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Functional Status Scale: Cross-Cultural Adaptation and Validation in Brazil

Pereira, Gabriela Alves MSc1; Schaan, Camila Wohlgemuth PhD2; Ferrari, Renata Salatti PhD2; Normann, Tatiana Coser PT1; Rosa, Nathalia Vieira PT1; Ricachinevsky, Claudia Pires MSc3; Reppold, Caroline Tozzi PhD1; Lukrafka, Janice Luisa PhD1

Pediatric Critical Care Medicine: October 2019 - Volume 20 - Issue 10 - p e457-e463
doi: 10.1097/PCC.0000000000002051
Online Clinical Investigations

Objective: The goal of the present study was to perform a cross-cultural adaptation and clinical validation of the Functional Status Scale for use in the Brazilian population.

Design: Cross-cultural adaptation study followed by a cross-sectional validation study.

Setting: Single-center PICU at a hospital in Porto Alegre, Brazil.

Patients: Children and adolescents of both sexes, 1 month and under 18 years old, who had been treated at the PICU.

Interventions: The cross-cultural adaptation consisted of the following stages: translation, synthesis of the translated versions, back translations, synthesis of the back translations, committee review, and pretesting. For the clinical validation stage, the Brazilian Functional Status Scale was applied within 48 hours after discharge from the PICU. The Brazilian Functional Status Scale’s reliability and validity properties were tested.

Measurements and Main Results: A total of 314 patients were evaluated. Median age was 24 months (7.0–105.0 mo), 54.1% were males, and their overall functional score was 9 ± 2.8. The Brazilian Functional Status Scale demonstrated excellent interobserver reliability, with an intraclass correlation coefficient of 0.98, and κ coefficients between 0.716 and 1.000 for the functional domains, which indicated good to excellent agreement. Using the Bland-Altman method, we confirmed low variability among the evaluator’s responses (0.93 to –1.06 points). Regarding the Brazilian Functional Status Scale’s content validity, there was a correlation between length of PICU stay (r = 0.378; p < 0.001) and time on invasive mechanical ventilation (r = 0.261; p < 0.05), and the test could discriminate between groups with different comorbidity levels (p < 0.001).

Conclusions: The Functional Status Scale has been culturally adapted and validated for use in Brazil and is now available for use in the assessment of functionality in Brazilian children and adolescents.

1Department of Physical Therapy, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

2Department of Physical Therapy, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

3Pediatric Intensive Care Unit, Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS), Brazil.

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Supported, in part, by grants from the Higher Education Improvement Coordination (CAPES).

The authors have disclosed that they do not have any potential conflicts of interest.

This work was performed at the Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre (RS), Brazil.

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Copyright © 2019 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies