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Cross-cultural adaptation of the Brazilian version of the Speech-Specific Reinvestment Scale – SSRS

ABSTRACT

Purpose

To present the cross-cultural equivalence of the Brazilian version of the Specific Reinvestment Scale in Speech – SRRS through its cultural and linguistic adaptation.

Methods

After the SSRS was translated into Brazilian Portuguese, the back-translation was done and the items were compared. Discrepancies were modified by consensus of a committee of SLPs. The SSRS, named “Escala de Reinvestimento Específico na Fala – EREF”, has 39 questions and six alternatives in the answer key: “strongly disagree”, “disagree”, “slightly disagree”, “slightly agree”, “agree” and “strongly agree”. The mean score is computed by the sum of each subdimension. Negative items may not be included in the EREF scoring or need reversed coding process before using them. For cultural equivalence, the EREF was applied to a total of 74 professionals working in an activity involving communication with the public, speakers of Brazilian Portuguese as a first language, with an extra item in the answer key - “not applicable” - to identify issues that might not have been understood or were not appropriate for the target population and Brazilian culture.

Results

The scale was initially applied to 56 participants, thirteen of whom found it difficult to complete 27 questions. After adaptation of those sentences, the modified EREF was applied to 13 more participants and no further cultural and / or conceptual barriers were found.

Conclusion

Cultural equivalence between the SSRS and its translated version to Brazilian Portuguese – EREF was verified. The next steps for the EREF validation for Brazilian Portuguese will be carried out.

Keywords
Voice; Validation Studies; Communication; Voice Quality; Speech, Language and Hearing Sciences; Questionnaires; Evaluation Studies; Translations

RESUMO

Objetivo

Realizar a equivalência cultural da versão brasileira da escala SSRS, por meio de sua adaptação cultural e linguística.

Método

Após tradução da SSRS para o português brasileiro e retro tradução para o inglês, os itens foram comparados com o instrumento original. As discrepâncias existentes foram modificadas por consenso por um comitê de fonoaudiólogos, resultando na Escala de Reinvestimento Específico na Fala – EREF. A EREF tem 39 questões e seis alternativas na chave de resposta: “discordo totalmente”, “discordo”, “discordo ligeiramente”, “concordo ligeiramente”, “concordo” e “concordo totalmente”. A pontuação é a soma das pontuações médias de cada subdimensão da escala, sendo que os itens negativos não entram na contabilidade ou exigem pontuação reversa. Para a equivalência cultural, a EREF foi aplicada em um total de 74 profissionais em exercício de atividade envolvendo comunicação com público, falantes do português brasileiro como primeira língua, com acréscimo da opção “não aplicável” na chave de respostas, para identificação de questões não compreendidas ou não apropriadas para a população alvo e cultura brasileira.

Resultados

A escala foi inicialmente aplicada em 56 participantes. Treze encontraram dificuldade para o preenchimento de 27 questões. Após a adaptação da tradução das sentenças não compreendidas ou consideradas inapropriadas, a EREF modificada foi aplicada em mais 13 respondentes e não foram encontradas barreiras culturais e/ou conceituais.

Conclusão

Foi verificada equivalência cultural entre a SSRS e sua versão traduzida para o português brasileiro, a EREF. As próximas etapas para validação da EREF para o Português Brasileiro serão realizadas com a conclusão desta fase.

Descritores
Voz; Estudos de Validação; Comunicação; Qualidade da Voz; Fonoaudiologia; Questionários; Estudos de Avaliação; Tradução (produto)

INTRODUCTION

Communication is fundamental in all spheres of human relationships, whether in personal, business, or educational relationships. The term communicate comes from the Latin – communicare – which means “to make it common”(11 Nöth W. Comunicação: os paradigmas da simetria, antissimetria e assimetria. Matrizes. 2011;1:85-108. https://doi.org/10.11606/issn.1982-8160.v5i1p85-107.
https://doi.org/10.11606/issn.1982-8160....
). In other words, communication is efficient when the interlocutor can transmit the desired message to the receiver, who fully understands it. The message can be encoded in different ways, whether verbal – through speech or writing – or non-verbal – such as using gestures and facial expressions. In an oral speech, verbal and non-verbal language is always present, whether the interlocutor is aware of them or not, and for good communication, one must agree with the other, completing each other and in coherence.

