{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:22:12Z","timestamp":1791832932035,"version":"4.3.4"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"unspecified","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S147895152610176X_sec1a\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Assessing the multidimensional nature of suffering in palliative care is challenging. The Suffering Pictogram (SP) is a visual instrument developed to facilitate the communication and measurement of this experience in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610176X_sec2b\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To translate, cross-culturally adapt, and validate the SP into Brazilian Portuguese (SP-BR) for cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610176X_sec3c\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A sample of 222 cancer patients completed the SP-BR and the FACIT-Sp-12 scale. Psychometric properties were assessed using exploratory factor analysis (EFA), internal consistency (Cronbach\u2019s alpha), and convergent validity (Pearson\u2019s correlations).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610176X_sec4d\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EFA confirmed a unidimensional structure (loadings 0.40\u20130.73; variance explained 34.42%). Internal consistency was robust (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u00a0=\u00a00.80). The SP-BR showed a moderate correlation with the FACIT-Sp-12 (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610176X_sec5e\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SP-BR is a validated, unidimensional Brazilian Portuguese instrument suitable\u00a0for holistic suffering assessment in clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610176X_sec6f\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>The SP-BR is a brief tool for holistic suffering assessment, making it suitable\u00a0for efficient screening in clinical and research settings, including those with limited resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s147895152610176x","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:55:10Z","timestamp":1771408510000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Cross-cultural adaptation and validation of the Suffering Pictogram for Brazilian cancer patients"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-7905","authenticated-orcid":false,"given":"Ana Cl\u00e1udia Mesquita","family":"Garcia","sequence":"first","affiliation":[{"name":"Federal University of Alfenas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliza Mara das Chagas","family":"Paiva","sequence":"additional","affiliation":[{"name":"Federal University of Alfenas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Bezerra","family":"Perlamagna","sequence":"additional","affiliation":[{"name":"Federal University of Alfenas"},{"name":"Federal University of Alfenas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tais Rodrigues","family":"Caproni","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana Maria Coelho Leite","family":"Fava","sequence":"additional","affiliation":[{"name":"Federal University of Alfenas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everson","family":"Meireles","sequence":"additional","affiliation":[{"name":"Federal University of Alfenas"},{"name":"Federal University of Rec\u00f4ncavo da Bahia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talita Prado","family":"Sim\u00e3o","sequence":"additional","affiliation":[{"name":"Federal University of Alfenas"},{"name":"Federal University of Vi\u00e7osa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0649-0739","authenticated-orcid":false,"given":"Seng Beng","family":"Tan","sequence":"additional","affiliation":[{"name":"Subang Jaya Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"S147895152610176X_ref2","first-page":"11","volume-title":"Standards for Educational and Psychological Testing","year":"2014"},{"key":"S147895152610176X_ref6","first-page":"213","article-title":"Uses of exploratory factorial analysis in psychology","volume":"11","author":"Dam\u00e1sio","year":"2012","journal-title":"Avalia\u00e7\u00e3o Psicol\u00f3gica"},{"key":"S147895152610176X_ref7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233225"},{"key":"S147895152610176X_ref20","doi-asserted-by":"publisher","DOI":"10.1590\/S0101-60832010000100003"},{"key":"S147895152610176X_ref4","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3795"},{"key":"S147895152610176X_ref8","unstructured":"Facit Group. Functional assessment of chronic illness therapy - spiritual well-being 12 item scale. https:\/\/www.facit.org\/measures\/facit-sp-12 (accessed 20 November 2025)."},{"key":"S147895152610176X_ref3","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0448"},{"key":"S147895152610176X_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"S147895152610176X_ref22","volume-title":"An\u00e1lise Fatorial Para Pesquisadores","author":"Pasquali","year":"2006"},{"key":"S147895152610176X_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/BF02289447"},{"key":"S147895152610176X_ref13","first-page":"348","article-title":"Some formal characteristics of pictograms","volume":"57","author":"Kolers","year":"1969","journal-title":"American Scientist"},{"key":"S147895152610176X_ref5","volume-title":"Pol\u00edtica Nacional de Cuidados Paliativos. 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e60"}}