Translation and cross-cultural adaptation of the Nijmegen Gender Awareness in Medicine Scale into Brazilian Portuguese

Abstract

The Nijmegen Gender Awareness in Medicine Scale (N-GAMS) measures gender sensitivity and gender role ideologies towards patients and physicians, but no Brazilian Portuguese version was available. This methodological study translated and adapted the instrument, assessed item equivalence through an expert committee and examined its feasibility. The process followed Beaton et al.'s six-stage protocol and completed the first five: translation, synthesis, back-translation, a committee of seven judges and pretest; appraisal by the original authors is planned after validation. The pretest was administered to seventh-semester medical students, with estimation of Cronbach's alpha, corrected item-total correlations and floor and ceiling effects. Twelve of the 32 items received comments from the committee and five were modified. Twenty of the 80 invited students responded, with no missing data and no difficulty understanding the items. The gender sensitivity (α = 0.811) and ideology towards patients (α = 0.857) subscales matched the original instrument, whereas the one towards physicians fell below the conventional threshold (α = 0.677). Nine items showed corrected item-total correlations below 0.30, seven of which had already been discarded in the Portuguese and French versions. Instructed to assess the translation, the judges criticized the content of the items. The Brazilian version proved comprehensible and applicable. The overlap between the items that underperformed in Brazil and those discarded elsewhere points to a limitation of the instrument itself. The judges' difficulty in separating criticism of content from the assessment of equivalence is relevant to future adaptations of stereotype scales.