Tradução, adaptação transcultural e validação do questionário EPOCH-RRT “Empowering Patients On Choices For Renal Replacement Therapy” para o contexto brasileiro

Abstract

Chronic Kidney Disease (CKD) is a worldwide public health problem. Globally, there are more than 1 million people on Renal Replacement Therapy (RRT). In Brazil, in the last 6 years, there has been an overall increase in the number of patients on chronic dialysis, as well as in the incidence and prevalence rates of this treatment. When the patient progresses to stage 5 of CKD and is indicated to start RRT, this transition process presents itself as a challenge for patients and caregivers in coping with the disease and its consequences. In Brazil, most patients start RRT in dialysis urgency or emergency, without planned access and without prior knowledge of CKD and how the treatment will be done. Guidelines recommend that all treatment options for CKD should include the conscious preference of a fully informed patient. However, only a minority receive pre-dialysis educational information, leading to a large number of unplanned initial dialysis. The study, “Empowering Patients on Choices for Renal Replacement Therapy” (EPOCH-RRT), aiming to identify patient priorities and gaps in shared decision-making, it has developed a new patient decision aid to provide relevant information about the two most used dialysis options. Through the interview protocols, with questions to assess demographic data, clinical history and patients' perception of their health, new information was obtained that helped to fill in these gaps regarding patients' perspectives on the choice of dialysis modality. This lack of educational-therapeutic focus, built with the participation of individuals affected by this disease, is also observed in Brazilian dialysis services and added to the fact that there are still few studies on the subject, led to this work, whose objective is: Perform the translation, cross-cultural adaptation and validation of the questionnaires used in the EPOCH-RRT Study for the Brazilian context. It is, therefore, a methodological study in which the steps recommended in the international literature for instruments in the health area were followed, consisting of initial translation, synthesis of translations, back translation, review by an expert committee, pre-test and evaluation of the instrument's psychometric properties. All ethical precepts were followed. As a result, the questionnaires were translated and adapted to the Brazilian context. The results of its application in 84 chronic renal patients undergoing hemodialysis, peritoneal dialysis and outpatients are also presented