Translation and psychometric evaluation of the Swedish version of the Interdisciplinary Education Perception Scale

Interprofessional education (IPE) is widely accepted worldwide, as a key part of training for health professionals and critical to an effective, patient-centred healthcare system. Several tools have been developed to evaluate IPE programmes and interventions globally. Many of the widely-used tools have been successfully adapted to suit specific cohorts and different languages; the Interdisciplinary Education Perception Scale (IEPS), however, has not yet been translated and validated for use in Sweden. The aim of this study was to translate the IEPS into Swedish and validate the psychometric properties of this new version. The 12-item IEPS underwent translation into Swedish and back-translation into English by suitable independent translators to ensure items retained their meaning. The new Swedish version was completed by 164 medical and nursing, occupational therapy and physiotherapy students on clinical placements in Stockholm. Principal Axis Factoring (PAF) and Oblique Oblimin Rotation confirmed a three-factor structure, that explained 77.4% of variance. The new 10-item Swedish version IEPS displayed good internal consistency with an overall Cronbach’s alpha of a = .88 and subscale values of .89, .88 and .66. The exclusion of two-items limits the transferability of this scale; however, the factor makeup was very similar to the original 12-item English version. It is suspected that minor differences were due to unavoidable deviations in meaning following translation (i.e. certain English words have no equivalent in Swedish). Nevertheless, the results imply that the Swedish version of the IEPS is a valid and reliable tool for assessing students’ perceptions and attitudes towards IPE within the Swedish health education system.     

A Turkish language equivalence of the Exercise of Self-Care Agency Scale

This article is about the pilot test of a Turkish version of the Exercise of Self-Care Agency Scale (ESCA) using a randomized convenience sample of 119 bilingual Turkish adolescents. The instrument was translated into Turkish, back translated, and pilot tested to linguistic equivalence. Bilingual participants were randomly assigned to four groups. Each participant was administered both the English and the Turkish versions of the scale but in different order at 5-week intervals. The results show that the Turkish version of the ESCA was linguistically equal to the English form. Test-retest correlations were acceptably high (r = .80 to .90). Internal consistency of the total scale of the ESCA was adequate, with an alpha coefficient of .89 for the Turkish version and .88 for the English version. Further research in the development of this translated form would need to demonstrate its applicability and generalizability to monolingual Turkish adolescents.     

Italian translation of the VISA-A score for tendinopathy of the main body of the Achilles tendon

Purpose. To translate and adapt the English VISA-A questionnaire to Italian, to perform reliability and validity evaluations of the Italian VISA-A version in patients with tendinopathy of the main body of the Achilles tendon. Methods. The VISA-A English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The VISA-A-I questionnaire was then administered to 50 male athletes (average age 26.4, range 18 - 49 years) with a diagnosis of tendinopathy of the main body of the AT. For test-retest evaluation, the 50 patients were asked to complete the questionnaire at first examination, and 30 minutes following the end of this examination. Results. The kappa statistics for 50 patients was 0.80 (range 0.7 - 0.86). There were no significant differences between the scores immediately after the consultation and 30 minutes later. Conclusions. Italian and the English versions of the VISA-A questionnaire evaluate the same aspects of clinical severity in patients with tendinopathy of the main body of the Achilles tendon.     

A French version of the Sickness Impact Profile (SIP): stages in the cross cultural validation of a generic quality of life scale.

The Sickness Impact Profile is a quality of life scale developed in the United States which is now widely used in clinical trials in chronic conditions such as chronic obstructive lung disease, angina, rheumatoid arthritis, chronic pain, psoriasis, inflammatory bowel disease and cancer. Validated generic scales permit cross cultural comparisons within disease processes in clinical trials. As a simple, direct translation of a scale is inadequate, we have created a French version of the original US version of the Sickness Impact Profile. The first phase was qualitative. A first French translation of the original US version was back translated into English by three independent translators. A second French version resulted from a consensus reached by a panel of lay subjects and health professionals after comparing the original US version, the first French version and the three back translations. This second version was tested with a group of 40 healthy volunteers. This qualitative phase resulted in a French Test Version with content and face validity. The quantitative phase assessed the equivalence of the rank order of each item, by sub scale, in the US version with that of the French Test Version, ie the rank of the French item was comparable (+/- 2) to the rank of the corresponding US item. The French Test Version was tested with 47 healthy subjects. Of the 136 items of the Sickness Impact Profile, 13 were retranslated to create a final French version. This was similarly tested on ten healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)     

The Indonesian version of the Premature Infant Pain Profile–Revised: Translation and adaptation of a neonatal pain assessment

