Adaptation and validation study of the Indonesian version of the Global Psychotrauma Screen in an undergraduate student population

BACKGROUND

The high incidence of potentially traumatic events (PTEs) in Indonesia warrants early identification of those with probable trauma-related disorders in order to tailor prevention and intervention for trauma-related symptoms.

OBJECTIVES

This study aims to adapt and validate a novel brief transdiagnostic screener, the Global Psychotrauma Screen (GPS), in Indonesian undergraduate students.

METHODS

An online survey was administered among Indonesian undergraduate students (N = 322). Exploratory factor analysis, reliability analyses, clinical validity analyses, and correlational analyses were performed to evaluate the construct validity, reliability, clinical validity, and convergent-divergent validity of the Indonesian GPS. Hierarchical multiple regression was conducted to assess the relationship between risk factors and trauma-related symptoms. The relationship between four categories of trauma-related symptom severity and social/work functioning was measured using Analysis of Covariance.

RESULTS

Exploratory factor analysis yielded a single-factor solution. The Indonesian GPS demonstrated good internal consistency, test-retest correlation, and absolute agreement, indicating good reliability. The Indonesian GPS also had an acceptable area under the curve, sensitivity, and specificity for a probable diagnosis of Post-Traumatic Stress Disorder (PTSD), Complex-PTSD (CPTSD), depression, and generalized anxiety disorder (GAD). We also established evidence for the convergent and divergent validity of GPS. The GPS risk factors (low psychological resilience, other stressful events, history of mental illness, and low social support) contributed to predicting trauma-related symptoms after controlling for gender, age, employment status, and faculty background. Additionally, in comparison to participants from the mild and low categories of GPS symptoms scores, participants from the severe and moderate category reported impaired lowered social/work functioning.

CONCLUSION

The current findings indicate that the Indonesian GPS is a valid and reliable transdiagnostic trauma screener for Indonesian undergraduate students. This first comprehensive validation of the GPS in Indonesia calls for more research in Lower-middle Income Countries (LMICs) as a way towards prevention and early intervention for trauma-related symptoms.

Psychometric Properties of the Principal Instructional Leadership Scale (PILS) in Saudi Arabia

BACKGROUNDS

The principal instructional leadership describes how school principals oversee the curriculum, instruction, and assessment. The main aims of the current study were translation and evaluation of the psychometric properties of the Principal Instructional Leadership Scale (PILS) in a Saudi Arabian population.

METHODS

The translation and cross-cultural adaptation process has been conducted in five stages, including forward translation, translation synthesis, backward translation, expert committee, and pilot testing. Face, content, construct, and convergent validity were used to establish validity. Cronbach's alpha coefficient and McDonald's omega (Ω) were used for internal consistency.

RESULTS

To validate the PILS structure, the total sample (N = 724) was randomly split into two subgroups, each comprising 362 individuals, for Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). Five factors obtained from EFA explain 71.07 % of the variance in PILS. The PILS encompasses domains of improving curriculum quality, teaching, and enhancing the effectiveness of adaptive learning, adding to the dimensions covered by previous instructional leadership measures. The five components show strong internal consistency (0.93 to 0.97). Both first-order and second-order CFAs confirmed the 5-factor model, meeting criteria (CFI > 0.91, GFI > 0.9, IFI > 0.9, RMSEA<0.05). All 21 items displayed suitable internal consistency (Cronbach's α > 0.8, McDonald's omega >0.7). Second-order average variance extracted validity (0.50) indicated PILS validity. Gender invariance analysis revealed no significant differences (∆CFI < 0.01, ΔRMSEA<0.01) in PILS structure between genders.

CONCLUSION

The reliability and validity of the Arabic rendition of PILS are commendable, making it suitable for evaluating principal instructional leadership in Saudi Arabia.

Adapting the athlete sleep behavior questionnaire (ASBQ) for Arabic-speaking populations: Translation, reliability testing, and validation using classical theory and item response theory

Sleep is essential for athletes' physical performance as well as their general health, well-being, and quality of life. To assess athletes' sleep behaviors, the Athlete Sleep Behavior Questionnaire (ASBQ) was developed in the English language. However, a validated Arabic-version of the ASBQ is lacking. This study aimed to translate the ASBQ into Arabic (ASBQ-AR) and evaluate its reliability and validity among Arabic-speaking athletes. A total of 458 participants (254 athletes, 202 non-athletes) from four Arabic countries completed the ASBQ-AR and the Insomnia Severity Index (ISI) questionnaires. The psychometric properties of the ASBQ-AR were examined using unidimensional reliability analysis, confirmatory factor analysis (CFA), Item Response Theory (IRT), and convergent validity. The ASBQ-AR had acceptable internal consistency (Cronbach's α = 0.723, McDonald's ω = 0.725) and a factorial structure, confirming its construct validity. CFA demonstrated improved model fit indices after the removal of two potentially misfitting items (items 4 and 13); however, the model's fit to the data remains suboptimal. IRT results indicated that the majority of items demonstrated a good model fit, suggesting effective measurement of the intended construct without significant interference, except for ASBQ-AR 4. Additionally, ASBQ-AR 4 appears to present the highest level of difficulty for respondents. In terms of convergent validity, the mean ASBQ-AR global score was correlated with the mean ISI global score (r = 0.5, p < 0.0001). The ASBQ-AR is a reliable and valid tool for assessing maladaptive sleep practices among Arabic-speaking athletes. Additional refinements to the ASBQ-AR are warranted to optimize its psychometric properties.

Translation, cross-cultural adaptation and clinimetric properties of the Brazilian Portuguese version of the Brace Questionnaire

PURPOSE

To perform a cross-cultural adaptation and validation of the Brazilian-Portuguese versions of the Brace Questionnaire in adolescent idiopathic scoliosis.

METHODS

A forward-backward translation process was employed to produce a Brazilian Portuguese version of the Brace Questionnaire, followed by comprehensive cross-cultural adaptation stages. The measurements of internal consistency and test-retest reliability were assessed by Cronbach's a and intraclass correlation coefficient (ICC), respectively. The Pearson's correlation coefficient was used to analyze the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire.

RESULTS

A total of 84 scoliosis patients (age 13.4 ± 2.0 years, thoracic Cobb angle 33.3° ± 13.8°, and lumbar Cobb angle 29.8° ± 14.3°) were included. The Brace Questionnaire showed excellent internal consistency (Cronbach α = 0.93) and moderate reliability (ICC = 0.86). The correlations between the Brace Questionnaire and Scoliosis Research Society-22 were r = 0.66; p = 0.011. In addition, it was found that the Brazilian version of the Brace Questionnaire does not have ceiling and floor effects.

CONCLUSIONS

The Brazilian-Portuguese adaptation of the brace questionnaire shows excellent reliability and can be a valid tool for psychometric assessment in adolescent idiopathic scoliosis.

Cross-cultural adaptation, reliability, validity and responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ-Sp) in Spain

BACKGROUND

The Michigan Hand Outcomes Questionnaire (MHQ) is a self-report tool widely recognized for measuring the health status of patients with hand and wrist problems from a multidimensional perspective. The aim of this study is to translate and culturally adapt the MHQ and validate its psychometric properties of validity, reliability, and responsiveness for different hand problems in Spain.

METHODS

The MHQ was translated and culturally adapted following the recommendations of the American Association of Orthopaedic Surgeons. The validation process adhered to the current Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) group and was conducted on 262 hand patients. Reliability was assessed through internal consistency using Cronbach's alpha. The study evaluated the test-retest reliability of the measurements using the intraclass correlation coefficient (ICC). Additionally, the measurement error was calculated using the standard error of measurement (SEM) and smallest detectable change (SDC). To assess the structural validity, confirmatory factor analysis (CFA) was employed, while construct validity was evaluated using Pearson's correlation coefficient. Finally, responsiveness was assessed using effect size (ES), standardized response mean (SRM), and minimum clinically important difference (MCID).

RESULTS

The reliability of the test was confirmed through internal consistency analysis, with a good Crombach's Alpha (0.82-0.85), and test-retest analysis, with good values of ICC (0.74-0.91). The measurement error was also assessed, with low values of SEM (1.70-4.67) and SDC (4.71-12.94)). The CFA confirmed the unidimensionality of each scale with goodness of fit indices, while the MHQ showed a high and negative correlation with DASH (r = - 0.75, P < 0.001) and DASH-work (r = - 0.63, P < 0.001) and was irrelevant with EQ-5D (r = - 0.01, P > 0.005) and grip strength (r = 0.05, P > 0.005). At week 5, all 222 patients across the three diagnosed hand subgroups showed moderate to high values above 0.92 for ES and SRM, with one MCID above 6.85.

CONCLUSIONS

The MHQ-Sp was culturally adapted, and the results of this version showed good reliability and validity as well as high responsiveness for a wide range of hand conditions after surgical or conservative treatment in Spain.

Unlocking the Hidden Dimensions of Cancer Care: Cross-Cultural Adaptation and Feasibility Study of ESAS-FS, Assessing Spiritual Pain and Financial Distress in a Spanish-speaking Population with Advanced Cancer

INTRODUCTION

Spiritual pain and financial distress are two important dimensions of cancer care that are often overlooked. Both dimensions can have a significant impact on the quality of life of patients with cancer and their families.

