Anxiety Inventory for Respiratory Disease: Cross-Cultural Adaptation and Semantic Validity of the Brazilian Version for Individuals with Chronic Obstructive Pulmonary Disease

Abstract

Danielle Soares Rocha Vieira,1 Cintia Vieira Del Moro,1 Sabrina Leal Pscheidt,1 Maíra Junkes-Cunha,2 Marcio Mesquita Judice,3 Livia Arcencio,1 Abebaw Mengistu Yohannes4,5 1Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Araranguá, SC, Brazil; 2Department of Gymnastics and Health, Federal University of Pelotas, Pelotas, RS, Brazil; 3Pulmonology Department, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil; 4Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA; 5Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Abebaw Mengistu Yohannes, 372 School of Health Professions Department of Physical Therapy, 1720 2nd Avenue South, Birmingham, AL, 35294, USA, Tel [phone], Email [email protected]: Most instruments available to screen for anxiety in people with chronic obstructive pulmonary disease (COPD) are not disease specific. Therefore, the Anxiety Inventory for Respiratory Disease (AIR) was developed to measure anxiety for this patient group; however, it requires cross-cultural adaptation for use in non-English speaking countries.Purpose: To carry out cross-cultural adaptation of the AIR scale for Brazilian patients with COPD and to analyze its semantic validity.Patients and Methods: This methodological study followed six stages: 1) Initial translation by two independent translators fluent in English; 2) Synthesis of translations; 3) Back translation by two English first language translators; 4) Expert committee review (eight healthcare professionals, a methodologist, the translators, and back-translators); 5) Pre-final version evaluation with 30 patients with COPD through a cognitive interview; and 6) Submission of documents. Semantic validity was analyzed by agreement rate and content validity index (CVI) for the committee equivalence assessments.Results: 1) Initial translation: the two translated versions presented eight divergences; 2) Synthesis of translations: the differences were discussed to reach consensus; 3) Back-translation: there were no important inconsistencies; 4) Expert Committee: the experts proposed eight and the instrument developer proposed three changes, which were analyzed and voted on, resulting in the pre-final version; 5) Evaluation of the pre-final version: data collection allowed for other changes and the formulation of instructions by applying the adapted instrument in an interview format. Patients rated the questions as clear or very clear; 6) The expert committee and the developer approved the final documents. The agreement rate and CVI were ≥ 0.80 for all items of the scale final version.Conclusion: The process of cross-cultural adaptation followed all necessary stages and the semantic validity results were adequate, providing the Brazilian version of the AIR to assess anxiety symptoms in patients with COPD.Keywords: COPD, AIR scale, surveys and questionnaires, Anxiety

Keywords

• background: most instruments available to screen for anxiety in people with copd are not disease specific. therefore
• the anxiety inventory for respiratory disease (air) was developed to measure anxiety for this patient group
• however
• it requires cross-cultural adaptation for use in non-english speaking countries. purpose: to carry out cross-cultural adaptation of the anxiety inventory for respiratory disease (air) scale for brazilian patients with chronic obstructive pulmonary disease (copd) and to analyze its semantic validity. patients and methods : this methodological study followed six stages: 1) initial translation by two independent translators fluent in english
• 2) synthesis of translations
• 3) back translation by two english first language translators
• 4) expert committee review (eight healthcare professionals
• a methodologist
• the translators
• and back-translators)
• 5) pre-final version evaluation with 30 patients with copd through a cognitive interview
• and 6) submission of documents. semantic validity was analyzed by agreement rate and content validity index (cvi) for the committee equivalence assessments. results: 1) initial translation: the two translated versions presented eight divergences
• 2) synthesis of translations: the differences were discussed to reach consensus
• 3) back-translation: there were no important inconsistencies
• 4) expert committee: the experts proposed eight and the instrument developer proposed three changes
• which were analyzed and voted on
• resulting in the pre-final version
• 5) evaluation of the pre-final version: data collection allowed for other changes and the formulation of instructions by applying the adapted instrument in an interview format. patients rated the questions as clear or very clear
• 6) the expert committee and the developer approved the final documents. the agreement rate and cvi were ≥ 0.80 for all items of the scale final version. conclusion: the process of cross-cultural adaptation followed all necessary stages and the semantic validity results were adequate
• providing the brazilian version of the air to assess anxiety symptoms in patients with copd.