Strategies for assessing mental health in Haiti: Local instrument development and transcultural translation
Strategies for assessing mental health in Haiti: Local instrument development and transcultural translation
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DOI：
10.1177/1363461513502697
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发表时间：
2013-08-01
影响因子：
2.5
通讯作者：
Brewster, Aimee-Rika T.
中科院分区：
文献类型：
--
作者：
Kaiser, Bonnie N.;Kohrt, Brandon A.;Brewster, Aimee-Rika T.
缺乏文化上适当的心理健康评估工具是筛选和评估干预措施效力的主要障碍。简单翻译调查表会产生误导和不准确的结论。已经提出了多种替代方法，本研究比较了在海地农村测试的两种方法。首先，一个既定的跨文化翻译过程被用来开发贝克抑郁量表（BDI）和贝克焦虑量表（BAI）的海地Kreyl版本。这需要进行焦点小组讨论，评估可理解性、可接受性、相关性和完整性。第二，定性数据收集，开发新的工具：Kreyl苦恼成语（KDI）和Kreyl功能评估（KFA）量表。对于BDI和BAI，一些项目被发现是不等价的，由于缺乏特异性，人际解释，或概念不等价。对于所有筛查工具，如果项目难以认可或严重污名化，代表身体疾病的躯体经历，或难以理解，则对其进行调整。在定性开发阶段之后，BDI和BAI分别在31名和27名成年人中进行了试点，并取得了良好的可靠性。如果没有这些开发适当工具的努力，筛查的尝试将捕获非典型痛苦，日常现象和潜在精神病症状的组合。最后，一个跨文化适应和当地开发的工具相结合，适当地确定那些需要照顾的人，通过占当地突出的痛苦症状及其负面后果。
The lack of culturally appropriate mental health assessment instruments is a major barrier to screening and evaluating efficacy of interventions. Simple translation of questionnaires produces misleading and inaccurate conclusions. Multiple alternate approaches have been proposed, and this study compared two approaches tested in rural Haiti. First, an established transcultural translation process was used to develop Haitian Kreyl versions of the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). This entailed focus group discussions evaluating comprehensibility, acceptability, relevance, and completeness. Second, qualitative data collection was employed to develop new instruments: the Kreyl Distress Idioms (KDI) and Kreyl Function Assessment (KFA) scales. For the BDI and BAI, some items were found to be nonequivalent due to lack of specificity, interpersonal interpretation, or conceptual nonequivalence. For all screening tools, items were adjusted if they were difficult to endorse or severely stigmatizing, represented somatic experiences of physical illness, or were difficult to understand. After the qualitative development phases, the BDI and BAI were piloted with 31 and 27 adults, respectively, and achieved good reliability. Without these efforts to develop appropriate tools, attempts at screening would have captured a combination of atypical suffering, everyday phenomena, and potential psychotic symptoms. Ultimately, a combination of transculturally adapted and locally developed instruments appropriately identified those in need of care through accounting for locally salient symptoms of distress and their negative sequelae.