METHODS

This study conducted a cross-cultural adaptation, feasibility study, and psychometric properties of the Edmonton Symptom Assessment System-Financial and Spiritual (ESAS-FS) in a Spanish-speaking population with advanced cancer. The ESAS-FS is a patient-reported outcome measure that assesses 12 symptoms, including spiritual pain and financial distress.

RESULTS

In the cross-cultural adaptation process, the terms "spiritual pain" and "financial distress" were refined to "sufrimiento espiritual" and "preocupación por asuntos económicos" respectively, with strong professional consensus and high patients' acceptancy (relevant questions 80%, appropriate terms 91%). A cohort of 100 onco-hematologic patients revealed that 70% experienced spiritual pain (mean 2.9/10), while 49% reported financial distress (mean 2.2/10). Symptomatic analyses illustrated significant associations of spiritual pain with various symptoms like fatigue, drowsiness, and depression. Similarly, financial distress correlated notably with drowsiness, depression, and anxiety. Moreover, a distinct correlation was observed between spiritual pain and financial distress.

CONCLUSION

The findings of this study suggest that the ESAS-FS is a valuable tool for assessing spiritual pain and financial distress in Spanish-speaking patients with advanced cancer. The tool can be used to identify patients who are experiencing these dimensions of distress and to provide them with appropriate care.

Cross-Cultural Adaptation and Validation of the ICIQ-BD for Brazilian Women With Lower Urinary Tract Symptoms

INTRODUCTION AND HYPOTHESES

The International Continence Society recommends the International Consultation on Incontinence Questionnaire-Bladder Diary (ICIQ-BD) for the assessment, management, and monitoring of lower urinary tract symptoms (LUTS). Translation, cross-cultural adaptation and validation will establish a valid and reliable tool for Brazilian women with LUTS.

METHODS

A cross-sectional study involving 101 women was carried out at the Urogynecology Outpatient Clinic in Belo Horizonte, Brazil, between August 2020 and April 2022. The process of cross-cultural adaptation and validation was executed following the ICIQ Group's protocol. Reviewed by an expert committee, the first pre-test was followed by subsequent adaptations, resulting in a second adapted version that underwent expert revisions. A second pretest was conducted, followed by cross-cultural adaptation and construct validation. Finally, the International Consultation on Incontinence Questionnaire-Bladder Diary-Brazilian Portuguese Version (ICIQ-BD-Br) underwent a validation process.

RESULTS

Construct validity (IVC >0.78) and internal consistency were satisfactory (α-Cronbach coefficient 0.87-0.94). The following adjustments were made: a specific field was created to document sleep and wake times, and a printed score ranging from 0 to 4 was included in the bladder sensation column. Test-retest reliability ranged from fair to excellent for all analyzed items (Spearman correlation: 0.64-0.95). Criterion validity analysis indicated slight agreement for one of the four symptoms analyzed (nocturia k=0.32). The final version was approved by the ICIQ Group.

CONCLUSIONS

The ICIQ-BD-Br has been adapted for use in Brazilian Portuguese and has exhibited robust construct validity and reliability for Brazilian women with LUTS.

Cross-Cultural Adaptation, Validation, and Diagnostic Accuracy of the Voice Fatigue Handicap Questionnaire-Persian Version

OBJECTIVE

The current study aimed to determine the psychometric characteristics of a translated version of the Voice Fatigue Handicap Questionnaire in Persian by examining the validity, reliability, and diagnostic accuracy using data collected from people with and without dysphonia.

STUDY DESIGN

Cross-sectional study.

METHOD

The original questionnaire was translated from Italian to Persian using the International Quality of Life Assessment criteria. The translated version was completed by 122 people with dysphonia and 49 people without dysphonia. The validity, reliability, and diagnostic accuracy of the Voice Fatigue Handicap Questionnaire Persian-version were evaluated. A panel of five voice-specializing Speech and Language Pathologists and 20 native Persian speakers (with dysphonia) in a pilot study confirmed the translated version for content and face validity, respectively. The internal consistency was evaluated by Cronbach's alpha and McDonald omega coefficients. The intraclass correlation coefficient was used to examine the test-retest reliability. For discriminant validity, the mean total and subscale scores of respondents with and without dysphonia were compared through independent t tests. Finally, sensitivity, specificity, and ideal cut-off value were determined using the receiver-operating characteristic curve.

RESULTS

Cronbach's alpha coefficient was 0.965 for the total score (functional: α = 0.883, emotional: α = 0.944, physical: α = 0.917). Also, the McDonald omega coefficient was 0.966 for the total score (functional: ω = 0.889, emotional: ω = 0.933, physical: ω = 0.920). The intraclass correlation coefficient for measuring the test-retest reliability was 0.971 for the total score (functional: ICC=0.937, emotional: ICC=0.954, physical ICC=0.976). The results of the independent samples t tests indicated that the dysphonia group obtained significantly higher mean scores (total and subscale scores) than the group without dysphonia. The cutoff value of 13.5 was determined based on the optimal balance of sensitivity (0.992) and specificity (0.918).

CONCLUSION

The Voice Fatigue Handicap Questionnaire-Persian version is a valid and reliable questionnaire to identify individuals at high risk of vocal fatigue and subsequent dysphonia.

Cross-cultural adaptation and psychometric properties of the Thai version of the patient-reported outcomes measurement information system short form- depression 8a in individuals with chronic low back pain

BACKGROUND

The study aimed to cross-culturally adapt the Patient-Reported Outcomes Measurement Information System Short Form v1.0 - Depression 8a (PROMIS SF v1.0 - Depression 8a) into Thai and evaluate its psychometric properties in individuals with chronic low back pain (CLBP).

METHODS

The PROMIS SF v1.0- Depression 8a was translated and cross-culturally adapted into Thai using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred and sixty-nine individuals with CLBP completed the Thai version of PROMIS SF v1.0- Depression 8a (T-PROMIS-D-8a) scale and a set of measures assessing validity criterion domains. Structural validity, internal consistency, and test-retest reliability at a 7-day interval of the T-PROMIS-D-8a scale were computed and its construct validity was evaluated by computing correlations with the Thai version of Patient Health Questionnaire-9 (T-PHQ-9), Numeric Rating Scale of pain intensity (T-NRS), and Fear Avoidance Beliefs Questionnaire (T-FABQ).

RESULTS

Data from 269 participants were analyzed. Most participants were women (70%), and the sample had a mean age of 42.5 (SD 16.6) years. The findings supported the unidimensionality, internal consistency (Cronbach's alpha = 0.94), and test-retest reliability (ICC [2,1] = 0.86) of the T-PROMIS-D-8a. A floor effect was observed for 16% of the sample. Associations with the T-PHQ-9, T-NRS, and T-FABQ supported the construct validity of the T-PROMIS-D-8a.

CONCLUSIONS

The T-PROMIS-D-8a was successfully translated and culturally adapted. The findings indicated that the scale is reliable and valid for assessing depression in Thai individuals with CLBP.

The Chinese translation and cross-cultural adaptation of PRISMA-7 questionnaire: an observational study to establish the accuracy, reliability and validity

BACKGROUND

Frailty is a health condition linked to adverse health outcomes and lower life quality. The PRISMA-7, a 7-item questionnaire from the Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA), is a validated case-finding tool for frailty with good sensitivity and specificity. This study aimed to translate, culturally adapt, and validate the PRISMA-7 questionnaire for Chinese use.

METHODS

A prospective observational study with convenience sampling recruited bilingual adults aged 65 and over living in the community. The Functional Autonomy Measurement System (SMAF) was the gold standard benchmark. The English PRISMA-7 questionnaire was culturally adapted to Chinese using forward and backward translation. Intra- and inter-rater reliability were determined using the intraclass correlation coefficient (ICC). Face, content and criterion validity were determined. The Receiver Operator characteristic (ROC) curve determined the optimal cut-off score.

RESULTS

One-hundred-twenty participants (55 females and 65 males) were recruited. The Chinese PRISMA-7 questionnaire had excellent intra-rater and inter-rater reliability (ICC = 1.000). The rigorous forward and backward translation established the face and content validity. The moderately high correlations between the English PRISMA-7 with SMAF (r = - 0.655, p <  0.001) and Chinese PRISMA-7 with SMAF (r = - 0.653, p <  0.001) pairs established the criterion validity. An optimal cut-off score of three "Yes" responses was reported with 100% sensitivity and 85.3% specificity.

CONCLUSION

This translation, cross-cultural adaptation, and validation study established the Chinese PRISMA-7 questionnaire. The preliminary results suggest adequate diagnostic test accuracy for frailty screening among the Chinese-literate community.

Cross-cultural adaptation of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to Brazilian Portuguese and its psychometric properties-A multicenter cross-sectional study

OBJECTIVE

To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its psychometric properties.

RESULTS

The scale was evaluated by 15 experts, and 239 patients from three tertiary hospitals in Rio de Janeiro. All participants signed a consent form. Data have shown adequacy of the model (KMO=0.839, Bartlett's test of sphericity: χ2(171) = 2241.3, p = 0.000010), good adjusted content validity (CVCa ≥ 0.90), internal consistency and reliability, such as α = 0.927.

