Cross-cultural adaptation and content validity of the Parkinson’s disease quality of life questionnaire for patients on device-aided therapy into Brazilian Portuguese
DOI:
https://doi.org/10.11606/issn.2317-0190.v32i2a234298Keywords:
Parkinson Disease, Deep Brain Stimulation, Quality of Life, TranslatingAbstract
Objective: Parkinson’s disease (PD) is a chronic and progressive neurodegenerative disorder characterized by both motor and non-motor symptoms. Device-aided therapy (DAT) has emerged as a promising approach for the treatment of PD, highlighting the importance of assessing the quality of life in patients undergoing such interventions. The objective of this study was to perform the cross-cultural adaptation and evaluate the content validity of the Parkinson’s Disease Quality of Life Questionnaire for Patients on Device-Aided Therapy (PDQ-DAT) for Brazilian Portuguese. Method: This methodological study was conducted at the Medical Specialties Center of Santa Casa in Belo Horizonte, Brazil, following international guidelines for cross-cultural adaptation. The process included the following steps: initial translation, synthesis of the translations, back-translation, expert committee review, and pre-testing. The pre-final version of the instrument was administered to a sample of thirty PD patients undergoing deep brain stimulation (DBS). The content validity index (CVI) was assessed based on three criteria: clarity/comprehension, relevance/importance, and comprehensiveness. Results: The adapted version of the PDQ-DAT demonstrated satisfactory semantic, idiomatic, cultural, and conceptual equivalence. The participants (mean age: 62.7 ± 5.2 years) reported ease in understanding the items, indicating good acceptability of the instrument. All items of the PDQ-DAT-Br achieved a CVI greater than 0.9 across the three evaluated criteria, confirming excellent content validity. Conclusion: The PDQ-DAT-Br proved to be a valid and user-friendly tool for assessing the quality of life of individuals with PD undergoing DBS in the Brazilian context.
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References
Dorsey ER, Sherer T, Okun MS, Bloem BR. The Emerging Evidence of the Parkinson Pandemic. J Parkinsons Dis. 2018;8(s1):S3-S8. Doi: https://doi.org/10.3233/JPD-181474
Simon DK, Tanner CM, Brundin P. Parkinson Disease Epidemiology, Pathology, Genetics, and Pathophysiology. Clin Geriatr Med. 2020;36(1):1-12. Doi: https://doi.org/10.1016/j.cger.2019.08.002
Silva ABRL, Oliveira RWG, Diógenes GP, Aguiar MFC, Sallem CC, Lima MPP, et al. Premotor, nonmotor and motor symptoms of Parkinson's Disease: A new clinical state of the art. Ageing Res Rev. 2023;84:101834. Doi: https://doi.org/10.1016/j.arr.2022.101834
Braak H, Del Tredici K, Rüb U, de Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson's disease. Neurobiol Aging. 2003;24(2):197-211. Doi: https://doi.org/10.1016/s0197-4580(02)00065-9
Jost ST, Kaldenbach MA, Antonini A, Martinez-Martin P, Timmermann L, Odin P, et al. Levodopa Dose Equivalency in Parkinson's Disease: Updated Systematic Review and Proposals. Mov Disord. 2023;38(7):1236-1252. Doi: https://doi.org/10.1002/mds.29410
Bastide MF, Meissner WG, Picconi B, Fasano S, Fernagut PO, Feyder M, et al. Pathophysiology of L-dopa-induced motor and non-motor complications in Parkinson's disease. Prog Neurobiol. 2015;132:96-168. Doi: https://doi.org/10.1016/j.pneurobio.2015.07.002
Antonini A, Pahwa R, Odin P, Isaacson SH, Merola A, Wang L, et al. Comparative Effectiveness of Device-Aided Therapies on Quality of Life and Off-Time in Advanced Parkinson's Disease: a systematic review and Bayesian network meta-analysis. CNS Drugs. 2022;36(12):1269-1283. Doi: https://doi.org/10.1007/s40263-022-00963-9
Chung SJ, Jeon SR, Kim SR, Sung YH, Lee MC. Bilateral effects of unilateral subthalamic nucleus deep brain stimulation in advanced Parkinson's disease. Eur Neurol. 2006;56(2):127-32. Doi: https://doi.org/10.1159/000095704
Nowak DA, Topka H, Tisch S, Hariz M, Limousin P, Rothwell JC. The beneficial effects of subthalamic nucleus stimulation on manipulative finger force control in Parkinson's disease. Exp Neurol. 2005;193(2):427-36. Doi: https://doi.org/10.1016/j.expneurol.2005.01.003
Kawaguchi M, Miyagi Y, Kishimoto J, Samura K, Tokunaga Y, Watari M, et al. Development of Quality of Life Questionnaire for Patients with Parkinson's Disease Undergoing STN-DBS. Neurol Med Chir (Tokyo). 2021;61(8):475-483. Doi: https://doi.org/10.2176/nmc.oa.2020-0388
Schlickmann TH, Tessari MS, Borelli WV, Marconi GA, Pereira GM, Zimmer E, et al. Prevalence, distribution and future projections of Parkinson disease in Brazil: insights from the ELSI-Brazil cohort study. Lancet Reg Health Am. 2025;44:101046. Doi: https://doi.org/10.1016/j.lana.2025.101046
Saba RA, Maia DP, Cardoso FEC, Borges V, F Andrade LA, Ferraz HB, et al. Guidelines for Parkinson's disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms. Arq Neuropsiquiatr. 2022;80(3):316-329. Doi: https://doi.org/10.1590/0004-282X-ANP-2021-0219
