Translation and cross-cultural adaptation of the NutriQoL<sup>®</sup> questionnaire to the Portuguese language: Brazilian version

OLIVEIRA, João Paulo Lima de; SANTOS, Mônica Sabrina Ribeiro dos; MACHADO, Hellen Custódio; AGUIAR, Sarah Leão Fiorini de; FERREIRA, Lívia Garcia

doi:10.1590/1678-9865202134e200285

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ORIGINAL • Rev. Nutr. 34 • 2021 • https://doi.org/10.1590/1678-9865202134e200285 copy

Translation and cross-cultural adaptation of the NutriQoL^® questionnaire to the Portuguese language: Brazilian version

Tradução e adaptação do questionário NutriQoL^® para a língua portuguesa: versão Brasileira

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The objective of this study was to translate and cross-culturally adapt the NutriQoL^® into Brazilian Portuguese.

Methods

The NutriQoL^® comprises 17 questions that evaluate the quality of life of patients receiving home enteral nutrition therapy. The methodological procedures included the translation from the Spanish version into Portuguese by two translators, synthesis of the translations, back translation, evaluation by a committee of judges composed of 24 individuals in which a content validity index > 0.78 was considered acceptable, and generation of the pre-final version. A pre-test to analyze its semantic equivalence was administered to 12 patients receiving home enteral nutrition therapy. The final version of the questionnaire was then prepared.

Results

A summary version of the questionnaire was obtained using two versions of the translation. Both back translations were identical for 73.6% of sentences (n=25). Twenty-four volunteers were included in the committee of judges. The content validity index was 0.88±0.11, and 14.7% (n=5) of questions had a low content validity index and were thus reformulated. In the pre-test, 35.3% (n=12) of items obtained low levels of understanding and required adjustment. In the preparation of the final version, the inconsistencies of the items mentioned were corrected and/or adjusted.

Conclusion

After completing the methodological procedures, a Brazilian Portuguese version of the NutriQoL^® questionnaire was obtained. Following the validation process, it can be used by dieticians and other health professionals to assess the quality of life of patients receiving home enteral nutrition therapy to contribute to improvements in care practices.

Keywords:
Homebound persons; Nutrition therapy; Quality of life; Surveys and questionnaires

Question	CVI
1.1	0.88
1.2	0.92
2.1	0.83
2.2	0.83
3.1	0.96
3.2^*	0.71
4.1	0.92
4.2	0.92
5.1	0.96
5.2	0.83
6.1	0.79
6.2^*	0.71
7.1	1.00
7.2	1.00
8.1^*	0.75
8.2	1.00
9.1	0.88
9.2	1.00
10.1	0.88
10.2^*	0.67
11.1	1.00
11.2	1.00
12.1^*	0.83
12.2^*	0.67
13.1	0.96
13.2	1.00
14.1^*	0.83
14.2^*	0.92
15.1^*	0.88
15.2^*	0.83
16.1^*	0.83
16.2^*	0.79
17.1	1.00
17.2	1.00
CVI (Mean±SD)	0.88±0.11

Items^*	I had a lot of difficulty understanding		I had little difficulty understanding		I understood perfectly
Items^*	n	% Freq	n	% Freq	n	% Freq
2.1	1	8.3	7	58.3	4	33.3
2.2	1	8.3	5	41.7	6	50.0
6.1	0	0	7	58.3	5	41.3
6.2	0	0	4	33.3	8	66.7
10.1	0	0	2	16.7	10	83.3
10.2	0	0	3	25.0	9	75.0
12.1	2	16.7	2	16.7	8	66.7
12.2	2	16.7	2	16.7	8	66.7
16.1	6	50.0	1	8.3	5	41.7
16.2	5	41.7	2	16.7	5	41.7