Communication has always been important and has stood out more and more since the professions that use communication as the main factor in the development of their work are increasing at the expense of manual work(22 Svec JG, Behlau M. April 16th: the World Voice Day. Folia Phoniatr Logop. 2007;59(2):53-4. http://dx.doi.org/10.1159/000098337. PMid:17337894.
http://dx.doi.org/10.1159/000098337...
). At the end of the 20th century, 62% of the workforce based their livelihood on communication skills - hearing, voice, speech, and language - and 38% who did not use communication for work - such as farmers and workers – needed it for proper insertion into society. In other words, communication is fundamental for professional and personal growth, and its competence is increasingly demanded in society(33 Ruben RJ. Redefining the survival of the fittest:communication disorders in the 21st century. Laryngoscope. 2000;110(2 Pt 1):241-5. http://dx.doi.org/10.1097/00005537-200002010-00010. PMid:10680923.
http://dx.doi.org/10.1097/00005537-20000...
).

Developing communication skills and bringing verbal and non-verbal language into agreement requires training and knowledge. To help those people with difficulty and make this training more specific and direct, it is important to assess the skills involved in communication, including self-assessment protocols.

Self-assessment protocols are important tools for measuring individuals' knowledge about the impact of their condition – whether it is a problem or something to be improved – on their social and professional relationships(44 WHO: World Health Organization. WHOQOL. Measuring Quality of Life. The World Health Organization Quality of Life Instruments (THE WHOQOL-100 AND THE WHOQOL-BREF). Geneva: WHO; 1997.). Despite their frequent use, most of them are still aimed at health issues such as quality of life questionnaires. In Brazil, there are still few instruments capable of investigating the self-assessment of an individual's communication. However, this panorama should change due to the importance of communication.

The “Speech-Specific Reinvestment Scale - SSRS”(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
) is a new psychometric measure that aims to quantify someone's predisposition to exercise conscious control and monitoring of speech. It encompasses issues not only of conscious control over speech movements (tongue, lip, and jaw movement) but also conscious monitoring of the content and manner of speaking, as well as facial and body movement to achieve the ultimate goal of communication, that is, to allow the recipient to perceive and understand the speech.

The scale was developed based on the reference of the Reinvestment Theory(66 Masters RSW. Knowledge, knerves and know-how: the role of explicit versus implicit knowledge in the breakdown of a complex motor skill under pressure. Br J Psychol. 1992;83(3):343-58. http://dx.doi.org/10.1111/j.2044-8295.1992.tb02446.x.
http://dx.doi.org/10.1111/j.2044-8295.19...

7 Masters RS, Polman RC, Hammond NV. “Reinvestment”: A dimension of personality implicated in skill breakdown under pressure. Pers Individ Dif. 1993;14(5):655-66. http://dx.doi.org/10.1016/0191-8869(93)90113-H.
http://dx.doi.org/10.1016/0191-8869(93)9...
-88 Masters RS, Maxwell J. The theory of reinvestment. Int Rev Sport Exerc Psychol. 2008;1(2):160-83. http://dx.doi.org/10.1080/17509840802287218.
http://dx.doi.org/10.1080/17509840802287...
) on body limb motor control. According to this theory, motor skills require two types of processing: implicit and explicit. The first is beneficial for well-practiced, relatively automated motor skills, working with pre-established knowledge and requiring little attention and working memory resources. On the other hand, the second is rule-based and requires considerable attention and working memory resources.

