CULTURAL ADAPTATION OF THE ALCOHOL, ALCOHOLISM AND ALCOHOLIC ATTITUDE SCALE - SPANISH VERSION

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1 CULTURAL ADAPTATION OF THE ALCOHOL, ALCOHOLISM AND ALCOHOLIC ATTITUDE SCALE - SPANISH VERSION Divane de Vargas Erika Gisseth León Caroline Figueira Pereira Marina Nolli Bittencourt

2 INTRODUCTION The alcohol use caused 6.2% of deaths among mens and 1.1% of deaths among woman. (OMS 2011) This use is higher in Latin America than other countries in the world. Global rate of deaths attributed to alcohol were 7.6% men and 4.0% for women (OMS 2014)

INTRODUCTION Acording to statistics, it is possible that nurses and health professionals in general, are more likely to have contact with alcoholics in their daily work.

3 INTRODUCTION Acording to statistics, it is possible that nurses and health professionals in general, are more likely to have contact with alcoholics in their daily work. which should stimulate the study of the attitudes of these professionals facing the phenomenon since there is evidence that attitudes are precursors of both the quality and quantity of care provided. ( Rassool, Villar, Carraro 2006; Rassool, Rawaf 2008; Vargas 2011)

4 INTRODUCTION Attitudes Attitudes are formed by beliefs, experiences and knowledge. Actions They are precursors Quality Care This may influence in Clinic Practice

5 INTRODUCTION There are few studies on the attitudes of health professionals in Spanish language because there is lack of instruments available in that language to measure attitudes. For this reason the adaptation of tools that enable knowledge of the Spanish speaking nurses attitudes it s necessary for the field of nursing in these regions.

6 INTRODUCTION Attiude scales available in Spanish: Nursing Education in alcohol and Drug Education NEADA: Vasquez (2005) Seaman Manello Nurses Attitudes Towards Alcohol and Alcoholism Scale: (Navarrete ; Villar 2004).

INTRODUCTION SCALES DISADVANTAGES : NEADA: No publications on the methodological process of content validity. Lack of published studies on the psychometric qualities.

7 INTRODUCTION SCALES DISADVANTAGES : NEADA: No publications on the methodological process of content validity. Lack of published studies on the psychometric qualities. SEAMAN MANELLO : There is no clarity on the technical procedures which do not meet international recommendations suggested for adaptation processes which compromises the validity and reliability of the instruments in Spanish language.

Seeking a scale with evidence of a proper process of construction, was found the Scale of

(EAFAA) Was built in 2005 in Brazil in order to cover the main groups of attitudes (moral,

refining process 165 items. It was made construct validation and reliability verification.

8 Seeking a scale with evidence of a proper process of construction, was found the Scale of attitudes towards alcohol, alcoholism and alcohol addicts. (EAFAA) Was built in 2005 in Brazil in order to cover the main groups of attitudes (moral, disease, etiologic and human factors ) Initially was 225 items It was submitted to a refining process 165 items. It was made construct validation and reliability verification. 96 items Distributed in five factors 50 items Distributed in four factors Again it was done construct validation and reliability verification.

9 AIMS GENERAL AIM Verify the content validity of the scale of attitudes of nurses towards alcohol, alcoholism and alcoholics Spanish version.

10 METHODOLOGY Research type Methodologic The instrument was adapted to the Spanish language in Colombian culture as the six steps suggested (Beaton et al., 2000) Translation, synthesis, back translation, evaluation version by a committee of judges, preparation of pre-test

11 (Beaton, 2000) METHODOLOGY

12 (Beaton, 2000) (Beaton, 2000) METHODOLOGY

13 METHODOLOGY (Beaton, 2000)

14 VALIDITY CONTENT Expert comitee review Qualitative evaluation: Semantic, idiomatic, conceptual and experimental equivalence. Quantitative evaluation: Validity content Index, Intraclass Correlation Coefficient (ICC) and Prevalence Adjusted Bias Adjusted Kappa (PABAK).

15 Study subjects Data collection instruments procedure for data collection VALIDITY CONTENT Pre-test Were selected by convenience 30 Colombian nurses Adapted version of EAFAA Questionnaire sociodemographic data Nurses were contacted personally in the workplace

16 RESULTS The total content validity index was 0,97 Items that have values less than 0.7 were considered for exclusion or adjustment. Were evaluated: Item representativeness Clarity Theoretical dimension 92% of the items had values above 0,7. 8% corresponds to 4 items. Three of them needed adjustments and one item (I20) was deleted. These results concide with the suggestions made by the experts.

