Translation into european portuguese of the check in, affirm, clarify, and answer tool for use in rehabilitation nursing
DOI:
https://doi.org/10.29352/mill0222e.44159Keywords:
communication; nursing care; rehabilitation nursing; sexual health; translatingAbstract
Introduction: Sexuality remains little addressed in Rehabilitation Nursing care, partly due to the absence of adequate European Portuguese instruments to guide professional communication. The Check In, Affirm, Clarify, and Answer Tool, developed in Canada, provides a holistic and accessible approach to support Rehabilitation Nursing Specialists in discussing sexuality.
Objective: To translate the Check In, Affirm, Clarify, and Answer Tool into European Portuguese, aiming to support Rehabilitation Nursing Specialists in communicating about sexuality with patients.
Methods: A rigorous and scientifically validated methodological protocol was followed, based on forward translation and back-translation. Two translators and two back-translators, all bilingual and experienced in nursing, participated. The versions were analyzed, reconciled, and compared with the original, ensuring semantic, conceptual, cultural, and operational equivalence.
Results: The translated and back-translated versions showed high similarity with each other and the original text (Similarity Index >98%), requiring only minimal linguistic adjustments. These minor modifications confirmed the adequacy of the European Portuguese version.
Conclusion: The translation and back-translation process proved effective, producing a European Portuguese version conceptually equivalent to the original. This version represents a useful resource for Rehabilitation Nursing Specialists, promoting ethical, inclusive, and person-centered communication, and should be validated in future clinical and academic use.
Downloads
References
Akalin, A., & Ozkan, B. (2021). Sexual myths and attitudes regarding sexuality of nursing students: A mixed method study. Perspectives in Psychiatric Care, 57(3), 1497–1504. https://doi.org/10.1111/ppc.12717
Åsberg, E., Giskeødegård, G., Karlsen, J., Kiserud, C., Aune, G., Nilsen, M., & Reidunsdatter, R. (2025). Sexual health in female and male cancer survivors – compared with age-matched cancer-free controls in Norway. Acta Oncologica, 64, 380–390. https://doi.org/10.2340/1651-226X.2025.42451
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014
Blamey, G., Van Tassel, B., Sagermann, E., Stain, A. M., Waterhouse, L., & Iorio, A. (2022). Sexual issues in people with haemophilia: Awareness and strategies for overcoming communication barriers. Haemophilia, 28(1), 36–41. https://doi.org/10.1111/hae.14447
Brislin, R., Lonner, W., & Thorndike, R. (1973). Cross-cultural research methods. John Wiley & Sons, 12(1), 7–10. https://doi.org/10.1177/136346157501200101
Carroll, C., Trotter, K., Mcmillian-Bohler, J., & Thompson, J. (2022). Improving perinatal sexual health assessment: PLISSIT model implementation. Women’s Healthcare, 10(6), 46–50. https://shre.ink/AGMz
Carvajal-Valcárcel, A., Benitez, E., Lizarbe-Chocarro, M., Galán-Espinilla, M. J., Vázquez-Calatayud, M., Errasti-Ibarrondo, B., Choperena, A., McCormack, B., Tyagi, V., & La Rosa-Salas, V. (2024). Translation, cultural adaptation, and validation of the spanish version of Person-Centred Practice Inventory-Staff (PCPI-S). Healthcare, 12(23), 2485. https://doi.org/10.3390/healthcare12232485
Carvalho, A., & Silva, J. (2021). Sexualidade das pessoas com deficiência física: Uma análise à luz da teoria das representações sociais. Revista Brasileira de Educacao Especial, 27(e0198), 529–544. https://doi.org/10.1590/1980-54702021v27e0198
Centre for Sexuality. (n.d.). Communication tips for parents. https://shre.ink/AGMC
Chaves, F., Cecilio, S., Reis, I., Pagano, A., & Torres, H. (2019). Translation and cross-cultural adaptation of the behavior change protocol for educational practices in diabetes mellitus. Revista Latino-Americana de Enfermagem, 27(e3164). https://doi.org/10.1590/1518-8345.2908-3164
Cruchinho, P., López-Franco, M. D., Capelas, M. L., Almeida, S., Bennett, P. M., Miranda da Silva, M., Teixeira, G., Nunes, E., Lucas, P., & Gaspar, F. (2024). Translation, cross-cultural adaptation, and validation of measurement instruments: A practical guideline for novice researchers. Journal of Multidisciplinary Healthcare, 17, 2701–2728. https://doi.org/10.2147/JMDH.S419714
De Souza, A., & Gagliotto, G. M. (2023). A construção histórica da Sexualidade: Porque ela ainda é um tabu? Educere - Revista Da Educação da UNIPAR, 23(2), 547–559. https://doi.org/10.25110/educere.v23i2.2023-002
Gamsby, P. (2020). The common ground of open access and interdisciplinarity. Publications, 8(1). https://doi.org/10.3390/publications8010001
Giles, M. L., Juando-Prats, C., McPherson, A., & Gesink, D. (2023). “But, You’re in a Wheelchair!”: A systematic review exploring the sexuality of youth with physical disabilities. Sexuality and Disability, 41(1), 141–171. https://doi.org/10.1007/s11195-022-09769-5
Hassan, M. M., Elmordy, Z. R. A., & Emam, A. M. (2023). Effect of nursing counseling based on BETTER model on sexuality and marital satisfaction among infertile women. Egyptian Journal of Health Care, 14(3), 342–360. https://doi.org/10.21608/ejhc.2023.316908
Ikedo, F., Castro, L., Fraguas, S., Rego, F., & Nunes, R. (2020). Cross-cultural adaptation and validation of the European Portuguese version of the heartland forgiveness scale. Health and Quality of Life Outcomes, 18(289). https://doi.org/10.1186/s12955-020-01531-9
Júnior, C. J. dos S., & Costa, P. J. M. de S. (2024). Adaptação transcultural de instrumentos em Medicina e na área de Saúde do Trabalhador. Medicina (Ribeirão Preto), 57(2). https://doi.org/10.11606/issn.2176-7262.rmrp.2024.214564
Lise, F., Neves, J., & Schwartz, E. (2022). Adaptação transcultural e validação de instrumentos de avaliação da saúde na América Latina. In J. López, E. Schwartz, & F. Lise (Eds.), Atenção à saúde das famílias latino-americanas: abordagens teóricas e práticas na educação (pp. 154–169). Editora UFFS. https://doi.org/10.7476/9786550190569.0012.
Lourenço, H. (2023). Avaliação da saúde sexual. In C. Marques-Vieira & L. Sousa (Eds.), Cuidados de Enfermagem de Reabilitação à Pessoa ao longo da vida (1a edição, pp. 203–211). Sabook Editores.
Marques, E. (2023). Reeducação sexo-afetiva nas pessoas com limitação física. In C. Marques-Vieira & L. Sousa (Eds.), Cuidados de Enfermagem de Reabilitação à Pessoa ao longo da vida (1a edição, pp. 281–285). Sabook Editores.
McCance, T., & McCormack, B. (2025). The person-centred nursing framework: A mid-range theory for nursing practice. Journal of Research in Nursing, 30(1), 47–60. https://doi.org/10.1177/17449871241281428
Moon, H. (2023). Nursing care for women with gynecologic cancer receiving radiotherapy: Current updates. Korean Journal of Women Health Nursing, 29(4), 257–262. https://doi.org/10.4069/kjwhn.2023.12.11
Moreira, J., Domingues, L., Silva, M., & Caeiro, C. (2024). Cross-cultural Adaptation and validation of the Person-centered therapeutic relationship in physiotherapy scale to european portuguese. Healthcare, 12(2455). https://doi.org/10.3390/healthcare12232455
Ordem dos Enfermeiros. (2019). Regulamento das competências específicas do Enfermeiro Especialista em Enfermagem de Reabilitação (Regulamento n.º 125/2011, alterado e republicado em 2019). Diário da República, 2.ª série, N.º 85. https://shre.ink/AGM5
Organização Mundial da Saúde. (1999). Declaration of sexual rights. 14th World Congress of Sexology. https://shre.ink/AGMo
Organização Mundial da Saúde. (2002). Defining sexual health: Report of a technical consultation on sexual health. https://shre.ink/AGMS
Organização Mundial da Saúde. (2004). Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) (Direcção-Geral da Saúde, Ed.). https://shre.ink/AGMx
Paiva, M. J. (2022). História da sexualidade IV: As confissões da carne. Teoria e Cultura, 17(1), 213–217. https://doi.org/10.34019/2318-101X.2022.v17.31702
Pinto, M., Martins, S., Mesquita, E., & Fernandes, L. (2021). European portuguese version of the clinical frailty scale: Translation, cultural adaptation and validation study. Acta Médica Portuguesa, 34(11), 749–760. https://doi.org/10.20344/amp.14543
Prodrossimo, A. F., Dias, J. P. P., Iankilevich, L., & Souza, J. M. (2021). Validação, tradução e adaptação transcultural de instrumentos de pesquisa clínico-educacionais: Uma revisão integrativa. Espaço Para a Saúde - Revista de Saúde Pública Do Paraná, 22(e736), 1–11. https://doi.org/10.22421/1517-7130/es.2021v22.e736
Registered Nurses’ Association of Ontario. (2025). People-centred care. https://rnao.ca/bpg/guidelines/people-centred-care
Rizzo, J. G. S., & Gonçalves, J. P. (2022). Sexualidade e surdez: Um diálogo a partir de Michel Foucault. Research, Society and Development, 11(1). https://doi.org/10.33448/rsd-v11i1.21024
Smith, A. B., & Barton, D. L. (2020). Prevalence and severity of sexual dysfunction and sexual dissatisfaction in coronary artery disease: An itegrative review. Canadian Journal of Cardiovascular Nursing, 30(2), 22–30. https://shre.ink/AGM8
Teixeira, F., Frasquilho, A. R., Saraiva, D., Frasquilho, V., Rabiais, I., Tomás, J., Severino, S., & Sousa, L. (2025). Rehabilitation nursing interventions at the level of the sexuality function in disabled persons. Rapid review. Rehabilitation and Sports Medicine, 5(109), 109. https://doi.org/10.56294/ri2025109
Teixeira, F., Guerra, N., Marques, J., Severino, S., & Sousa, L. (2026). From taboo to practice: Integrating sexual health in rehabilitation nursing. South Health and Policy, 5(415). https://doi.org/10.56294/shp2025415
Toprak, F. Ü., & Turan, Z. (2021). The effect of sexual health courses on the level of nursing students’ sexual/reproductive health knowledge and sexual myths beliefs in Turkey: A pretest‐posttest control group design. Perspectives in Psychiatric Care, 57(2), 667–674. https://doi.org/10.1111/ppc.12593
Wang, J., & Dong, Y. (2020). Measurement of text similarity: A survey. Information, 11(421). https://doi.org/10.3390/info11090421
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Millenium - Journal of Education, Technologies, and Health

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who submit proposals for this journal agree to the following terms:
a) Articles are published under the Licença Creative Commons (CC BY 4.0), in full open-access, without any cost or fees of any kind to the author or the reader;
b) The authors retain copyright and grant the journal right of first publication, allowing the free sharing of work, provided it is correctly attributed the authorship and initial publication in this journal;
c) The authors are permitted to take on additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, post it to an institutional repository or as a book), with an acknowledgment of its initial publication in this journal;
d) Authors are permitted and encouraged to publish and distribute their work online (eg, in institutional repositories or on their website) as it can lead to productive exchanges, as well as increase the impact and citation of published work
Documents required for submission
Article template (Editable format)

