Cross-cultural translation and validation of the ‘gut feelings’ questionnaire into Spanish and Catalan

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Abstract

Background: The gut feelings questionnaire (GFQ) is the only tool developed to assess the presence of a ‘sense of alarm’ or a ‘sense of reassurance’ in the diagnostic process of general practitioners (GPs). It was created in Dutch and English and has validated versions in French, German and Polish.

Objectives: To obtain a cross-cultural translation of the GFQ into Spanish and Catalan and to assess the structural properties of the translated versions.

Methods: A six-step procedure including forward and backward translations, consensus, and cultural and linguistic validation was performed for both languages. Internal consistency, factor structure, and content validity were assessed.

Results: Internal consistency was high for both questionnaires (Cronbach’s alpha for GFQ-Spa = 0.94 and GFQ-Cat = 0.95). The principal component analysis identified one factor with the sense of alarm and the sense of reassurance as two opposites, explaining 76% of the total variance for the GFQ-Spa, and 77% for the GFQ-Cat.

Conclusion: Spanish and Catalan versions of the GFQ were obtained. Both have been cross-culturally adapted and showed good structural properties.

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Family physicians’ diagnostic gut feelings are measurable: construct validation of a questionnaire

Christiaan F Stolper, Margje Van de Wiel, Henrica CW de Vet … (2013)

Background Family physicians perceive that gut feelings, i.e. a ‘sense of reassurance’ or a ‘sense of alarm’, play a substantial role in diagnostic reasoning. A measuring instrument is desirable for further research. Our objective is to validate a questionnaire measuring the presence of gut feelings in diagnostic reasoning. Methods We constructed 16 case vignettes from real practice situations and used the accompanying ‘sense of reassurance’ or the ‘sense of alarm’ as reference labels. Based on the results of an initial study (26 family physicians), we divided the case vignettes into a group involving a clear role for the sense of reassurance or the sense of alarm and a group involving an ambiguous role. 49 experienced family physicians evaluated each 10 vignettes using the questionnaire. Construct validity was assessed by testing hypotheses and an internal consistency procedure was performed. Results As hypothesized we found that the correlations between the reference labels and corresponding items were high for the clear-case vignettes (0.59 – 0.72) and low for the ambiguous-case vignettes (0.08 – 0.23). The agreement between the classification in clear sense of reassurance, clear sense of alarm and ambiguous case vignettes as derived from the initial study and the study population’s judgments was substantial (Kappa = 0.62). Factor analysis showed one factor with opposites for sense of reassurance and sense of alarm items. The questionnaire’s internal consistency was high (0.91). We provided a linguistic validated English-language text of the questionnaire. Conclusions The questionnaire appears to be valid. It enables quantitative research into the role of gut feelings and their diagnostic value in family physicians’ diagnostic reasoning.

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The diagnostic role of gut feelings in general practice A focus group study of the concept and its determinants

Erik Stolper, Marloes Van Bokhoven, Paul Houben … (2009)

Background General practitioners sometimes base clinical decisions on gut feelings alone, even though there is little evidence of their diagnostic and prognostic value in daily practice. Research into these aspects and the use of the concept in medical education require a practical and valid description of gut feelings. The goal of our study was therefore to describe the concept of gut feelings in general practice and to identify their main determinants Methods Qualitative research including 4 focus group discussions. A heterogeneous sample of 28 GPs. Text analysis of the focus group discussions, using a grounded theory approach. Results Gut feelings are familiar to most GPs in the Netherlands and play a substantial role in their everyday routine. The participants distinguished two types of gut feelings, a sense of reassurance and a sense of alarm. In the former case, a GP is sure about prognosis and therapy, although they may not always have a clear diagnosis in mind. A sense of alarm means that a GP has the feeling that something is wrong even though objective arguments are lacking. GPs in the focus groups experienced gut feelings as a compass in situations of uncertainty and the majority of GPs trusted this guide. We identified the main determinants of gut feelings: fitting, alerting and interfering factors, sensation, contextual knowledge, medical education, experience and personality. Conclusion The role of gut feelings in general practice has become much clearer, but we need more research into the contributions of individual determinants and into the test properties of gut feelings to make the concept suitable for medical education.

