Translation and cross-cultural adaptation of the “Stroke Rehabilitation Motivation Scale”

Abstract

Introduction: Stroke is an important cause of disfunction and loss of functionality and productivity. The degree of functional recovery achieved after a stroke is variable and dependent of plastic reorganization of the Central Nervous System (CNS). Rehabilitation is a vital component for recovery and acquisition of independence and must be focused on patient´s objectives and
desires. Regarding this, a patient´s motivation to treatment is considered one of the most important aspects in rehabilitation, with positive relations between motivation, plastic changes in CNS and motor and functional improvements. Therefore, it is crucial to measure this psychological construct in stroke patients undergoing rehabilitation. Thus, the “Stroke Rehabilitation Motivation Scale” was created for this purpose. Objective: The goal of this study was to translate and cross-culturally adapt this scale to Brazil. Methods: The study protocol consisted in 9 steps: 1) Preparation: discussion and organization of the methods performed; 2) Forward translations: creation of two translated versions of the scale in portuguese (V1 and V2); 3) Reconciliation: elaboration of a Consensual Version (Vc) form V1 and V2; 4) Back translations: formulation of two translations of the Vc back to English; 5-6) Review and harmonization of back-translations: review of back-translations by na expert´s committee and preparation of the First Brazilian Version (VB1); 7) Pre-test: VB1 tested with 10 stroke patients for comprehension and aplicability evaluation; 8) Review of pre-test results and Finalization: validity content study done as from the answer to the pre-test; 9) Final review: review and creation of the Final Brazilian Version of the scale (FBV); and 10) Final report: descriptive report on all the modifications made on the original scale. Results: VB1 revealed good comprehension levels in between the pre-test patients. The content validity study demonstrated high inter-rater agreement between the experts committee members. Only 3 of the 34 items of the scale scored less than 4 on the Content Validity Index (CVI), with a total score of 0,97 and a Kappa coeficient score of 0.868, for the entire scale (p<0,001). Conclusion: At the final review fase, only few grammar corrections were suggested and the FBV of the “Stroke Rehabilitation Motivation Scale” was considered easily understood and adequately adapted for stroke patients in Brazil.