Cultural adaptation and validation of the City of Hope Quality of Life Ostomy Questionnaire (COH-QOL-OQ) for Brazilians

This study aimed to adapt and validate the City of Hope Quality of Life Ostomy Questionnaire (COH-QOL-OQ) for Brazilians. After accomplishment of ethical issues, the COH-QOL-OQ cultural adaptation and validation was based on modified Beaton et al (2007) methodology. COH-QOL-OQ is a specific tool to assess quality of life in stoma patients and was developed by Grant et al (2004). For adaptation process, the COH-QOL-OQ was translated from English to Portuguese by two independent translators. The Portuguese translations were evaluated by a Panel consisting of 3 WOC nurses, who analyzed the semantic, idiomatic, cultural and conceptual equivalences. The resulted version was administered to a focus group and the new version was back-translated by two different independent translators and the back translations were evaluated by Dr Grant. The adapted version was applied to a convenience sample of 215 adult stoma patients (51.6% men; 73% >50 years old; 67.4% with colostomy) to analyze internal consistency (Cronbach´s alpha). Results showed translation difficulty rated as moderate for few words or expressions, mainly the word how, but also for others like severe and great deal, which were modified to obtain adequate Brazilian semantic and language equivalence. Consensus among experts was also difficulty for some of the qualitative descriptions of Likert scale. Few stoma patients in the focus group had moderate difficulty to understand some items suggesting few changes to improve it. For the final adapted version, all items remained with the same meanings as the original instrument as confirmed by Dr Marcia Grant evaluation, also confirming its content validity. Cronbach´s alpha were 0.83; 0.86; 0.82; 0.78 and 0.92 respectively for Physical, Psychological, Social and Spiritual Well Being domains and overall QOL. COH-QOL-OQ adapted version kept semantic, idiomatic, conceptual and cultural equivalence to the original instrument and confirmed content validity and internal consistency.