DISCUSSION

CuPDPH is a rating scale on observable professional attitudes. Illnesses change lives and impose adaptation to a new situation, perceived as depersonalization, leading patients to try to regain control of their lives. Patients expressed "ill will" to fill out the scale. Psychiatric patients' scale filling time was higher than others. A sample from three Rio de Janeiro third-level hospitals may not reflect the country's population; also, this adaptation may not comprise all linguistic variations of Brazilian Portuguese and Portuguese-speaking countries.

CONCLUSION

The Portuguese version of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH), a 19-item, six-component version is a reliable instrument to measure the perception of internal medicine, surgical, and psychiatric patients on the maintenance of their dignity in Rio de Janeiro, Brazil. This knowledge could be used in advancing research on patients' perception of dignity, as well as professional ethical competencies, staff-patient relationship skills, and leadership development in medical and other healthcare professional education.

Challenges of Measuring Self-Reported Exposure to Occupational Biomechanical Risk Factors Amongst People with Low Literacy Engaged in Manual Labour: Findings from a Cross-Cultural Adaptation and Psychometric Investigation in an African Population with Chronic Low Back Pain

PURPOSE

Occupational biomechanical factors are implicated in the aetiology and progression of low back pain (LBP). This study cross-culturally adapted and psychometrically investigated the Occupational Risk Factor Questionnaire (ORFQ) in a low literate Nigerian Igbo population with chronic LBP.

METHODS

Forward and back translation of the original ORFQ by clinical and non-clinical translators was followed by an expert committee review. The adapted ORFQ was pre-tested amongst rural Nigerian adults with chronic LBP using cognitive think-aloud interviewing. Internal consistency (Cronbach's alpha) and test-retest reliability (unweighted and linear weighted k statistic for item-by-item agreement, and intra-class correlation coefficient-ICC) were investigated amongst 50 rural and urban Nigerian dwellers with chronic LBP. Spearman's correlation and regression analyses were conducted with the Igbo-ORFQ, and measures of disability [World Health Organisation Disability Assessment Schedule (WHODAS 2.0), Roland Morris Disability Questionnaire (RMDQ), Back performance scale (BPS)], pain intensity [Eleven-point box scale (BS-11)] and social support [Multidimensional Scale of Perceived Social Support (MSPSS)], to test construct validity with 200 rural Nigerian dwellers with chronic LBP.

RESULTS

Cross-cultural adaptation highlighted difficulty conceptualising and concretising exposure to biomechanical risk factors. Item-by-item agreement, internal consistency (α = 0.84) and intraclass correlation coefficient (ICC = 0.83) were good. Some unexpected direction of associations between the biomechanical components of the Igbo-ORFQ, and disability, pain intensity, and social support prohibits establishment of construct validity.

CONCLUSION

Prospective studies comparing the Igbo-ORFQ to other measures of exposure to occupational biomechanical risk factors are required to establish the construct validity of the Igbo-ORFQ.

Reliability and validity of cross‑culturally adapted oral health‑related quality‑of‑Life instruments for Brazilian children and adolescents: a systematic review

OBJECTIVE

This systematic review aimed to review the reliability and validity of oral health-related quality of life (OHRQoL) questionnaires for Brazilian children and adolescents. Also, the cross-cultural adaptation was evaluated.

METHODS

This systematic review is registered in PROSPERO (CRD42022300018) and was performed based on the COSMIN guideline. Electronic searches were performed in the PubMed/MEDLINE, Web of Science, Lilacs, BVS (BIREME), Scielo, and Embase databases until March 2023 by two independent reviewers. There was no restriction on time or language. The following studies were included: validation studies and cross-cultural adaptation of OHRQoL instruments into Brazilian Portuguese; studies that evaluated the measurement properties of OHRQoL questionnaires in children and adolescents and that reported at least one of the measurement properties: reliability, internal consistency, error measurement, content validity, construct validity, criterion validity, discriminant validity, and/or convergent validity. The following were excluded: studies of systematic reviews of OHRQoL measures; studies reporting OHRQoL assessment through instruments; construction (development) and validation of a new instrument; questionnaires that had a single item; and validation for Portuguese from Portugal. The cross-cultural adaptation process and psychometrics of the included studies were verified.

RESULTS

6556 articles were identified, and 19 manuscripts were included. All studies were conducted in Brazil, and the age of the participants ranged from 2 to 15.42 years old. Sixteen articles presented the cross-cultural validation steps. Cronbach's alpha of the revised instruments ranged from 0.59 to 0.86.

CONCLUSIONS

It can be concluded that most studies provided information and evidence regarding validity, reliability, translation, and cultural adaptation.

Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study

OBJECTIVE

To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties.

METHODS

The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability.

RESULTS

The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855.

CONCLUSIONS

The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.

4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis

BACKGROUND

Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4DSP) into Spanish.

METHODS

A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated.

RESULTS

The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively.

CONCLUSIONS

The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

The transcultural adaptation and validation of the Chinese version of the Oral Health Literacy Scale for Diabetic Patients

BACKGROUND

Diabetic patients' oral health concerns are a reality for every diabetic patient in China. The attitudes of diabetic patients toward early identification of oral literacy influence oral literacy in diabetes patients. Diabetes patients' oral health literacy is critical for providing focused education and therapies. However, no instrument exists to measure oral health literacy in Chinese diabetic patients. In this study, the English version of the oral health literacy among people living with diabetes (OHLD) scale was cross-culturally validated to provide a reliable tool for assessing the oral health literacy of diabetic patients in China.

OBJECTIVE

The oral literacy among people living with diabetes (OHLD) scale was Chineseized and its reliability and validity tested, and the OHLD scale was revised to test the reliability and validity of the Chinese version of the OHLD scale and to provide a tool for assessing the oral health literacy of diabetic patients in China.

METHODS

A modified version of the Brislin translation model was used, cross-cultural adaptation was performed through expert consultation and pre-survey, and expert opinion was used to assess content validity to form the Chinese version of the Oral Health Literacy Scale for Diabetic Patients, which was administered to 420 diabetic patients in two tertiary hospitals in Liaoning Province from March to August 2023. The reliability of the scale was tested. SPSS 25.0 and AMOS 23.0 were used to analyze the data.

RESULTS

The Chinese version of the OHLD scale consisted of three dimensions and 10 entries. Structure of the validity analysis: three factors were extracted from the exploratory factors with a cumulative variance contribution of 79.794%; Content validity results:An item's content validity index (I-CVI) was 0.857 to 1 at the entry level, and the content validity index of the scale (S-CVI) was 0.928 at the scale level. The results of the reliability analyses were: the Cronbach's alpha coefficient for the total scale was 0.908; the Cronbach's alpha coefficients for the factors and dimensions were 0.853 to 0.922; the split-half reliability was 0.827; and the test-retest reliability was 0.848. The results of the validation factor analysis showed that (χ2/df) was 1.430, the root mean square of the error of approximation (RMSEA) was 0.045, the comparative fit index (CFI) was 0.989, and the Tucker Lewis index (TLI) was 0.985, which showed that the model had an overall good fit.

CONCLUSION

The Chinese version of the OHLD scale has good reliability and validity and can be used as a valid tool for assessing diabetes mellitus patients in China.

Simplified Chinese version of the core outcome measures index (COMI) for patients with neck pain: cross-cultural adaptation and validation

PURPOSE

The aim of this study was to translate and cross-culturally adapt the Core Outcome Measures Index for (COMI) into a Simplified Chinese version (COMI-SC) and to evaluate the reliability and validity of COMI-SC in patients with neck pain.

METHODS

The COMI-neck was translated into Chinese according to established methods. The COMI-neck questionnaire was then completed by 122 patients with a hospital diagnosis of neck pain. Reliability was assessed by calculating Cronbach's alpha and intraclass correlation coefficient (ICC). Construct validity was assessed by correlating the COMI-neck with the Neck Pain and Disability Scale (NPDS), the Neck Disability Index (NDI), the VAS and the Short Form (36) Health Survey (SF-36). Using confirmatory factor analysis to validate the structural, convergent and discriminant validity of the questionnaire.

RESULTS

The COMI-neck total scores were well distributed, with no floor or ceiling effects. Internal consistency was excellent (Cronbach's alpha = 0.861). Moderate to substantial correlations were found between COMI-neck and NPDS (r = 0.420/0.416/0.437, P < 0.001), NDI (r = 0.890, P < 0.001), VAS (r = 0.845, P < 0.001), as well as physical function (r = - 0.989, P < 0.001), physical role (r = - 0.597, P < 0.001), bodily pain (r = - 0. 639, P < 0.001), general health (r = - 0.563, P < 0.001), vitality (r = - 0.702, P < 0.001), social functioning (r = - 0.764, P < 0.001), role emotional (r = - 0.675, P < 0.001) and mental health (r = - 0.507, P < 0.001) subscales of the SF-36. An exploratory factor analysis revealed that the 3-factor loading explained 71.558% of the total variance [Kaiser-Mayer-Olkin (KMO) = 0.780, C2 = 502.82, P < 0.001]. CMIN/DF = 1.813, Tucker-Lewis index (TLI) = 0.966 (> 0.9), Comparative Fit Index (CFI) = 0.982 (> 0.9), Normed Fit Index (NFI) = 0.961 (> 0.9), RMSEA = 0.082 (< 0.5) indicating that the model fits well.

