J Rheumatol. The 4th orientation has achieved excellent levels of agreement among experts, ranging from 96.6% to 100% and average of 98.3%, regarding pain assessment in non-verbal children. empty, empty-handed, empty-headed, empty out, With Reverso you can find the English translation, definition or synonym for empty-leg flight and thousands of other words. realizar la traducción para el portugués de Brasil y la adaptación cultural de la escala, Face, Legs, Activity, Cry, Consolability revised(FLACCr), con niños menores de 18 años de edad, afectados por la parálisis cerebral, presentando o no deterioro cognitivo y que no pueden comunicar su dolor. Among the structured tools for pain assessment in children with neurological impairment, stands out the Face, Legs, Activity, Cry, Consolability revised (FLACCr). São Paulo, SP, Brazil, 2013, Table 3 Evaluation of the attributes Comprehensibility, Simplicity, Relevance and Credibility, of the four instructions of the FLACCr. methodological development study of translation into Portuguese and cultural adaptation of the FLACCr. J Child Health Care. It was asked to the experts to assess the semantic equivalence, idiomatic equivalence and experimental or cultural equivalence 8. Disponível em: http://www.agaleradodownload.org/ novo-dicionario-aurelio-5-0 She sounded as though she had just run up two flights of stairs. Dev Med Child Neurol. These professionals evaluated the title, the five categories of pain assessment proposed in the FLACCr scale, with their respective descriptors and the four scale's application instructions, according to the following attributes 11: Comprehensibility - the category evaluated expressed clarity and intelligibility; Simplicity - the category evaluated expressed one idea; Objectivity - the assessed category allows one response, considering the behaviors described; Typicity - the evaluated category is expressed in a consistent or typical way proper of the assessed category; Relevance - the category evaluated expresses relevance with consistent phrases; Credibility - the evaluated category is described in a way that does not seem uncharacteristic or unreasonable. Researchers on the theme reinforce the importance of family approach/caregivers of children with CP, helping in the recognition of signals of pain and thus contributing to a better clinical outcome(20,22). The final version of the instrument back-translated into English was sent to the author of the original scale, and had full agreement with the Brazilian version. Evaluation of translation and back-translation by an expert committee. The four instructions presented excellent agreement rates, with the lowest average in the 4th instruction. Is worth mentioning that, it is still incipient the discussions on pain assessment in vulnerable populations, such as children with CP. All rights reserved. This evaluation also aimed to verify the validation of the content of the scale. fueron necesarios tres ciclos de la técnica Delphi para el consenso entre los jueces. [ Links ], . [ Links ], . Pain assessment in the pediatric population demands technical-scientific knowledge and practical skill. Dev Med Child Neurol. [ Links ], . Of the total, 28 (93.3%) were female and 26 (86.6%) had professional training time and time of performance in pediatrics greater than 10 years. 2011 Sep;15(3):210-20. February 14, 2014; Accepted: [ Links ], . It was emphasized the importance of the fourth scale instruction, in which family/caregiver are asked about specific behaviors considered warning signs for the characterization of pain. Consequently, the symbol FLACCr was maintained in the Portuguese version spoken in Brazil, as shown in Figure 1. It is possible to state that, the results obtained in the cultural equivalence phase, in which the adjustment has been completed, are consistent with evidence of satisfactory results. 2003 Aug;18(4):295-9. The four scale instructions achieved consensus greater than 80%, ranging as follows: 1st instruction from 96.7% to 100% (99.1% average); 2nd instruction from 96.7% to 99.2% (99.2% average); 3rd instruction from 96.7% to 100% (99.1% average); and 4th instruction from 96.6% to 100% (98.3% average). In the absence of family/caregiver, the professional is committed to observe the child more frequently, recognizing behaviors and normal postures and warning signs 20. [ Links ], . Adaptação Transcultural para o Português do Instrumento "The Bowel Disease Questionnaire", utilizado para a avaliação de desordens gastrointestinais funcionais. Children with CP may present significant variations related to postural impairment and movement of the limbs. As quatro orientações alcançaram os seguintes níveis de consenso: 1ª 99,1%, 2ª 99,2%, 3ª 99,1% e 4ª 98,3%. This is goodbye! Descritores: Dor; Criança; Paralisia Cerebral; Estudos de Validação. The other categories of the scale achieved consensus greater than 80%, with some considerations on the approximation of the professional at the bedside, in the approach of family/caregiver. Pediatric Nursing. The five categories of the scale, shown in Tables 1and 2, achieved consensus greater than 80%, ranging as follows: Face from 93% to 100% (95.5% average); Legs from 83.3% to 93.3% (90% average); Activity from 90% to 100% (94.4% average); Cry from 90% to 96.6% (94.4 average); and Consolability from 96.7% to 100% (99.4% average). Thus, the descriptors of the Legs category were maintained according to established consensus. 