Translation, cultural adaptation, reliability, and validity evidence of the Feeding/Swallowing Impact Survey (FS–IS) to Brazilian Portuguese

Abstract

The purpose of this study was to translate and adapt the Feeding/Swallowing Impact Survey (FS–IS) into Brazilian Portuguese and provide a validated instrument for caregivers of children with feeding/swallowing disorders. This cross-cultural study involved initial translation, synthesis of translations, back-translation, Committee of Experts, and pre-test. The sample consisted of 95 primary caregivers of children with feeding/swallowing disorders classifed by Pediatric Dysphagia Evaluation Protocol (PDEP) in mild (n=9), moderate–severe (n=40), or profound (n=46) dysphagia. Reliability and evidence of validity based on test content, response processes, internal structure and the relations to other variables were investigated. Internal consistency, test–retest, exploratory and confrmatory factor analysis were performed, in addition to the correlation with PedsQL™ Family Impact Module (PedsQLTMFIM). The pre-test participants did not report any difculties in understanding the translated version. The Brazilian Portuguese version of FS–IS (Pt–Br–FS–IS) presented Cronbach's Alpha of 0.83, Exploratory Factor Analysis verifed that the instrument would not be unifactorial (KMO=0.74 and Bartlett’s sphericity test p<0.001) and Confrmatory Factor Analysis confrmed the original model in three subscales with χ2 /df=1.23, CFI=0.92, TLI=0.90, RMSEA (90% CI) 0.049 (0.011–0.073) adjustment indexes and the ICC was excellent in all subscales and total score. The correlation with PedsQL™FIM was signifcant in the total score and subscales. This study successfully translated and cross-culturally adapted the FS–IS instrument to the Brazilian Portuguese language and the investigation of its reliability and validity evidence suggests that the Pt–Br–FS–IS is a reliable and valid tool to measure the impact of feeding/swallowing disorders on the quality of life of caregivers of afected children.