Tradução e adaptação transcultural do Cardiac Children’s Hospital Early Warning Score para a língua portuguesa do Brasil

Abstract

The Cardiac Children's Hospital Early Warning Score (CHEWS) is an English-built instrument to assist in the early identification of signs of clinical deterioration in patients diagnosed with heart disease during hospitalization. The objective is to translate and cross-culturally adapt CHEWS to the Portuguese language of Brazil. This is a methodological study for translation and cross-cultural adaptation of CHEWS, which has five evaluation sections (Neurological Behavior, Cardiovascular, Respiratory, Professional Concern and Family Concern), developed in five stages, as recommended by the World Health Organization. Data were analyzed using SPSS version 20 statistical software using descriptive statistics. Project submitted and approved by the Research Ethics Committees of the Federal University of Ceará and the co-participating institution under opinions 94926918.6.0000.5054 and 94926918.6.3001.5039, respectively. The results were described according to the five steps: 1) Initial translation, performed by two Brazilian translators (T1 and T2) with fluency in the original language (English), independently; 2) Expert panel, in which the main researcher prepared the synthesis of the initial translations in a single Portuguese version (T12); and subsequently a committee of experts composed of seven professionals (two initial translators, three cardiovascular health specialists and two specialists in instrument development or translation studies) evaluated the conceptual, semantic, cultural and idiomatic equivalences of the synthesis version (T12). The suggestions were accepted and all items presented equivalence higher than 70%, characterizing the instrument equivalent to the original version, generating the Portuguese version of the instrument: CHEWS-Br; 3) back-translation to the original language, performed by a translator with experience in the translation of health instruments, native to the English language and fluent in Portuguese; 4) pre-test and cognitive interview, conducted by five trained nurses with at least two years of experience in pediatric cardiovascular health, who performed a total of 50 CHEWS-Br applications to patients with heart disease admitted to the pediatric ward of the cardiovascular referral hospital. from Fortaleza-CE; and 5) final version of the instrument properly translated. In conclusion, the CHEWS translation and cross-cultural adaptation process resulted in a translated and adapted instrument for the Brazilian context (CHEWS-Br), providing to nurses a potential tool to identify early signs of clinical deterioration in hospitalized patients with heart disease.