Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese

Figures & data

Table 1 Solutions Adopted by the Translators’ Committee* for the Ambiguities and Discrepancies Found in the Translations of the BHAB Questionnaire

Items	Ambiguity or Discrepancy	Solution	Justification
a1, c1	The verb “greet” may mean “cumprimentar” or “tratar” (speak to)	“tratar”	Treating supposes an individualising intention
a2	The verb “need” may mean “necessidade” or “dever” (strong need)	“necessidade”	The “eye contact” of nurses is not an obligation
a3, a11, a13, a15, c2, c5, c8, c11, c13	The word “handover” was translated by “transferência” and by “passagem de turno”	“passagem de turno”	Idiomatic expression in Portuguese language
a4, a6, a13, a14, c10	The word “discussion” may mean “debate” or “discussão”	“discussão”	During handover nurses can discuss with patients the plan of care for the shift
a5, c4, c5, c14	The word “incoming nurses” was translated by “enfermeiros que entram de serviço” and by “enfermeiros que entram de turno”	“enfermeiros que entram de turno”	Alignment with the translation of the word “handover” by “passagem de turno”
a7, a15, a16, a18, c5, c11, c12, c14	The word “outcoming nurses” was translated by “enfermeiros que saem de serviço” and by “enfermeiros que saem de turno”	“enfermeiros que saem de turno”	Alignment with the translation of the word “handover” by “passagem de turno”
a8, c7	The verb “listen to” may mean “ouvir” or “escutar”	“escutar”	Patients can make important contributions to the continuity of care
a9, c7	The verb “react to” may mean “reagir” or “responder”	“responder”	Patients can ask questions or raise concerns during handover
a10	The statement “there is no need” may mean “nurses shouldn’t use”	“os enfermeiros não têm necessidade”	Nurses can use or control their non-verbal communication during handover
a11, a12	The verb “need” may mean “necessidade” or “dever” (strong need)	“dever”	Nurses’ attention to feelings and concerns was considered a duty during handover
a11	The verb “look for” may mean “procurar” and “pesquisar” or can have the meaning of “be aware of” or “estar atento”	“estar atento”	It is necessary to be aware of the patients’ reactions during handover, especially when the information is not positive
a12, c9	The word “notes” which can mean “notas de enfermagem” or “registos de enfermagem”	“registos de enfermagem”	The term “registos de enfermagem” is more comprehensive than “notas de enfermagem”
a16, c12	The expression “presenting condition” was translated by “presente condição” and by “quadro clínico de apresentação”	“presente condição”	The “presente condição” is more comprehensive than “quadro clínico de apresentação”
a16	The verb “need” may mean “necessidade” or “dever” (strong need)	“dever”	The explanation of the “condição presente” is a way to communicate complete, accurate and timely information
a17, c13	The verb “refer to” may mean “referir”, “mencionar” or “consultar”	“consultar”	Nurses may need to access records
a18, c14	The words “treatment plan” were translated as “plano de tratamento” and “plano de cuidados”	“plano de cuidados”	The term “plano de cuidados” is more comprehensive than “plano de tratamento”
c2	The word “position” was translated as “posição” e “local”	“local”	Depending on where nurses are positioned, it will be easier or more difficult for patients to see, hear and participate

Note: *The Translators’ Committee included three bilingual translators with Portuguese as their mother tongue, one of whom was familiar with the NBH.

Table 2 Solutions Adopted by the Multiprofessional Committee* to the Ambiguities and Discrepancies Found in the Back-Translations of the BHAB Questionnaire

Items	Ambiguity or Discrepancy	Solution	Justification
a2	The expression “make eye contact” was translated as “ter” and “fazer contacto visual”	“estabelecer contacto visual”	The term “estabelecer” is more common in Portuguese than “ter” and “fazer”
a2	The verb “need to” (“necessitam”) may mean “necessidade” or “necessidade forte”, according to whether it is a desirable conduct or an imperative norm	“necessidade”	It was considered that this is a desirable behaviour as patients may refuse to participate in the handover
a3, c2, c5, c8, c11, c13	The term “passagem de turno” was translated by “change shift” and “handover”	“handover”	The term “handover” is commonly used in the English hospital context
a3	The verb “permitir” was translated by “allow” and “enable”	“allow”	It was considered that “allow” conveys the idea that nurses manage information during handover
a6	Conceptual divergence in “os enfermeiros que estão de saída de turno devem pedir aos enfermeiros que entram para esclarecer as informações discutidas”	“para validarem as informações discutidas”	Only nurses leaving shifts can clarify incoming nurses
a10, a17	The expression “It is not necessary for nurses” was translated as “os enfermeiros não têm necessidade”	“não há necessidade de os enfermeiros”	Maintains the neutrality and formal coherence of the original: “It is not necessary”
a11	The statement “os enfermeiros devem estar atentos” was translated as “nurses must be careful” and “nurses should be attentive”	“estar atentos”	It’s closer to “nurses should look for”
a12	The statement “os enfermeiros devem estar atentos” was translated as “nurses must be attentive” and “nurses should be attentive”	“necessidade”	Verbalisation of patients’ concerns are a form of participation in the handover
a12	Semantic ambiguity in “particular patient concerns” due to the ordering of the English idiomatic possessive “particular”	“preocupações específicas do cliente”	The English word “particular” here refers to the patient’s concern, meaning something that is of particular concern to him/her
a16, c12	The expression “presente condição do cliente” was translated as “apparent clinical condition” and “patient’s clinical picture”	“estado clínico atual”	It was decided that it is more common in clinical Portuguese
a18, c13	The term “registos médicos” was translated as “patient’s medical records” and “patient’s medical records”	“registos clínicos do cliente”	Patient clinical records include medical and nursing records
a18, c14	The statement “devem ter em atenção no próximo turno” was translated to “nurses on the next shift must keep in mind” and “look out for on the next shift”	“devem monitorizar no próximo turno”	The verb “monitorizar” is commonly used by nurses to designate what needs to be monitored
c3	The term “informação médica” was translated to “medical information” and “medical details”	“informação clínica”	The term “informação clínica” is more comprehensive

Notes: *The Multiprofessional Committee included four bilingual translators (two with a mother tongue in Portuguese, and two in English), a nurse with current experience in performing the NBH, a monolingual nurse and a linguistic professional.