People can be high or low reinvestors and those who reinvest high are more likely to fail in stressful situations that involve complex skills and are linked to rules(66 Masters RSW. Knowledge, knerves and know-how: the role of explicit versus implicit knowledge in the breakdown of a complex motor skill under pressure. Br J Psychol. 1992;83(3):343-58. http://dx.doi.org/10.1111/j.2044-8295.1992.tb02446.x.
http://dx.doi.org/10.1111/j.2044-8295.19...

7 Masters RS, Polman RC, Hammond NV. “Reinvestment”: A dimension of personality implicated in skill breakdown under pressure. Pers Individ Dif. 1993;14(5):655-66. http://dx.doi.org/10.1016/0191-8869(93)90113-H.
http://dx.doi.org/10.1016/0191-8869(93)9...
-88 Masters RS, Maxwell J. The theory of reinvestment. Int Rev Sport Exerc Psychol. 2008;1(2):160-83. http://dx.doi.org/10.1080/17509840802287218.
http://dx.doi.org/10.1080/17509840802287...
). Thus, when elaborating the SSRS scale, the authors hypothesized that the personality trait predisposing to awareness of control and monitoring of speech would be negatively related to performance in conversational speech. The results pointed to the confirmation of the hypothesis.

Also, the results validated four SSRS sub-dimensions, one of control and three of speech monitoring: 1. Sub-dimension of self-awareness of speech movement - SASN, 2. Sub-dimension of public awareness of the way of speaking - PASC, 3. Sub-dimension of public awareness of movement during the speaking content - PMASC, 4. Sub-dimension of public awareness of movement during speech - PAMS(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
). The scale enables to assessment of the sub-dimensions distinctly or jointly, which makes it even more robust to examine any variable effects on speech performance, including non-verbal ones, as suggested by the Reinvestment Theory literature(99 Malhotra N, Poolton JM, Wilson MR, Uiga L, Masters RSW. Examining movement-specific reinvestment and performance in demanding contexts. J Sport Exerc Psychol. 2015;37(3):327-38. http://dx.doi.org/10.1123/jsep.2014-0220. PMid:26265344.
http://dx.doi.org/10.1123/jsep.2014-0220...
).

Since the Speech-Specific Reinvestment Scale – SSRS(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
) was developed in English, to use it in other languages, it must be translated and culturally adapted according to the international rules of the Scientific Advisory Committee of Medical Outcome Trust(1010 Aaronson N, Alonso J, Burnam A, Lohr KN, Patrick DL, Perrin E, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11(3):193-205. http://dx.doi.org/10.1023/A:1015291021312. PMid:12074258.
http://dx.doi.org/10.1023/A:101529102131...
).

This study aimed to carry out the cultural equivalence of the Brazilian version of the SSRS scale, through its cultural and linguistic adaptation.

We should emphasize that, as this is a new scale, there is still no repercussion of its use, although it has great potential. The Brazilian adaptation is the first to be carried out with the instrument.

METHODS

After formal authorization from the authors to use the Speech-Specific Reinvestment Scale - SSRS(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
) instrument, the research was approved by the Research Ethics Committee of the Federal University of São Paulo/CEP UNIFESP (opinion number 4.356.465 and CAAE: 36606720.0 .0000.5505). All participants signed the Informed Consent Form – ICF.

Adult professionals participated in an activity involving oral communication with the people, with a minimum experience of three months in the position. There was no distinction of the level of communication use, age, or socioeconomic-cultural level for this study.

The original version was translated into Brazilian Portuguese by two speech-language therapists fluent in the foreign language (Translator 1 and Translator 2). These translations were superimposed, resulting in the first version in Portuguese – PV, maintaining the conceptual integrity of the items. The back-translation was performed by a third speech-language therapist, also fluent in English, without access to the original version of the instrument and the study objectives.

The translation and back-translation were compared to each other and the original instrument. A committee composed of five speech-language therapists specialized in voice, with proficiency in English and knowledge of specific vocabulary for communication assessment analyzed and discussed the existing discrepancies. The necessary changes were carried out by consensus resulting in the Committee's version 1 – the semantic and language equivalence version, entitled Escala de Reinvestimento Específico da Fala – EREF.