PurposePain assessment is a key component of good pain management in hospitalized infants. This study aimed to translate and adapt a version of pain measurement in infants, the Premature Infant Pain Profile Revised (PIPP-R) into Indonesian.MethodThe adaptation process of the measuring instrument used a modified Brislin method which included forward translation, back translation 1, group discussion 1, back translation 2, group discussion 2, and pilot testing on neonatal nurses: feasibility test, inter-rater reliability using intraclass correlation (ICC), and internal consistency using Cronbach's α coefficient.ResultsThe PIPP-R version in English has been translated into Indonesian. In general, nurses assessed this measuring instrument as feasible. The inter-rater reliability showed a high agreement (ICC = 0.968, P = 0.001) and this measuring instrument had good internal consistency (Cronbach's α = 0.856).ConclusionThe Indonesian version of PIPP-R is easy to use and shows good psychometric properties. The use of this measuring instrument will help nurses and researchers obtain accurate infant pain intensity measurement values.     

Psychometric properties of the Arabic version of Quality of Life Index

AIM: This paper reports a study to translate the English language version of the Quality of Life Index into Arabic and estimate its reliability and content validity. BACKGROUND: Quality of life has become an important concern in health care and social policy. It is a difficult construct to define and measure, as it is determined by cultural, ethical, personal and religious values. The generic Ferrans and Powers Quality of Life Index was developed to measure quality of life of healthy individuals. Specific versions of the index were developed for particular diseases, such as diabetes, cancer and end-stage kidney disease. The instruments were initially developed for English-speaking clients and were later translated into several languages and used within a variety of cultures. However, there were no Arabic versions of the tool available to measure the quality of life of general populations or of people with particular diseases. METHOD: The Quality of Life Index was translated into Arabic using two of the techniques suggested in the literature for translation - back translation and bilingual technique. The same process was followed in the translation of the original scale and various disease-specific versions of the instrument. The work took place between 1995 and 2004. FINDINGS: The translated Arabic Quality of Life Index demonstrated a high degree of accuracy of translation and estimates of content validity. Subsequent to the translation of the original scale into Arabic, 13 disease-related versions of the instrument were translated and are ready for use with clients who speak Arabic. Four of the versions have been used to collect data from clients. The results revealed high estimates of reliability for the generic, diabetes, cancer and dialysis versions. CONCLUSION: The Arabic version of the Quality of Life Index is highly reliable and has sufficient content validity for measuring quality of life of Arabic-speaking clients.     

Translation and cultural adaptation of the Piper Fatigue Scale for use in Sweden.

The aim of this study was to translate and culturally adapt the revised Piper Fatigue Scale to Swedish. For translation, guidelines for cross-cultural adaptation were used. Two teams independently translated the instrument and two other teams produced back-translations, after which a multidisciplinary committee decided on a Swedish version. In pre-test interviews, ten cancer patients were encouraged to think out loud while completing the Swedish version. Their verbal responses were analysed and used for a second revision. The initial translations varied in words, expressions and grammar, shown in a lack of equivalence to the original instrument after back-translation. In order to establish semantic equivalence, the committee changed some grammatical constructions, and some words were replaced for experiential and conceptual equivalence. When analysing the pre-test, obscurities due to the phrasing of some items were revealed and dealt with in the second revision. This study does not fulfil the process of validation for a translated instrument but offers a sound basis for further accumulation of evidence for validity, and facilitates the choice of an appropriate instrument for studying cancer-related fatigue in Sweden.     

Italian translation of the VISA-A score for tendinopathy of the main body of the Achilles tendon

Purpose. To translate and adapt the English VISA-A questionnaire to Italian, to perform reliability and validity evaluations of the Italian VISA-A version in patients with tendinopathy of the main body of the Achilles tendon.

Methods. The VISA-A English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The VISA-A-I questionnaire was then administered to 50 male athletes (average age 26.4, range 18 – 49 years) with a diagnosis of tendinopathy of the main body of the AT. For test-retest evaluation, the 50 patients were asked to complete the questionnaire at first examination, and 30 minutes following the end of this examination.

Results. The kappa statistics for 50 patients was 0.80 (range 0.7 – 0.86). There were no significant differences between the scores immediately after the consultation and 30 minutes later.

Conclusions. Italian and the English versions of the VISA-A questionnaire evaluate the same aspects of clinical severity in patients with tendinopathy of the main body of the Achilles tendon.     

