Translation and Adaption of Questionnaires: A Nursing Challenge

Abstract

Background Translation of previously developed questionnaires has often been the choice when addressing research to groups whose language is not English. In the translation of health-related questionnaires, it is highly important to assure congruency between the words and their true meaning in the language to which the questionnaire is translated. Aim To describe the semantic problems encountered in translating a standardized questionnaire from English (the Identity and Experiences Scale) to Norwegian according to the World Health Organizations translation protocol. Design A mixed-method study was used with the formation of four focus groups and a postal survey. Data sources Eighteen respondents from a nursing college in Oslo, an aged community in northeast Norway, and a community organization of retired persons in southeast Norway were focus group participants. In sum, 141 persons participated in the postal survey. Findings A number of semantical challenges in relation to interpretation and understanding of the meaning and use of words in the Identity and Experiences Scale were found. Discussion Words bearing emotional weight and connected to complex operational concepts were found to be problematic. Various American-English colloquial expressions also caused semantical challenges. Other problems were related to sentence structure and grammar form. Conclusion Translation, adaptation, and validation of questionnaires or scales for practice and research are very time-consuming and require careful planning and the adoption of rigorous methodological approaches to derive a reliable and valid measure of the concept of interest in the target population. Implications for nursing Translation quality is a methodological issue that nurses need to take seriously. It is highly recommended that nurses follow and document steps in a procedure of forward translation, qualitative reviews of translated items with regard to clarity, common language and conceptual adequacy, back translation, testing on lay panels, and committee review, or a probable variation of this procedure.