Trends in Psychiatry and Psychotherapy
Trends in Psychiatry and Psychotherapy
Original Article

Adaptation of the Barriers to Access to Care Evaluation (BACE) scale to the Brazilian social and cultural context

Adaptacao da Escala de Avaliacao das Barreiras ao Acesso ao Cuidado (BACE) para o contexto social e cultural brasileiro

Leticia Silva; Paula Freitas Ramalho da Silva; Ary Gadelha; Sarah Clement; Graham Thornicroft; Jair de Jesus Mari; Elisa Brietzke

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INTRODUCTION: A significant gap between the number of individuals who need mental health care and the ones who actually have access to it has been consistently demonstrated in studies conducted in different countries. Recognizing the barriers to care and their contributions to delaying or preventing access to mental health services is a key step to improve the management of mental health care. The Barriers to Access to Care Evaluation (BACE) scale is a 30-item self-report instrument conceived to evaluate obstacles to proper mental health care. The main constraint in the investigation of these barriers in Brazil is the lack of a reliable instrument to be used in the Brazilian social and cultural context. OBJECTIVE: To describe the translation and adaptation process of the BACE scale to the Brazilian social and cultural context. METHOD: The translation and adaptation process comprised the following steps: 1) translation from English to Brazilian Portuguese by two authors who are Brazilian Portuguese native speakers, one of whom is a psychiatrist; 2) evaluation, comparison and matching of the two preliminary versions by an expert committee; 3) back-translation to English by a sworn translator who is an English native speaker; 4) correction of the back-translated version by the authors of the original scale; 5) modifications and final adjustment of the Brazilian Portuguese version. RESULTS AND CONCLUSION: The processes of translation and adaptation described in this study were performed by the authors and resulted in the Brazilian version of a scale to evaluate barriers to access to mental health care.


Mental disorders, barriers of care, services, prevention


INTRODUÇÃO: Uma lacuna significativa entre o número de indivíduos que necessitam de cuidado na área de saúde mental e aqueles que efetivamente têm acesso a ela tem sido consistentemente demonstrada em estudos realizados em diferentes países. Reconhecer as barreiras ao cuidado e suas contribuições no sentido de retardar e até impedir o acesso a serviços de saúde mental é um passo essencial para melhorar o manejo em saúde mental. A escala Barriers to Access to Care Evaluation (BACE) é um instrumento de autorrelato, composto de 30 itens, concebido para avaliar os obstáculos ao cuidado adequado em saúde mental. O principal empecilho na investigação dessas barreiras no Brasil é a inexistência de um instrumento confiável para ser utilizado no contexto social e cultural brasileiro. Objetivo: Descrever o processo de tradução e adaptação da escala BACE para o contexto social e cultural brasileiro. MÉTODO: O processo de tradução e adaptação incluiu os seguintes passos: 1) tradução do inglês para o português brasileiro por dois autores, falantes nativos de português brasileiro, sendo que um deles é psiquiatra; 2) avaliação, comparação e correspondência das duas versões preliminares por um comitê especialista; 3) retrotradução para inglês por um tradutor juramentado, falante nativo de inglês; 4) correção da versão retrotraduzida pelos autores da escala original; 5) alterações e ajustes finais da versão em português brasileiro. RESULTADOS E CONCLUSÃO: Os processos de tradução e adaptação aqui descritos foram realizados pelos autores e resultaram na versão brasileira de uma escala para avaliar as barreiras ao acesso ao cuidado em saúde mental.


Transtornos mentais, barreiras do cuidado, servicos, prevencao


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