Introduction: This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia. Methods: This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity. Results: The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach’s alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen’s kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94–0.97), showing a significant correlation between the total scores of REPOS-P and NRS. Conclusion: The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P.
Dement Geriatr Cogn Disord Extra 2021;11:314–323

中文翻译：

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葡萄牙语版鹿特丹老年疼痛观察量表的翻译、跨文化适应和验证

简介：本研究报告了葡萄牙语版鹿特丹老年疼痛观察量表 (REPOS) 的翻译、文化适应和验证，这是一种荷兰量表，用于评估患有或不患有痴呆症的无法沟通的患者的疼痛。方法：这是一项涉及巴西（临床阶段）和荷兰（培训阶段）的疼痛和神经科多中心研究。我们进行了回顾性横断面、两阶段分析，将 REPOS 翻译和文化适应葡萄牙语版本 (REPOS-P) 并评估其心理测量特性。八名卫生专业人员接受了培训，以观察腰痛患者。REPOS 由 2 分钟观察后评分为存在或不存在的 10 个行为项目组成。REPOS 评分≥3 结合数值评定量表 (NRS) ≥4 表明疼痛。所有项目和说明中的内容有效性指数 (CVI) 均显示 CVI 值最大。根据在 NRS 和 REPOS-P 之间发现的较高相关系数，可能表明存在足够的收敛效度。结果： REPOS-P 用于 80 名平均年龄为 60 岁的患者 (SD 11.5)。Cronbach 的 α 系数显示 REPOS-P 的内部一致性中等（α = 0.62），这与 REPOS 的原始研究相一致。所有卫生专业人员在平均 10 周的培训中都达成了高水平的评估者协议，确保了可重复性。Cohen 的 kappa 为 0.96（SD 0.03），组内相关系数为 0.98（SD 0.02），表明培训师（研究人员）和受训者（医疗保健专业人员）之间的 REPOS-P 得分具有较高的可靠性。Pearson 相关系数为 0.95（95% 置信区间 0.94-0.97），表明 REPOS-P 和 NRS 的总分之间存在显着相关性。结论：REPOS-P 是不同医疗保健专业人员评估老年腰痛患者的宝贵量表。应用时间短、易于使用、说明清晰、应用所需的简短培训是 REPOS-P 的基本特征。
Dement Geriatr Cogn Disord Extra 2021；11:314–323