Adaptação do protocolo Montreal Cognitive Assessment Hearing Impairment (MoCA-HI) para o português brasileiro

Abstract

The decrease in sensory stimulation resulting from hearing loss associated with the time of sensory deprivation, can cause not only serious communicative alterations, but also compromise the cognitive system. Thus, it is essential to evaluate the cognitive processes of subjects with hearing loss, but with adequate instruments so as not to result in erroneous diagnoses. Therefore, this study aimed to adapt the Montreal Cognitive Assessment Hearing Impairment (MoCA-HI) instrument to Brazilian Portuguese (BP). This is an observational descriptive, cross-sectional, quantitative and qualitative research, with a sample chosen by convenience. The procedures for adapting the instrument were performed based on the original protocol, version adapted by Dawes et al. (2019) and covered six steps: Step 1 - Translation and backtranslation of the MoCA-HI: a psychologist, a speech therapist and an English teacher participated, who performed the translations, compared the translations and backtranslated them into the original language; Step 2 - Analysis and selection of stimuli: two Ph.D. speech therapists and one master's student speech therapist participated, carried out analyzes regarding cultural and psycholinguistic barriers and pertinent modifications, when necessary in agreement with the original authors; Step 3 - Semantic analysis of stimuli: 12 subjects participated, with at least four years of schooling, without self-reported auditory and cognitive complaints; Step 4 - Analysis by non-specialist judges 1: five elderly people participated, with a minimum of four years of schooling, without self-reported auditory and cognitive complaints; Step 5 - Analysis by a non-specialist judge 2: one elderly person, with at least four years of schooling, without self-reported auditory and cognitive complaints; Step 6 - Pilot study: participated 30 elderly people, aged 60 years and over, with at least four years of formal education, neurologically healthy, being a group with quadratonal mean (500Hz, 1000Hz, 2000Hz and 4000Hz) within the normal range (<20dB) and another with hearing loss, hearing aid users. Finally, a performance analysis was carried out, which included 20 elderly people, of whom ten had a quadratonal mean within the normal range and ten had hearing loss using hearing aids, these being paired for age and education. All adaptation steps were assisted by the author of the original version of the instrument. Data were analyzed descriptively and quantitatively. Parametric Tstatistics, Gwet's First-order Agreement Coefficient (AC1) and the Content Validity Ratio (CVR) were used. In short, this study had cultural and linguistic adaptations in its stages, in addition to adaptations to be used during the application of the instrument, with the aim of providing greater understanding by the evaluated subjects. Furthermore, no differences were found regarding the tasks in the studied groups, except for the visuospatial/executive task, which should be analyzed carefully, as the participants' difficulties in understanding the task were evidenced from the beginning of the process of adapting the instrument. Therefore, the adaptation process resulted in an instrument that has satisfactory content validity.