17 RESULTS Intraclass Correlation Coefficient Type Intraclass Lower Upper Tipo Correlation a Bound Bound Value df1 df2 Sig Representatividade Item Single Measures.205 b,081,622 16, ,000 representativeness Average Measures.928 c,815,988 16, ,000 Clareza Clarity FatorTheoretical dimension Intraclass Correlation Coefficient 95% Confidence Interval F Test with True Value 0 The scale presented adequate correlation values above 0.8 Single Measures.200 b,078,615 15, ,000 Average Measures.926 c,810,988 15, ,000 Single Measures.074 b,020,362 5, ,000 Average Measures.800 c,503,966 5, ,000

18 RESULTS Prevalence Adjusted Bias Adjusted Kappa (PABAK) Less than zero = minimum agreement or inadequate Higher than zero = strong agreement. Item representativeness: 0,891. Clarity : 0,877. Theoretical dimension: 0,765.

FINAL CONSIDERATIONS To make modifications to the instrument were taken into consideration: Analysis of the results obtained in the qualitative assessment

19 FINAL CONSIDERATIONS To make modifications to the instrument were taken into consideration: Analysis of the results obtained in the qualitative assessment (semantic, conceptual and idiomatic equivalence) The results obtained through the applied statistical tests IVC, ICC and the adjusted kappa Index (PABAK).

20 FINAL CONSIDERATIONS Application of the pre-test The data obtained from responses were organized and analyzed in Microsoft Excel 2013 program, by calculating the frequency response of all the participants. Resulting in 95% of comprehension of the items, wich means that the instrument is easy to fill. These results indicate that the instrument is suitable to evaluation of its psychometric properties in upcoming research.

21 REFERENCES Ajzen I. Attitudes, Personality, and Behavior [Internet]. McGraw-Hill Education (UK); 2005 Alabarce J, Romero MM, Fernández I, Viñals EC, Trujillo AG, Isabel A, et al. Existen instrumentos válidos para medir actitudes profesionales frente al drogodependiente? Evidentia. 2012;9(39). Allen E. Techniques of Attitude Scale Construction [Internet]. 1st ed. Appletton Century Crofts, editor. New York; 1957 Allport G. A Handbook of Social Psychology. Clark Univ. Worcester; Altmann TK. Attitude: a concept analysis. Nurs Forum [Internet] Artes R. Aspectos estatisticos da analise fatorial de escalas de avaliacao. Rev Psiquiatr clín (Säo Paulo).

22 REFERENCES Bartko J. THE INTRACLASS CORRELATION COEFFICIENT AS A MEASURE OF RELIABILIT. Psychol Rep [Internet] [cited 2015 Mar 19];19. Beaton D, Bombardier C, Guillemin F, Ferraz M. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine (Phila Pa 1976) Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross- Cultural Adaptation of Health Status Measures Bland J, Altman G. A NOTE ON THE USE OF THE INTRACLASS CORRELATION COEFFICIENT IN THE EVALUATION OF AGREEMENT BETWEEN TWO METHODS OF MEASUREMENT. Compur Rio/ Med [Internet] Chen G, Faris P, Hemmelgarn B, Walker RL, Quan H. Measuring agreement of administrative data with chart data using prevalence unadjusted and adjusted kappa. BMC Med Res Methodol CICAD. Elementos orientadores para las políticas públicas sobre drogas en la subregión

23 REFERENCES Crothers E. Determinants of Nurses Attitudes toward the Care of Patients with Alcohol Problems. ISRN Nurs. 2011;2011:11. Cund A. Alcohol education revisited: exploring how much time we devote to alcohol education in the nursing curriculum. Nurse Educ Elsevier Ltd; 2013 Cunha LMA Da. Modelos Rasch e Escalas de Likert e Thurstone na medição de atitudes. Ciências, Fac. D E Gilchrist G, Moskalewicz J, Slezakova S, Okruhlica L, Torrens M, Baldacchino. Staff regard towards working with substance users: a European multi-centre studya [Internet]. Addiction Gorsuch RL. Factor Analysis [Internet] Happell B, Carta B, Pinikahana J. Nurses knowledge, attitudes and beliefs regarding substance use: A questionnaire survey. Nurs Heal Sci [Internet] Hogan T. Introdução à prática de Testes Psicológicos

24 REFERENCES Iqbal N, McCambridge O, Edgar L, Young C, Shorter GW. Health-care professionals attitudes across different hospital departments regarding alcohol-related presentations. Drug Alcohol Rev 2015 Feb 19 Lage L V., Levy RA, Ciconelli RM. Instrumentos de avaliação em reumatologia: importância de sua tradução e validação para nosso idioma. Rev Bras Reumatol [Internet]. Sociedade Brasileira de Reumatologia; Lopez J. Percepción, conocimientos y actitudes de las enfermeras de urgencias y salud mental frente al alcoholismo y otras drogodependencias. Metas Enferm. 2014;17(2): Mandeville P. El Coeficiente de Correlación Intra clase. Cienc UANL [Internet] Maneesriwongul W, Dixon JK. Instrument translation process: a methods review. J Adv Nurs [Internet] Oct

25 Erika Gisseth León

Cross-cultural adaptation of an instrument to measure the family-centered care

Original Article Cross-cultural adaptation of an instrument to measure the family-centered care Adaptação transcultural de instrumentos de medida do cuidado centrado na família Tammy O Hara Neves Silva