Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.

Measurement of parent satisfaction in french-speaking PICUs: a need for translation and cultural adaptation of the empathic questionnaire

Background and aims: Family-centred care is an expected standard in PICU and parent reported outcomes are rarely measured. The Dutch validated EMPATHIC questionnaire provides accurate measures of parental perceptions of family-centred care in PICU. A French version would provide an important resource for quality control and benchmarking with other PICUs. The study aimed to translate and to assess the French cultural adaptation of the EMPATHIC questionnaire. Methods: In September 2012, following approval from the developer, translation and cultural adaptation were performed using a structured method (Wild et al. 2005). This included forward-backward translation and reconciliation by an official translator, harmonization assessed by the research team, and cognitive debriefing with the target users' population. In this last step, a convenience sample of parents with PICU experience assessed the comprehensibility and cultural relevance of the 65-item French EMPATHIC questionnaire. The PICUs in Lausanne, Switzerland and Lille, France participated. Results: Seventeen parents, including 13 French native and 4 French as second language speakers, tested the cognitive equivalence and cultural relevance of the French EMPATHIC questionnaire. The mean agreement for comprehensibility of all 65 items reached 90.2%. Three items fell below the cut-off 80% agreement and were revised for inclusion in the final French version. Conclusions: The translation and the cultural adaptation permitted to highlight a few cultural differences that did not interfere with the main construct of the EMPATHIC questionnaire. Reliability and validity testing with a new sample of parents is needed to strengthen the psychometric properties of the French EMPATHIC questionnaire.

Translation and cultural adaptation of the Perceived Stigmatization Questionnaire for burn victims in Brazil

This methodological study aimed to describe the process of translation and cultural adaptation of the Perceived stigmatization Questionnaire (PSQ) and analyze the internal consistency of the items in the step of pre-testing. The PSQ was developed to evaluate the perception of stigmatizing behaviors of burn victims. The adaptation process was carried out from August 2012 to February 2013, comprising the steps outlined in the literature. As part of this process, the pre-test with 30 adult burn victims was held. All participants at this step reported to understand the instrument items and the scale of responses. There were no suggestions or changes in the tested version. The value of Cronbach’s alpha at pre-test was 0.87. The contribution of this study is to describe the operation of each of the steps of this methodological process and show the internal consistency of the items in the pre-test.

Cultural and textual properties in the translation and interpretation of allusions. An analysis of allusions in Dorothy L. Sayers’ detective novels translated into Finnish in the 1940s and the 1980s

