validity index was satisfactory, obtaining CVI=1 in five items and one with CVI= 0.86 (item 6), being reviewed and modified. In the pre-test, the sample consisted of 40 participants, the majority of whom were female (82.5%) and were single (50%). Regarding the perception of the impact of COVID-19 on the participants' quality of life, an average COV19-QoL score of 3.46 (±0.94) and satisfactory internal consistency (Cronbach's alpha of 0.843) were obtained. Participants considered the scale clear and understandable and did not make any suggestions for modification. For the analysis of psychometric properties, the sample consisted of 128 participants, the majority of whom were female (73.4%) and were single (61.7%). Regarding the perception of the impact of COVID-19 on QoL, an average score of 3.46 (±1.19) was obtained in COV19-QoL and internal consistency was satisfactory (0.830). Regarding convergent construct validity, a significant positive correlation of moderate magnitude was confirmed between the COV19-QoL score and the total DASS-21 (r = 0.435), as well as in the “Depression” domains (r = 0.424), “Stress” (r = 0.431) and “Anxiety” (r = 0.401). In the correlation between COV19-QoL and the dimensions of the SF-36, a significant negative correlation, of moderate magnitude, was confirmed with the domains “Physical Aspects” (r= - 0.335), “Pain” (r= - 0.378), “Social Aspects” (r= - 0.424), “Emotional Aspects” (r= - 0.361) and “Mental Health” (r= - 0.415) and of low magnitude in “Functional Capacity” (r= - 0.218) and “State general health” (r= - 0.187). In the discriminant validity of COV19-QoL, discriminatory power was confirmed, as participants with “Depression” (3.77), “Anxiety” (3.76) and “Stress” (3.84) showed a greater impact of COVID -19 in QOL, compared to those who did not, who obtained averages of 3.22 for Depression (p ≤ 0.005), 3.23 for Anxiety (p ≤ 0.041) and 3.22 for Stress (p ≤ 0.001). In the confirmatory factor analysis, satisfactory values were found in the Comparative Fit Index (CFI=0.905), in the Tucker-Lewis Index (TLI=0.908), in the Standardized Fit Index (NFI =0.967), in the Adequacy Index (GFI =0.884), the Adjusted Adequacy Index (AGFI=0.819) and the Mean Square Error of Approximation (RMSEA=0.034). The scale is unidimensional, with factor loadings on item 1 (0.663), item 2 (0.769), item 3 (0.544), item 4 (0.799), item 5 (0.420) and item 6 (0.716). CONCLUSION: The COV19-QoL is culturally adapted and presented satisfactory evidence of reliability and validity for the Brazilian context.