Skip to main content

Research Repository

Advanced Search

Cross-cultural validation of the Portuguese version of the educational needs assessment tool (PORTENAT)

Cruz, Arm�nio; Machado, P.; Hill, J.; Campos, M.; Ap�stolo, J.; Marques, A.; Malcata, A.; Ndosi, M.

Cross-cultural validation of the Portuguese version of the educational needs assessment tool (PORTENAT) Thumbnail


Arm�nio Cruz

P. Machado

J. Hill

M. Campos

J. Ap�stolo

A. Marques

A. Malcata

Profile Image

Dr Mwidimi Ndosi
Associate Professor in Nursing Rheumatology


Objectives: To undertake a cross-cultural adaptation and validation of the educational needs assessment tool (ENAT) into Portuguese. Methods: The first phase of this research (cross-cultural adaptation) utilised a well-established translation method comprising five sequential steps: forward--translation, synthesis of translations, back-translation, expert committee and field-testing of the adapted version. The second phase involved collecting data from 123 patients and subjecting them to Rasch analysis for validity testing including cross-cultural invariance. Results: The translation and field-testing phase went smoothly giving rise to minor adjustments in the phrasing of some items. The preliminary analysis of the 39 items, revealed some deviations from the model with the overall item-person interaction fit statistics 2(df) = 56.025 (39), p = 0.038. Significant item-item correlations caused artificial inflation of the internal consistency, therefore violating the model assumption of local independence of items. To correct this, all locally dependent items were then grouped into their respective domains, creating a 7 testlet-scale which demonstrated a good fit to the Rasch model, 2(df) = 2.625 (7), p = 0.917 and internal consistency PSI = 0.975. Analysis of the pooled (Portuguese and the English) data revealed cross-cultural DIF, requiring adjustments in two testlets: 'treatments' and 'support' which ensured cross--cultural equivalence. Conclusions: This study confirms the Portuguese ENAT is a robust unidimensional tool with which toassess the educational needs of Portuguese people with RA. Cross-cultural adjustments are required only if the data from Portugal and the UK are pooled or compared. The tool is now available for use in clinical practice and research.


Cruz, A., Machado, P., Hill, J., Campos, M., Apóstolo, J., Marques, A., …Ndosi, M. (2015). Cross-cultural validation of the Portuguese version of the educational needs assessment tool (PORTENAT). Acta Reumatologica Portuguesa, 2015(3), 242-253

Journal Article Type Article
Acceptance Date Jan 2, 2015
Publication Date Jan 1, 2015
Publicly Available Date Jun 6, 2019
Journal Acta Reumatologica Portuguesa
Print ISSN 0303-464X
Publisher Sociedade Portuguesa de Reumatologia
Peer Reviewed Peer Reviewed
Volume 2015
Issue 3
Pages 242-253
Keywords Patient education, needs assessment, validity, reliability, Rasch analysis, Cross-cultural, Rheumatoid arthritis
Public URL
Publisher URL file:///C:/Users/ln-hacker/Downloads/958_cross_cultural_validation_of_the_portuguese_version_of_the_educational_needs_assessment_tool_portenat_file%20(1).pdf
Related Public URLs


You might also like

Downloadable Citations