Cultural Adaptation Research Articles

Validation and cross-cultural adaptation of health-related quality of life scale: a psychometric study for elderly care home residents

Purpose This study aims to validate and adapt the Health-Related Quality of Life (HRQoL) scale for use among elderly patients in Arabic-speaking care homes. Design/methodology/approach A total of 210 participants completed the Arabic-translated HRQoL scale to assess its reliability, validity and cultural adaptation. Internal consistency, test–retest reliability, exploratory factor analysis and content validity were examined. Findings Results demonstrated high internal consistency (Cronbach’s alpha = 0.85–0.90), robust test–retest reliability (intraclass correlation coefficient = 0.91) and strong construct validity Originality/value This study provides a culturally adapted and psychometrically validated HRQoL scale tailored for Arabic-speaking elderly care home residents. It addresses a significant gap in the availability of reliable tools to assess HRQoL in this population. By ensuring linguistic and cultural relevance, this study offers a robust instrument for evaluating quality of life, guiding interventions and improving care practices. The findings contribute to advancing evidence-based geriatric care in Arabic-speaking contexts, with implications for broader application in similar cultural settings. This work supports efforts to enhance the well-being and dignity of elderly individuals in care homes.

Translating the Public Sphere: Analyzing Linguistic and Cultural Dimensions in Publicistic Texts

This study explores the challenges and strategies involved in translating publicistic texts, which are characterized by their rich use of figurative language, complex syntactic structures, and culturally specific references. Publicistic texts play a critical role in shaping public discourse by conveying ideological and social narratives; however, their translation requires more than a literal rendering. Drawing on theories of figurative language (Glucksberg & McGlone, 2001) and intercultural communication (Iriye, 1979; Kulikova et al., 2017), the research examines how translators navigate linguistic complexities—such as idiomatic expressions and non-standard syntactic forms—while also adapting culturally embedded elements for target audiences. Employing a qualitative methodology that integrates comparative discourse and content analyses of selected texts and their translations, the study identifies common translation strategies, including domestication and the use of explanatory notes, as well as the inherent tensions between fidelity to the source and cultural adaptation. The findings underscore the translator’s role as an active mediator who shapes the final text, influencing its ideological and cultural impact. This research contributes to translation studies by offering insights into the effective handling of linguistic and cultural nuances in the public sphere, with implications for both academic practice and professional training.

Cultural and Linguistic Adaptation of International Students at Russian Medical Universities: A Narrative Case Study

In the context of the intense internationalization process of higher education institutions globally, and amid the emergence of the conception of transcultural universities whereas students encounter the complex and multidimensional character of cultural and linguistic diversity, the effectiveness of international students’ cultural adaptation is becoming more salient than ever. In this paper, accordingly, the authors aimed at gaining an insight to foreign students’ cultural and linguistic adaptation process at Russian medical universities. International students from 49 countries were surveyed enabling respondents to elaborate on their intercultural experiences in Russia. Narratives were gathered from foreign students (N = 200) and investigated applying Polkinghorne’s concept of narrative analysis followed by the application of an innovative method, the identification of linguistic lacunas (lexical gaps) between students’ native languages and the Russian language. Linguistic lacunas were identified in 28 cases from the semantic domains of food, national holidays, personality traits, urban and rural areas, restaurants, nature, communication, transportation, local government, habits, events, and artifacts. 97% of respondents were able to evoke a best experience in Russia, that shed light on the following major thematic groups: travel, friends, cuisine, local events, and university. Worst experiences were revealed by 84,5% of students – those originated from the domains of language, cultural differences, weather, infrastructure, unpleasant events, racism, discrimination, and bureaucracy. 50,5% of respondents were parts of an intercultural misunderstanding or conflict, mostly due to the language barrier, discrimination, bad behavior of locals, lack of cultural knowledge, and racism. Results of the study can be effectively utilized primarily in the preparation of and assistance to international students in Russia to alleviate their cultural adaptation process by enhancing their intercultural awareness and transcultur

Using the ADAPT guidance to culturally adapt a brief intervention to reduce alcohol use among injury patients in Tanzania

Harmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) in emergency departments (EDs) effectively reduce alcohol intake and re-injury rates. However, most BNIs are developed in high-income countries, with limited evidence of their effectiveness in LMICs. To address this gap, we culturally adapted a BNI for alcohol-related injury patients at Kilimanjaro Christian Medical Centre (KCMC), a tertiary hospital in Tanzania. Our study followed the ADAPT guidance to culturally adapt an existing high-income country BNI for use in the KCMC, a tertiary hospital in Tanzania. The adaptation included: 1) a systematic review of effective alcohol harm reduction interventions in similar settings; 2) consultations with local and international healthcare professionals experienced in counseling and substance abuse treatment; 3) group discussions to refine goals and finalize adaptations. The adapted BNI protocol and assessment scales ensured intervention fidelity. At KCMC, 30% of injury patients screened positive for alcohol use disorder (AUD), with a five-fold increased risk of injury, primarily from road traffic accidents and violence. A systematic review highlighted limited data on patient-level interventions in low-resource settings. Our adapted BNI, ‘Punguza Pombe Kwa Afya Yako (PPKAY)’, based on the FRAMES model, showed high feasibility and acceptability, with 84% of interventions achieving ≥80% adherence and 98% patient satisfaction. PPKAY is the first culturally adapted alcohol BNI for injury patients in an African ED. Our study demonstrates our approach to adapting substance use interventions for use in low resource settings and shows that cultural adaptation of alcohol use interventions is feasible, beneficial and empowering for our team. Our study lays a framework and method for other low resourced settings to integrate cultural adaptation into the implementation of a BNI in low resource EDs.

Psychometric validation and cultural adaptation of the Persian Galveston orientation and amnesia test and orientation-log for assessing traumatic brain injury

Post-traumatic amnesia (PTA) is a common symptom of acute traumatic brain injury (TBI). The Galveston Amnesia and Orientation Test (GOAT) and Orientation-Log (O-Log) are commonly used assessment tools to evaluate PTA following TBI. In this study, we aimed to validate the Persian versions of both scales. The forward-backward translation method was used, and a panel of experts, including three neuroscientists, one epidemiologist, and four lay experts with TBI experience, evaluated the scales. A total of 140 mild TBI patients aged 12 years and older were subsequently assessed with scales. Reliability was assessed using two approaches including Cronbach’s Alpha and Intraclass Correlation Coefficient (ICC). The total ICCs were 0.870 (95% CI: 0.818–0.907) and 0.687 (95% CI: 0.564–0.776) for the GOAT and O-Log, respectively. The Cronbach’s alpha values for the GOAT and O-Log were 0.64 and 0.75, respectively. A significant correlation was also found between the GOAT score and the O-Log (r = 0.729, p < 0.001). The Persian GOAT and O-Log were validated as reliable tools for monitoring TBI patients’ orientation. The interviews revealed significant cultural considerations that must be considered when the scales are translated and validated to ensure their validity and reliability in diverse cultural contexts and prevent bias.

Validation of a Swedish version of the National Institute of Health - Chronic Prostatitis Symptom Index.

Chronic primary prostate pain syndrome (PPPS), usually referred to as chronic prostatitis with chronic pelvic pain syndrome (CP/CPPS), affects approximately 10% of all men. The National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) was developed for clinical assessment and research evaluation of this patient category. The objective of this study was to translate the NIH-CPSI into Swedish, including cross-cultural adaptation and testing it for validity and reliability. Material and methods: Fifty men with chronic PPPS participated in the testing of a new Swedish questionnaire. The initial translation included forward and backward translation followed by a comprehensive review by anexpert committee. The preliminary Swedish translation was tested for face validity and test-retest reliability. In all steps of the translation, both medical experts and laymen participated. Results: The Swedish translation showed a high degree of consistency with the original version. A few cultural adaptations were jointly agreed upon. The questionnaire was assessed to be clear to understand and having good face validity. The test-retest reliability showed an intraclass correlation (ICC) of 0.89 (95% confidence interval [CI] = 0.82-0.94) which indicates good to excellent reliability. The standard error of measurement and minimal detectable change were 2.5 and 7.0 respectively. A Bland Altman plot showed no systematic difference between test-retest. Conclusion: This study brings to health care providers and researchers a Swedish version of the internationally recognised NIH-CPSI questionnaire having good validity and reliability, a beneficial addition in the management of men suffering from chronic PPPS in Sweden.

