Tradução e adaptação cultural para o Brasil da escala Pain Assessment in Advanced Dementia PAINAD

Abstract

By the fact of the pain being among the principal factors that can negatively impact the quality of life of elderly patients with cognitive impairment, their evaluation, measurement and management can help to improve the quality of life of these individuals. For this the use of specific tools to assess pain is of paramount importance. In this study we aimed to perform the translation and cultural adaptation to Brazilian Portuguese Scale Pain Assessment in Advanced Dementia (PAINAD) used to measure pain in patients with severe dementia and who can not verbally communicate pain. The scale has five items that are based in the assessment and observation of the physiological and behavioral state, such as breathing, negative vocalization, facial expression, body language and the capacity to consolability, your total score ranges from 0 to 10 points based on a standard scale pain. The process of cultural adaptation of PAINAD instrument followed the steps: translation, consensual version of the translations, retrotratução, committee review and pre - test equivalence. This process ensured the psychometric properties such as reliability and content validity as well as a better understanding of the instrument in the final version for the target population. As theoretical reference, the instrument was submitted to PAINAD translation into Brazilian Portuguese by two bilingual translators who performed the job independently. The two versions were compared by researchers to obtain a consensual version that was poured into the original language, English, three other independent qualified translators who did not participate in the first stage. The consensual version in Portuguese and back-translation were compared with the original version of PAINAD as the conceptual equivalence, semantic, idiomatic and cultural of six judges with expertise in both languages and specialists in the area for this evaluation to the Likert scale was used for each item and the scale after the index validity content (IVC) was calculated to produce a final version translated and adapted. For items that had IVC ≤ 0.75 suggested modifications were made by the judges, ensuring proper final version in Brazilian Portuguese and preserving the validity of the instrument. In the last step, the instrument was evaluated by 27 health professionals regarding the understanding and clarity of the items, as well as practical aspects of its application. PAINAD The instrument was adapted to Brazilian culture and showed semantic equivalence with the original. The application of the instrument for a sample of health professionals showed clarity and understanding of all the items of the instrument.