Tradução universal, adaptação transcultural e validação da versão portuguesa da Escala Avaliação Funcional Pediátrica de Terapia de Doença Crônica: FADIGA (PEDSFACIT-F)

Abstract

Introduciton: Fatigue is a prevalent symptom in healthy children with acute and chronic diseases. It is a subjective experience of tiredness and exhaustion, which affects the quality of life in the physical, mental and emotional aspects. The evaluation of fatigue in Brazilian and Portuguese children and adolescents requires ageappropriate self-reporting instruments that are valid, reliable and standardized. Objective: To translate, cross-culturally adapt and validate the Portuguese version of the Pediatric-Functional Assessment of Chronic Illness Therapy -Fatigue (pedsFACIT-F). Material and methods: Translation and Cross-cultural adaptation of the peds-FACIT-F was performed according to universal approach and standard international guidelines. The Portuguese version of the peds-FACIT-F was administered to 323 children and adolescents aged 8 -18, 173 healthy 150 with chronic diseases (cancer, juvenile idiopathic arthritis and diabetes). Reliability (internal consistency and test-retest reliability) was assessed. Item Response Theory (IRT) model assumptions were evaluated using Confirmatory Factor Analyses (CFA) and Exploratory Factor Analyses (EFA). Items were calibrated using a Graded Response Model (GRM) to estimate item difficulty and item discrimination. Differential Item and Functioning (DIF) was examined in respect to age, gender and clinical condition. Results: No major cultural adaptations were needed. Internal consistency (Cronbach’s alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0,92) were good. CFA and EFA supported sufficient unidimensionality of the 13 peds-FACIT-F items (CFI = 0.92, TLI = 0.90, RMSEA = 0.097). The factor loads varied from 0.44 to 0.80.The data also fit the GRM and demonstrated good coverage across fatigue construct (threshold parameters range: -1,42 a 4,56) ranged from -1,42 to 4.56. No items demonstrated significant DIF for age, gender and clinical condition. Conclusion: The Portuguese version of the peds-FACIT-F provides a reliable, precise, and valid measure as assessed by robust psychometric properties. Stability of the measurement properties of the peds-FACIT-F allows its use to assess fatigue in clinical research in Brazilian and Portuguese children and adolescents.