The EREF followed the original protocol, remaining with 39 questions and six alternatives to mark the frequency of occurrence of the situation described in: totally disagree (1), disagree (2), slightly disagree (3), slightly agree (4), agree (5), totally agree (6). At that time, the four sub-dimensions of the scale were still maintained: 1. Sub-dimension of self-awareness of speech movement, 2. Sub-dimension of public awareness of the way of speaking, 3. Sub-dimension of public awareness of movement during the speaking content, 4. Sub-dimension of public awareness of movement during speech. The score for each sub-dimension of SSRS(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
) is calculated using the average scoring method. The average composite score for the EREF is calculated by the equally weighted sum of the four average scores for the sub-dimensions. To calculate the averages of each sub-dimension and composite average score, these steps are followed:

Q.1-13: Sub-dimension of self-awareness of speech movement

Total score: ___ ÷ 13 = Average sub-dimension score: ___

Q.15-27: Sub-dimension of public awareness of the way of speaking

Total score: ___ ÷ 13 = Average sub-dimension score:___

Q.29-33: Sub-dimension of public awareness of movement during the speaking content

Total Score: ___ ÷ 5 = Average sub-dimension score: ___

Q.35-38: Sub-dimension of public awareness of movement during speech

Total Score: ___ ÷ 4 = Average sub-dimension score: ___

Total = Sum of average scores:_________

It is important to emphasize that there are four negative questions in the EREF - one for each subdimension of the scale. Questions 14, 28, 34, and 39 are not part of the total EREF score, as they were developed to check the quality of individuals' responses, including reliability. If the evaluator feels the need to include them in the score, he must remember to perform the reverse score, as described in the original protocol(55 Lo ESC, Wong AWK, Tse ACY, Ma EPM, Whitehill TL, Masters RSW. Development of a psychometric measure of the propensity to consciously control and monitor speech production. J Speech Lang Hear Res. 2020;63(4):963-82. http://dx.doi.org/10.1044/2020_JSLHR-19-00365. PMid:32310711.
http://dx.doi.org/10.1044/2020_JSLHR-19-...
).

For cultural equivalence, the EREF was applied to 74 speaking voice professionals with the addition of the option “not applicable” to identify issues not understood or inappropriate for the target population and Brazilian culture. A space for filling in observations was also added at the end of the scale, allowing volunteers to explain their difficulties or doubts. If volunteers found any difficulty in answering the scale, a new translation and adaptation should be carried out until cultural and/or conceptual barriers were no longer found.

RESULTS

In the first stage, 61 individuals responded to the EREF online. Five answers were incompletes. Therefore, 56 individuals were included in the sample. Of these, 13 indicated “not applicable” in at least one of the scale's questions. A total of 27 questions were identified as not understood or not appropriate for the target population and Brazilian culture and were discussed by the Speech-Language Pathologist committee. Question two, for example, was changed from “I am aware of how my mouth moves when I speak” to “I notice how my mouth moves when I speak” to use an easily accessible language and closer to all respondents. Also, it was decided to add the pronoun “I” to all questions, excluding sentences with hidden subjects to avoid any misinterpretation. As an example, we have question five, in which the phrase “I think of the movement of my lips when speaking” was adjusted to “I think of the movement of my lips when I speak”.

Also, the Committee of Speech-Language Pathologists analyzed what the respondents had written in the space for observations, and they concluded that many had marked “not applicable” not because the questions had not been understood, but because those individuals had never paid attention to the context of the question. Thus, they should have marked “disagree” as they do not agree with that statement instead of “not applicable”. Therefore, the instructions for filling out the scale were revised for proper filling.