Kulttuuriset ja tekstuaaliset tekijät alluusioiden kääntämisessä ja tulkinnassa. Alluusiot Dorothy L. Sayersin 1940- ja 1980-luvuilla suomennetuissa salapoliisiromaaneissa Väitöskirja käsittelee alluusioiden kääntämistä ja tulkintaa. Alluusio on intertekstuaalinen viittaus, jonka tulkitsemiseen tarvitaan implisiittistä tietoa tutuksi oletetusta viittauskohteesta. Käännösongelma alluusiosta tulee, mikäli kohdekulttuurin lukijat eivät tunne viittauskohdetta eivätkä voi päätellä alluusion merkitystä. Tutkimus pyrkii kuitenkin uuden analyysimenetelmän avulla osoittamaan, että vieraat alluusiot eivät välttämättä johda tulkintaongelmiin. Väitöskirja jakautuu kahteen osaan: analyysimenetelmän kehittämiseen (luvut 1-5) sekä tapaustutkimukseen (luvut 6-7). Kehitetyn menetelmän avulla pystytään analysoimaan aikaisempaa tarkemmin, millaisia tulkintamahdollisuuksia alluusiot tarjoavat eri lukijakunnille ja miten lähdetekstin alluusioiden kulttuuriset ja tekstuaaliset piirteet korreloivat käännösstrategioiden kanssa. Tapaustutkimus selvittää, millaisia tulkintamahdollisuuksia Dorothy L. Sayersin 1940- ja 1980-luvuilla suomennettujen salapoliisiromaanien alluusiot tarjosivat aikansa suomalaisille lukijoille. Tavoitteena on myös hahmottaa, miten suomentajien käännösratkaisut ja alluusioiden tulkintamahdollisuudet liittyvät toisaalta lähdetekstin alluusioiden piirteisiin ja toisaalta kohdekulttuurin kontekstiin. Tapaustutkimus tarjoaa näin uutta tietoa suomennoskirjallisuuden ja salapoliisiromaanien historiasta. Analyysimenetelmä määrittelee aikaisempaa alluusioita ja intertekstuaalisuutta käsitelleen tutkimuksen pohjalta ne kulttuuriset ja tekstuaaliset piirteet, jotka vaikuttavat alluusioiden kääntämiseen ja tulkintaan. Kulttuurisessa mielessä alluusio voi olla tietylle lukijakunnalle tuttu tai tuntematon. Tekstuaalisia tekijöitä ovat alluusion muodon ja tyylin tunnusmerkillisyys sekä alluusion pintamerkityksen koherenttius uudessa tekstikontekstissa, ilman tietoa viittauskohteesta. Alluusioiden tulkinnassa on perinteisesti erotettu toisaalta allusiivinen tulkintamahdollisuus, jossa alluusio on lukijoille tuttu ja yhdistettävissä viittauskohteeseensa, toisaalta kulttuuritöyssy, jonka muodostaa lukijoille tuntematon ja pintamerkitykseltään inkoherentti alluusio. Tutkimuksessa määritellään kulttuuristen ja tekstuaalisten tekijöiden perusteella lisäksi kaksi muuta mahdollisuutta. Pseudo-allusiivisessa tulkinnassa tuntematon alluusio erottuu ympäröivästä tekstikontekstista tyyliltään ja on koherentti ainakin kuvaannollisessa mielessä ilman viittauskohdettaan. Ei-allusiivisessa tulkinnassa taas vieras alluusio sulautuu kontekstiin sekä muodoltaan että merkitykseltään niin, ettei lukija edes huomaa mahdollista alluusiota. Tulkintamahdollisuuksien jakauma antaa yleiskuvan siitä, miten tietty lukijakunta pystyi tulkitsemaan tekstin alluusioita. Lisäksi analyysi tarkastelee lähdetekstin ja käännöksen välillä tulkintamahdollisuuksissa tapahtuneita muutoksia sekä niiden vaikutusta tulkinnan vaatimaan vaivannäköön (effort) ja alluusion funktioihin. Tapaustutkimus perehtyy Sayers-suomennosten kulttuurikonteksteihin tarkastelemalla salapoliisiromaanien asemaa suomalaisessa kirjallisuusjärjestelmässä, suomennoksilta odotettuja piirteitä sekä suomentajien ammattikuvaa, taustoja ja työoloja. Tulosten perusteella alluusioiden kääntäminen oli vaativa tehtävä sekä 1940- että 1980-luvun suomentajille. Lähdetekstien alluusioista 60–70 prosenttia oli todennäköisesti kohdelukijoille vieraita. Molempina aikakausina suomennoksilta odotettiin silti sekä kielellistä sujuvuutta että lähdetekstin merkitysten välittämistä. 