Polish translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment

Abstract

Purpose: The Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated nutritional screening, assessment, monitoring, and triage tool. The aim of this study was to perform translation, cultural adaptation, as well as linguistic and content validation of the translated and culturally adapted version of the PG-SGA for the Polish setting. Methods: The study was performed in concordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles. Patients (n=174) and healthcare professionals (HCPs, n=188) participated in the study. Comprehensibility and difficulty were assessed by patients for the PG-SGA Short Form, and by HCPs for the professional component. Content validity was assessed for the full PG-SGA by HCPs only. Evaluations were operationalized by a 4-point scale. Item and scale indices were calculated using the average item ratings divided by the number of respondents. Item indices <0.78 required further analysis of the item, while scale indices ≥0.90 were defined as excellent and 0.80–0.89 as acceptable. Results: The PG-SGA Short Form was rated as excellent for content validity (Scale-CVI = 0.90) by HCPs and easy to comprehend (Scale-CI = 0.96) and use (Scale-DI = 0.94) by patients. The professional component of the PG-SGA was perceived as acceptable for content validity (Scale-CVI = 0.80), comprehension (Scale-CI = 0.87) and difficulty (Scale-DI = 0.80). The physical exam was rated the least comprehensible, the most difficult, and with the lowest content validity. We found significant differences in scale indices (p<0.05 for all) between HCPs with different professions and between those being familiar with PG-SGA and not. Conclusion: Translation and cultural adaptation of the PG-SGA for the Polish setting preserved the purpose and conceptual meaning of the original PG-SGA. Validation revealed that the Polish version of PG-SGA is well understood and easy to complete by patients and professionals, and considered relevant by professionals. However, detailed results indicate the need for appropriate training of the Polish HCPs, especially physicians and nurses, mainly in the worksheets related to the metabolic demand and physical exam.