Loch, Ana Paula; Finch, Tracy; Fonsi, Mylva; Soárez, Patrícia Coelho de

doi:10.1590/1806-9282.66.10.1383

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 66 (10) • Out 2020 • https://doi.org/10.1590/1806-9282.66.10.1383 copiar

Cross-cultural adaptation of the NoMAD questionnaire to Brazilian Portuguese

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

INTRODUÇÃO:

O questionário Normalisation Measure Development (NoMAD) tool busca identificar os fatores contextuais determinantes no processo de implementação de intervenções complexas em saúde. Este artigo tem por objetivo traduzir e adaptar culturalmente o NoMAD para o português do Brasil.

MÉTODOS:

A adaptação transcultural foi realizada em cinco etapas: 1-Tradução do questionário para o português; 2-Síntese e criação da primeira versão; 3-Retro-tradução do instrumento para a língua de origem; 4-Revisão por grupo de especialista e profissionais-alvo do instrumento; e 5-Pré-teste. A versão final do questionário foi respondida por usuários do sistema de monitoramento clínico em serviços de assistência especializada às pessoas vivendo com HIV/AIDS e sua consistência interna foi avaliada por meio de alpha de Cronbach.

RESULTADOS:

O questionário foi respondido por 188 profissionais, 87,7% eram do sexo feminino e média de idade de 45,2 anos. A versão final do questionário apresentou α de Cronbach superiores a 0.70 nos construtos coerência (0.74), ação coletiva (0.70), participação cognitiva (0,71) e monitoramento reflexivo (0.81).

CONCLUSÃO:

O questionário NoMAD foi adaptado transculturalmente e pode ser utilizado para avaliar a implementação de intervenções complexas no cuidado em saúde.

PALAVRAS-CHAVE:
Ciência da implementação; Inquéritos e Questionários; Promoção da Saúde/organização & administração

Characteristics	N (%)
Gender
Female	164 (87.7)
Male	23 (12.3)
Age
Mean (minimum - maximum)	45.2 (20.6 – 75.6)
Education
Elementary School	1 (0.5)
High school	7 (3.7)
Technical high school	4 (2.1)
Incomplete higher education	5 (2.7)
Higher education	47 (25.0)
Higher education with specialization	92 (48.9)
Master degree	10 (5.3)
PhD	2 (1.1)
Not filled	20 (10.6)
Working time in the health service
Less than one year	8 (4.3)
From 1 to 2 years	33 (17.6)
From 3 to 5 years	33 (17.6)
From 6 to 10 years	33 (17.6)
From 11 to 15 years	24 (12.8)
More than 15 years	53 (28.2)
Not filled	4 (2.1)
Occupation
Manager	47 (25)
Nurse	43 (22.9)
Pharmacist	19 (10.1)
Doctor	14 (7.4)
Administrative assistant	9 (4.8)
Nursing technician	9 (4.8)
Social worker	6 (3.2)
Psychologist	6 (3.2)
Pharmacy assistant	5 (2.7)
Health agent	4 (2.1)
Nursing assistant	2 (1.1)
Dentist	1 (0.5)
Intern	1 (0.5)
Others	22 (11.7)
General questions about the intervention:
Q1. When you use SIMC, how familiar does it feel?	2.5 (3.4)
Q2. Do you think that the SIMC is currently used regularly as part of your job?	2.9 (3.2)
Q3. Do you think that the SIMC will become a regular part of your job?	7.1 (2.8)