1940-luvun suomentajien tehtävää vaikeutti lisäksi mm. se, että suomentaminen oli enimmäkseen sivutoimista ja englanti oli harvoin parhaiten hallittu vieras kieli. Nämä olosuhteet lienevät vaikuttaneet etenkin vähäarvoisena pidetyn salapoliisikirjallisuuden suomennoksiin. 1980-luvulla suomentajien aikataulut olivat realistisempia, englannin taidot parempia ja päätoiminen suomentaminen mahdollista. Myös salapoliisiromaanien arvostus oli lisääntynyt. Sekä 1940- että 1980-luvun suomennoksissa kohdelukijoille vieraitakin alluusioita oli usein säilytetty, mikäli ne olivat koherentteja ilman viittauskohdettaan. Sen sijaan vieraita ja pintamerkitykseltään epäselviä alluusioita oli muokattu tai poistettu. Kuitenkin 1980-luvun suomentajat säilyttivät lähdetekstin alluusioita useammin ja tarkemmin kuin 1940-luvun suomentajat. Varsinkin poisjättämistä esiintyi 1940-luvun suomennoksissa enemmän. Alluusioiden tulkintamahdollisuudet olivat kaikissa käännöksissä muuttuneet sikäli, että melko harvat suomennetut alluusiot olivat enää kohdelukijoiden tunnistettavissa. Toisaalta myös kulttuuritöyssyt olivat harvinaisia. Erot 1940- ja 1980-luvun suomennosten välillä näkyivätkin pseudo-allusiivisissa ja ei-allusiivisissa tulkintamahdollisuuksissa. 1980-luvun suomennoksissa vieraat alluusiot oli johdonmukaisesti säilytetty niin, että käännetyt alluusiot voitiin tulkita pseudo-alluusioiksi. Sen sijaan 1940-luvun suomennoksissa vieraita alluusioita oli usein muokattu tai jätetty pois tavalla, joka johti ei-allusiiviseen tulkintaan. Kohdelukijoiden kannalta 1980-luvun suomennettujen alluusioiden tulkitseminen lienee vaatinut jonkin verran enemmän vaivaa. Toisaalta pseudo-allusiivisten käännösten pohjalta oli useimmiten mahdollista rakentaa koherentti tulkinta, ja monesti ne jopa välittivät samankaltaisia funktioita kuin lähdetekstin alluusiot. 1940-luvun suomennosten muokkaukset ja poistot periaatteessa helpottivat tulkintaa, mutta mahdollisia kulttuuritöyssyjä esiintyi edelleen, jopa kääntäjän tekemien muutosten seurauksena. 1940-luvun suomennoksissa myös käännettyjen alluusioiden funktiot olivat muuttuneet enemmän lähdetekstin alluusioihin nähden. Kaiken kaikkiaan 1980-luvun suomennokset olivat lähempänä oman aikansa hyvän käännöksen piirteitä. Toisaalta alluusioiden muokkaaminen sai 1940-luvun suomennokset muistuttamaan enemmän perinteistä arvoituksen ratkaisuun keskittyvää salapoliisiromaania, joten tältä osin ne lienevät vastanneet kohdelukijoiden odotuksia. Kulttuurikontekstin vaikutus siis näkyi sekä käännösstrategioissa että käännettyjen alluusioiden tulkintamahdollisuuksissa. Tutkimustuloksissa korostui kuitenkin myös se, että lähdetekstin alluusion pintamerkitys saattaa vaikuttaa käännösratkaisuihin. Lisäksi käännetyt pseudo-alluusiot saattavat välittää samankaltaisia funktioita kuin lähdetekstin alluusiot. Toisin kuin yleensä on esitetty, kohdelukijoille vieraiden alluusioiden säilyttäminen saattaakin siis olla toimiva ratkaisu.