CONCLUSION

COMI-neck was shown to have acceptable reliability and validity in patients with non-specific chronic neck pain and could be recommended for patients in mainland China.

LEVEL OF EVIDENCE

Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

Cross-cultural adaptation, reliability and validity of the Turkish version of the Henry Ford Hospital Headache Disability Inventory (HDI/T) in patients with cervicogenic headache

PURPOSE

Cultural adaptation to Henry Ford Hospital Headache Disability Inventory (HDI) and investigating the validity and reliability of this inventory.

METHODS

International standards were followed in conducting the cultural adaption of Henry Ford Hospital Headache Disability Inventory Turkish version (HDI-T). Test-Retest reliability (intraclass correlation coefficient, ICC) and internal consistency (Cronbach's alpha) were included in the psychometric assessments; Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the structural validity; and construct validity was performed by examining relationship the HDI-T between the Headache Impact Test-6 (HIT- 6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14), and Nottingham Health Profile (NHP).

RESULTS

HDI-T showed excellent test-retest reliability (ICC =0.901), excellent internal consistency (Cronbach's a = 0.935), and low to high correlation with Headache Impact Test-6 (HIT-6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14) and Nottingham Health Profile (NHP). Following EFA, two factors (emotional and functional) were extracted, accounting for 50.734% of the total variation. The dimensional structure of the HDI-T obtained in the EFA was confirmed by CFA.

CONCLUSION

The HDI-T is a reliable and valid instrument to determine the symptoms and disability in the Turkish population with cervicogenic headaches.Implications for RehabilitationHenry Ford Hospital Headache Disability Inventory Turkish version (HDI-T) is an outcome measure with high validity and reliability to obtain objective data in the determination of disability due to cervicogenic headache.HDI-T is recommended for all rehabilitation professionals to evaluate both the disability levels before rehabilitation and the changes during the rehabilitation process in patients with cervicogenic headaches in the Turkish population.Physiotherapists, orthopedists and neurosurgeons can also use HDI-T to objectively evaluate the secondary effects of their treatment for neck problems.

Cross-cultural adaptation and validation of the Italian version of the Western Ontario Rotator Cuff (WORC) index

The aim of the study was to accomplish translation, cross-cultural adaptation and validation of the Western Ontario Rotator Cuff (WORC) Index questionnaire for its use in Italy. The WORC original version was translated and cross-culturally adapted into Italian. Subsequently, it was administered to a population of 60 patients suffering from rotator cuff disease to evaluate the validity and reliability of the Italian version. The content validity evaluated the correlation between questions and total score of each domain through Pearson's correlation coefficient. The construct validity was similarly assessed through Pearson's correlation coefficient by testing the correlation between the Italian WORC and the Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Reliability was assessed using two methods: internal consistency by calculating the Cronbach's alpha coefficient for each domain; and test-retest by means of the intraclass correlation coefficient (ICC). The translation and cross-cultural adaptation of the Italian version did not reveal any major problems. No significant floor or ceiling effects were found. All the questions were linearly related to the concept expressed by the domain of belonging. Overall correlation with the DASH score was 0.75. Internal consistency was very high overall (α = 0.93) as well as reliability (overall ICC = 0.87). The Italian version of the WORC questionnaire is a valid and reproducible measuring instrument and can be considered a valid tool for the evaluation of the effectiveness of a treatment in terms of quality of life, in Italian patients affected by rotator cuff diseases.Level of evidence Diagnostic study, level II.

Translation, cultural adaptation and assessment of psychometrics properties of the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) in Persian language speaking people

BACKGROUND

To translate and cross-culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) into Persian (NMQ-E-P) and evaluate the psychometric properties in a general population with different occupational tasks across nine body regions.

METHODS

This cross-sectional study was designed according to the standard guidelines and the COSMIN checklist. The NMQ-E-P was achieved through forward and backward translation methods and consensus to produce the final draft. A Persian-speaking population (n = 571, age 38.24 ± 7.65 years, female = 46.2%) was recruited from industries and office workers with three occupational task inclusion criteria: assembly, office, and lifting. Psychometric properties included validity for face (from confirmed clarity, simplicity, and readability), content (via the content validity index); and construct (through known group validity); additionally, the properties of internal consistency (Cronbach's α); and test-retest reliability (Kappa coefficient of agreement) were considered.

RESULTS

No significant issues during the translation process were found. The NMQ-E-P showed adequate internal consistency for all regions (α ≥ 0.87). The test-retest reliability was examined with Kappa agreement correlation coefficient and all items, except ankle regions, showed very good agreements (Kappa coefficient = 0.87-1.0). Excellent ICC values were obtained for quantitative variables (ICC > 0.88) and good construct validity was revealed (p < 0.001).

CONCLUSION

The Persian version of the NMQ-E has very good validity and reliability and can be used by researchers and professionals to evaluate the prevalence of MSDs in nine body regions simultaneously.

Translation and validation of the Breastfeeding Motivation Scale in China

BACKGROUND

There are several versions of the Breastfeeding Motivation Scale (BMS), which have been shown to measure maternal breastfeeding motivation, but there is not a Chinese version yet. The study aimed to translate the BMS into Chinese and subsequently assess its psychometric properties among Chinese mothers during the postpartum period.

METHODS

The study was composed of two phases. The translation of BMS closely followed the principals of good practices. Phase 1 included a comprehensive translation, back-translation, cross-cultural adaptation, and pretest to develop the Chinese version of the BMS. From 1 December 2021 to 1 July 2022, the Chinese version of the BMS was administered to 206 postnatal mothers in our maternity wards to assess its psychometric properties. Phase 2 involved psychometric property testing, including testing of the internal consistency, test-retest reliability, content validity, construct validity, convergent validity and discriminant validity.

RESULTS

Minor modifications in four items were recommended after translations. The Cronbach's α coefficient of the Chinese version of the BMS was .887, and the intraclass correlation coefficient was .897 (P < 0.001). The model fit was acceptable (χ2/df = 2.40, P < 0.001, RMSEA = 0.08, CFI = 0.91, IFI = 0.92 and TLI = 0.90) according to the confirmatory factor analysis. The composite reliability values corresponding to each latent variable were 0.733 ~ 0.926, and the average variance extracted values were 0.476 ~ 0.653. The correlations among the five measured variables were all lower than .85 and the square roots of average variance extracted from the variable were greater than the interconstruct correlations among the five measured variables in the model.

CONCLUSIONS

The Chinese version of the BMS has good reliability and validity and provides a reliable assessment tool for measuring maternal breastfeeding motivation. It also provides support to develop culturally sensitive interventions for Chinese mothers' who are breastfeeding.

Translation and validation of Hindi version of patient scar assessment scale in patients with postburn facial scar

Background

Patient scar assessment scale (PSAS) is a reliable and standard tool for assessment of scars by the observer and the patient. Till now the scale has not been translated to Hindi. The objective of the study was to translate and validate the PSAS to Hindi.

Materials and Methods

We did forward and backward translation of the English PSAS together with its validation. In total, 64 patients with postburn facial scars were included. The validation committee consisted of 6 bilingual members.

Results

The PSAS-Hindi showed good internal consistency with Cronbach's α of 0.86. Test-retest reliability showed good correlation with intra class coefficient being 0.94 (95% confidence interval: 0.83-0.97).

Conclusion

The PSAS was successfully translated to Hindi, and cross-cultural adaptation was made.

Validation and psychometric testing of the Arabic version of the mental health literacy scale among the Saudi Arabian general population

OBJECTIVE

This study aimed to validate the Arabic Version of the Mental Health Literacy Scale (Arabic-MHLS) among the Saudi Arabian general population, assessing its internal consistency, test-retest reliability, and structural validity.

METHODS

A total of 700 Arabic-speaking Saudi adults were randomly selected to complete the electronic questionnaire in May 2023, which generated 544 participants. Data were coded and stored in the ZdataCloud research data collection system database. Test-retest reliability was assessed using a subsample of 48 participants who completed the questionnaire twice, with a one-week interval. Structural validity was examined using confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA).

RESULTS

The Arabic-MHLS demonstrated good internal consistency (Cronbach's alpha = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.89). EFA revealed a four-factor model closely resembling the model identified in the Slovenian validation of MHLS, with factor loadings ranging from 0.40 to 0.85. The four factors included knowledge of mental health disorders, knowledge of help-seeking, knowledge of self-help strategies, and knowledge of professional help also showed good internal consistency.

CONCLUSION

The Arabic-MHLS is a valid and reliable tool for assessing mental health literacy in the Saudi Arabian general population. However, further research is needed to refine the measurement tool and understand the complex relationships between mental health literacy and other mental health-related concepts. This will contribute to the development of targeted interventions and policies aimed at improving mental health literacy and promoting mental well-being in the Saudi Arabian population and beyond.

