- 2026, Volume 57 - Number 2
- Published: January 8, 2026
Cross-cultural adaptation and psychometric validation of the Children with Special Health Care Needs Screener© for European Portuguese in a school setting
Maria do Céu Coelho Monteiro Pires 1, Maria do Céu Aguiar Barbieri-Figueiredo 2, Armando Manuel Marques Silva 3, Andrea Moreira Arrué 4, Joana Guarda-Rodrigues 5, Eliane Tatsch Neves 6, Eva Guilherme Menino 7
1 ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; Portuguese Red Cross School of Health, Lisbon, Portugal; 2 ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; Faculty of Nursing, University of Huelva, Spain; Porto Nursing School, Porto, Portugal; 3 Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal; Nursing School of Coimbra, Coimbra, Portugal; 4 Federal Institute of Paraná, Paraná, Brazil; Federal Technological University of Paraná, Paraná, Brazil; 5 Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Lisbon, Portugal; School of Nursing, University of Lisbon, Lisbon, Portugal; 6 Federal University of Santa Maria, Rio Grande do Sul, Brazil; 7 School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Center for Innovative Care and Health Technology, Leiria, Portugal
Maria do Céu Coelho Monteiro Pires, Maria do Céu Aguiar Barbieri-Figueiredo, Armando Manuel Marques Silva, Andrea Moreira Arrué, Joana Guarda-Rodrigues, Eliane Tatsch Neves, Eva Guilherme Menino
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Andrea Moreira Arrué, Email not available
Abstract
Introduction and Objectives: Children with special health care needs (CSHCN) constitute a growing and heterogeneous group. The Children with Special Health Care Needs Screener© (CSHCN Screener©) is a brief (five-item), reliable, and clinically useful instrument for identifying these children. The objective of this study was to culturally adapt and evaluate the psychometric properties of the CSHCN Screener© for Portuguese children in a school setting, based on the translation and adaptation of the instrument validated for Brazilian Portuguese. Method: The study comprised two phases: (a) cross-cultural adaptation with experts and a pre-test, including face validity, with 54 parents/guardians (PG); and (b) reliability assessment in a sample of 301 PG through internal consistency (Cronbach’s alpha), test-retest (kappa coefficient), and content validity with experts, using the content validity index (CVI). Results: The final instrument is culturally appropriate. The items demonstrated adequate reliability (α = 0.75 and 0.77). The overall test–retest concordance coefficient (Test 1 – Retest 1 to Test 5 – Retest 5) demonstrated considerable temporal stability (kappa > 0.8). Face validity indicated that the CSHCN Screener© is easily understood by PG. Experts agreed on the relevance, comprehensibility, and comprehensiveness of the content (CVI = 1.00). Discussion: The CSHCN Screener©, culturally adapted to European Portuguese, is reliable and useful for identifying CSHCN who present one or more of the five consequences included in the questionnaire, and will contribute to developing policies that promote health, with an emphasis on transdisciplinary intervention, specifically in the school context. It shows high potential for adaptation and applicability in different care contexts.
