Adaptação transcultural das versões brasileiras do pediatric oral health-related quality of life(B-POQL) e do teen oral health-related quality of life (B-TOQOL)

Abstract

Instruments to measure the impact of oral problems on oral health-related quality of life (OHRQOL) in children and adolescents provides a new perspective to better understand the dimension of inequities and define groups that require greater care in oral health. Therefore, the Pediatric Oral Health-Related Quality of Life (POQL) and the Teen Oral Health-Related Quality of Life (TOQOL) represent the only instruments developed so far for children and adolescents aged 2 to 18 years with a particular focus on low-income or minority populations. These questionnaires are available only in English, Turkish, and Spanish. So, the aim of this study was to perform the translation and cross-cultural adaptation of POQL and TOQOL into Brazilian Portuguese. POQL is an instrument directed to children (2 to 7 years old) and pre-adolescents (8 to 14 years old), consisting of 10 items distributed in domains: Physical, Functional, Social and Emotional. The TOQOL is directed to adolescents (13 to 18 years old) and covers five domains: Physical, Functional, Social, Emotional and Oral Problems. Both have versions directed to the age groups involved and their parents/guardians. Initially, discussions were held about conceptual and item equivalence by a committee of experts on the subject. Then, semantic equivalence was performed, involving the following steps: (1) translations of POQL and TOQOL into Brazilian Portuguese, performed by two independent translators, Brazilians and fluent in English; (2) unification of the two translations by an expert committee; (3) back-translations were independently performed by two English native translators who have English as their native language and who are fluent in Brazilian Portuguese; (4) unification of the two back-translations by an expert committee; (5) evaluation of the unified version by the authors of the original instruments; (6) review of the translations and back-translations according to the considerations of the original authors and the expert committee; (7) pre test with the application of the questionnaires to a group of 50 subjects - 10 participants for each version of the POQL (3 versions) and TOQOL (2 versions) questionnaires, including Brazilian parents/guardians, children and adolescents, to assess the understanding and acceptability of the instruments, and subsequent correction of the identified needs; (8) elaboration of the final instruments in Brazilian Portuguese. In general the translations and back-translations were very similar and small changes were needed. In the pre test with a target population, subtle changes were indicated and incorporated in the final version of the instruments. After the completion of all steps, the Brazilian versions of B-POQL and B-TOQOL were obtained.The translations and back-translations evaluated by the original authors and by specialists, and the incorporation of suggestions from the target population, allowed the development of a version of B-POQL and B-TOQOL, in Brazilian Portuguese, semantically equivalent to the original instrument.