Cultural adaptation and validation of Ostomy Adjustment Inventory-23 (OAI-23) for Brazilians

AIMS: To adapt and validate the Ostomy Adjustment Inventory-23 (OAI-23) for Brazilians. METHODS:  After accomplishment of ethical issues, OAI-23 cultural adaptation and validation was based on modified Beaton et al (2007) methodology. OAI-23 is a specific tool to assess adjustment in stoma patients and was developed by Simmons, Maekawa and Smith (2007). For adaptation process, the OAI-23 was translated from English to Portuguese by two independent translators. The Portuguese translations were evaluated by a Panel consisting of 4 researchers: 2 stoma-therapy nurses, 1 proctologist and 1 specialist in Quality of Life research. After administering the questionnaire to 13 stoma patients, the new version was back-translated by two different independent translators. The adapted version was completed by a convenience sample of 191 adult stoma patients (57.1% women; mean age of 58.9 (SD=14.6) years old; 74.1% with colostomy) from 4 Brazilian cities to analyze the following psychometric properties: internal consistency (Cronbach´s alpha superior and/or equal 0.70); stability (ICC superior and/or equal 0.70); convergent validity, using scores on Brazilian adapted version of Janis & Field Self Esteem Scale (Ulhôa 1980) as the correlate (Spearman coefficient); and discriminant validity related to demographic and clinical variables (Kruskall-Wallis test). RESULTS: Full agreement among experts was obtained after a focus group process; and almost all stoma patients understood the Portuguese version, suggesting few changes to improve it, confirming its content validity. Cronbach´s alpha were 0.85; 0.65; 0.67; 0.61 and 0.58 respectively for overall score and OAI-23 factors (acceptance, anxious preoccupation, social engagement, anger); ICC=0.90 (p<0.001); r=0.51 to 0.22 (p<0.001 for almost); overall OAI-23 discriminated groups according to age (p=0.024) and acceptance (p<0.004), anxious preoccupation (p<0.008) and social engagement (p<0.043) factors for religious activities. CONCLUSIONS: OAI-23 can be considered reliable and valid to assess adjustment in Brazilian stoma patients.