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      Cross-cultural validation of the “DISABKIDS” questionnaire for quality of life among Colombian children with chronic diseases 1

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          ABSTRACT

          Objective:

          to describe the cross-cultural validation process of the “DISABKIDS” questionnaire in Colombia, for both the children and adolescents’ version and the parents’ version, an instrument intended to measure the health-related quality of life of Colombian children and adolescents with chronic diseases.

          Method:

          the cross-cultural validation process was conducted according to an international consensual systematic methodology, called standardized linguistic validation, to ensure linguistic equivalence with the original questionnaire.

          Results:

          the pretest’s cognitive interviews revealed a need to adjust the questionnaire, which consisted of asking for “health condition” rather than only asking for “condition”. Due to the cultural context, the word “condition” used in the original version, when translated to Spanish, refers to socioeconomic conditions rather than health conditions. For this reason, 11 items in the children’s version and eight items in the parents’ version were adjusted.

          Conclusions:

          the Colombian version of DISABKIDS-37 to measure health-related quality of life among children and adolescents with chronic diseases in both the children’s and parents’ versions is equivalent to the original version and is appropriate for use in Colombia. Future studies can assess the questionnaire’s psychometric properties.

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          Most cited references15

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          Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations

          Background Research questionnaires are not always translated appropriately before they are used in new temporal, cultural or linguistic settings. The results based on such instruments may therefore not accurately reflect what they are supposed to measure. This paper aims to illustrate the process and required steps involved in the cross-cultural adaptation of a research instrument using the adaptation process of an attitudinal instrument as an example. Methods A questionnaire was needed for the implementation of a study in Norway 2007. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. Results The adaptation process included investigation of conceptual and item equivalence. Two forward and two back-translations were synthesized and compared by an expert committee. Thereafter the instrument was pretested and adjusted accordingly. The final questionnaire was administered to opioid maintenance treatment staff (n=140) and harm reduction staff (n=180). The overall response rate was 84%. The original instrument failed confirmatory analysis. Instead a new two-factor scale was identified and found valid in the new setting. Conclusions The failure of the original scale highlights the importance of adapting instruments to current research settings. It also emphasizes the importance of ensuring that concepts within an instrument are equal between the original and target language, time and context. If the described stages in the cross-cultural adaptation process had been omitted, the findings would have been misleading, even if presented with apparent precision. Thus, it is important to consider possible barriers when making a direct comparison between different nations, cultures and times.
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            A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach.

            The health-related quality of life (HRQoL) literature presents a confused picture of what 'equivalence' in the cross-cultural use of HRQoL questionnaires means and how it can be assessed. Much of this confusion can be attributed to the 'absolutist' approach to the cross-cultural adaptation of HRQoL questionnaires. The purpose of this paper is to provide a model of equivalence from a universalist perspective and to link this to the translation and adaptation of HRQoL questionnaires. The model evolved from reviews of the HRQoL and other literatures, interviews and discussions with researchers working in HRQoL and related areas and practical experience in the adaptation and development of HRQoL instruments. The model incorporates six key types of equivalence. For each type of equivalence the paper provides a definition, proposes various strategies for examining whether and how types of equivalence can be achieved, illustrates the relationships between them and suggests the order in which they should be tested. The principal conclusions are: (1) that a universalist approach to the cross-cultural adaptation of HRQoL instruments requires that six types of equivalence be taken into account; (2) that these are sufficient to describe and explain the nature of the cross-cultural adaptation process; (3) that this approach requires careful qualitative research in target cultures, particularly in the assessment of conceptual equivalence; and (4) that this qualitative work will provide information which will be fundamental in deciding whether to adapt an existing instrument and which instrument to adapt. It should also result in a more sensitive adaptation of existing instruments and provide valuable information for interpreting the results obtained using HRQoL instruments in the target culture.
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              A systematic survey instrument translation process for multi-country, comparative health workforce studies.

              As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the language and context of different health systems. To describe the pre-data collection systematic translation process used in a twelve country, eleven language nursing workforce survey. We illustrate the potential advantages of Content Validity Indexing (CVI) techniques to validate a nursing workforce survey developed for RN4CAST, a twelve country (Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland, Spain, Sweden, and Switzerland), eleven language (with modifications for regional dialects, including Dutch, English, Finnish, French, German, Greek, Italian, Norwegian, Polish, Spanish, and Swedish), comparative nursing workforce study in Europe. Expert review panels comprised of practicing nurses from twelve European countries who evaluated cross-cultural relevance, including translation, of a nursing workforce survey instrument developed by experts in the field. The method described in this paper used Content Validity Indexing (CVI) techniques with chance correction and provides researchers with a systematic approach for standardizing language translation processes while simultaneously evaluating the cross-cultural applicability of a survey instrument in the new context. The cross-cultural evaluation process produced CVI scores for the instrument ranging from .61 to .95. The process successfully identified potentially problematic survey items and errors with translation. The translation approach described here may help researchers reduce threats to data validity and improve instrument reliability in multinational health services research studies involving comparisons across health systems and language translation. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                09 August 2018
                2018
                : 26
                : e3020
                Affiliations
                [2 ]PhD, Full Professor, Facultad de Salud, Universidad Manuela Beltrán, Bogotá, Colombia.
                [3 ]PhD, Associate Professor, Departamento de Enfermería, Universidad de Alicante, Alicante, Spain.
                Author notes
                Corresponding Author: Nadia Carolina Reina Gamba Universidad Manuela Beltrán. Programa de Enfermería Av. Boyacá # 38B-20 sur CEP: 110841, Bogotá, Colombia E-mail: artemisa1210@ 123456hotmail.com
                Article
                00336
                10.1590/1518-8345.2378.3020
                6091385
                30110098
                4ffef829-670a-4774-9509-46d25ac9aa2c
                Copyright © 2018 Revista Latino-Americana de Enfermagem

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 14 July 2017
                : 06 May 2018
                Page count
                Figures: 9, Tables: 0, Equations: 0, References: 21, Pages: 1
                Categories
                Original Articles

                quality of life,chronic disease,child,adolescent,validation studies,surveys and questionnaires

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