Cross-cultural adaptation of the PROFFIT Instrument to measure financial toxicity in people living with cancer within a UK population

BACKGROUND

This study aimed to develop a British version of the Patient Reported Outcomes for Fighting Financial Toxicity of Cancer (PROFFIT): originally designed to measure financial toxicity in cancer for an Italian universal healthcare system. The instrument was carefully evaluated for crosscultural equivalence, face validity and practicality.

METHODS

A systematic approach to cross-cultural adaptation was used, including forward translation, synthesis, backward translation, consolidation of translations with an expert committee, and cognitive interviews. As part of the cognitive interview process, 18 cancer patients completed a structured interview of 60-90 min in length.

RESULTS

The translated and modified PROFFIT questionnaire demonstrated good psycho-linguistic properties, including high compliance (only one item was revised for clarity), high retrieval from memory, high decision-making processes, and high response processes.

CONCLUSION

PROFFIT has been found to be functional and adaptable in a new social environment. The tool may be useful for tailoring interventions to address and measure financial hardships within the cancer population, which appear to be a current challenge for public health.

POLICY SUMMARY

Even in universal healthcare systems, financial toxicity due to the increase in outof-pocket expenses poses a significant problem. The FT phenomenon warrants proper attention in the United Kingdom since it may negatively impact financial well-being, quality of life, psychosocial health, and treatment adherence.

French Translation and Cross-cultural Adaptation of the Scale for the Assessment and Rating of Ataxia

The Scale for the Assessment and Rating of Ataxia (SARA) is a widely used scale for assessing the severity of ataxia in clinics, natural history studies, and treatment trials worldwide. However, no French translation with validated cross-cultural adaptation is available. This study aimed to translate and adapt the SARA into French. The translation process was conducted according to the ISPOR guidelines for the translation and cultural adaptation process for patient-reported outcomes. A total of five translators, an expert committee, and two physiotherapists took part in the process to assess and ensure comprehension and language equivalences of the final French version. A few misinterpretations were pointed out during the translation process and were changed accordingly by the translation team. The French version of the SARA is ready to be used in clinical and research settings with French-speaking populations living with ataxia.

Development and validation of a French-language cross-cultural adaptation of the Pedi-IKDC Questionnaire

BACKGROUND

The Pedi-IKDC is an English-language, knee-specific, paediatric questionnaire used by orthopaedic surgeons around the world as a valuable patient-reported outcome measure (PROM). The objective of this study was thus to extend the applicability of the Pedi-IKDC to French-speaking Canadian patients, for both clinical practice and research, by developing a French-language cross-cultural adaptation of the original version.

HYPOTHESIS

The French adaptation of the Pedi-IKDC is valid and reliable for evaluating French-speaking children with knee conditions.

PATIENTS AND METHODS

The Pedi-IKDC was translated to French by a panel of orthopaedic surgeons then back-translated by a professional translator. The original English version and the back-translation were compared to assess their similarity and confirm the faithfulness of the French translation. The validity of the French version was then tested at a major paediatric hospital in French-speaking Canada, in 203 children, including 163 with knee pain and 40 without knee symptoms. Internal consistency, construct validity, and discriminant capacity of the French version were assessed.

RESULTS

Internal consistency of the Pedi-IKDC adaptation was excellent (Cronbach's alpha, 0.934 in the knee-pain group). Construct validity was robust, with all nine hypotheses adapted from the original Pedi-IKDC article demonstrating strong (n=7) or moderate (n=2) correlations (p<0.001). The evaluation of discriminant capacity identified no statistically significant score differences according to most of the respondent characteristics (body mass index, age group, type of diagnosis, and type of treatment). However, scores differed significantly between females and males.

DISCUSSION

The French-language cross-cultural adaptation of the Pedi-IKDC obtained using a universally recognized method for translating PROMs demonstrated good performance, with psychometric properties similar to those of the original Pedi-IKDC and of its Danish, Italian, and Russian adaptations.

LEVEL OF EVIDENCE

II.

[Adaptation and validation of the MoVac-flu scale on motivation towards the flu vaccine]

OBJECTIVE

To translate, adapt and validate the psychometric properties of MoVac-flu scale in order to be used in Spanish.

METHOD

The present research was an analytical observational study of cross-cultural adaptation and validation into Spanish of the MoVac-flu scale. It has been carried out between the months of March and July 2022. The sample size was 142 people who were obtained by consecutive sampling. The processes used for the adaptation have been translation, validation by a committee of experts, back-translation and pilot test. For validation, the psychometric properties of reliability, internal consistency, appearance validity, content validity, utility and ceiling-floor effect have been verified.

RESULTS

The internal consistency of the MoVac-flu scale in its version translated into Spanish was high, showing a McDonald's ω of 0.914.

CONCLUSIONS

The MoVac-flu scale in Spanish allows to measure the degree of motivation towards vaccination against influenza in the adult population.

Cross-cultural adaptation to Spanish of the Perceived Sensivity to Medicines scale

BACKGROUND AND OBJECTIVE

Patients' views regarding the actions and side effects of medicines can be measured with the Perceived Sensitivity to Medicines (PSM) scale. The aim of this study was to translate and adapt the PSM scale for use in the Spanish population.

MATERIALS AND METHODS

The translation and cultural adaptation of the PSM scale and a pretest of the Spanish version were carried out with 50 patients receiving outpatient care in various specialties.

RESULTS

There were no difficulties in the stages of the translation and adaptation process. In the cognitive interview, participants found the five items easy to understand (mean score of 3.86±0.24 out of 4).

CONCLUSION

Given its brevity, the Spanish version of the PSM scale represents an easily applicable tool for both research and clinical purposes.

Cross-cultural adaptation and psychometric evaluation of the "Modification of Hall's professionalism scale for use with pharmacists"

BACKGROUND

Professionalism is the demonstration of behaviors that guide the actions of health professionals. In Pharmacy, its implementation is possible through assessment instruments for pharmacists, such as the "Modification of Hall's Professionalism Scale for Use with Pharmacists".

OBJECTIVE

To translate the "Modification of Hall's Professionalism Scale for Use with Pharmacists" into a Brazilian Portuguese version and evaluate its psychometric properties for pharmacists.

METHOD

The methodological process of this study took place in three stages: translation and cross-cultural adaptation of the instrument original version into a Brazilian Portuguese version; validation of the scale content through consensus among geographically distinct experts and, finally; examination of the scale psychometric measurement properties through a convenience sample of 600 Brazilian pharmacists. At this stage, construct validity was verified using Exploratory Factor Analysis (EFA) and reliability was examined by calculating the composite reliability.

RESULTS

The adapted instrument to a Brazilian Portuguese version demonstrated content validity with coefficients considered acceptable, above 0.8. The EFA demonstrated a structure supported by six factors and 39 items. The H index suggested high stability for all factors as well as composite reliability.

CONCLUSION

The Brazilian Portuguese version of the instrument presented appropriate content validity coefficients and psychometric properties. This measure may be useful for future studies on professionalism regarding teaching strategies and assessment of this construct among pharmacists.

Translation and cultural adaptation of the Greek integrated palliative care outcome scale (IPOS): challenges in a six-phase process

AIM

To translate and culturally adapt IPOS to the Greek population.

METHODS

A four phases- sequential study, which included verification of conceptual equivalence, double forward- backward translations and conceptual cognitive debriefing. Focus group interviews used 'think aloud' and 'verbal probing' techniques. Interviews were audio-recorded, transcribed verbatim and thematically analyzed using predefined categories. Purposely sampled from two oncology and palliative care units in Athens.

RESULTS

The Integrated Palliative Care Outcome Scale was well accepted by both patients and health professionals. Overall comprehension and acceptability of the scale were good. The comprehension and judgement challenges identified in the pre-final version were successfully resolved in the cognitive interviewing phase. Five out of the seventeen translated items of the scale were modified after cognitive debriefing. Comprehension difficulties were identified with specific terms (e.g., energy/feeling depressed) and with some answer options. Severity of symptoms and not their impact was a common difficulty. A judgement challenge was reported in relation to 7-days recall and fluctuation of symptoms. Layout concerns in relation to length of questions were also stated. All questions were considered important and none as inappropriate.

CONCLUSION

This study demonstrated face and content validity and acceptability of the Integrated Palliative Care Outcome Scale in the Greek context. Cognitive Interviewing proved valuable in refining concepts within the specific cultural context.

CLINICAL IMPLICATIONS

The IPOS outcome measure tool is now being used routinely in a palliative care service in Athens and is currently used to evaluate service outcomes.

Cross-cultural adaptation for international nursing students from the Belt and Road Initiative in China: A follow-up survey study

Background

and Purpose: As the number of international students from Belt and Road Initiative countries continues to increase in China, it is essential to find methods to improve cross-cultural adaptation in the host country, a crucial aspect of the experiences of international nursing students. Therefore, this study aimed to investigate the change in cross-cultural adaptation of international nursing students during the first year in China.

Methods

Data collection was conducted for international nursing students (n = 108) between September 2019 and August 2020, focusing on sociocultural adaptation, academic adaptation, and academic performance of international nursing students using validated questionnaires.

