Translation, Cultural Adaptation, and Validation of A Nursing Process Mobile Application for Use in the United States

This methodological study describes the cultural adaptation and validation of the e-Nurse mobile application for use in the United States. Originally developed in Portuguese to support the teaching of clinical reasoning and the Nursing Process to Brazilian undergraduate nursing students, the application was translated and culturally adapted into American English. The process followed established steps: translation, synthesis, back-translation, expert committee review, app adaptation, pretest, and development of the final version. An expert committee evaluated a total of 225 items, all of which were validated with agreement indices ranging between 0.81 and 0.87. In the pretest phase, 20 US nursing students used the adapted version of the app to work through clinical scenarios and identify appropriate nursing diagnoses. The correct response rates ranged from 73% to 100%, with 55% of the students achieving >90% correct responses. App quality was assessed via User Version of the Mobile Application Rating Scale (uMARS), with an overall mean score of 4.03 (±0.40). Usability was evaluated using the System Usability Scale (SUS), with a mean score of 74.3 (±15.93), which is classified as "excellent." The findings indicate that the English version of e-Nurse is a promising educational tool to support nursing education and clinical reasoning in the American cultural and linguistic setting.