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Consensus on gut feelings in general practice

Erik Stolper, Paul Van Royen, Margje Van de Wiel … (2009)

Background General practitioners sometimes base clinical decisions on gut feelings alone, even though there is little evidence of their diagnostic and prognostic value in daily practice. Research to validate the determinants and to assess the test properties of gut feelings requires precise and valid descriptions of gut feelings in general practice which can be used as a reliable measuring instrument. Research question: Can we obtain consensus on descriptions of two types of gut feelings: a sense of alarm and a sense of reassurance? Methods Qualitative research including a Delphi consensus procedure with a heterogeneous sample of 27 Dutch and Belgian GPs or ex-GPs involved in academic educational or research programmes. Results After four rounds, we found 70% or greater agreement on seven of the eleven proposed statements. A "sense of alarm" is defined as an uneasy feeling perceived by a GP as he/she is concerned about a possible adverse outcome, even though specific indications are lacking: There's something wrong here. This activates the diagnostic process by stimulating the GP to formulate and weigh up working hypotheses that might involve a serious outcome. A "sense of alarm" means that, if possible, the GP needs to initiate specific management to prevent serious health problems. A "sense of reassurance" is defined as a secure feeling perceived by a GP about the further management and course of a patient's problem, even though the doctor may not be certain about the diagnosis: Everything fits in. Conclusion The sense of alarm and the sense of reassurance are well-defined concepts. These descriptions enable us to operationalise the concept of gut feelings in further research.

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Author and article information

Journal

Journal ID (nlm-ta): Eur J Gen Pract

Journal ID (iso-abbrev): Eur J Gen Pract

Journal ID (publisher-id): IGEN

Journal ID (publisher-id): igen20

Title: The European Journal of General Practice

Publisher: Taylor & Francis

ISSN (Print): 1381-4788

ISSN (Electronic): 1751-1402

Publication date Collection: January 2019

Publication date (Electronic): 05 November 2018

Volume: 25

Issue: 1

Pages: 39-43

Affiliations

[a ]Majorca Primary Care Department, Trencadors Primary Health Centre , Llucmajor, Spain;

[b ]Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service—IbSalut , Baleares, Spain;

[c ]Balearic Islands Health Research Institute (IdISBa) , Majorca, Spain;

[d ]Department of General Practice, CAPHRI Care and Public Health Research Institute Faculty of Health, Medicine and Life Sciences, Maastricht, University , Maastricht, The Netherlands;

[e ]Department of Primary and Interdisciplinary Care, University of Antwerp , Antwerp, Belgium

Author notes

Supplemental data for this article can be accessed here .

Gut feelings questionnaire is available from http://www.gutfeelings.eu/questionnaire/

CONTACT Bernardino Oliva-Fanlo boliva@ 123456ibsalut.caib.es Majorca Primary Care Department, Trencadors Primary Health Centre , C/Xoric 9 07609-Llucmajor (I. Baleares), Llucmajor, Spain

Author information

Bernardino Oliva-Fanlo http://orcid.org/0000-0001-7861-1168

Sebastià March http://orcid.org/0000-0001-7238-9519

Erik Stolper http://orcid.org/0000-0001-8854-3269

Magdalena Esteva http://orcid.org/0000-0001-8238-7891

Article

Publisher ID: 1514385

DOI: 10.1080/13814788.2018.1514385

PMC ID: 6394285

PubMed ID: 30394147

SO-VID: 4db4616b-ee35-43cb-aea2-73db99d209c3

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 29 May 2018

Date revision received : 12 July 2018

Date accepted : 15 August 2018

Page count

Figures: 1, Tables: 0, Pages: 6, Words: 2395

Funding

Funded by: Majorca Primary Care Department

Award ID: PI005/17

This work was supported by the Majorca Primary Care Department under grant PI005/17; semFYC under the Isabel Fernández PhD grant 2016; and Balearic Cancer League (AECC-Baleares).

Cross-cultural translation and validation of the ‘gut feelings’ questionnaire into Spanish and Catalan

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Chinese Journal of General Practice

Most cited references 7

Family physicians’ diagnostic gut feelings are measurable: construct validation of a questionnaire

The diagnostic role of gut feelings in general practice A focus group study of the concept and its determinants

Consensus on gut feelings in general practice

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