Cross-cultural adaptation of the short form of the Healing Encounters and Attitudes Lists tool for the Brazilian context: pilot study

BACKGROUND AND OBJECTIVES: Several contextual factors (CFs) are related to therapeutic interventions and can have a positive or negative impact on the symptoms of patients with chronic musculoskeletal pain. Despite the increasing use of self-administered measurement tools, there is currently no tool available to assess the impact of CFs on health treatments in Brazil. The aim of this study was to translate and cross-culturally adapt the short form of the HEAL tool to the Brazilian context.

METHODS: The cross-cultural adaptation consisted of translation from English to Portuguese, back-translation, review by a committee of experts, and pre-testing with questionnaires on sociodemographic data, pain intensity, level of functionality, and the HEAL tool. A descriptive analysis of the participants' pre-test data was performed, and the internal consistency of the instrument was assessed using Cronbach's alpha test.

RESULTS: Four translators, five specialists and thirty patients with chronic musculoskeletal pain participated in the study. The final version was well understood by the pre-test participants, except for the subscale “Attitudes towards Complementary and Alternative Medicine”, in which 70% of the participants had doubts. As a solution, examples were included in the items evaluated. The subscales of the HEAL tool showed excellent internal consistency.

CONCLUSION: The Brazilian version of the HEAL tool is available for research and clinical practice and can help identify the interference of CFs in the treatment of chronic musculoskeletal pain. However, we recommend caution in using this tool until other measures have been widely evaluated.