Results

The mean score at the follow-up time verified an increased level of sociocultural and academic adaptation and academic performance. Academic adaptation is a complete mediator between sociocultural adaptation and academic performance at two-time points, and the size of the mediation effect accounted for 95.9 % of the total effect in six months and 99.0 % in one year.

Conclusions

The findings emphasized the importance of sociocultural and academic adaptation in cross-cultural adaptation and suggest that educational institutions should provide learning environments supporting these factors to ensure academic success.

Translation, cultural adaptation and validation of the revised patients' attitudes towards deprescribing (rPATD) questionnaire in Romanian older adults

BACKGROUND

Deprescribing is part of ensuring appropriate medication use and may reduce medication-related harm. Capturing the beliefs and attitudes of patients towards deprescribing by using a validated tool may support optimizing medication use in practice.

OBJECTIVES

To translate, culturally adapt and validate the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Romanian and to investigate the attitudes and beliefs of older adults towards deprescribing.

METHODS

The rPATD questionnaire was translated using forward-backward translation into Romanian and culturally adapted. The psychometric properties were evaluated in older adults ≥65 years of age. Structural validity was assessed by item load on factors using an exploratory factor analysis (EFA) which was compared to the original English version and the internal consistency by Cronbach's alpha. Construct validity was evaluated by calculating the Spearman's rank correlation coefficients between the factor scores obtained using the revised version of the Romanian rPATD and scores on the Beliefs about Medicines Questionnaire (BMQ) Specific Concerns Romanian version. Floor and ceiling effect were also examined.

RESULTS

We translated the questionnaire and administered it to 224 participants (median age 72 years [interquartile range: 68.0; 77.0]). In the EFA individual items loaded onto 4 factors, grouped similarly to the English version (Involvement, Burden, Appropriateness, Concerns about Stopping factors). Two items from each of the Involvement and Appropriateness factors were removed to improve factor loading and avoid cross-loading. The Cronbach's alpha values for the 4 factors ranged between 0.522 and 0.773. The scores for Burden and Concerns about Stopping factors were found to be positively correlated with BMQ Specific Concerns score. We identified a ceiling effect for one of the four factors (Involvement) and no floor effects.

CONCLUSIONS

The Romanian rPATD was validated in 4 factor structure similar to the original English questionnaire. The Romanian version of the questionnaire may support the health care professionals in Romania to initiate and support patient-centered deprescribing.

Arabic translation, cross cultural adaptation, and validation of Foot Health Status Questionnaire among Saudi individuals with plantar fasciitis

BACKGROUND

Measuring quality of life (QoL) plays an essential role in enabling meaningful cross-cultural comparisons. The Foot Health Status Questionnaire (FHSQ) is a valid tool for assessing both foot-specific and general health-related quality of life (HrQoL), making it suitable for evaluating Plantar Fasciitis (PF) patients.

METHODOLOGY

The aim of this study is to translate the FHSQ into Arabic following methodological assessments of the translation procedure. The translation was done using forward and back translation. A pre-test questionnaire was distributed among 50 patients, resulting in the final FHSQ-Ar version, which then underwent various psychometric evaluations among 87 persons with PF, including internal consistency, dimensionality, reliability, interpretability, and construct validity against the 100-mm Visual Analogue Scale (VAS).

RESULTS

Internal consistency was adequate, ranging from 0.70 to 0.92. Reliability values ranged from 0.69 to 0.80, with a poor standard error of measurement (individual) but an acceptable standard error of measurement (group). Two domains exhibited floor effects, while one domain showed a ceiling effect. Regarding validity, three out of four hypothesized correlations with VAS scores were confirmed. Factor analysis revealed four dimensions, and confirmatory factor analysis demonstrated good fit (comparative fit index = 0.98, standardized root mean square = 0.06).

CONCLUSION

The psychometric properties of the FHSQ-Ar were satisfactory. Further validation for other diseases may be warranted.

The cross-cultural adaptation and psychometric properties of the menstrual symptom questionnaire (MSQ) among Chinese women of reproductive age

Objective

This study reports on a translation of the Menstrual Symptom Questionnaire (MSQ) into Chinese, a cross-cultural adaptation among Chinese women of reproductive age, and an assessment of its reliability and validity.

Methods

Previously published translation guidelines were followed to translate and cross-culturally adapt the English version of MSQ to produce a Chinese version. This Chinese version was then administered to 2800 Chinese women of reproductive age recruited by convenience sampling method. The reliability of the Chinese MSQ was tested for internal consistency and test-retest reliability. The concurrent and construct validity of the questionnaire was evaluated using correlation and factor analysis.

Results

The Chinese version of the MSQ showed no linguistic or semantic issues. The internal consistency of the Chinese MSQ Cronbach'α = 0.912, and the test-retest reliability r = 0.911. The exploratory factor analysis identified four factors. The confirmatory factor analysis demonstrated that the four factor structure of the Chinese version of the MSQ (Pain Experience, Emotional Changes, Pain Coping Strategies, and Other Physical Symptoms) is reasonable among Chinese women of reproductive age. There was a significant correlation found between these four factors and both the Pittsburgh Sleep Quality Index and the SF-8 Health Survey.

Conclusion

The Chinese version of the MSQ achieved semantic equivalence in translation and demonstrated good reliability and validity among Chinese women of reproductive age. Thus, it can serve as an effective tool to assess the experience of menstrual symptoms among Chinese women.

Italian version of the Cumberland Ankle Instability Tool (CAIT-I)

STUDY DESIGN

Evaluation of the psychometric properties of a translated, culturally adapted questionnaire.

OBJECTIVE

Translating, culturally adapting, and validating the Italian version of the Cumberland Ankle Instability Tool (CAIT-I).

SUMMARY OF BACKGROUND DATA

Ankle sprains are one of the most common musculoskeletal injuries and can lead to chronic ankle instability (CAI). The International Ankle Consortium recommends the Cumberland Ankle Instability Tool (CAIT) as a valid and reliable self-report questionnaire assessing the presence and severity of CAI. At this moment, there is no validated Italian version of CAIT.

METHODS

The Italian version of the CAIT (CAIT-I) was developed by an expert committee. Test-retest reliability of the CAIT-I was measured in 286 healthy and injured participants within a 4-9-day period, by using Intraclass Correlation Coefficients (ICC2,1). Construct validity, exploratory factor analysis, internal consistency and sensitivity were examined in a sample of 548 adults. Instrument responsiveness over 4 time points was determined in a subgroup of 37 participants.

RESULTS

The CAIT-I demonstrated excellent test-retest reliability (ICC≥0.92) and good internal consistency (α = .84). Construct validity was confirmed. Identified cut-off for the presence of CAI was 24.75, with sensitivity= 0.77 and specificity= 0.65. There were significant differences across time for CAIT-I scores (P < .001), demonstrating responsiveness to change, but no floor or ceiling effects.

CONCLUSION

The CAIT-I demonstrates acceptable psychometric performance as a screening and outcome measure. The CAIT-I is a useful tool to assess the presence and severity of CAI.

Cross-cultural adaptation of The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire: A methodological systematic review

BACKGROUND

The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) is a reliable and sensitive measure of disability to determine functional status and evaluate curative effects in low back pain, it has now been cross-cultural translated into many other languages and adapted for use in different countries. We aim to evaluate the translation procedures and measurement properties of cross-cultural adaptations of the JOABPEQ.

METHODS

Studies related to cross-cultural adaptation of the JOABPEQ in a specific language/culture were searched in PubMed, Embase, CINAHL, SciELO, PsycINFO, SinoMed, and Web of Science from their inception to March 2022. The Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and the Consensus-based Standards for the Selection of Health Status Measurement Instruments guideline were used for evaluation.

RESULTS

Nine different versions of cross-cultural JOABPEQ adaptations in 8 different languages/cultures were included. The adaptation process was not strictly performed, such as standard forward translation and expert committee review were rarely reported. Content validity (8/9), floor and ceiling effects (3/9), reliability (4/9), and interpretability (6/9) were assessed in most of the adaptations, while agreement (2/9), responsiveness (2/9), and the internal consistency (2/9) were not. JOABPEQ can replace functional and quality of life score to reduce the burden of scientific research.

CONCLUSION

We recommend Persian-Iranian, simplified Chinese-Chinese Mandarin, Thai and Gunaydin G's Turkish adaptations for application. The numerical pain rating scale/visual analogue scale in low back pain and lower extremities, as well as numbness in lower extremities could not be neglected in JOABPEQ adaptations.

Translation and psychometric evaluation of the Persian version of Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS)

BACKGROUND

The present study aimed to translate and validate the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) in Iran.

METHODS

Following standard forward and backward translation procedure, content and face validity were tested by specialists and a sample of 32 patients. Then, in a cross sectional study, a sample of patients with knee disorders, recruited through simple sampling, completed the KOS-ADLS and the Short-Form Health Survey (SF-36) in their first visit to physiotherapy clinics in Tehran. Regarding construct validity, the Spearman's correlation (rs) and one-way ANOVA were employed to evaluate the correlations between the Persian KOS-ADLS and SF-36 subscales (convergent validity) and known groups comparison, respectively. Test-retest reliability and internal consistency were evaluated by intraclass correlation coefficient (ICC) and the Cronbach's α coefficient.

