{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:38Z","timestamp":1760146958056,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Introduction: Caring for a dependent individual, particularly over an extended period, places significant strain on family caregivers, often leading to adverse physical, mental, emotional, social, and economic outcomes for both caregivers and those they care for. Common challenges include anxiety, depression, loneliness, and diminished overall well-being. E-health applications have emerged as effective tools to support family caregivers by promoting positive mental health through online interventions, enhancing problem-solving skills, autonomy, interpersonal relationships, self-control, and a prosocial attitude. Methods: This study aimed to translate and culturally adapt the Spanish \u201cProgram to Promote Positive Mental Health through the Cuidadoras Cr\u00f3nicos Manual\u201d into the Portuguese context, supporting its implementation as a smartphone application. The process involved translation, back-translation by two native experts, and refinement through a focus group with eight participants. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: The translation and back-translation processes identified several adjustments, which informed discussions in the focus group. Three key themes emerged: (i) conceptual and semantic equivalence, (ii) optimisation of content, and (iii) relevance and timeliness of the manual. Conclusions: The Spanish manual for promoting positive mental health among family caregivers was successfully translated and culturally adapted into European Portuguese. Validated through expert input, this marks the first version of the manual tailored to Portuguese caregivers, using Positive Mental Health models to support caregivers of individuals with chronic conditions.<\/jats:p>","DOI":"10.3390\/healthcare13010031","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T09:13:32Z","timestamp":1735290812000},"page":"31","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Translation and Cultural Adaptation of an E-Health Program to Promote Positive Mental Health Among Family Caregivers in Portugal"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7046-3404","authenticated-orcid":false,"given":"Sandra","family":"Carreira","sequence":"first","affiliation":[{"name":"Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3045-043 Coimbra, Portugal"},{"name":"Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8306-8702","authenticated-orcid":false,"given":"N\u00faria","family":"Albacar-Riob\u00f3o","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Rovira i Virgili (URV), 43003 Tarragona, Spain"}]},{"given":"Carme","family":"Ferr\u00e9-Grau","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Rovira i Virgili (URV), 43003 Tarragona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5620-3478","authenticated-orcid":false,"given":"Carlos","family":"Sequeira","sequence":"additional","affiliation":[{"name":"Nursing School of Porto, 4200-072 Porto, Portugal"},{"name":"Center for Health Technology and Services Research & Health Research Network Associated Laboratory (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal"}]},{"given":"Carmen","family":"Andrade","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research & Health Research Network Associated Laboratory (CINTESIS@RISE), Nursing School of Porto (ESEP), 4200-450 Porto, Portugal"},{"name":"Department of Nursing, Family and Community Health, School of Health, University of the Azores, 9500-321 Ponta Delgada, Portugal"}]},{"given":"Odete","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3045-043 Coimbra, Portugal"},{"name":"School of Nursing, University of Minho, 4710-057 Braga, Portugal"},{"name":"Nursing Research Centre, University of Minho, 4710-057 Braga, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"ref_1","unstructured":"(2024, May 30). Pordata. Available online: https:\/\/www.pordata.pt\/portugal\/indice+de+envelhecimento+e+outros+indicadores+de+envelhecimento-526."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"103971","DOI":"10.1016\/j.archger.2019.103971","article-title":"Challenges and needs of informal caregivers in elderly care: Qualitative research in four European countries, the TRACE project","volume":"87","author":"Vaskelyte","year":"2020","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1034\/j.1600-0560.2002.56.x","article-title":"The 2030 problem: Caring for aging baby boomers","volume":"37","author":"Knickman","year":"2002","journal-title":"Health Serv. Res."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Barbosa, F., Voss, G., and Delerue Matos, A. (2020). Health impact of providing informal care in Portugal. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01841-z"},{"key":"ref_5","first-page":"e629","article-title":"The Impact of Informal Caregiving for Older Adults on the Health of Various Types of Caregivers: A Systematic Review","volume":"59","author":"Bom","year":"2019","journal-title":"Gerontologist"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"104003","DOI":"10.1016\/j.ijmedinf.2019.104003","article-title":"Effectiveness of health web-based and mobile app-based interventions designed to improve informal caregiver\u2019s well-being and quality of life: A systematic review","volume":"134","author":"Grau","year":"2020","journal-title":"Int. J. Med. Inf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e20190370","DOI":"10.1590\/1983-1447.2020.20190370","article-title":"Review of nursing diagnosis validation studies: Caregiver role strain","volume":"41","author":"Lourenco","year":"2020","journal-title":"Rev. Gauch. Enferm."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Andrade, C., Tavares, M., Soares, H., Coelho, F.C., and Tom\u00e1s, C. (2022). Positive Mental Health and Mental Health Literacy of Informal Caregivers: A Scoping Review. Int. J. Environ. Res. Public Health\/Int. J. Environ. Res. Public Health (Multidiscip. Digit. Publ. Inst.), 19.","DOI":"10.3390\/ijerph192215276"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1001\/jama.2014.304","article-title":"Caregiver burden: A clinical review","volume":"311","author":"Adelman","year":"2014","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1111\/jan.13714","article-title":"Training informal caregivers to care for older people after stroke: A quasi-experimental study","volume":"74","author":"Araujo","year":"2018","journal-title":"J. Adv. Nurs."},{"key":"ref_11","first-page":"3518050","article-title":"Telehealth Interventions for Family Caregivers of Persons with Chronic Health Conditions: A Systematic Review of Randomized Controlled Trials","volume":"2021","author":"Graven","year":"2021","journal-title":"Int. J. Telemed. Appl."