Cross-cultural adaptation of health-related quality of life questionnaire: English version of Qualiveen abstract]

INTRODUCTION: The Qualiveen questionnaire is a urinary disorder-specific health-related quality of life (HRQL) instrument. Developed in French, the instrument's translation into English was the first step of a process leading to an HRQL questionnaire that can be used in a different culture. However, the cultural adaptation of an HRQL questionnaire is achieved only when the psychometric properties of the translated questionnaire are documented. AIM: To develop an equivalent English version of the Qualiveen questionnaire and to assess its discriminative measurement properties. METHODS: Fifty-five Canadian out-patients with multiple sclerosis (MS) completed a set of questionnaires, including the Qualiveen; the MS Quality Of Life-54 (MSQOL-54), an MS-specific HRQL questionnaire; urinary function assessment; and the expanded disability status scale (EDSS) twice at an interval of 2 to 4 weeks. RESULTS: The English Qualiveen proved to be test-retest reliable (intraclass correlation coefficient=0.94). Consistent with a priori predictions, we found a strong association between overall Qualiveen score and degree of incontinence (0.63), a moderate association with type of urinary symptoms (0.49), a weak association with manner of voiding (0.28) and weak or absent associations with MSQOL-54, EDSS bladder/bowel and global EDSS domains. Predictions proved to be generally accurate (weighted kappa=0.65). CONCLUSION: The test-retest reliability and cross-sectional construct validity of the English version of Qualiveen are excellent and similar to the original French version. Further studies should explore Qualiveen's longitudinal validity and responsiveness.     

Translation and Testing of the Cardiac Diet Self-Efficacy Scale for Use With Taiwanese Older Adults

ABSTRACT Objectives: The purposes of this investigation were to translate the Cardiac Diet Self-Efficacy (CDSE) scale from English to Mandarin Chinese and to test the validity, reliability, and feasibility of the translated scale in a sample of Taiwanese older adults.
Design and Sample: This study used a methodological design to translate the CDSE based on the Brislin's model: (1) translation from source language (SL) of English to the target language (TL) of Chinese, (2) evaluation of Chinese version, (3) blind back translation from Chinese to English, (4) comparison of original and back-translated English versions, and (5) evaluation of the translated scale by a committee of bilingual Taiwanese experts. The translated CDSE scale was tested with 156 community-dwelling Taiwanese older adults, and any problems occurring during the administration of the scale were documented.
Results and Conclusions: The validity and reliability of the Chinese version of CDSE scale were acceptable. However, the validity of items may have been impacted by differences in culture, language, and educational levels between English-speaking and Chinese-speaking populations. These findings suggest the need for further methodological study to evaluate and refine translation tools to resolve differences in culture, language, and educational levels between SL and TL.     

Development and psychometric evaluation of the German version of the Medication Regimen Complexity Index (MRCI-D)

Background Several factors contribute to the complexity of pharmacotherapeutic regimens, like the total number of medications to be taken, the number of dosage units to take at a time, dosage frequency, as well as specific directions concerning the administration. The Medication Regimen Complexity Index (MRCI) is a validated instrument developed in English for the measurement of the complexity of a given pharmacotherapeutic regimen. Objectives Translation of the MRCI into German and evaluation of the translated instrument (MRCI‐D) in order to make it more easily accessible for use in German practice and research. Methods The process of validation included the translation of the English version to German, back‐translation into English, comparison of the back‐translated and the original versions, pre‐tests, and pilot‐testing of the German version by three raters using 20 medication regimens for inpatients. The subsequent psychometric evaluation included the calculation of inter‐rater and test–retest reliability, as well as the assessment of convergent validity. Results The number of medications correlated highly and statistically significantly with the MRCI‐D score (0.91, P < 0.001), indicating sufficient convergent validity of the instrument. Both inter‐rater and test–retest reliability were very high (intraclass correlation coefficients above 0.80 in all cases). Conclusion Our results demonstrate that the German version of the MRCI reflects the complexity of therapeutic regimens with similar validity and reliability as the established English version. Thus, it may be a valuable tool to analyse therapeutic regimens in both clinical practice and science.     

Could a simple educational intervention modify beliefs about whiplash? A preliminary study among professionals working in a rehabilitation ward.