RESULTS

In total 101 patients were included in the study. The mean age of patients was 42.39 (SD = 9.2). The finding indicated that the KOS-ADLS had strong correlations with SF-36 physical functioning, bodily pain subscales, and also physical component summary while it had lower correlations with other subscales of the SF-36 as expected. The KOS-ADLS was able to differentiate between the subgroups of patients who differed in BMI. The acceptable level of intraclass correlation coefficient (ICC = 0.91) and Cronbach's α coefficient (α = 0.91) was obtained for the Persian KOS-ADLS. Also no floor and ceiling effects were observed for the questionnaire.

CONCLUSIONS

The Persian version of KOS-ADLS was found to be a reliable and valid outcome measure for assessing daily living activities in patients who suffer from knee pathological conditions.

French Canadian cross-cultural adaptation of CAPTSure©, an index for the Clinical Assessment of Post-Thrombotic Syndrome in children

PURPOSE

Post-thrombotic syndrome (PTS) is the most common complication of deep venous thrombosis (DVT). The index for the Clinical Assessment of Post-Thrombotic Syndrome in children (CAPTSure©) is a clinical tool for the diagnosis and severity rating of PTS in pediatric patients. The purpose of this study was to translate and adapt CAPTSure© for French-speaking patients.

METHODS

We conducted a cross-sectional study to perform linguistic and cultural adaptation of CAPTSure©, using a rigorous translation process followed by cognitive debriefings in twenty French-speaking pediatric patients aged up to 18 years old with a history of upper or lower extremity DVT at least 6 months prior.

RESULTS

Forward and backward translations were used to produce a pre-final French version of CAPTSure©, followed by cognitive debriefings in twenty participants (median age: 11.5 years, 55% male, median CAPTSure© score: 26). The participants felt that the questionnaire was thorough, with an adequate length. Eight out of fourteen (57%) items in the LE questionnaire and 7/12 (58%) of the items in the UE questionnaire were modified following participants' and a multidisciplinary expert committee's input, leading to the final French version of CAPTSure©.

CONCLUSIONS

CAPTSure© was successfully adapted for French-speaking pediatric patients. This will ease the diagnosis and severity rating of PTS in children in clinical practice and allow international research collaborations for additional non-English-speaking patients.

Spanish version of the pain beliefs questionnaire: Translation, cross-cultural adaptation, validation, and psychometric properties in a working population

BACKGROUND

Chronic musculoskeletal pain is a major health problem and a common cause of disability in the workplace. Beliefs related to musculoskeletal pain may influence its onset and perpetuation. Consequently, tools designed to identify potentially harmful beliefs are needed. However, the Pain Beliefs Questionnaire (PBQ) is not available for individuals speaking European-Spanish.

OBJECTIVES

To translate and culturally adapt the original English version of the PBQ into European-Spanish and evaluate its psychometric properties among Spanish workers with and without chronic musculoskeletal pain.

DESIGN

Study on measurement properties.

METHODS

A translation and cultural adaptation process was based on a forward-backward translation process. One hundred fifty-one active workers were included. Participants completed the PBQ (composed of the organic and psychological subscales), the Pain Catastrophizing Scale (PCS), and the Hospital Anxiety and Depression Scale (HADS). Finally, thirty participants completed the PBQ again two weeks later for test-retest reliability.

RESULTS

The PBQ showed adequate internal consistency (Cronbach's alpha: 0.72-0.73), good item response stability (weighted Kappa: 0.65-0.90), and reliability (Intraclass Correlation Coefficient: 0.72-0.80). A positive correlation was found between the PCS and the organic subscale (r = 0.403). However, no significant correlations were found between the HADS and the PBQ subscales. Workers with chronic musculoskeletal pain showed greater scores in the organic subscale and lower scores in the psychological subscale than workers without pain.

CONCLUSION

The Spanish version of the PBQ was linguistically accurate and acceptable for use by workers with and without musculoskeletal pain.

Cross-cultural adaptation and psychometric validation of the Chinese version of career success in nursing scale (CSNS)

OBJECTIVE

To translate the career success in nursing scale (CSNS) into Chinese and evaluate its psychometric properties.

BACKGROUND

A lower sense of career success seriously affects the enthusiasm of nurses and increases their turnover rate. Therefore, an accurate assessment of the career success level of nurses is necessary. However, China does not have a professional tool for assessing the career success of nurses.

METHODS

The stratified sampling method was used to recruit participants from 22 hospitals of different grades in 5 cities in China. A total of 650 and 348 subjects were selected for item analysis and reliability and validity tests, respectively, of the translated initial scale.

RESULTS

The Chinese version of the CSNS (C-CSNS) with 33 items had good psychometric properties. Cronbach's α was 0.960, split-half reliability was 0.893, and ICC within two weeks was 0.981. Exploratory factor analysis extracted 5 common factors that explained 63.73% of the total variance, and confirmatory factor analysis supported acceptable construct validity.

CONCLUSION

The C-CSNS has adequate construct validity and excellent psychometric properties and can be used for accurate assessment of nurses' career success.

IMPLICATIONS FOR NURSING MANAGEMENT

A new tool that is more suitable for the Chinese hospital nursing context is available for evaluating Chinese clinical nurses' career success. Nursing managers can formulate appropriate management strategies according to the evaluation results to assist nurses in career development planning, thereby improving their career success level.

The RU_SATED as a measure of sleep health: cross-cultural adaptation and validation in Chinese healthcare students

BACKGROUND

The RU_SATED scale is a multidimensional instrument measuring sleep health, consisting of Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration dimensions. We adapted and validated the Chinese RU_SATED (RU_SATED-C) scale.

METHODS

The RU_SATED-C scale was developed through a formal linguistic validation process and was validated in an observational longitudinal survey design. Healthcare students completed the RU_SATED scale, Sleep Quality Questionnaire, and Patient Health Questionnaire-4 among two sites of Hangzhou and Ningbo, China. Psychometric assessments included structural validity, longitudinal measurement invariance, convergent and divergent validity, internal consistency, and test-retest reliability.

RESULTS

A total of 911 healthcare students completed the RU_SATED-C scale at baseline (Time 1, T1) and follow-up (Time 2, T2) with an average time interval of 7 days + 5.37 h. Confirmatory factor analysis (CFA) confirmed a single-factor model and resulted in an acceptable model fit. The two-factor model previously found in the Japanese version fit better than the one-factor model, whereas the one-factor model fit had a better fit than the two-factor model found in the English version. Longitudinal CFA resulted in negligible changes in fit indices for four forms of increasingly restrictive models and supported that a single-factor model was equivalent over time. The data also endorsed longitudinal measurement invariance among the two-factor models found in the English and Japanese samples. The RU_SATED-C scale total score displayed a moderately strong negative correlation with sleep quality; however, negligible associations were observed with anxiety and depression. Ordinal Cronbach's alpha and Ordinal McDonald's omega at T1 and T2 ranged from suboptimal to acceptable. The RU_SATED-C scale and all items were significantly correlated across time intervals.

CONCLUSION

The RU_SATED-C scale is an easy-to-use instrument with potentially valid data for the measurement of multidimensional sleep health. Use of the RU_SATED-C scale can help raise awareness of sleep health and could pave the way for important efforts to promote healthy sleep.

The Chinese version of the Computer Vision Syndrome Questionnaire: translation and cross-cultural adaptation

BACKGROUND

The Spanish version of the Computer Vision Syndrome Questionnaire (CVS-Q^©) is a validated instrument, with good psychometric properties, to measure Computer Vision Syndrome (CVS) in workers using Video Display Terminals (VDTs). To date, there are no known valid instruments in Chinese for the assessment of CVS despite the high exposure to VDTs at work that this population presents. For this, the purpose of this study is to translate and cross-culturally adapt the CVS-Q^© into Chinese.

METHODS

A study with five consecutive stages: direct translation, synthesis of translations, back translation, consolidation by a committee of experts, and pre-test. During the pre-test, a cross-sectional pilot study was conducted on VDT users (n = 44) who completed the Chinese version of the questionnaire plus an ad hoc post-test to assess the comprehensibility of the scale and to verify aspects of its applicability and feasibility. Data concerning sociodemographic information, general and ocular health, use of optical correction and varying exposure to VDTs was also collected.

RESULTS

The entire sample considered the Chinese version of the CVS-Q^© simple, clear, and easy to understand and 95.5% also found it easy to complete. 88.7% considered that the scale did not need any improvement. The final version of the Chinese scale to measure CVS was obtained (the CVS-Q CN^©). The mean age of participants was 31.3 ± 9.8 years, 47.6% were women, and 57.1% used VDTs to work for more than 8 h/day.

CONCLUSIONS

The CVS-Q CN^© can be considered an easy tool to assess CVS in workers exposed to digital devices in China. This version would facilitate research, its use in clinical practice, and the prevention of occupational hazards in the workplace.

Validation of the German Glasgow Sensory Questionnaire and replication of sensory processing differences in students with higher and lower Autism-Spectrum Quotient

BACKGROUND

The Glasgow Sensory Questionnaire (GSQ) gives insight into sensory processing differences (hypo- and hyper-sensitivity across modalities), which is a clinically defining characteristic of autism spectrum disorder (ASD). Because there is no validated German version of this instrument, this study aimed at validating the German GSQ. Further, a replication of the GSQ's sensory processing differences was intended.

