The significance of exploring conceptual equivalence within the process of the cross-cultural adaptation of tools: The case of the Patient's Perception of Feeling Known by their Nurses Scale

INTRODUCTION

The exploration of conceptual equivalence within the process of the cross-cultural adaptation of tools is usually neglected as it generally assumed that the theoretical construct of a tool is conceptualized in the same way in both the original and target culture. This article attempts to throw light on the contribution of the evaluation of conceptual equivalence to the process of adaptation, and for tool development. To illustrate this premise, the example of the cross-cultural adaptation of the Patients' Perception of Feeling Known by their Nurses (PPFKN) Scale is presented.

DESIGN

An adapted version of the Sousa and Rojjanasrirat (Journal of Evaluation in Clinical Practice, 2011, 17(2), 268-274) guidelines was used to translate and culturally adapt the PPFKN Scale to Spanish language and culture. A qualitative descriptive study was added to the traditional process of translation and pilot study to explore the concept in the target culture and recognize conceptual equivalence.

METHODS

Experts in the tool concept, bilingual translators and the author of the tool participated in the translation of the original tool into Spanish. A pilot study of the Spanish version with a sample of 44 patients and a panel of six experts from different fields evaluated its clarity and relevance. In addition, seven patients participated in a descriptive qualitative study using semi-structured individual interviews to explore the phenomenon in the new culture. A content analysis following the Miles, Huberman & Saldaña (Qualitative data analysis, a methods sourcebook, 2014) approach was used to analyze qualitative data.

RESULTS

The cross-cultural translation and adaptation of the PPFKN scale into Spanish required a thorough revision. More than half of the items needed discussions to reach consensus regarding the most appropriate Spanish term. In addition, the study confirmed the four attributes of the concept identified in the American context and allowed for new insights within those attributes to appear. Those aspects reflected characteristics of the phenomenon of being known in the Spanish context and were added to the tool in the format of 10 new items.

CONCLUSIONS

A comprehensive cross-cultural adaptation of tools should incorporate, together with the study of linguistic and semantic equivalence, the analysis of the conceptual equivalence of the phenomenon in both contexts. The identification, acknowledgment and study of the conceptual differences between two cultures in relation to a phenomenon becomes an opportunity for deeper study of the phenomenon in both cultures, for understanding of their richness and depth, and for the proposal of changes that may enhance the content validity of the tool.

CLINICAL RELEVANCE

The evaluation of conceptual equivalence of tools within the process of cross-cultural adaptation will make it possible for target cultures to rely on tools both theoretically sound and significant. Specifically, the cross-cultural adaptation of the PPFKN scale has facilitated the design of a Spanish version of the tool that is linguistically, semantically and theoretically congruent with Spanish culture. The PPFKN Scale is a powerful indicator that evidences nursing care contribution to the patient's experience.

How bilinguals refer to Mandarin throwing actions in English

AIMS AND OBJECTIVES

In the present study, we tested how Mandarin-English bilinguals choose English words to refer to prototypical Mandarin throwing actions. Languages differ in how they refer to events. In Mandarin and English, words for throwing actions differ notably on a variety of dimensions so there are few perfect translation equivalents. In previous studies, when faced with the challenge of how to speak about such events, bilinguals sometimes use language-specific ways in each language, sometimes show convergence, sometimes use more general terms, and there are times when they can be quite creative.

DESIGN/METHODOLOGY

We showed video clips of six prototypical Mandarin throwing actions (corresponding to rēng , diū , pāo , tóu , shuāi , shuǎi ) to Mandarin-English bilinguals and English monolinguals. Participants labeled the actions and chose the English word most closely corresponding to the action. The bilinguals did the same in Mandarin.

FINDINGS/CONCLUSION

The results showed that the bilinguals chose many of the same words in English as English monolinguals did. However, the bilinguals differed from the monolinguals in two ways: (1) they tended to choose more different responses and (2) they referred to diū actions most often as throw rather than lob as the monolinguals did.

ORIGINALITY

These results suggest that bilinguals use a variety of strategies to refer to the not-easily-translatable.

Heart Attacks, Bloody Noses, and Other "Emotional Problems": Cultural and Conceptual Issues With the Spanish Translation of Self-Report Emotional Health Items

This article examines how respondents understood items in the Spanish versions of the Short-Form 36 (SF-36v2). Cognitive interviews of the SF-36 were conducted in 2 phases with 46 Spanish speakers living in the United States. Roughly one-third (17/46) of respondents had difficulty understanding the Role Emotional items upon their initial reading, and almost half (21/46) provided examples that were inconsistent with the intended meaning of the items. The findings of this study underscore the importance of conducting cognitive testing to ensure conceptual equivalence of any instrument regardless of how well validated it appears to be.