Tradução, adaptação transcultural e análise das propriedades clinimétricas da escala de medida de participação (PM-Scale) para uso em sobreviventes do acidente vascular cerebral

Abstract

INTRODUCTION: The Participation Measure Scale (PM-Scale) was developed to assess participation in individuals after stroke and has shown adequate measurement properties. However, PM-Scale is only available in French and English versions. OBJECTIVES: 1. Transculturally translate and adapt the PM-Scale into Brazilian Portuguese; 2. test its reproducibility, convergent validity and diagnostic capability; 3. measure item and response scoring patterns using the Rasch model; 4. link the PM-Scale concepts with those of the CIF. METHODS: Methodological study. The translation process followed standardized guidelines that consisted of six phases. Three evaluations were carried out, with an interval of seven to 14 days. The first evaluation consisted of the application of 22 items from the PM-Scale, in addition to the application of the SATIS-Stroke and SS-QOL. In the two subsequent evaluations, the PM-Scale evaluation was repeated in order to analyze its reproducibility. All scales were applied in the form of an interview, by two trained professionals. Reproducibility was assessed using the Intraclass Correlation Coefficient (ICC2.1) and the Bland-Altman plot. Convergent validity was analyzed using Spearman's correlation coefficient. The Rasch model was used to analyze the validity of item and response scoring patterns. Accuracy was estimated based on the area under the ROC (Receiver Operating Characteristic) curve with a 95% confidence interval and considering sensitivity and specificity. For all analyses, a significance level of (p < 0.05) was considered. The linking of the PM-Scale concepts with the CIF was conducted through specific and updated linkage rules. RESULTS: 110 individuals participated in the study, with a mean age of 57.02±11.50. Excellent intra- and inter-rater reliability was observed (ICC = 0.87; 95% CI: 0.81-0.91 and ICC = 0.77; 95% CI: 0.66-0.84). When analyzing the agreement, the Bland-Altman plots showed a relatively skewed distribution around the midline in both comparisons. There was a significant correlation between PM-Scale and SATIS-Stroke (rs=0.38, p<0.001) and between PM-Scale and SS-QOL (rs=0.20; p=0.001). Rasch model analysis revealed one erratic item, two items with MnSq> 1.3 et <2 in the outfit, one item with MnSq> 1.3 et <2 in the infit and outfit, and one predictable item. The accuracy was satisfactory. Adequate agreement was found between the evaluators during the linking process. 24 ICF codes were linked to the concepts measured by the PM-Scale. CONCLUSIONS: The final Brazilian version of the PM-Scale was adequate, one-dimensional, linear and reliable for the participation of Brazilians with stroke. It is a scale that includes the nine domains of “Activity and Participation” of the CIF, it is low-cost and quick to apply.