The initial instruction was: “Select the most appropriate options to indicate how much you agree with each of the statements: (1) Totally Disagree, (2) Disagree, (3) Slightly Disagree, (4) Slightly Agree, (5) Agree, (6) Totally agree (Note: There is no right or wrong answer for each sentence). If you do not understand any of the phrases or understand that it is not appropriate for the scale, select the option “not applicable”. At the end of the sentences, there is a space to fill in “comments.” After deliberation by the Committee of Speech-Language Pathologists and the understanding that the instructions should be clearer, there was a change to: “Select the most appropriate options to indicate how much you agree with each of the statements: (1) Totally disagree, (2) Disagree, (3) Slightly disagree, (4) Slightly agree, (5) Agree, (6) Totally agree (Note: There is no right or wrong answer for each sentence). If you do not understand any of the phrases or understand that this question within the questionnaire does not make sense, select the option “not applicable”. This marking should only be performed in these cases. If you select “not applicable”, we ask that you explain your difficulties or doubts in the space dedicated to filling in the comments at the end of the sentences.”

The adjusted EREF - version 2 of the Speech-Language Pathologist Committee - was applied to 13 new respondents, totaling 69 volunteers included in the sample and no cultural and/or conceptual barriers were identified. Figure 1 shows the mapping of the participants and Box 1 shows their characterization.

Figure 1
Organizational chart for completing the survey questionnaire and inclusion and exclusion of participants
Box 1
Characterization of the sample according to gender, age (in years), and profession.

This last version applied, then resulted in the final version of the EREF, following cultural and linguistic equivalence. Box 2 shows the entire process of translation, semantic and cultural equivalence of the SSRS into Brazilian Portuguese.

Box 2
Process of translation and cultural adaptation of the Speech-Specific Reinvestment Scale - SSRS to Brazilian Portuguese

The final composition of the translated and the culturally adapted Brazilian version of the SSRS, called EREF (Annex 1), has 39 items, like the original protocol.

DISCUSSION

Communication plays a great power within today's society. Using communication, we can convince, persuade, influence, arouse interests and feelings, and even provoke expectations in the interlocutor(1111 Pinheiro DCS. O papel do plano de comunicação preventivo em momento de crise na organização [Trabalho de Conclusão de Curso]. Goiânia: Faculdade de Informação e Comunicação, Universidade Federal de Goiás; 2005.). Within an organization, for example, well-used communication can establish peaceful relationships, homogenization, and integration of ideas. Communication is a means as well as a tool and, considering its fundamental role, there must be a way to evaluate it, in its different aspects. For this purpose, the SSRS was created.

When a new protocol is proposed, there are rules in its development so that there are no difficulties in its application with the target population. The same must be thought for the use of this protocol in other countries. Therefore, the validation of the protocol for each language and culture is essential. Obtaining cultural equivalence is the first step for the validation of protocols and aims to eliminate cultural and linguistic barriers between the instrument and its target population in different countries(1010 Aaronson N, Alonso J, Burnam A, Lohr KN, Patrick DL, Perrin E, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11(3):193-205. http://dx.doi.org/10.1023/A:1015291021312. PMid:12074258.
http://dx.doi.org/10.1023/A:101529102131...
). The cultural equivalence model used for this research has already been successfully performed in validations of other protocols in Brazil(1212 Gasparini G, Behlau M. Quality of Life: Validation of the Brazilian Version of the Voice-Related Quality-of-Life (V-RQOL) Measure. J Voice. 2009;23(1):76-81. http://dx.doi.org/10.1016/j.jvoice.2007.04.005. PMid:17628396.
http://dx.doi.org/10.1016/j.jvoice.2007....

13 Costa T, Oliveira G, Behlau M. Validation of the Voice Handicap Index: 10 (VHI-10) to the Brazilian Portuguese. CoDAS. 2013;25(5):482-5. http://dx.doi.org/10.1590/S2317-17822013000500013. PMid:24408554.
http://dx.doi.org/10.1590/S2317-17822013...

