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, ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; Portuguese Red Cross School of Health, Lisbon, Portugal
Maria do Céu Aguiar Barbieri-Figueiredo, ICBAS School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; Faculty of Nursing, University of Huelva, Spain; Porto Nursing School, Porto, Portugal
Armando Manuel Marques Silva, Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal; Nursing School of Coimbra, Coimbra, Portugal
Andrea Moreira Arrué, Federal Institute of Paraná, Paraná, Brazil; Federal Technological University of Paraná, Paraná, Brazil
Joana Guarda-Rodrigues, Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Lisbon, Portugal; School of Nursing, University of Lisbon, Lisbon, Portugal
Eliane Tatsch Neves, Federal University of Santa Maria, Rio Grande do Sul, Brazil
Eva Guilherme Menino, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Center for Innovative Care and Health Technology, Leiria, Portugal

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.

Keywords: Child health. School health services. Reproducibility of results.