Transcultural adaptation of the children's anxiety questionnaire in Brazil.
Josiane Ramos Garcia Rodrigues, Marla Andréia Garcia de Avila, Milena Temer Jamas and 3 others
PMID 33611862WHAT IT FOUND
A face-based anxiety questionnaire for children now exists in Brazilian Portuguese after expert and child testing, but nurses should not treat it as validated until further testing is done.
Key findings
01Expert judges gave the adapted wording high agreement: semantic equivalence 1.0, idiomatic, conceptual and cultural equivalence 0.92, and overall agreement 0.94.
02After revising faces that children did not recognise, the second child image test showed 93.3% agreement for each feeling face and 100% agreement for 'More or less' and 'A lot'.
03In the story test with 17 children, boys and girls reported different scores for themselves and for Agatha, with 45.5% of boys and 16.7% of girls giving higher scores for Agatha.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The children were recruited by convenience sampling, so they may not represent all Brazilian hospital children. The pre-test included children aged 4 to 10 years, although the stated purpose was to assess anxiety in children aged 4 to 8 years. The child testing samples were small: 7 in the first image round, 15 in the second image round, and 17 in the story round. The study did not test how questionnaire scores relate to observed anxiety, clinical outcomes, or treatment response. Only one story, about a girl, was used, which may have affected how boys responded. Only 13 of the 61 invited healthcare professionals responded to the expert review.
The easy way to misread this
Do not conclude that the Brazilian version is a validated anxiety measure. This paper reports translation, expert agreement and small child pretesting; the authors say further validation will be done later.