Item	Original version	Consensus for the prefinal version (T_1,3)	Final version
1.1	Con la NED mantengo mis horarios habituales para comer (ejemplo: desayuno, almuerzo, merienda y cena)	With HEN (home enteral nutrition), I maintain my usual eating times (example: breakfast, lunch, snack and dinner)	With HENT (home enteral nutrition therapy), I maintain my usual eating times (example: breakfast, lunch, snack and dinner)
2.1	La NED se adapta a mis preferencias por las características de la alimentación (ejemplo: textura, color, olor, temperatura, sabor)	HEN can be adapted to my preferences in terms of food characteristics (example: texture, color, smell, temperature, flavor)	HENT can be adjusted to my preferences in terms of food characteristics (e.g., texture, color, smell, temperature, flavor)
3.1	Desde que tomo la NED me es más fácil moverme, me siento más ágil	Since receiving HEN, I move more easily, and I feel more agile	Since receiving HENT, I move more easily, and I feel more agile
4.1	Con la NED puedo seguir haciendo mis tareas cotidianas (ejemplo: leer el periódico, cocinar, lavar el coche, limpiar, ver la TV)	With HEN, I can continue doing my daily activities (example: reading the newspaper, cooking, washing the car, cleaning, watching TV)	With HENT, I can continue doing my daily activities (example: reading the newspaper, cooking, washing the car, cleaning, watching TV)
5.1	Desde que tomo la NED veo que mi aspecto físico va mejorando (ejemplo: me veo más saludable)	Since I started receiving HEN, I can see that my physical appearance is improving (example: I see myself as healthier)	Since I started receiving HENT, I can see that my physical appearance is improving (example: I see myself as healthier)
6.1	Conseguir los preparados de la NED es sencillo (ejemplo: está disponible en las farmacias, obtengo la receta fácilmente)	Obtaining HEN preparations is simple (example: it is available in pharmacies, the prescription is easily available)	Obtaining HENT preparations is simple (example: buy online, buy in a physical store, provided by the municipality), or I make the recipe at home
7.1	Con la NED confío en que estoy bien nutrido	With HEN, I trust that I am well nourished	With HENT, I trust that I am well nourished
8.1	Con la NED he recuperado peso	With HEN, I regained weight	With HENT, I regained weight
9.1	La NED me permite poder salir con mis amigos	HEN allows me to go out with my friends	HENT allows me to go out with my friends and/or family
10.1	La NED daña mi piel (ejemplo: sequedad, irritación, infecciones)	HEN damages my skin (example: dryness, irritation, infections)	The tube used for HENT damages my skin (example: dryness, irritation, infections)
11.1	La NED me impide dormir bien	HEN prevents me from sleeping well	HENT prevents me from sleeping well
12.1	Me preocupa que mi cuerpo se adapte a la NED y no pueda volver a alimentarme como antes	I worry that my body will adapt to HEN and that I cannot go back to eating as before	I worry that my body will get used to HENT and that I cannot go back to eating as before
13.1	Con la NED echo de menos masticar y saborear alimentos	With HEN, I miss chewing and tasting food	With HENT, I miss chewing and tasting food
14.1	Con la NED tengo molestias físicas por la alimentación (ejemplo: pesadez de estómago, ardores, sequedad de boca, regurgitaciones)	With HEN, I feel physical discomfort due to feeding (e.g., heavy stomach, burning sensations, dry mouth, reflux)	With HENT, I feel physical discomfort due to feeding (e.g., heavy stomach, burning sensations, dry mouth, reflux)
15.1	Con la NED mi familia vigila más mi alimentación	With HEN, my family monitors my diet better	With HENT, my family and/or caregiver monitors my diet better
16.1	Con la NED limito las actividades con mis amigos a aquellas que no estén relacionadas con la comida	With HEN, I limit activities with my friends to those that are not related to food	With HENT, I limit the activities with my friends to activities that do not involve food
17.1	Desde que tomo la NED estoy más preocupado por mi salud	Since I started receiving HEN, I am more concerned about my health	Since I started receiving HENT, I am more concerned about my health