2000;25(24):3186-91. J Neurosci Nurs. Using the Delphi tecnique to examine the content validity of nursing diagnosis. Clinical validation of FLACC: preverbal patient pain scale. Voepel-Lewis T, Merkel S, Tait AR, Trzcinka A, Malviya S. The reliability and validity of the Face, Leg, Activity, Cry, Consolability Observational Tool as a measure of pain in children with cognitive impairment. 2009 [acesso 20 jun 2013]. In the cultural equivalence phase, of the 30 participating professionals, 18 were nurses, six physicians and six physiotherapists. By following the methodological instructions, it was possible to develop, with satisfactory results, the translation and adaptation of the FLACCr scale of pain assessment. The researchers considered the suggestions of the experts, requiring a third round. After formal authorization from the author of the scale, the study was developed in two stages: translation into Brazilian Portuguese and cultural adaptation of the FLACCr scale of pain assessment. Proposed definition and classification of cerebral palsy. [ Links ], . [ Links ], 12. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Orthop Nurs. So, I'd say you need about 30-40 minutes of intense workout, without too much time in between sets. Rio de Janeiro [dissertação] Núcleo de Estudos de Saúde Coletiva do Departamento de Medicina Preventiva. Falcão DM, Ciconelli RM, Ferraz MB. The evaluation was performed based on the set of these experts' responses. (São Paulo) 2013;14(2):142-6. 2003 [acesso 20 out 2013]. Is worth mentioning that, in 2011, the Royal College of Nursing 16published a guide of good clinical practices for recognition and evaluation of acute pain in children, which included the evaluation of children with neurological impairment. 1997 ago;31(1):259-73. The authors named it FLACC revised (FLACCr) or revised FLACC (rFLACC)(5-7), and changed and expanded to four the number of application instructions of the scale. Después de la aprobación por el comité de ética, el proceso incluyó la traducción y retrotraducción, evaluación de la traducción y retrotraducción utilizando la técnica Delphi y evaluación de la equivalencia cultural. Since 2002, the authors of the FLACC scale made modifications in the evaluation descriptors, in order to adapt it to the care of children with cognitive impairment, aged between 4 and 19 years. The selection of the scale to be translated and submitted to cultural adaptation was determined after various researches in the literature, involving discussions with professionals on feasible instruments to be applied at the bedside and previous experience of the researchers in using the FLACC. 1993;46(12): 1414-32. The translated and backtranslated versions of the scale were sent to the experts for consensus, thus constituting the first round of evaluation. 2003 Feb;30(2):379-85. The 30 professionals also evaluated the four instructions for the application of the scale, according to the attributes Comprehensibility, Simplicity, Relevance and Credibility, as shown in Table 3. The purpose is to assist in the best possible way, this population so vulnerable(14-15). Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S.The FLACC: a behavioral scale for scoring postoperative pain in young children. [ Links ], . it was necessary three rounds of the Delphi technique to achieve consensus among experts. Mini Aurélio: dicionário da língua portuguesa. [ Links ], . The selection of the participating professionals of this first stage was essential to achieve the stated results. foram necessários três ciclos da técnica de Delphi para consenso entre os juízes. São Paulo, SP, Brazil, 2013. February 21, 2015, Corresponding Author: Edna Aparecida Bussotti Rua Ernesto dos Santos, 247 Jardim Independência CEP: 03225-000, São Paulo, SP, Brasil E-mail: edna.bussotti@samaritano.org.br, Correspondência: Edna Aparecida Bussotti Rua Ernesto dos Santos, 247 Jardim Independência CEP: 03225-000, São Paulo, SP, Brasil E-mail: edna.bussotti@samaritano.org.br, Correspondencia: Edna Aparecida Bussotti Rua Ernesto dos Santos, 247 Jardim Independência CEP: 03225-000, São Paulo, SP, Brasil E-mail: edna.bussotti@samaritano.org.br, This is an open-access article distributed under the terms of the Creative Commons Attribution License, Final version in Portuguese spoken in Brazil of the FLACCr scale of pain assessment. Solodiuk J, Curley MAQ. São Paulo, SP, Brazil, 2013. Among the existing instruments, the FLACCr was indicated