Background
Our objective was to verify the reliability, internal consistency and construct validity of the Barthel Index in Brazilian cancer patients in palliative care.
Methods
We included patients with cancer, both sexes, and age greater than or equal to 18 years. We used to evaluate patients the Barthel Index, Karnofsky Performance Scale (KPS), and European Organization for Research in the Treatment of Cancer Questionnaire-core 15 (EORTC-QLQ-C15-PAL). The measurement properties evaluated in this study were test–retest and inter-rater reliability and construct validity (tested by means of correlations with other instruments).
Results
We included 220 patients for construct validity and a subsample of 27 patients for reliability analyses. We observed adequate reliability (intraclass correlation coefficient ≥ 0.962) and internal consistency (Cronbach’s alpha = 0.942). There were adequate correlations between the Barthel Index and the KPS (rho = 0.766), and the functional capacity domain of the EORTC-QLQ-C15-PAL (rho = -0.698).
Conclusion
The Brazilian version of the Barthel Index presents adequate test–retest and inter-rater reliability, acceptable internal consistency, and valid construct for measuring functional independence in cancer patients.
BACKGROUND:
The original structure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been contested in several languages.
OBJECTIVE:
To assess the structural validity of the Brazilian version of WOMAC among patients with knee osteoarthritis.
DESIGN AND SETTING:
Structural validity study conducted at physiotherapy clinics and primary healthcare units.
METHODS:
The study included males and females aged 40 to 80 years who were all native Brazilian Portuguese speakers, with knee pain in the previous six months and a diagnosis of knee osteoarthritis. We used exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) with implementation of a polychoric matrix and the robust diagonally weighted least squares (RDWLS) extraction method. The adequacy of the model was assessed using the following fit indices: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR) and chi-square/degree of freedom (DF).
RESULTS:
203 patients with knee osteoarthritis were included. The model proposed in this study with two factors, i.e. “pain” (items 1, 2, 3 and 4) and “physical function” (items 10, 11, 16, 17, 18, 19, 21 and 22), showed adequate fit indices in CFA: chi-square/DF = 1.30; CFI = 0.976; TLI = 0.970; RMSEA = 0.039; and SRMR = 0.070. The factorial loads ranged from 0.68 to 0.76 for the “pain” domain and 0.44 to 0.62 for the “physical function” domain.
CONCLUSION:
The Brazilian version of WOMAC with two domains, i.e. “pain” (four items) and “physical function” (eight items), presents the best structure.
INTRODUCTION Cross-cultural adaptations of questionnaires in developing countries, such as Brazil, have fostered a major debate involving the fields of economics, health, politics and culture. 1 Today, with the development and dissemination of the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures 2 and of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), 3 standardization of cross-cultural adaptation relating to culture, language and country is providing positive outcomes within scientific and clinical contexts. Within healthcare sciences, especially in the field of prevention and rehabilitation of musculoskeletal injuries, it is common to use questionnaires to measure self-reported outcomes, mainly in relation to pain and functional disability. 4-6 Among the questionnaires for screening of musculoskeletal injuries, in addition to instruments that were created by researchers for specific evaluations, 7,8 the Nordic Musculoskeletal Questionnaire (NMQ) stands out through its widespread use for locating musculoskeletal pain in diverse populations. 9-12 However, the NMQ does not have a severity score, and it is not possible to use it to make inferences about functional disability. Therefore, as a way to fill this gap, the Self-Estimated Functional Inability because of Pain (SEFIP) questionnaire was developed and published in 1999. This is an instrument created based
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