Brazilian version of the Critical Care Functional Rehabilitation Outcome Measure: translation, cross-cultural adaptation and evaluation of clinimetric properties

ABSTRACT Objective: To translate, crossculturally adapt and evaluate the clinimetric properties of the Critical Care Functional Rehabilitation Outcome Measure for evaluating the functionality of patients admitted to intensive care units in Brazil. Methods: The process of translation and cross-cultural adaptation involved the following steps: initial translation, synthesis, back-translation, expert committee review and pretesting. The intra- and interrater reliability and agreement were analyzed between two physical therapists who evaluated the same group of patients (n = 35). The evaluations were performed by each therapist independently and blinded to the score assigned by the other professional. The qualitative analysis was performed by the review committee, and the experts adapted and synthesized the Portuguese translation of the Critical Care Functional Rehabilitation Outcome Measure. Results: There was agreement between the initial Brazilian translations of the Critical Care Functional Rehabilitation Outcome Measure scale. The conceptual, idiomatic, semantic and experimental equivalences between the original and translated versions were assessed, resulting in the final Brazilian version of the scale, called the Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos. The evaluation of the clinimetric properties showed evidence of a high degree of agreement and reliability, as all had an intraclass correlation coefficient above 0.75. The overall intraclass correlation coefficient was 0.89. Conclusion: The translated version of the Critical Care Functional Rehabilitation Outcome Measure scale for assessing the functionality of patients admitted to an intensive care unit can be used reliably in Brazil following translation and cross-cultural adaptation to Brazilian Portuguese and presents evidence of excellent interrater reliability.

摘要
目的：对重症监护功能康复结局量表（Critical Care Functional Rehabilitation Outcome Measure）进行翻译、跨文化调适，并评估其临床测量学属性，以用于评估巴西重症监护病房收治患者的功能状态。
方法：本次翻译与跨文化调适流程包含以下步骤：初译、译稿合成、回译、专家委员会评审与预试验。由两名物理治疗师对同一组患者（n=35）开展评估，分析其组内与组间信度及一致性；两名治疗师独立完成评估，且对彼此给出的评分设盲。定性分析由评审委员会完成，专家团队对该量表的葡萄牙语译稿进行调适与整合。
结果：初始巴西葡萄牙语译稿间具有一致性。评估了原版与译稿在概念、习语、语义及实验维度上的等效性，最终形成该量表的巴西葡萄牙语正式版，命名为Medida de Resultado da Reabilitação Funcional em Cuidados Intensivos。临床测量学属性评估结果显示，该量表具有较高的一致性与信度：所有指标的组内相关系数（intraclass correlation coefficient, ICC）均大于0.75，总体组内相关系数为0.89。
结论：经巴西葡萄牙语翻译与跨文化调适后，本研究所获得的该量表巴西版可在巴西可靠地用于评估重症监护病房患者的功能状态，且具备优异的组间信度证据。