Page 50 - Portuguese Journal - SPORL - Vol 61. Nº1

reflects a moderate limitation. Finally, a score research team (Table 1) after discussions within
higher than 43 indicates a severe limitation . 1 the focus groups. Regarding the questionnaire
instructions, the panel of specialists decided
Results to use the term “tontura” (dizziness) rather
The original version of the DHI-PC (Figure 1) was than “tontura/vertigem” (dizziness/vertigo) to
translated into European Portuguese by two translate “dizziness.” The maximum DHI-PC
independent bilingual translators who were score in the study population was 72 points.
independent users of the English language and This pre-final version was back-translated into
whose mother tongue was that to which the the original language by two independent
DHI-PC was translated (neither translators bilingual translators who had not seen the
had medical training). The two translators original version, had no medical training, and
and the research team (composed of six whose mother tongue was that of the original
otorhinolaryngologists) together revised the questionnaire. The final consensus version of
translations until reaching a consensus for the DHI-PC was based on the two translations.
the first version in European Portuguese The back-translations were sent to the team
(consensus version of the DHI-PC). The pre- that developed the original instrument for
test participants of the focus groups were review and formal approval.
questioned regarding their understanding of
the items in the questionnaire—dubious or Discussion
equivocal aspects—and were asked to make The diagnosis of vestibular disorders is usually
observations and/or suggestions for changes. based on the clinical history and symptom
The discussion among the groups continued characterization, which may be difficult
until no new information was presented. The in pediatric patients and can thus hinder
team responsible for the adaptation reached a diagnosis.
consensus based on the alterations discussed in In the adult population, the DHI has been
11
the focus groups to achieve semantic, idiomatic, used to quantify the impact of balance
experimental, and conceptual equivalence that disorders and has been translated and
ensured an accurate translation and adequate validated in several countries. Validation
cultural adaptation. This was the pre-final into the Portuguese language and for the
consensus version of the instrument in Portuguese population was performed
Portuguese for use in children and adolescents by Garcia et al. in 2008 . The DHI-PC, an
12
(Figure 2). adaptation for the pediatric population, is
Items 1, 7, 8, 12, and 18 were adapted by the intended to be answered by the children’s

Table 1
Adaptation of the questionnaire’s items

Items Literal translation Adapted translation

O problema do seu filho fá-lo sentir-se O seu filho sente-se mais cansado por causa
Item 1)
cansado? deste problema?
Devido a este problema o seu filho
Item 7) Devido a este problema o seu filho fica ansioso?
fica tenso?
As outras pessoas ficam enervadas As outras pessoas ficam ansiosas com o problema
Item 8)
com o problema do seu filho? do seu filho?
Este problema faz com que o seu filho
Item 12) Este problema faz com que o seu filho se sinta triste?
se sinta infeliz?
Devido a este problema, o seu filho Devido a este problema, o seu filho tem dificuldade
Item 18)
tem dificuldade em andar de bicicleta? em andar de bicicleta, trotinete ou patins?

50 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery