Translation and cultural adaptation of the Mother-Generated Index into Brazilian Portuguese:a postnatal quality of life study

OBJECTIVE: quality of life issues are central to maternal health and well-being. Within the context of a study examining postnatal quality of life, we set out to translate into Brazilian Portuguese the Mother-Generated Index and ensure its cross-cultural adaption for use in a Brazilian context. DESIGN: the Mother-Generated Index, a subjective quality of life tool, underwent a validated process of translation and cultural adaptation: synthesis of two independently translated versions, back-translation and review by an expert committee was followed by testing of the preliminary tool with 30 mothers. SETTINGS: community-based study in city in north-eastern Brazil. PARTICIPANTS: 30 postpartum mothers, interviewed approximately 30 days after birth. FINDINGS: while the mothers understood the concept of identifying and scoring quality of life aspects, many did not grasp the concept behind the use of 'spending points' to produce a relative ranking of these aspects. We resolved this by giving the mothers 'spending beans' instead; beans are a regional food staple. This use of a physical 'currency' solved the problem. DISCUSSION: this modified approach was ratified by the committee of experts and used with success on a further sample of 91 mothers. The whole process aimed to ensure semantic equivalence of the translated tool, and following this process we concluded that face validity of the Brazilian Portuguese Mother-Generated Index was good. While considerable resources are required to ensure a robust process of translation and adaptation, this is necessary if valid and reliable tools are to be produced. IMPLICATIONS: We conclude that the Mother-Generated Index is a valid tool to measure quality of life among Brazilian postpartum mothers, as it allows a simple and understandable way of assessing the various dimensions involved in their quality of life. Moreover, the Mother-Generated Index can provide healthcare professionals the opportunity to become aware of all significant aspects of a woman׳s life after childbirth.