as an appropriate tool for this population. Ayres MT. Special needs require special attention: A pilot project implementing the paediatric pain profile for children with profound neurologic impairment in a in-patient following surgery. Clinical validation of the paediatric pain profile. In 2003, it was proposed to simplify the methodology, specifically in the stages of translation and back-translation 17. Disponível em: http://www.rcn.org.uk/__data/assets/ pdf_file/0004/269185/003542.pdf Validated instruments of pain assessment are useful tools when used in a planned and systematic manner, particularly in the development of the discussion within the care team on forms of assessment and management of pain, enabling continuous process improvement 14. realizar a tradução para a língua portuguesa do Brasil e adaptação cultural da escala Face, Legs, Activity, Cry, Consolability revised(FLACCr), com crianças de até 18 anos de idade, acometidas por paralisia cerebral, apresentando ou não comprometimento cognitivo e impossibilitadas de relatar sua dor. Clinical Practice Guideline: The recognition and assessment of acute pain in children. J Clin Epidemiol. Therefore, it will be possible to assess pain more reliably. Les « vols à vide » sont des vols opérés afin d'acheminer un appareil au point de départ et au point d'arrivée d'une série de vols charter. Anesth Analg. estudio de desarrollo metodológico de traducción al portugués y adaptación cultural de la FLACCr. Although the Legs category had achieved consensus with satisfactory results, it presented the lowest average of agreement when compared to the other categories. Nurs Diagn. Accordingly, 38 professionals were invited (18 nurses, 10 physicians and 10 physiotherapists), and 30 (78.9%) returned the completed questionnaires. In the results of the expert committee, it was observed that the instrument had not achieved consensus equal to or greater than 80% in the translation and backtranslation of the categories: Face (60% consensus in translation and 40% in back-translation), Activity (40% consensus in translation and 50% in back-translation), Cry (60% consensus in translation and 50% in backtranslation), Consolability (60% consensus in translation and 60% in back- translation), 1st scale application instruction (60% consensus in translation and 60% in back-translation), 2ndinstruction (40% consensus in translation), 3rd instruction (60% consensus in translation and 60% in back-translation) and 4thinstruction (20% consensus in translation and 20% in back-translation). Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. Researchers in this area recommend two translators for validation and two translators for back-translation 8. São Paulo, SP, Brazil, 2013, Table 2 Evaluation of the attributes Typicity, Relevance and Credibility, of the five categories of the FLACCr. The process included the five categories of the scale and the four application instructions, considering levels of agreement equal to or greater than 80%. J Psychiatr Ment Health Nurs. This study followed the method described in the literature 8, with variation in the number of translators in the stages of translation and back-translation, which did not influence in the results presented in Tables 1, 2 and 3. … Translation into Portuguese and back-translation into English. (INRS). 2009Aug;16(6):531-8. If the three legs of the ridge were each thinned down to a single-pixel-wide skeleton, the point where the three legs intersect is the location of the minutia. You can complete the translation of empty-leg flight given by the English-French Collins dictionary with other dictionaries such as: Wikipedia, Lexilogos, Larousse dictionary, Le Robert, Oxford, Grévisse, English-French dictionary : translate English words into French with online dictionaries. As consensus, it was considered agreement indexes greater than or equal to 80%. Translation and Cultural Adaptation of Quality of Life Questionnaires: An Evaluation of Methodology. Traducción de la letra de This Is Goodbye de Imminence al portugués. The flight will take four hours. To carry out the evaluation of the FLACCr, it was used the Likert scale, which is based on the indication of a degree of agreement or disagreement of the translation and back translation, comparing them with the original scale. The group was comprised by professionals with experience in pediatrics and assistance for children with CP, evidencing that 26 (86.6%) had experience in the area of pediatrics for over 10 years and 73.2% had assisted children with CP daily and frequently in the previous year. 2002 Oct;34(5):228-36. The next stage of this study is to evaluate the reliability and consistency of the psychometric properties of the FLACCr in children with CP. Traducción de 'Legs' de ZZ Top del Inglés al Griego. Universidade Federal do Rio de Janeiro [Internet]. move en Español - Traducción de la palabra move por Nglish, amplio diccionario y traducción en español-inglés e inglés-español, traducción y aprendizaje del inglés. The study was submitted to the Ethics Committee of the Federal University of São Paulo, and approved under protocol number 1480/10. [ Links ], . Mitchell A, Boss BJ. 2008. [ Links ], . However, the 4th instruction is clear and highlights that the practitioner can approach the family/caregiver to discuss specific behaviors indicative of pain, which can be added to the scale, so that other professionals have access to this information. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Rev Dor. 2003MarApr;29(2):140-6. The four instructions achieved the following consensus levels: 1st 99.1%, 2nd 99.2%, 3rd 99.1% and 4th 98.3%. eur-lex.europa.eu. São Paulo, SP, Brazil, 2013, Evaluation of the attributes Typicity, Relevance and Credibility, of the five categories of the FLACCr. According to the proposal, using the scale of pain assessment, the evaluator should talk to family/ caregiver on behavior and conducts considered normal for the child and warning signs of pain, representing a complementary procedure for an accurate evaluation. The FLACC scale of pain assessment was developed in 1997, based on behavioral parameters, intended for use by health professionals and aiming at contributing to clinical practice in pain assessment in nonverbal children or with speech impairment, which are unable to report their pain 4. And we don't want that, now do we? vol à vide ; voyage à vide ; trajet à vide. A concordância obtida para as cinco categorias foi: Face 95,5%, Pernas 90%, Atividade 94,4%, Choro 94,4% e Consolabilidade 99,4%. Cultural adaptation to Brazilian Portuguese of the Face, Legs, Activity, Cry, Consolability revised (FLACCr) scale of pain assessment. Pain in children with cerebral palsy and implications on nursing practice and research: integrative review. The FLACCr presents five evaluation categories, with combined scores ranging from zero to ten. REMEMBER: switch legs so both sides gets an equal amount of training. Elinor Young almost died from polio when she was five, and answered God's call to serve as a missionary. [ Links ], . Hunt A, Goldman A, Seers K, Crichton N, Mastroyannopoulou K, Moffat V, et al. The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment. Table 1 Evaluation of the attributes Comprehensibility, Simplicity and Objectivity, of the five categories of the FLACCr. Salmond SW. Orthopedic nursing research priorities: a Delphi study. Malviya S, Voepel-Lewis T, Burke CN, Merkel S, Tait AR. Adverse effects of pain on the nervous systems of newborns and young children: a review of literature. ©2020 Reverso-Softissimo. Some researchers consider that the minimum consensus levels are between 50% and 80% 1213. [acesso 10 dez 2014]. [Internet]. The discussion among the experts was related to the comprehension of the first sentence of the orientation: "The revised FLACC can be used for all non-verbal children". The professionals evaluated the five categories of the Face, Legs, Activity, Cry and Consolability scale, considering the attributes Comprehensibility, Simplicity and Objectivity, as shown in Table 1, and Typicity, Relevance and Credibility, as shown in Table 2. The author of the original scale asked to maintain the title as it stands in English (FLACCr), with possible insertion of the letter "r" at the beginning or end of the title. This is one of the pioneering works in Brazil focused on the pediatric population with CP, presenting or not cognitive impairment. This study provides a specific method. [ Links ], . Validação da Chronic Pain Self-Efficacy Scale para a Língua Portuguesa. The method used to achieve consensus was the Delphi technique, which ensures anonymity of the experts, with absolute confidentiality of the responses. Disponível em: http://www.posgraduacao.iesc.ufrj.br/media/ tese/1372778284.pdf After the versions of the committee has returned, it was identified agreement equal to or greater than 80% in all categories of the scale. Collaborative Dictionary English-French. Many people came to this country in desperate flight from wars or famines. 1997 MayJun;23(3):293-7. Royal College of Nursing. The results were obtained by the sum of the values of the classification items SA and A of the Likert scale. If the healthcare team chooses an existing instrument in another language, it is necessary to develop the process of translation and cultural adaptation. Consequently, it is urgent in this environment, the instrumentalization of health professionals with tools able to standardize the practices and generate clinical and administrative indicators. Técnica Delphi na validação das intervenções de enfermagem. The results were analyzed using descriptive statistics, measurements of absolute and relative frequencies of the responses emitted by the committee of five experts and by the 30 health professionals, considering levels of agreement equal to or greater than 80%.
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