METHODS

University students of Technische Universität or Universitätsklinikum in Dresden, Germany, were recruited via email distribution or the university homepage and 297 German-speaking students completed the online survey, comprising the German GSQ, Autism-Spectrum Quotient (AQ) and Symptom-Checklist (SCL-90). For validation of the German GSQ, confirmatory factor analyses followed by exploratory factor analyses were applied.

RESULTS

The German GSQ has moderate to low validity, good to acceptable reliability, and a different internal structure from the original GSQ. Replicating the sensory processing differences in students with higher and lower AQ was not successful.

CONCLUSIONS

Results indicate that the GSQ, developed especially for individuals with ASD, is less informative for the general population if there are not enough individuals with higher AQ scores in the sample.

Translation and validation study of the Chinese version of the service user technology acceptability questionnaire

Objective

This study aimed to assess the reliability and validity of the translated Chinese version of the Service User Technology Acceptability Questionnaire (C-SUTAQ).

Methods

Patients with cancer (n ​= ​554) from a tertiary hospital in China completed the C-SUTAQ. Item analysis, content and construct validity test, internal consistency test, and test-retest reliability analysis were conducted on the instrument to test its applicability.

Results

The critical ratio of each item of the C-SUTAQ ranged from 11.869 to 29.656; the correlation of each item and subscale ranged from 0.736 to 0.929. The Cronbach's α value for each subscale ranged from 0.659 to 0.941, and the test-retest reliability ranged from 0.859 to 0.966. The content validity index of the scale level and the item level content validity index of the instrument were both 1. Exploratory factor analysis indicated it was reasonable that the C-SUTAQ consists of six subscales after rotation. Confirmatory factor analysis demonstrated good construct validity (χ²/df ​= ​2.459, comparative fit index ​= ​0.922, incremental fit index ​= ​0.907, standardized root mean square residual ​= ​0.060, root-mean-square error of approximation ​= ​0.073, goodness of fit index ​= ​0.875, normed fit index ​= ​0.876.

Conclusions

The C-SUTAQ had good reliability and validity and may be useful to assess Chinese patients' acceptability of telecare. However, the small sample size limited generalization and there is a need to expand the sample to include persons with other diseases. Further studies are required using the translated questionnaire.

Evidence-based geriatric knowledge among healthcare providers in Vietnam: adaptation, validation, and pilot of the knowledge about older patients quiz

BACKGROUND

Vietnam's aging population is growing rapidly, but its health workforce's capacity to provide quality geriatric care is not clearly understood. We aimed to provide a cross-culturally relevant and validated instrument to assess evidence-based geriatric knowledge among healthcare providers in Vietnam.

METHODS

We translated the Knowledge about Older Patients Quiz from English to Vietnamese using cross-cultural adaptation methods. We validated the translated version by evaluating its relevance to the Vietnamese context, as well as its semantic and technical equivalence. We fielded the translated instrument on a pilot sample of healthcare providers in Hanoi, Vietnam.

RESULTS

The Vietnamese Knowledge about Older Patients Quiz (VKOP-Q) had excellent content validity (S-CVI/Ave) and translation equivalence (TS-CVI/Ave) of 0.94 and 0.92, respectively. The average VKOP-Q score was 54.2% (95% CI: 52.5-55.8) and ranged from 33.3 to 73.3% among 110 healthcare providers in the pilot study. Healthcare providers in the pilot study had low scores on questions related to the physiopathology of geriatric conditions, communication techniques with sensory impaired older adults, and differentiating age related changes from abnormal changes or symptoms.

CONCLUSIONS

The VKOP-Q is a validated instrument to assess geriatric knowledge among healthcare providers in Vietnam. The level of geriatric knowledge among healthcare providers in the pilot study was unsatisfactory, which supports the need for further assessment of geriatric knowledge among a nationally representative sample of healthcare providers.

[Spanish translation and cross-cultural adaptation of the Pressure Ulcer Quality of Life Questionnaire (PU-QOL).]

OBJECTIVE

Pressure ulcers (PU) are the most prevalent of the dependency-related injuries, affecting the quality of life of the patients who suffer them. However, there are no instruments adapted to the Spanish context to evaluate this quality of life. The use of specific tools in Spanish to evaluate the quality of life perceived by patients with PUs is considered an indispensable element for healthcare decisions. The aim of this paper was to translate and culturally adapt the Pressure Ulcer Quality of Life Questionnaire (PU-QOL) into Spanish for the measurement of health-related quality of life in patients with pressure ulcers.

METHODS

A translation, back-translation, and pre-test method was used on the target population to obtain an adapted version of the original PU-QOL instrument. The area was Primary Care. The participants were fifteen Primary Care patients. Main steps: 1) Direct translation; 2) Synthesis and concordance of versions by an expert committee; 3) Back translation; 4) Consistency of the back translation with the author from the original questionnaire; and 5) Analysis of comprehensibility through cognitive interviews with a sample of patients.

RESULTS

An instrument to measure perceived quality of life in patients with PU was obtained, composed of ten scales and eighty-three items. The scales and items of the original questionnaire were maintained. Conceptual and semantic analysis produced adjustments in wording, clarification and reformulations adapted to the Spanish context.

CONCLUSIONS

We present this first phase of translation and cross-cultural adaptation of the PU-QOL questionnaire in Spanish, which could be a useful tool for decision-making on health care in patients with PUs.

Patient-centered care and geriatric knowledge translation among healthcare providers in Vietnam: translation and validation of the patient-centered care measure

BACKGROUND

People are living longer, and the majority of aging people reside in low- and middle-income countries (LMICs). However, inappropriate healthcare contributes to health disparities between populations of aging people and leads to care dependency and social isolation. Tools to assess and evaluate the effectiveness of quality improvement interventions for geriatric care in LMICs are limited. The aim of this study was to provide a validated and culturally relevant instrument to assess patient-centered care in Vietnam, where the population of aging people is growing rapidly.

METHODS

The Patient-Centered Care (PCC) measure was translated from English to Vietnamese using forward-backward method. The PCC measure grouped activities into sub-domains of holistic, collaborative, and responsive care. A bilingual expert panel rated the cross-cultural relevance and translation equivalence of the instrument. We calculated Content Validity Indexing (CVI) scores at both the item (I-CVI) and scale (S-CVI/Ave) levels to evaluate the relevance of the Vietnamese PCC (VPCC) measure to geriatric care in the Vietnamese context. We piloted the translated instrument VPCC measure with 112 healthcare providers in Hanoi, Vietnam. Multiple logistic regression models were specified to test the a priori null hypothesis that geriatric knowledge is not different among healthcare providers with perception of high implementation compared with low implementation of PCC measures.

RESULTS

On the item level, all 20 questions had excellent validity ratings. The VPCC had excellent content validity (S-CVI/Ave of 0.96) and translation equivalence (TS- CVI/Ave of 0.94). In the pilot study, the highest-rated PCC elements were the holistic provision of information and collaborative care, while the lowest-rated elements were the holistic attendance to patients' needs and responsive care. Attention to the psychosocial needs of aging people and poor coordination of care within and beyond the health system were the lowest-rated PCC activities. After controlling for healthcare provider characteristics, the odds of the perception of high implementation of collaborative care were increased by 21% for each increase in geriatric knowledge score. We fail to reject the null hypotheses for holistic care, responsive care and PCC.

CONCLUSION

The VPCC is a validated instrument that may be utilized to systemically evaluate the practice of patient-centered geriatric care in Vietnam.

Translation and cross-cultural adaptation of the National Health Service Sustainability Model to the Chinese healthcare context

BACKGROUND

International attention is being paid to the issue of making evidence sustainable after implementation. Developing an identification model is essential to promote and monitor the sustainability of evidence implementation. However, this model is not available in Chinese. This study aims to translate the National Health Service Sustainability Model into Chinese and to verify whether the model is adapted to the Chinese healthcare environment.

METHODS

This study follows the translation and validation guidelines developed by Sousa and Rojjanasrirat. The translations include forward and backward translations and their comparison. Expert reviews were used to validate the content validity of the Chinese version of the National Health Service sustainability model. Cognitive interviews were used to assess the validity of the language in the Chinese setting.

RESULTS

The translation was conducted by a bilingual research team and took 12 months. Expert reviews were undertaken with eight experts, and cognitive interviews with six participants. The content validity of the model is excellent, but at least 20% of the experts still felt that items one, three, five and nine needed refinements. In the cognitive interviews, most items, instructions and response options were well understood by the participants responsible for the evidence-based practice project. However, some language issues were still identified in items one, three, four, five, seven, nine, and ten. Participants reported that the sustainability results of the model assessment were consistent with their previous judgments of the items. Based on the expert review and interview results, items one, three, four, five, seven, nine and ten require further refinement. In summary, seven of the ten items have been amended.

CONCLUSIONS

This study provides insight into how the National Health Service sustainability model can be used in the Chinese healthcare setting and paves the way for future large-scale psychometric testing.