Tradução e adaptação transcultural do exame neurológico de dubowitz no Brasil

Abstract

Cross-cultural adaptation refers to a complex process, which aims to verify language problems and cultural adequacy in preparing an instrument for use in another environment. In Brazil, the lack of adapted and validated child neurological assessment instruments becomes a challenge for health services and research. Thus, this study aimed to perform the translation and cross-cultural adaptation into Brazilian Portuguese of the neurological assessment instrument named Dubowitz Neurological Examination, making it available for use in Brazil, in addition to investigating the factors associated with the Exame Neurológico de Dubowitz score (END) in premature newborns (PTNB). The methodological process consisted of two translations of the instrument from the original language to the target language, a synthesis of the translations, two back-translations from the target language to the original language, evaluation by a committee of judges, pre-test and preparation of the final version. After this process, the adapted instrument was applied to 40 PTNBs, in addition to a sociodemographic questionnaire being applied to parents. The present study demonstrated an agreement among the judges of 98.03%, and the Kappa index value was 0.76, indicating a substantial agreement. The understanding of the 34 items of the instrument in the pre-test phase varied from 82% to 100%. In addition, PTNBs with a low score on the END had low gestacional age, a longer hospitalization period and a greater need for orotracheal intubation. Positive correlations were also found between domains of END and birth weight, age of mother and APGAR in the fifth minute, income and maternal and paternal education. Linear regression analyzes explained 26% of the variance of the END, maintaining weight, income and age as significant predictors. We concluded that the END was adequately translated and adapted to Brazilian culture. The importance of the neurological assessment of the premature neonate in the first months of life is emphasized, in order to provide early intervention to the PTNB who presents changes in the assessment.