Arten TLS, Hamdan AC. Depressive symptoms in Brazilian Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: A Cross-Sectional study. Appl Neuropsychol Adult. 2024:1-9. Doi: https://doi.org/10.1080/23279095.2024.2423836
Silva AG, Leal VP, Silva PR, Freitas FC, Linhares MN, Walz R, et al. Difficulties in activities of daily living are associated with stigma in patients with Parkinson's disease who are candidates for deep brain stimulation. Braz J Psychiatry. 2020;42(2):190-194. Doi: https://doi.org/10.1590/1516-4446-2018-0333
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-91. Doi: https://doi.org/10.1097/00007632-200012150-00014
Coster WJ, Mancini MC. Recommendations for translation and cross-cultural adaptation of instruments for occupational therapy research and practice. Rev Ter Ocup Univ São Paulo. 2015;26(1):50–57. Doi: https://doi.org/10.11606/issn.2238-6149.v26i1p50-57
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94-104. Doi: https://doi.org/10.1111/j.1524-4733.2005.04054.x
Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27(5):1159-1170. Doi: https://doi.org/10.1007/s11136-018-1829-0
Cruz DMC, Parkinson S, Rodrigues DS, Carrijo DCM, Costa JD, Fachin-Martins E, et al. Cross-cultural adaptation, face validity and reliability of the Model of Human Occupation Screening Tool to Brazilian Portuguese. Cad Bras Ter Ocup. 2019;27(4):691–702. Doi: https://doi.org/10.4322/2526-8910.ctoAO2007
Bernardo LD, Pontes TB, Souza KI, Santos SG, Deodoro TMS, Almeida PHTQ. Adaptação transcultural e validade de conteúdo do Activity Card Sort ao português brasileiro. Cad Bras Ter Ocup. 2020;28(4):1165–79. Doi: https://doi.org/10.4322/2526-8910.ctoAO2051
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-4. Doi: https://doi.org/10.1136/jnnp.55.3.181
Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr. 2003;61(3B):777-81. Doi: https://doi.org/10.1590/s0004-282x2003000500014
Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. Doi: https://doi.org/10.1002/nur.20147
Coimbra MR, Almeida-Leite CM, Faria-Fortini I, Christo PP, Scalzo PL. King's Parkinson's Disease Pain Scale (KPPS): Cross-cultural adaptation to Brazilian Portuguese and content validity. Clin Neurol Neurosurg. 2021;208:106815. Doi: https://doi.org/10.1016/j.clineuro.2021.106815
Zhao N, Yang Y, Zhang L, Zhang Q, Balbuena L, Ungvari GS, et al. Quality of life in Parkinson's disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci Ther. 2021;27(3):270-279. Doi: https://doi.org/10.1111/cns.13549
Spindler P, Alzoobi Y, Kühn AA, Faust K, Schneider GH, Vajkoczy P. Deep brain stimulation for Parkinson's disease-related postural abnormalities: a systematic review and meta-analysis. Neurosurg Rev. 2022;45(5):3083-3092. Doi: https://doi.org/10.1007/s10143-022-01830-3
Bucur M, Papagno C. Deep Brain Stimulation in Parkinson Disease: A Meta-analysis of the Long-term Neuropsychological Outcomes. Neuropsychol Rev. 2023;33(2):307-346. Doi: https://doi.org/10.1007/s11065-022-09540-9
Razmkon A, Abdollahifard S, Taherifard E, Roshanshad A, Shahrivar K. Effect of deep brain stimulation on freezing of gait in patients with Parkinson's disease: a systematic review. Br J Neurosurg. 2023;37(1):3-11. Doi: https://doi.org/10.1080/02688697.2022.2077308
Zhu K, Peng S, Wu Y, Zhao Y, Lu Z. Deep brain stimulation of the subthalamic nucleus improves sleep in Parkinson disease patients: A systematic review and meta-analysis. Medicine (Baltimore). 2023;102(32):e34509. Doi: https://doi.org/10.1097/MD.0000000000034509
Instituto Brasileiro de Geografia e Estatística (IBGE). Continuous National Household Sample Survey - Continuous PNAD [text on the Internet]. Rio de Janeiro: IBGE; 2022 [cited 2024 Dec 15] Available from: https://atlasescolar.ibge.gov.br/mundo/3012-indicadores-sociais/educacao/21654-grau-de-instrucao-2019.html
Klietz M, Rippena L, Lange F, Tulke A, Paracka L, Dressler D, et al. Validating the Parkinson's disease caregiver burden questionnaire (PDCB) in German caregivers of advanced Parkinson's disease patients. Int Psychogeriatr. 2019;31(12):1791-1800. Doi: https://doi.org/10.1017/S1041610219000206
Alves WLT, Faria-Fortini I, Galvão ACDR, Cardoso FEC, Scalzo PL. Cross-cultural adaptation of the Activities of Daily Living Questionnaire-Brazil in Parkinson's disease. Arq Neuropsiquiatr. 2021;79(12):1101-1108. Doi: https://doi.org/10.1590/0004-282X-ANP-2020-0396
Louzada AMPE, Faria-Fortini I, Vargas AP, Souza Cruz AC, Scalzo PL. Cross-cultural adaptation of the Parkinson's Disease Caregiver Burden Questionnaire. Rev Neurocienc. 2024;32:1-20. Doi: https://doi.org/10.34024/rnc.2024.v32.16521
Rocha RMS, Faria-Fortini I, Scalzo PL. Telephone-based application of the Activities of Daily Living Questionnaire in patients with Parkinson's disease. Arq Neuropsiquiatr. 2024;82(5):1-8. Doi: https://doi.org/10.1055/s-0044-1787135
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