Could a simple educational intervention modify beliefs about whiplash? A preliminary study among professionals working in a rehabilitation ward. OBJECTIVE: Whiplash and its consequences remain an alarming clinical and social problem, and psychosocial factors could play a role. We aimed to translate and assess the effects on beliefs of an evidence-based educational booklet on whiplash-associated disorders among professionals who work in a rehabilitation ward. METHODS: After translation/back-translation of the English version of The Whiplash Book, we undertook a before-and-after prospective study. The main outcome assessment was final score on the whiplash belief questionnaire (WBQ) involving nine questions assessing beliefs and attitudes about the consequences of whiplash rated on a 5-point Likert scale ranging from "completely agree" to "complete disagree." Final scores range from 9 to 45, low scores indicating positive beliefs. Demographic, educational and professional data, as well as personal medical history of neck pain, were recorded. Acceptability of the booklet was rated on a 10-point scale and by open questions. RESULTS: Among the 50 professionals included in the study, 48 completed the questionnaire. Whiplash beliefs tended to be positive at first assessment (WBQ score 23.37+/-6.45). Reading the whiplash booklet significantly improved beliefs (14.27+/-4.39; P<0.05). Global evaluation of the booklet on a 10-point scale was good (8.13+/-1.05) as was acceptability (8.13+/-1.05). CONCLUSION: After reading a booklet about whiplash translated into French, beliefs about the consequences of whiplash were changed for the better in this sample of French-speaking healthy professionals working in a rehabilitation ward. This simple educational intervention translated into French could be used for education and for ameliorating beliefs about the consequences of whiplash among health care professionals and the public.     

VISA-P score for patellar tendinopathy in males: Adaptation to Italian

Purpose. To translate and adapt the English VISA-P questionnaire to Italian and to perform reliability and validity evaluations of the Italian VISA-P version in patients with patellar tendinopathy.

Methods. The VISA-P English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon. The original version was compared with the back translation. The VISA-P-I questionnaire was then administered to 25 male athletes (average age 27.9, range 18–32 years) with a diagnosis of patellar tendinopathy. For test-retest evaluation, the 25 patients were asked to complete the questionnaire at first examination, and 30 minutes following the end of this examination.

Results. The kappa statistics for 25 patients was 0.78. There were no significant differences between the scores immediately after the consultation and 30 minutes later.

Conclusions. Italian and the English versions of the VISA-P questionnaire evaluate the same aspects of clinical severity in patients with patellar tendinopathy.     

Self-assessment of nursing competencies – validation of the Finnish NCS instrument with Italian nurses

Aim: Research focusing on competence assessment of practicing nurses has recently increased. However, few generic instruments are available for this purpose. This study reports cultural validation of the Italian version of the Nurse Competence Scale (NCS, English version) by exploring nurses’ perceptions of the use of the NCS instrument. Methods: Content validity of the Italian version of the NCS was assessed during the translation and back‐translation process. Thereafter, cultural validity was further explored by conducting self‐assessments and semi‐structured interviews with 10 nurses, who practise medicine, cardiology and intensive care wards. First, the Italian version of the 73‐item NCS was used to assess nurses’ competence levels and the frequency of using competencies in practice settings. Second, semi‐structured interviews were conducted to evaluate nurses’ perceptions of the use of the instrument. Results: The advanced beginners obtained a high overall competence level and the experienced nurses a very high overall competence level. These results are similar with the earlier findings of nurse competence levels with the NCS. The overall frequency of using NCS competencies in clinical practice indicated good cultural validity of the instrument. The instrument was considered easy to understand and to complete, and the Italian version was considered to express the domain of nursing. However, a need to make semantic specifications for some items for the Italian version was pointed out. Conclusions: This explorative pilot study reports a first phase cultural validation process. Carefully performed translation alone does not ensure validity of translated instrument. Interview method is recommended to deepen the understanding of concept in question and the content validity of the instrument. The results support previous research findings of the use of the NCS instrument and show that it could be very useful in competence assessment for Italian nurses.     

Reflections on the process of translation and cultural adaptation of an instrument to investigate taste and smell changes in adults with cancer

Taste and smell changes are common and distressing symptoms in patients with cancer, which may contribute to decreased nutritional intake leading to malnutrition and reduced quality of life. Evidence‐based knowledge available to healthcare staff regarding dietary counselling of patients with taste and smell changes is lacking. To be able to develop advice to patients, these symptoms need to be characterised and assessed. The Taste and Smell Survey (TSS) is a 16‐item questionnaire in English, which has been used in Canada to investigate self‐perceived changes in taste and smell reported by patients with cancer. As no equivalent instrument exists in Swedish, we therefore translated the TSS. This article describes and discusses experiences of using a 5‐step process for translation and cultural adaptation of the TSS. Each of the five steps was found to elicit different, essential information contributing to the enhancement of the translation and building further upon refinements of the previous steps. Using a structured, multistep approach to translation and cultural adaptation, we have produced a robust instrument to investigate taste and smell changes specifically adapted for use in the Swedish language and culture.     