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Carvalho, D., Sequeira, C., Querido, A., Tomas, C., Morgado, T., Valentim, O., Moutinho, L., Gomes, J., and Laranjeira, C. (2022). Positive Mental Health Literacy: A Concept Analysis. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.877611"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ferre-Grau, C., Raigal-Aran, L., Lorca-Cabrera, J., Ferre-Bergada, M., Lleixa-Fortuno, M., Lluch-Canut, M.T., Puig-Llobet, M., and Albacar-Rioboo, N. (2019). A multi-centre, randomized, 3-month study to evaluate the efficacy of a smartphone app to increase caregiver\u2019s positive mental health. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7264-5"},{"key":"ref_14","unstructured":"World Health Organization (2012). National eHealth Strategy Toolkit, World Health Organization."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e21708","DOI":"10.2196\/21708","article-title":"A mobile app\u2013based intervention program for nonprofessional caregivers to promote positive mental health: Randomized controlled trial","volume":"9","year":"2021","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Petrovic, M., and Gaggioli, A. (2020). Digital Mental Health Tools for Caregivers of Older Adults-A Scoping Review. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.00128"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s10433-021-00679-7","article-title":"A research framework for the United Nations Decade of Healthy Ageing (2021\u20132030)","volume":"19","author":"Keating","year":"2022","journal-title":"Eur. J. Ageing"},{"key":"ref_18","unstructured":"Krueger, R.A., and Casey, M.A. (2015). Focus Group: A Practical Guide for Applied Research, SAGE Publications. [5th ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Frey, B.B. (2018). The Sage of Encyclopedia of Educational Research, Measurement, and Evaluation, SAGE Publications, Inc.","DOI":"10.4135\/9781506326139"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bloor, M., Frankland, J., Thomas, M., and Robson, K. (2001). Focus Groups in Social Research, SAGE Publications Ltd.","DOI":"10.4135\/9781849209175"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Morgan, D.L. (1997). Focus Groups As Qualitative Research, SAGE Publications Inc.","DOI":"10.4135\/9781412984287"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/2041-210X.12860","article-title":"The use of focus group discussion methodology: Insights from two decades of application in conservation","volume":"9","author":"Wilson","year":"2018","journal-title":"Methods Ecol. Evol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qual. Res. Sport Exerc. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gjersing, L., Caplehorn, J.R., and Clausen, T. (2010). Cross-cultural adaptation of research instruments: Language, setting, time and statistical considerations. BMC Med. Res. Methodol., 10.","DOI":"10.1186\/1471-2288-10-13"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.pragma.2005.06.021","article-title":"Text and context in translation","volume":"38","author":"House","year":"2006","journal-title":"J. Pragmat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.beth.2016.09.005","article-title":"A Meta-Analysis of Cultural Adaptations of Psychological Interventions","volume":"47","author":"Hall","year":"2016","journal-title":"Behav. Ther."},{"key":"ref_29","unstructured":"WHO (2019). iSupport for Dementia: Training and Supporting Caregivers of People with Dementia, World Health Organization."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1177\/1471301220910333","article-title":"Training and support for caregivers of people with dementia: The process of culturally adapting the World Health Organization iSupport programme to Portugal","volume":"20","author":"Teles","year":"2021","journal-title":"Dementia"},{"key":"ref_31","unstructured":"WHO (2017). Global Action Plan on the Public Health Response to Dementia 2017\u20132025, World Health Organization."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Naunton Morgan, B., Windle, G., Sharp, R., and Lamers, C. (2022). eHealth and web-based interventions for informal carers of people with dementia in the community: Umbrella review. J. Med. Internet Res., 24.","DOI":"10.2196\/preprints.36727"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e90","DOI":"10.2196\/jmir.7111","article-title":"Internet-delivered health interventions that work: Systematic review of meta-analyses and evaluation of website availability","volume":"19","author":"Rogers","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Leng, M., Zhao, Y., Xiao, H., Li, C., and Wang, Z. (2020). Internet-based supportive interventions for family caregivers of people with dementia: Systematic review and meta-analysis. J. Med. Internet Res., 22.","DOI":"10.2196\/preprints.19468"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Guay, C., Auger, C., Demers, L., Mortenson, W.B., Miller, W.C., G\u00e9linas-Bronsard, D., and Ahmed, S. (2017). Components and outcomes of internet-based interventions for caregivers of older adults: Systematic review. J. Med. Internet Res., 19.","DOI":"10.2196\/jmir.7896"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Feng, H., Hu, M., Hu, H., Li, H., Ning, H., Chen, H., Liao, L., and Peng, L. (2019). Web-based interventions to improve mental health in home caregivers of people with dementia: Meta-analysis. J. Med. Internet Res., 21.","DOI":"10.2196\/13415"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Hopwood, J., Walker, N., McDonagh, L., Rait, G., Walters, K., Iliffe, S., Ross, J., and Davies, N. (2018). Internet-based interventions aimed at supporting family caregivers of people with dementia: Systematic review. J. Med. Internet Res., 20.","DOI":"10.2196\/jmir.9548"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Herron, D., and Runacres, J. (2023). The Support Priorities of Older Carers of People Living with Dementia: A Nominal Group Technique Study. Healthcare, 11.","DOI":"10.3390\/healthcare11141998"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Soares, S., Hoffmeister, L.V., Fernandes, M.F., Henriques, A., and Costa, A. (2024). The Use of Digital Technologies in the Promotion of Health Literacy and Empowerment of Informal Caregivers: Scoping Review. JMIR Aging, 7.","DOI":"10.2196\/54913"}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/13\/1\/31\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:01:22Z","timestamp":1760115682000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/13\/1\/31"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,27]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["healthcare13010031"],"URL":"https:\/\/doi.org\/10.3390\/healthcare13010031","relation":{},"ISSN":["2227-9032"],"issn-type":[{"type":"electronic","value":"2227-9032"}],"subject":[],"published":{"date-parts":[[2024,12,27]]}}}