NoMAD item according to the theoretical construct	Mean (Standard Deviation)	1-Stronglydisagree	2-Dis-agree	3-Neither agree nor disagree	4-Agree	5- Strong-ly agree
Coherence
CO1. I am able to perceive how the SIMC can bring changes in the current work routine.	(n=176; 12 Neutral).	4.1 (0.6)	-	21 (11.9%)	109 (61.9%)	46 (26.1%)
CO2. The employees of this organization have a shared understanding of the purpose of the SIMC (n=169; 19 Neutral).	3.5 (0.9)	-	46 (30.3%)	77 (50.7%)	4 (2.6%)	25 (16.5%)
CO3. I understand how the SIMC affects the essential activities of my own work (n=174; 14 Neutral).	3.9 (0.6)	-	4 (2.3%)	32 (18.4%)	109 (62.6%)	29 (16.7%)
CO4. I can see how the SIMC improves and facilitates my work. (n=171; 17 Neutral).	3.9 (0.7)	-	6 (3.5%)	37 (21.6%)	96 (56.1%)	32 (18.7%)
Cognitive Participation
PC1. There are people who decisively boost the use of the SIMC and get others involved. (n=169; 19 Neutral).	3.7 (0.8)	-	40 (24.4%)	86 (61%)	1 (0.7%)	14 (9.9%)
PC2. I believe that participating in the SIMC is a legitimate part of my role (n=180; 8 Neutral).	4.0 (0.7)	-	5 (2.8%)	26 (14.4%)	106 (58.9%)	43 (23.9%)
PC3. I am willing to take up new ways of working with my colleagues, with a view to using the SIMC. (n=181; 7 Neutral).	4.2 (0.5)	-	1 (0.6)	11(6.1%)	124 (68.5%)	45 (24.9%)
PC4. I shall continue to give my support for the SIMC (n=176; 12 Neutral).	4.2 (0.5)	-	-	9 (5.1%)	113 (64.2%)	54 (30.7%)
Collective action
AC1. I can easily integrate the SIMC into my existing work (n=170; 18 Neutral).	3.6 (0.8)	1 (0.6%)	20 (11.8%)	46 (27%)	85 (50%)	18 (10.6%)
AC2. The SIMC hinders labor relations between workers (n=171; 17 Neutral).	2.0 (0.8)	46 (26.9%)	87 (50.9%)	32 (18.7%)	6 (3.5%)	-
AC3. I trust the abilities of other people to use the SIMC (n=172; 16 Neutral).	3.8 (0.7)	1 (0.6%)	9 (5.2%)	38 (22.1%)	101 (58.7%)	23 (13.4%)
AC4. The activities/functions related to the use of the SIMC are given to professionals with adequate capacity to perform them (n=172; 16 Neutral).	3.9 (0.6)	-	2 (1.2%)	35 (20.3%)	107 (62.2%)	28 (16.3%)
AC5. Staff receives sufficient training to enable them to implement the SIMC (n=165; 23 Neutral).	3.1 (1.1)	14 (8.5%)	36 (21.8%)	46 (27.9%)	57 (34.5%)	12 (7.3%)
AC6. The resources available suffice to give due support to the SIMC (n=168; 20 Neutral).	3.4 (0.9)	3 (1.8%)	25 (14.9%)	62 (36.9%)	65 (38.7%)	13 (7.7%)
AC7. The management gives appropriate support to the SIMC (n=171; 17 Neutral).	3.8 (0.9)	2 (1.2%)	11 (6.4%)	42 (24.6%)	76 (44.4%)	40 (23.4%)
Reflexive Monitoring
MR1. I am aware of the reports made by professionals in [organization/department/health service] regarding the impact on the use of the SIMC (n=165; 23 Neutral).	3.5 (0.9)	5 (3%)	19 (11.5%)	39 (23.6%)	86 (52.1%)	16 (9.7%)
MR2. The employees involved agree that the SIMC is worthwhile (n=169; 19 Neutral).	3.8 (0.7)	-	6 (3.6%)	44 (26%)	89 (52.7%)	30 (17.7%)
MR3. I value the effects that the SIMC has had upon my work (n=158; 30 Neutral).	3.7 (0.8)	-	9 (5.7%)	59 (37.3%)	61 (38.6%)	29 (18.3%)
MR4. It is possible to use the team's feedback with regard to the SIMC to further improve it in the future (n=167; 21 Neutral)	3.9 (0.7)	-	7 (4.1%)	34(20.4%)	100 (59.9%)	26 (15.6%)
MR5 I am able to change my own way of working with the SIMC (n=172; 16 Neutral).	3.9 (0.6)	1 (0.6%)	2 (1.2%)	32 (18.6%)	118 (68.6%)	19 (11%)

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[1] CORRESPONDING AUTHOR: Ana Paula Loch, Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Av. Dr Arnaldo, 455, São Paulo, SP, Brasil – 01246-903 Tel: +55 11 99529-8823 E-mail: anapaulaloch@gmail.com