title: Cultural adaptation and linguistic validation of the Family Decision Making Self Efficacy Scale (FDMSES).
abstract: BACKGROUND
  Nurses, following their ethical mandate, collaborate with other health and social professionals or people involved in caring activities. Caregivers in this context are becoming more and more significant for the family or the cared person, who for their stable presence and emotional proximity play a pivotal caring role. To maximize the contribution of caregivers, objective tools that emphasize their skill sets are necessary. The cross-cultural adaptation and validation of the Family Decision Making Self-Efficacy Scale is part of a larger project aimed at understanding the resilience of caregivers in the field of palliative care. Self-efficacy is one of the aspects of personality most closely associated with resilience. Self-efficacy is shown in a specific context, therefore, its study and evaluation of its level, require capabilities that enable individuals perceive themselves as effective in a particular circumstance. The Family Decision Making Self- Efficacy Scale assesses the behavior of caregivers of patients at the end of their life.
  
  
  METHODS
  The Family Decision Making Self-Efficacy Scale was translated (forward and back translation) and was adapted to the Italian clinical cultural setting by a research team that included experts in palliative care, native translators with experience in nursing and experts in nursing. A consensus on the wording of each item in relation to semantic, idiomatic, experiential and conceptual equivalence was sought. The clarity of the wording and the pertinence of the items of the scenario with the conscious patient and with the unconscious patient were evaluated by a group of caregivers who tested the instrument.
  
  
  RESULTS
  The Italian version of the instrument included 12 items for the scenario with the conscious patient and 12 for the scenario with the unconscious patient. The working group expressed consensus on the pretesting version of the instrument. The pre-testing version of the scale was tested on 60 caregivers, 47 taking care of conscious patients and 13 taking care of unconscious patients. In both cases the content of the items was judged relevant and understandable.
  
  
  CONCLUSIONS
  The results for the cross-cultural validation were satisfactory and allowed the application of the instrument in the Italian context.
authors.affiliation: RN, MSN, PhD student in Nursing Science, University of Rome Tor Vergata, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Limardi
authors.affiliation: RN, MSN, President Center of Excellence for Nursing Scholarship Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rocco
authors.affiliation: RN, MSN, PhD Research fellow in Nursing Science, Centre of Excellence for Nursing Scholarship Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Stievano
authors.affiliation: RN, MSN, Research fellow in Nursing Science, University of Rome Tor Vergata, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vellone
authors.affiliation: Head of Health Foundation FARO, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Valle
authors.affiliation: Department of Systems Medicine, Chair of Medical Oncology, Tor Vergata University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Torino
authors.affiliation: RN, MSN, Associate professor in Nursing Science, University of Rome Tor Vergata, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003466:Cultural Characteristics; D003657:Decision Making; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult