EMPATHIC-30: translation and validation in Portugal of the questionnaire that measures parental satisfaction in pediatric intensive care units

Introduction and objectives: The EMpowerment of PArents in THe Intensive Care-30 (EMPATHIC-30) questionnaire evaluates parental satisfaction in Pediatric Intensive Care Units (PICUs) and has been translated and validated in several countries. This study aimed to translate, culturally adapt and validate the EMPATHIC-30 into European Portuguese, ensuring conceptual, semantic and cultural equivalence, where no validated questionnaire currently exists. Methods: A cross-sectional study was conducted using a non-probabilistic convenience sample. The translation and cultural adaptation followed a standardized process including forward translation, back-translation, expert panel review, and pre-testing. The Portuguese EMPATHIC-30 was then administered to parents of hospitalized children. Exclusion criteria included hospital stays under 24 hours, readmissions, the neonatal period, an inability to understand Portuguese, and patient death. Reliability was assessed using Cronbach’s alpha, and convergent validity and divergent validity using Spearman’s correlation and Cohen’s d test, respectively. Exploratory factor analysis assessed internal structure. Statistical significance was set at p < 0.05. Results: The process resulted in a culturally appropriate Portuguese version, with good comprehension. A total of 134 questionnaires were analyzed; most respondents were mothers (79.9%) and Portuguese nationals (92.5%). Domain-level internal consistency was acceptable for most domains (0.706-0.756), except for the Organization domain (0.461). Convergent validity showed correlations > 0.4 in five cases (Rs: 0.240-0.482, p < 0.01). Divergent validity showed significant differences in parental participation according to nationality and for the Organization domain according to admission characteristics. Exploratory factor analysis suggested a single-component model explaining 62.5% of the variance. Conclusion: The Portuguese version of the EMPATHIC-30 showed adequate psychometric properties for use in Portuguese PICU and may support quality assessment and family-centered care.