Cross-cultural adaptation and validation of the Social Needs: Patient Questionnaire to European spoken Portuguese
DOI:
https://doi.org/10.32385/rpmgf.v41i6.14098Keywords:
Social needs, Patient, Health, SocioeconomyAbstract
Objectives: To cross-culturally adapt and validate the Social Needs: Patient Questionnaire (SN-PQ) for European Portuguese for individuals 18 to 65 years old.
Methods: Observational study, the questionnaire underwent cross-cultural adaptation following translation debriefing and back-translation to English, and its internal consistency, doubts, and criticism. The validation stage used a Google Forms version of the questionnaire distributed via social networks, with its score being calculated, and gender, the Socioeconomic Deprivation Index, and suffering from multimorbidity were used as context variables. The SN-PQ score was calculated as the sum of the eleven needs, higher score meaning more needs.
Results: The correlation between SEDI and SN-PQ was moderately negative and significant, ρ=-0.415, p<0.001. Women more frequently showed concern about food and medical care expenses, p=0.027 and p=0.007, respectively. People with higher socio-economic stratum showed significantly less housing problems, p=0.001, more confidence in completing documents alone, p=0.010, and dealing with health and problems, p=0.010. For n=61 (48.8%) of this sample, there was at least one social need, transport to and from medical appointments being the most frequent one. No differences were found by gender, p=0.069, age group, p=0.122, or having multimorbidity, p=0.291.
Discussion: This is the first Portuguese study to address these social needs of health. It is worth stressing the pertinence of further research for a deeper understanding of the relationship between a person’s social needs and health consequences.
Conclusion: In this online sample, 48.8% reported at least one social need that should be addressed in Primary Care for better results and health consequences. A better socio-economic class meant fewer social needs.
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References
1. Magnan S. Social determinants of Health 101 for health care: five plus five [homepage]. Washington: National Academy of Medicine; 2017. Available from: https://nam.edu/perspectives/social-determinants-of-health-101-for-health-care-five-plus-five/
2. Bleacher H, Lyon C, Mims L, Cebuhar K, Begum A. The feasibility of screening for social determinants of health: seven lessons learned. Fam Pract Manag. 2019;26(5):13-9.
3. World Health Organization. Social determinants of health [homepage]. Geneva: WHO; 2023 [cited 2023 Dec 27]. Available from: https://www.who.int/social_determinants/sdh_definition/en/
4. NEJM Catalyst. Social determinants of health (SDOH) [homepage]. NEJM Catalyst. 2017 Dec 1. Available from: https://catalyst.nejm.org/doi/abs/10.1056/CAT.17.0312
5. Barton LR, Parke KA, White CL. Screening for the social and behavioral determinants of health at a school-based clinic. J Pediatr Health Care. 2019;33(5):537-44.
6. PORDATA. Estatísticas sobre Portugal e Europa [homepage]. Lisboa: PORDATA; s.d. [cited 2024 Jan 4]. Available from: https://www.pordata.pt/pt/estatisticas/pobreza
7. Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, et al. Multimorbidity. Nat Rev Dis Primers. 2022;8(1):48.
8. Prazeres F, Santiago LM, Simões JA. Defining multimorbidity: from English to Portuguese using a Delphi technique. Biomed Res Int. 2015;2015:965025.
9. Prazeres F, Santiago L. Prevalence of multimorbidity in the adult population attending primary care in Portugal: a cross-sectional study. BMJ Open. 2015;5(9):e009287.
10. Santiago LM, Prazeres F, Boto T, Maurício K, Rosendo I, Simões JA. Multimorbidity daily life activities and socio-economic classification in the central Portugal primary health care setting: an observational study. Fam Med Prim Care Rev. 2020;22(1):54-8.
11. Prazeres F, Santiago L. Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study. Health Qual Life Outcomes. 2016;14(1):156.
12. Ribeiro AI, Launay L, Guillaume E, Launoy G, Barros H. The Portuguese version of the European Deprivation Index: development and association with all-cause mortality. PLoS One. 2018;13(12):e0208320.
13. Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796-804.
14. Biscaia AR, Heleno LC. Primary health care reform in Portugal: Portuguese, modern and innovative. Cien Saude Colet. 2017;22(3):701-12.
15. Regatia R, Santiago LM. Multimorbilidade: impacto no exercício da medicina centrada na pessoa e no distress médico em medicina geral e familiar [Multimorbidity: impact on patient-centered medicine and distress among general practice physicians]. Rev Port Med Geral Fam. 2023;39(1):37-44. Portuguese
16. Coelho BM, Santiago LM. Medicina centrada na pessoa: validação populacional de um instrumento de medida pela pessoa [Person-centered medicine: validation of a person perception instrument]. Rev Port Med Geral Fam. 2022;38(3):247-56. Portuguese
17. RAND Health. Basic guidelines for translating surveys [homepage]. RAND Corporation; s.d. [cited 2023 Dec 30]. Available from: https://www.rand.org/health-care/surveys_tools/about_translations.html
18. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86(4):304-14.
19. Costa A, Lopes J, Sousa CJ, Santos O, Virgolino A, Nogueira P, et al. Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging. BMC Health Serv Res. 2021;21(1):1164.
20. Miranda MR. Classificação socioeconómica familiar em medicina geral e familiar: a comparação de dois modelos [dissertation]. Coimbra: Faculdade de Medicina da Universidade de Coimbra; 2020. Available from: https://hdl.handle.net/10316/97619
21. Peahl AF, Rubin-Miller L, Paterson V, Jahnke HR, Plough A, Henrich N, et al. Understanding social needs in pregnancy: prospective validation of a digital short-form screening tool and patient survey. AJOG Glob Rep. 2023;3(1):100158.
22. Santos P, Sá AB, Santiago LM, Hespanhol A. A árvore da WONCA: tradução e adaptação cultural para português [The WONCA tree: Portuguese translation and cultural adaptation]. Rev Port Med Geral Fam. 2021;37(1):28-35. Portuguese
23. Dwellness Communities. Why dwellness: empowering people to dwell in wellness [homepage]. DC; s.d. [cited 2025 Oct 20]. Available from: https://dwellnesscommunities.com/
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