The cross-cultural process of adapting observational tools for pediatric pain assessment: the case of the Dental Discomfort Questionnaire

Abstract

BackgroundA rigorous cross-cultural adaptation process of an existing instrument could be the best option for measuring health in different cultures, instead of developing a new tool, and prior to psychometric and validation testing. The Dental Discomfort Questionnaire (DDQ), a validated instrument for assessing toothache in young children, has not been cross-culturally adapted so far. This study aimed to explore the detailed phases of the cross-cultural adaptation process of a pain assessment tool, presenting the example of the DDQ Brazilian-Portuguese adapted version.MethodsThe study design was based on the universalist approach, which consists of a sequential analysis to assess the relevant phases of a cross-cultural process before testing the measures of the instrument: conceptual, item, semantic, and operational equivalences. Systematic information was gathered from the literature, expert discussions, translations, and pre-testing through cognitive interviews with Brazilian population.ResultsDetailed description of the three major phases for a cross-cultural adaptation process was given. Notes of the changes done in the structure of the presented instrument (DDQ) were specifically pointed out at each phase. Conceptual and item analyses showed that there are similarities in the DDQ construct between the original and Brazilian cultures that require minor modifications. Translations and back-translations allowed the development of the preliminary Brazilian-Portuguese version of the DDQ, which was tested and underwent other minor changes to improve its comprehensibility.ConclusionsDescribing the phases was important to show how changes are made in a cross-cultural adaptation process of an instrument. This also could help researchers in adapting similar pediatric pain assessment tools to different cultures. A Brazilian-Portuguese version of the DDQ was presented.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-897) contains supplementary material, which is available to authorized users.

Reliability and validity of cross‑culturally adapted oral health‑related quality‑of‑Life instruments for Brazilian children and adolescents: a systematic review

“…All studies [ 17 – 35 ] have a cross-sectional design and were carried out in Brazil. The mean age of participants ranged from 2 [ 20 ] to 15.42 years [ 22 ], however, two studies did not report this information [ 21 , 32 ]. The number of participants ranged from 20 [ 32 , 35 ] to 342 [ 25 ].…”

“… SANTOS et al,2016 [ 28 ] Brazil Cross-sectional 90 boys and 104 girls, 13 years old NR Absent Present Adolescents Discriminant validity revealed a significant difference between the mean scores for the domains of dental self-confidence and psychological impact between groups with and without malocclusion. The Brazilian version of the PIDAQ for adolescents has satisfactory psychometric properties and applies to this age group in Brazil DAHER et al,2014 [ 21 ] Brazil Cross-sectional study 30 parents/ guardians of children, age N.R. English Present Present Children Conceptual and item analyses showed that there are similarities in the DDQ construct between the original and Brazilian cultures that require small modifications.…”

Tradução, Adaptação Transcultural E Avaliação Preliminar Da Pain Catastrophizing Scale-Parents Para Uso No Brasil

“…The developer of the PCS-P authorized its translation and cross-cultural adaptation to Brazilian Portuguese, and it was carried out in accordance with previously published guidelines 16 17 , 18 Two bilingual translators (T1 and T2), whose native language is Brazilian Portuguese, translated the PCS-P separately and produced two independent written translations. T1 was aware of the concepts that were being examined in the questionnaire in order to provide equivalence from a clinical perspective.…”

“…In the reception area of the dental offices, one of the two trained researchers individually interviewed each parent/other relative using the Brazilian-Portuguese PCS-P and the Brazilian Dental Discomfort Questionnaire(DDQ-B) 18 19 The DDQ-B was used as an observational measure of the child’s dental pain, analyzing the concurrent and construct validity properties of the PCS-P, given that we intended to check whether PCS-P was able to be used in assessments of patients with dental pain/discomfort.…”

Daily Toothbrushing Frequency and the Association with Parental Report of Dental Pain and Discomfort in Preschool Children

“…Campo Magro has a population of 24,843 residents and a Human Development Index of 0.701, which is slightly below the Brazilian average (0.755). Its economy is based primarily on family farming and tourism activities [20].…”