Translation and Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema into Portuguese Language

Objective The objective of the study is to describe the process of translation and cross-cultural adaptation of the Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) into (Brazilian) Portuguese. Methods The process was comprised of five steps - translation, back translation, revision by an expert panel, pretest, and final translation. The first translation was performed by two professionals of the healthcare area, and the back translation was performed by two translators. An expert panel assessed the questions for semantics and idiomatic, cultural, and conceptual equivalence. The pretest was conducted on 10 patients with lymphedema. Results Small differences were identified between the translated and back-translated versions, which were revised by the expert panel. The patients included in the pretest found 10 questions difficult to understand; these questions were reassessed by the same expert panel. Conclusion The results of the translation and cross-cultural adaptation of the Lymph- ICF-LL resulted in a Brazilian Portuguese version, which still requires validation with various samples of the local population.

Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand Questionnaire

The objective of the present study was to translate, adapt and validate a Brazilian Portuguese version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. The study was carried out in two steps. The first was to translate the DASH into Portuguese and to perform cultural adaptation and the second involved the determination of the reliability and validity of the DASH for the Brazilian population. For this purpose, 65 rheumatoid arthritis patients of either sex (according to the classification criteria of the American College of Rheumatology), ranging in age from 18 to 60 years and presenting no other diseases involving the upper limbs, were interviewed. The patients were selected consecutively at the rheumatology outpatient clinic of UNIFESP. The following results were obtained: in the first step (translation and cultural adaptation), all patients answered the questions. In the second step, Spearman's correlation coefficients for interobserver evaluation ranged from 0.762 to 0.995, values considered to be highly reliable. In addition, intraclass correlation coefficients ranged from 0.97 to 0.99, also highly reliable values. Spearman's correlation coefficients and the intraclass correlation coefficients obtained during intra-observer evaluation ranged from 0.731 to 0.937 and from 0.90 to 0.96, respectively, being highly reliable values. The Ritchie Index showed a weak correlation with Brazilian DASH scores, while the visual analog scale of pain showed a good correlation with DASH score. We conclude that the Portuguese version of the DASH is a reliable instrument.

Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Translation and cultural adaptation for Brazil of the Developing Nurses' Thinking model

OBJETIVOS:traduzir e adaptar culturalmente para a língua portuguesa do Brasil o modelo Developing Nurses' Thinking, utilizado como estratégia ao ensino do raciocínio clínico.MÉTODO:a tradução e adaptação cultural foi realizada por meio de tradução inicial, síntese das traduções, retrotradução, avaliação por comitê de especialistas e pré-teste com 33 estudantes de graduação em enfermagem.RESULTADOS:as etapas de tradução inicial, síntese das traduções e retrotradução foram realizadas a contento, havendo a necessidade de pequenos ajustes. Na avaliação pelo comitê de especialistas da versão traduzida, todos os itens obtiveram concordância superior a 80% na primeira rodada de avaliação e no pré-teste com os estudantes. O modelo mostrou-se adequado à sua finalidade.CONCLUSÃO:recomenda-se o uso do modelo como uma estratégia complementar ao ensino do raciocínio diagnóstico, visando a formação de enfermeiros mais conscientes sobre a tarefa diagnóstica e a importância da segurança do paciente.

Translation and cultural adaptation of Brazilian Detailed Assessment of Speed of Handwriting: conceptual and semantic equivalence

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Translation, cross-cultural adaptation and validation of the Portuguese version of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis

Translation, cross-cultural adaptation and validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. The original English version of the DYMUS was translated using the forward-backward technique, cross-culturally adaptated, pilot-tested in 40 patients, and then applied to 100 multiple sclerosis patients to assess the reliability and construct validity. Construct validity was assessed by Mann–Whitney test and Spearman’s correlation coefficient (rs). The internal consistency of the questionnaire was evaluated using Cronbach’s alpha coefficient and inter-item correlation. DYMUS-BR internal consistency was high (Cronbach’s alpha= 0.72); Cronbach’s alpha was 0.65 for the ‘dysphagia for solids’ subscale and 0.67 for the ‘dysphagia for liquids’ subscale and positive inter-item correlations was found between all items, except for weight loss question. Significant association (p<0.001) and correlation (rs = 0,357; p = 0.01) was found between DYMUS-BR and dysphagia self-assessment. The DYMUS-BR questionnaire maintained the characteristics of that originally described, demonstrating to be a reliable, valid, easy and consistent tool to be used by health professionals for preliminary selection of Brazilian MS patients who need more specific instrumental analyses of swallowing.

TRANSLATION AND CULTURAL ADAPTATION OF THE GLOBAL APPRAISAL OF INDIVIDUAL NEEDS - INITIAL

The objective of this study was to perform the translation on and cultural adaptation of the Global Appraisal of Individual Needs - Initial instrument, and calculate its content validity index. This is a methodological study designed for the cultural adaptation of the instrument. The instrument was translated into Portuguese in two versions that originated the synthesis of the translations, which were then submitted to the evaluation of four judges, experts in the field of alcohol and other drugs. After the suggested changes were made, the instrument was back-translated and resubmitted to the judges and authors of the original instrument, resulting in the final version of the instrument, Avaliacao Global das Necessidades Individuais - Inicial. The content validity index of the instrument was 0.91, considered valid according to the literature. The instrument Avaliacao Global das Necessidades Individuais - Inicial was culturally adapted to the Portuguese language spoken in Brazil; however, it was not submitted to tests with the target population, which suggests further studies should be performed to test its reliability and validity.

