Seixas-Moizes Julieta, Boerlage Anneke, Lia Érica Negrini, Santos Lucas Emmanuel Lopes E, Zucoloto Miriane Lucindo, Dach Fabíola, Papassidero Priscila Colavite, Wichert-Ana Laís Almeida Leal, Della Pasqua Oscar, Wiesebron Marianne Louise, Icuma Tatiana Reis, Lanchote Vera Lucia, Coelho Eduardo Barbosa, Tibboel Dick, Wichert-Ana Lauro
Department of Radiology, Hematology, and Oncology, University of São Paulo, Ribeirão Preto, Brazil.
Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.
Dement Geriatr Cogn Dis Extra. 2021 Dec 20;11(3):314-323. doi: 10.1159/000520455. eCollection 2021 Sep-Dec.
This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia.
This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity.
The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach's alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen's kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94-0.97), showing a significant correlation between the total scores of REPOS-P and NRS.
The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P.
本研究报告了鹿特丹老年疼痛观察量表（REPOS）葡萄牙语版本的翻译、文化调适及验证情况。REPOS是一种荷兰量表，用于评估有无痴呆的无法沟通患者的疼痛情况。
这是一项在疼痛和神经科开展的多中心研究，涉及巴西（临床阶段）和荷兰（培训阶段）。我们进行了一项回顾性横断面两阶段分析，将REPOS翻译并调适为葡萄牙语版本（REPOS-P），并评估其心理测量特性。8名卫生专业人员接受培训以观察腰痛患者。REPOS由10项行为条目组成，在2分钟观察后根据条目是否出现进行评分。REPOS得分≥3且数字评定量表（NRS）得分≥4表明存在疼痛。所有条目的内容效度指数（CVI）及说明显示CVI值均达到最大值。根据NRS与REPOS-P之间较高的相关系数，可认为存在充分的收敛效度。
对80名平均年龄60岁（标准差11.5）的患者使用了REPOS-P。克朗巴哈α系数显示REPOS-P具有中等程度的内部一致性（α = 0.62），这与REPOS的原始研究结果相符。所有卫生专业人员在中位10周的培训期内达到了较高的评分者间一致性水平，确保了可重复性。科恩kappa系数为0.96（标准差0.03），组内相关系数为0.98（标准差0.02），表明培训者（研究人员）与受训者（卫生保健专业人员）之间REPOS-P得分具有高度可靠性。皮尔逊相关系数为0.95（95%置信区间0.94 - 0.97），表明REPOS-P总分与NRS之间存在显著相关性。
REPOS-P是不同卫生保健专业人员评估老年腰痛患者的一种有价值的量表。应用时间短、易于使用、说明清晰以及应用所需的简短培训是REPOS-P的重要特征。