Item	Original version	Consensus for the prefinal version (T_1,3)	Final version
1.2	Mantener mis horarios habituales para comer, para mí es	Maintaining my usual eating times is, for me	Maintaining my usual eating times is, for me
2.2	Que la NED se adapte a mis preferencias por las características de la alimentación, para mí es	HEN can be adapted to my preferences in terms of food characteristics, for me is	HENT being adjusted to my preferences in terms of food characteristics, for me is
3.2	Que me sea más fácil moverme, sentirme más ágil, para mí es	Being able to move more easily, feeling more agile, for me is	Being able to move more easily and feeling more agile, for me is
4.2	Poder seguir haciendo mis tareas cotidianas, para mí es	To be able to continue doing my daily activities, for me is	Being able to continue doing my daily activities, for me is
5.2	Que mi aspecto físico vaya mejorando, para mí es	My physical appearance is improving, for me is	Improving my physical appearance, for me is
6.2	Que sea sencillo conseguir los preparados de la NED para mí es	To easily obtain the HEN preparations, for me is	Easily obtaining or preparing HENT preparations, for me is
7.2	Confiar en que estoy bien nutrido, para mí es	Trusting that I am well nourished, for me is	Trusting that I am well nourished, for me is
8.2	Recuperar peso, para mí es	To regain weight, for me is	Regaining weight, for me is
9.2	Poder salir con mis amigos, para mí es	Being able to go out with my friends, for me is	Being able to go out with my friends and/or family, for me is
10.2	Que mi piel se dañe, para mí es	That my skin is damaged, for me is	Skin damage caused by the use of the tube, for me is
11.2	Dormir bien, para mí es	To sleep well, for me is	Sleeping well, for me is
12.2	Que mi cuerpo se adapte a la NED y no pueda volver a alimentarme como antes, para mí es	My body has adapted to HEN and I cannot eat again as before, for me is	My body getting used to HENT and not being able to eat as before, for me is
13.2	Masticar y saborear alimentos, para mí es	Chewing and tasting food, for me is	Chewing and tasting food, for me is
14.2	Tener molestias físicas por la alimentación, para mí es	Feeling physical discomfort due to food, for me is	Feeling physical discomfort due to food, for me is
15.2	Que mi familia vigile más mi alimentación, para mí es	My family being able to better monitor my diet, for me is	The ability to my family and/or caregiver to better monitor my diet, for me is
16.2	Limitar las actividades con mis amigos a aquellas que no estén relacionadas con la comida, para mí es	To limit activities with my friends to those that are not related to food, for me is	Limiting activities with my friends to activities that do not involve food, for me is
17.2	Estar más preocupado por mi salud, para mí es	Being more concerned with my health, for me is	Being more concerned with my health, for me is

Item	Never/Sometimes/Always	Not at all important/Moderately important/Very important
1^*	With HENT (home enteral nutrition therapy), I maintain my usual eating times (example: breakfast, lunch, snack and dinner)	Maintaining my usual eating times, for me is
2^*	HENT can be adjusted to my preferences in terms of food characteristics (example: texture, color, smell, temperature, flavor)	HENT being adjusted to my preferences in terms of food characteristics, for me is
3^*	Since receiving HENT, I move more easily, and I feel more agile	Being able to move more easily and feeling more agile, for me is
4^*	With HENT, I can continue doing my daily activities (example: reading the newspaper, cooking, washing the car, cleaning, watching TV)	Being able to continue doing my daily activities, for me is
5^*	Since I started receiving HENT, I can see that my physical appearance is improving (example: I see myself as healthier)	Improving my physical appearance, for me is
6^*	Obtaining HENT preparations is simple (e.g., buy online, buy in a physical store, provided by the municipality), or I make the recipe at home	Easily obtaining or preparing HENT preparations, for me is
7^*	With HENT, I trust that I am well nourished	Trusting that I am well nourished, for me is
8^*	With HENT, I regained weight	Regaining weight, for me is
9^**	HENT allows me to go out with my friends and/or family	Being able to go out with my friends and/or family, for me is
10^*	The tube used for HENT damages my skin (example: dryness, irritation, infections)	Skin damage caused by the use of the tube, for me is
11^*	HENT prevents me from sleeping well	Sleeping well, for me is
12^*	I worry that my body will get used to HENT and that I cannot go back to eating as before	My body getting used to HENT and not being able to eat as before, for me is
13^*	With HENT, I miss chewing and tasting food	Chewing and tasting food, for me is
14^*	With HENT, I feel physical discomfort due to feeding (e.g., heavy stomach, burning sensations, dry mouth, reflux)	Feeling physical discomfort due to food, for me is
15^*	With HENT, my family and/or caregiver monitors my diet better	The ability of my family and/or caregiver to better monitor my diet, for me is
16^**	With HENT, I limit activities with my friends to activities that do not involve food	Limiting activities with my friends to activities that do not involve food, for me is
17^**	Since I started receiving HENT, I am more concerned about my health	Being more concerned with my health, for me is

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[1] Correspondence to:
L. G. GARCIA. E-mail: <livia.ferreira@ufla.com>.

Brasil

Brasil

Translation and cross-cultural adaptation of the NutriQoL® questionnaire to the Portuguese language: Brazilian version

Tradução e adaptação do questionário NutriQoL® para a língua portuguesa: versão Brasileira

ABSTRACT

Objective

Methods

Results

Conclusion

Translation and cross-cultural adaptation of the NutriQoL^® questionnaire to the Portuguese language: Brazilian version

Tradução e adaptação do questionário NutriQoL^® para a língua portuguesa: versão Brasileira