14 Moreti F, Zambon F, Oliveira G, Behlau M. Cross-cultural adaptation, validation, and cutoff values of the Brazilian version of the Voice Symptom Scale-VoiSS. J Voice. 2014;28(4):458-68. http://dx.doi.org/10.1016/j.jvoice.2013.11.009. PMid:24560004.
http://dx.doi.org/10.1016/j.jvoice.2013....
-1515 Behlau M, Rocha BR, Englert M, Madazio G. Validation of the Brazilian Portuguese CAPE-V Instrument—Br CAPE-V for Auditory-Perceptual Analysis. J Voice. 2020. In press. https://doi.org/10.1016/j.jvoice.2020.07.007.
https://doi.org/10.1016/j.jvoice.2020.07...
).

The cultural equivalence of the SSRS began with the cultural and linguistic adaptation, in which the version of the scale for semantic and language equivalence is applied. In this phase, 27 questions were identified as not understood or not appropriate for the target population and Brazilian culture and were discussed by the Speech-Language Pathologist Committee. The high number of questions with barriers for the target population (69%) raised the discussion by the Speech-Language Pathologists Committee regarding the understanding of the scale by the target population. Many respondents had not understood the real function of the “not applicable” option and instead of ticking it when they believed the question was not appropriate to the scale, some were checking this option because they did not fulfill the context of the question in their tasks of communication. That is, instead of answering the question following the frequency of responses from 1 to 6, the respondents put “not applicable”. This situation led to the need to review the instructions for filling out the scale and, in a new application, no difficulties were observed.

The cultural adaptation step is essential for the scale's language to approach the target population and for the consistency of the form of communication to be maintained in all questions. This step should be performed as many times as necessary until the scale/protocol is accepted by the target population. The SRSS for Brazilian Portuguese needed two reviews to be accepted.

With the completion of the cultural and linguistic equivalence process for Brazilian Portuguese, the EREF validation process that is the name of the adapted scale will begin. Its use will be important, as most voice self-assessment protocols are disease-specific, are not suitable for individuals with healthy voices, and do not address other oral communication issues. The SSRS is a specific scale for voice professionals and will be essential in Brazil to assess those who use the voice as their work tool, regardless of the level of classification of professional voice use.

CONCLUSION

Cultural equivalence between the SSRS and its version translated into Brazilian Portuguese called the EREF was verified. Therefore, the other validation of the EREF for Brazilian Portuguese will be started.

Annex 1. Translated and culturally adapted version of the Speech-Specific Reinvestment Scale –SSRS, called Escala de Reinvestimento Específico da Fala – EREF in Portuguese.

Pergunta 1 a 39: As frases a seguir descrevem sua autorreflexão enquanto fala no português brasileiro.

As questões precisam ser lidas com atenção. Algumas são positivas e outras negativas.

Selecione as opções mais adequadas para indicar o quanto você concorda com cada uma das questões:

1: Discordo totalmente

2: Discordo

3: Discordo ligeiramente

4: Concordo ligeiramente

5: Concordo

6: Concordo totalmente

(Nota: Não há resposta certa ou errada para cada frase)

