Abstract
BackgroundA link between mental health and freedom of choice has long been established, in fact, the loss of freedom of choice is one of the possible defining features of mental disorders. Freedom of choice has internal and external aspects explicitly identified within the capability approach, but received little explicit attention in capability instruments. This study aimed to develop a feasible and linguistically and culturally appropriate Hungarian version of the Oxford CAPabilities questionnaire—Mental Health (OxCAP-MH) for mental health outcome measurement.MethodsFollowing forward and back translations, a reconciled Hungarian version of the OxCAP-MH was developed following professional consensus guidelines of the International Society for Pharmacoeconomics and Outcomes Research and the WHO. The wording of the questionnaire underwent cultural and linguistic validation through content analysis of cognitive debriefing interviews with 11 Hungarian speaking mental health patients in 2019. Results were compared with those from the development of the German version and the original English version with special focus on linguistic aspects.ResultsTwenty-nine phrases were translated. There were linguistic differences in each question and answer options due to the high number of inflected, affixed words and word fragments that characterize the Hungarian language in general. Major linguistic differences were also revealed between the internal and external aspects of capability freedom of choices which appear much more explicit in the Hungarian than in the English or German languages. A re-analysis of the capability freedom of choice concepts in the existing language versions exposed the need for minor amendments also in the English version in order to allow the development of future culturally, linguistically and conceptually valid translations.ConclusionThe internal and external freedom of choice impacts of mental health conditions require different care/policy measures. Their explicit consideration is necessary for the conceptually harmonised operationalisation of the capability approach for (mental) health outcome measurement in diverse cultural and linguistic contexts.
Highlights
A link between mental health and freedom of choice has long been established, the loss of freedom of choice is one of the possible defining features of mental disorders
Forward translation Twenty-nine phrases were translated from the English source questionnaire to Hungarian language, including the 16 main questions of the OxCAP-MH instrument, two additional phrases not included in the final score, four instruction phrases (e.g. “Please tick one”), six different response options, and one explanatory sentence, i.e. “This questionnaire asks about your overall quality of life.”
Beside the linguistic differences in expressing freedom of choice in English and Hungarian languages, which further underline the need for robust methodological design in the translation process, e.g. professional back translation and a cognitive debriefing study in the target country, our study demonstrates the need for well-defined elaboration of the underlying freedom of choice concepts, when designing an instrument for the application of the capability approach in the mental health research area
Summary
A link between mental health and freedom of choice has long been established, the loss of freedom of choice is one of the possible defining features of mental disorders. Mental health research is an important field for the application of the capability approach because of the need to reduce inequalities across groups, reinforce patient participation in social activities, and incur improvements in how a person can live their life beyond more narrow health improvement outcomes [8]. Mental health research acknowledges a distinction between two different aspects of freedom of choice, and interprets freedom of choice as a concept, which arises if an individual is able to employ certain abilities and processes to re-determine both external and internal stimuli [10]. External constraints can become the basis of internal restrictions (e.g. compulsion in certain life circumstances), and internal constraints caused by mental disorders can be less significant if counterbalanced by adequate support or circumstances [11] Good examples of the latter one are addictions and phobias, where internal freedom capacity is restricted, but could be improved by external support or restrictions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