Translation and Cross-cultural Adaptation of the Lower Extremity Functional Scale Into a Brazilian Portuguese Version and Validation on Patients With Knee Injuries

STUDY DESIGN: Clinical measurement. OBJECTIVE: To translate and culturally adapt the Lower Extremity Functional Scale (LEFS) into a Brazilian Portuguese version, and to test the construct and content validity and reliability of this version in patients with knee injuries. BACKGROUND: There is no Brazilian Portuguese version of an instrument to assess the function of the lower extremity after orthopaedic injury. METHODS: The translation of the original English version of the LEFS into a Brazilian Portuguese version was accomplished using standard guidelines and tested in 31 patients with knee injuries. Subsequently, 87 patients with a variety of knee disorders completed the Brazilian Portuguese LEES, the Medical Outcomes Study 36-Item Short-Form Health Survey, the Western Ontario and McMaster Universities Osteoarthritis Index, and the International Knee Documentation Committee Subjective Knee Evaluation Form and a visual analog scale for pain. All patients were retested within 2 days to determine reliability of these measures. Validation was assessed by determining the level of association between the Brazilian Portuguese LEFS and the other outcome measures. Reliability was documented by calculating internal consistency, test-retest reliability, and standard error of measurement. RESULTS: The Brazilian Portuguese LEES had a high level of association with the physical component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.82), the Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.87), the International Knee Documentation Committee Subjective Knee Evaluation Form (r = 0.82), and the pain visual analog scale (r = -0.60) (all, P<.05). The Brazilian Portuguese LEES had a low level of association with the mental component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.38, P<.05). The internal consistency (Cronbach alpha = .952) and test-retest reliability (intraclass correlation coefficient = 0.957) of the Brazilian Portuguese version of the LEES were high. The standard error of measurement was low (3.6) and the agreement was considered high, demonstrated by the small differences between test and retest and the narrow limit of agreement, as observed in Bland-Altman and survival-agreement plots. CONCLUSION: The translation of the LEFS into a Brazilian Portuguese version was successful in preserving the semantic and measurement properties of the original version and was shown to be valid and reliable in a Brazilian population with knee injuries. J Ort hop Sports Phys Ther 2012;42(11):932-939, Epub 9 October 2012. doi:10.2519/jospt.2012.4101

Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.

The Spanish translation, cultural adaptation and validation of the Powe Fatalism Inventory

Background/significance. The scarcity of reliable and valid Spanish language instruments for health related research has hindered research with the Hispanic population. Research suggests that fatalistic attitudes are related to poor cancer screening behaviors and may be one reason for low participation of Mexican-Americans in cancer screening. This problem is of major concern because Mexican-Americans constitute the largest Hispanic subgroup in the U.S.^ Purpose. The purposes of this study were: (1) To translate the Powe Fatalism Inventory, (PFI) into Spanish, and culturally adapt the instrument to the Mexican-American culture as found along the U.S.-Mexico border and (2) To test the equivalence between the Spanish translated, culturally adapted version of the PFI and the English version of the PFI to include clarity, content validity, reading level and reliability.^ Design. Descriptive, cross-sectional.^ Methods. The Spanish language translation used a translation model which incorporates a cultural adaptation process. The SPFI was administered to 175 bilingual participants residing in a midsize, U.S-Mexico border city. Data analysis included estimation of Cronbach's alpha, factor analysis, paired samples t-test comparison and multiple regression analysis using SPSS software, as well as measurement of content validity and reading level of the SPFI. ^ Findings. A reliability estimate using Cronbach's alpha coefficient was 0.81 for the SPFI compared to 0.80 for the PFI in this study. Factor Analysis extracted four factors which explained 59% of the variance. Paired t-test comparison revealed no statistically significant differences between the SPFI and PFI total or individual item scores. Content Validity Index was determined to be 1.0. Reading Level was assessed to be less than a 6th grade reading level. The correlation coefficient between the SPFI and PFI was 0.95.^ Conclusions. This study provided strong psychometric evidence that the Spanish translated, culturally adapted SPFI is an equivalent tool to the English version of the PFI in measuring cancer fatalism. This indicates that the two forms of the instrument can be used interchangeably in a single study to accommodate reading and speaking abilities of respondents. ^