Discordo Totalmente Concordo Totalmente
1 Eu avalio o movimento da minha boca quando eu falo. 1 2 3 4 5 6
2 Eu percebo como a minha boca se move quando eu falo. 1 2 3 4 5 6
3 Eu dedico tempo para refletir sobre o movimento da minha boca depois de falar. 1 2 3 4 5 6
4 Eu dedico tempo para pensar no movimento da minha boca antes de falar. 1 2 3 4 5 6
5 Eu penso no movimento dos meus lábios quando eu falo. 1 2 3 4 5 6
6 Eu penso no movimento da minha língua quando eu falo. 1 2 3 4 5 6
7 Eu penso no movimento da minha mandíbula quando eu falo. 1 2 3 4 5 6
8 Eu penso no movimento da minha laringe quando eu falo. 1 2 3 4 5 6
9 Eu tento descobrir como o movimento da minha boca gera a pronúncia das palavras. 1 2 3 4 5 6
10 Eu repenso em como o movimento da minha boca me ajudou a falar sem dificuldades. 1 2 3 4 5 6
11 Eu penso em como o movimento da minha boca me ajudou a falar sem dificuldades. 1 2 3 4 5 6
12 Eu tento entender como minha fala surge do movimento da minha boca. 1 2 3 4 5 6
13 Eu percebo como minha boca se move para o que eu quero falar. 1 2 3 4 5 6
14 Eu não tento descobrir como o movimento da minha boca gera a pronúncia das palavras. 1 2 3 4 5 6
15 Eu me preocupo com a voz que eu uso para me apresentar aos outros. 1 2 3 4 5 6
16 Antes de falar com outras pessoas, eu penso como está minha pronúncia. 1 2 3 4 5 6
17 Eu me preocupo com a minha pronúncia quando eu sou convidado a dar minhas opiniões. 1 2 3 4 5 6
18 Eu fico preocupado(a) com o que as outras pessoas pensam sobre o volume da minha fala. 1 2 3 4 5 6
19 Eu me preocupo com o volume da minha fala quando eu estou me apresentando para outras pessoas. 1 2 3 4 5 6
20 Eu me preocupo em causar uma boa impressão no volume da minha fala. 1 2 3 4 5 6
21 Antes de falar com outras pessoas, eu penso no volume da minha fala. 1 2 3 4 5 6
22 Eu me preocupo com o volume da minha fala quando eu sou convidado(a) a dar minha opinião. 1 2 3 4 5 6
23 Eu fico preocupado(a) com o que as outras pessoas pensam sobre a velocidade da minha fala. 1 2 3 4 5 6
24 Eu me preocupo com a velocidade da minha fala quando eu estou me apresentando para outras pessoas. 1 2 3 4 5 6
25 Eu me preocupo em causar uma boa impressão com a velocidade da minha fala. 1 2 3 4 5 6
26 Antes de falar com outras pessoas, eu penso na velocidade da minha fala. 1 2 3 4 5 6
27 Eu me preocupo com a velocidade da minha fala quando eu sou convidado a dar minha opinião. 1 2 3 4 5 6
28 Antes de falar com outras pessoas, eu não penso em como está minha pronúncia das palavras. 1 2 3 4 5 6
29 Eu fico preocupado com o que as outras pessoas pensam sobre o conteúdo da minha fala. 1 2 3 4 5 6
30 Eu me preocupo com a organização do conteúdo do que eu vou falar ao me apresentar para outras pessoas. 1 2 3 4 5 6
31 Eu me preocupo em causar uma boa impressão com o conteúdo da minha fala. 1 2 3 4 5 6
32 Antes de falar com outras pessoas, eu penso no conteúdo do que eu vou falar. 1 2 3 4 5 6
33 Eu me preocupo com o conteúdo do que eu vou falar quando eu sou convidado(a) a dar minhas opiniões. 1 2 3 4 5 6
34 Eu não fico preocupado(a) com o que as outras pessoas pensam sobre o conteúdo do que eu vou falar. 1 2 3 4 5 6
35 Eu fico preocupado(a) com o que as outras pessoas pensam sobre o movimento da minha face quando eu falo. 1 2 3 4 5 6
36 Eu fico preocupado(a) com o que as outras pessoas pensam sobre o movimento do meu corpo quando eu falo. 1 2 3 4 5 6
37 Eu me preocupo em causar uma boa impressão com o movimento da minha face quando eu falo. 1 2 3 4 5 6
38 Eu me preocupo com o movimento da minha face quando eu sou convidado(a) a dar minhas opiniões. 1 2 3 4 5 6
39 Eu não me preocupo em causar uma boa impressão com os movimentos da minha face quando eu falo. 1 2 3 4 5 6
  • Study conducted at Universidade Federal de São Paulo – UNIFESP - São Paulo (SP), Brasil
  • Financial support: nothing to de declare.

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Publication Dates

  • Publication in this collection
    21 Jan 2022
  • Date of issue
    2022

History

  • Received
    24 Nov 2020
  • Accepted
    16 July 2021
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