Cultural Adaptation and Content Validity of the Type 2 Diabetes Distress Assessment Tool for Brazilian Culture

Abstract

Purpose

The purpose of the study was to translate, adapt, and validate the Type 2 Diabetes Distress Assessment Tool (T2-DDAS) for use in individuals with type 2 diabetes mellitus (T2DM) in Brazil. Considering the risks arising from glycemic instability, emotional regulation has become fundamental in the management of T2DM. Therefore, having valid instruments to assess emotional stress is essential.

Method

A methodological study was conducted consisting of the following steps: initial translation of the instrument by 2 independent bilingual translators, synthesis of the translated versions, back-translation by 2 additional bilingual translators, analysis by a committee of experts, pretesting of the consolidated version with 32 patients with T2DM treated at an adult outpatient clinic in a tertiary hospital in southeastern Brazil, submission of the translated version to the author of the original instrument, and content validation. Content validity was verified using the content validity index (CVI), content validity ratio (CVR), and modified kappa, ensuring the adequacy of the items for the target population.

Results

Most items obtained a CVI ≥0.80, indicating good adequacy. Minor modifications were made based on participants’ suggestions, improving the clarity of the items. The final version of the T2-DDAS in Brazilian Portuguese demonstrated high validity and adequacy for the Brazilian sociocultural context.

Conclusion

The Brazilian version of the T2-DDAS showed semantic and conceptual equivalence with the original, having been validated with methodological rigor. The results confirm its applicability to assess emotional distress in people with T2DM in Brazil.