Development of the Persian version of the Modified Modified Ashworth Scale: translation,adaptation, and examination of interrater and intrarater reliability in patients with poststroke elbow flexor spasticity

Purpose: Development of the Persian version of the Modified Modified Ashworth Scale (MMAS), and to investigate the interrater and intrarater reliability of the Persian MMAS when used to quantify elbow flexor spasticity in patients after stroke. Methods: The Persian MMAS was developed by the forward and backward translation procedure, a final review by an expert committee, and testing for acceptability and the clarity of item wording so that the scale could be used by Persian-speaking examiners. Psychometric testing included interrater and intrarater reliability. Elbow flexor spasticity was examined by two raters in 30 patients after stroke twice on two occasions using the Persian MMAS. The weighted κ was used for the statistical analysis. Results: The interrater and intrarater reliability was very good for the Persian MMAS (weighted κ: 0.81–0.91; 95% CI 0.68–0.98) with statistically significant agreement between raters and within raters (all p < 0.001). Conclusions: The Persian version of the MMAS was successfully developed. The Persian MMAS showed very good interrater and intrarater reliability in patients with elbow flexor spasticity after stroke. The results support the use of the Persian version of the MMAS both in clinical and research settings.

Implications for Rehabilitation

• The new Modified Modified Ashworth Scale (MMAS) is a clinical measure of spasticity, which was published in 2006 by Ansari et al.

• The MMAS was successfully translated and adapted into a Persian version. The Persian version of the MMAS showed very good interrater and intrarater reliability comparable to the original English version. The Persian version of the MMAS can be recommended for the assessment of muscle spasticity in Persian-speaking countries.

     

Equivalence of Chinese version of the Cohen-Mansfield Agitation Inventory

AIM: This paper is a report of a study undertaken to translate the Cohen-Mansfield Agitation Inventory from the original English into a Chinese language version and to establish the content, semantic and technical equivalence of the Chinese version. BACKGROUND: Ensuring the equivalence of a translated Chinese version of the Cohen-Mansfield Agitation Inventory for patients with dementia is an essential requirement for identifying culturally specific expressions of agitated behaviours. METHODS: In Phase I, five experts scrutinized the Inventory items to determine whether the behaviour described was relevant to the agitated behaviours present in the Taiwanese culture. In Phase II, experts did the initial translation into Chinese and then back-translated it into English. Four bilingual observers rated 31 residents with dementia to determine semantic equivalence across versions. In Phase III, the agitated behaviours of 32 residents were assessed by four observers using staff ratings and direct observation to determine the technical equivalence of the Chinese version. The study was carried out in Taiwan from August 2004 to April 2005. FINDINGS: In Phase I, the rating of behaviours described on the Cohen-Mansfield Agitation Inventory was relevant to the agitated behaviours based on Taiwanese culture with a content validity index (CVI) value of 0.993. In Phase II, intra-class coefficients for all items on the Chinese version and split-halves of Chinese and English versions ranged from 0.69 to 0.74. In Phase III, six possible results for estimation of reliability across methods and raters for the Chinese version ranged from 0.63 to 0.86. CONCLUSION: The Chinese Cohen-Mansfield Agitation Inventory had modest psychometric properties. Further studies are needed to assess criterion and conceptual equivalence.     

机械通气患者拔管后吞咽障碍筛查工具的汉化及信效度评价

目的:汉化机械通气患者拔管后吞咽障碍筛查工具(postextubation dysphagia screening,PEDS),并检验其信效度及诊断价值.方法:严格遵循Brislin翻译模型对PEDS工具进行汉化,并经专家函询、ICU护士认知性访谈及预试验调适问卷条目,将其应用于100例经口气管插管机械通气患者.问卷内...     

Dutch translation of the Fear of Pain Questionnaire: factor structure, reliability and validity.

BACKGROUND: The Fear of Pain Questionnaire (FPQ-III) is a 30-item self-report instrument measuring fear of a variety of pain-related stimuli. AIM: The present study was undertaken to develop a Dutch version of the FPQ-III, to assess the instrument's psychometric qualities, to examine the suggested factor structure, and to relate the FPQ-III to other general psychological constructs in order to assess its construct validity. METHOD: The questionnaire was translated following the forward-backward method. The final version was filled out by (n = 274) psychology freshmen. A random half of the subjects was re-tested after five weeks. RESULTS: Satisfactory psychometric qualities were obtained (average alpha = 0.90 and test-retest reliability = 0.71). Factor analysis supported the three-factor structure and also the results concerning divergent and convergent validity show strong similarity with the results from other studies. CONCLUSIONS: The Dutch translation of the FPQ-III appears to be a valid equivalent of the original English version and does represent a unique construct.