Cultural adaptation, translation and validation of the conflict in adolescence dating relationship inventory (CADRI) in the Greek language.

Dating violence (DV) is a major public health problem with serious consequences for the young population. The Conflict in Adolescent Dating Relationship Inventory (CADRI) is the most internationally used tool to measure DV. However, no tool has been translated, culturally adapted, or validated in the Greek context to assess the prevalence of DV in the Greek population. To culturally adapt, validate, and translate the Conflict in Adolescent Dating Relationship Inventory (CADRI) in the Greek language to ensure its reliability and cultural and linguistic validity in the Greek population. A cross-cultural adaptation process and cross-sectional study were carried out. There were two phases in the research. First, face validity was assessed after the first phase of translation, which included cross-cultural item adaptation, content validation and expert review of the instrument. In the second stage, the scale's psychometric qualities were assessed on a sample of nursing college students. A CADRI instrument was used to assess DV. The final sample comprised a total of 177 university students. The internal consistency and reliability were good (>0.7), with a Cronbach's alpha of 0.889 for the violence perpetrated subscale and 0.925 for the violence suffered subscale, indicating strong correlations between the total item scores. After exploratory factor analysis was performed, the structure obtained was similar to the original structure. Furthermore, 88.7% of university students perpetrated DV in the last year on their partners, and 90.7% suffered DV, with verbal and emotional violence the most common types. This study provides robust evidence of the validity and reliability of the CADRI for measuring DV in the Greek university population. Additionally, the high prevalence makes it necessary to create DV prevention plans and further research, especially among nursing students. Validation of the CADRI in Greece will increase the knowledge of DV in this population, which lacks validated instruments. The results obtained with the CADRI can be applied to the prevention of DV in young people.

Risk Management and Patient Safety; The National Safety and Quality Health Service (NSQHS) Standards

Purpose: The research aims at modifying two Standards of the National Safety and Quality Health Service (NSQHS) framework for UAE healthcare institutions which include both Clinical Governance and Medication Safety standards. This adaptation process is crucial for linking these standards to UAE regulations and healthcare infrastructure because of substantial cultural as well as legal technological and organizational differences between Australia and the UAE. Healthcare facilities in UAE will receive upgraded patient safety and quality of care through standards adaptations which reflect their specific operational needs. Methodology: The analysis methodically evaluates healthcare systems in Australia and UAE by involving their governance structures along with their combination of diverse cultures and system capabilities. A structured framework development method guides standard alignment with the UAE’s regulatory framework and adds suitable leadership strategies for diverse patient populations. The study delves into technology adoption mainly through artificial intelligence (AI) and digital health tools which enhance clinical decision-making ability and patient information retrieval. This analysis determines the implementation feasibility of electronic prescribing and medication tracking frameworks which will support the Medication Safety Standard within the UAE context due to its advanced technology infrastructure. Findings: A comprehensive governance framework requires development in order to achieve compatibility between the Clinical Governance Standard and UAE healthcare framework standards and employee population diversity. A combination of healthcare analytics with AI capabilities leads to substantial improvements in governance decision processes and patient care programs and quality assessment activities. The standard needs effective solutions to address regulatory matching requirements and cultural adaptation needs in order to function properly. Tests show that implementing electronic prescribing systems with nation-wide medication reconciliation programs will improve provider accountability and healthcare professional communication while decreasing medication errors. Adequate technology infrastructure within the UAE promotes these initiatives though the healthcare systems experiences impedance because of technical inconsistencies and regulatory barriers across regions. Unique Contribution to Theory, Practice and Policy: The UAE requires the development of a specific Clinical Governance Framework to fulfill legal requirements and address multicultural patient needs in the nation. Healthcare institutions must use AI and digital health technology to create data-driven decisions and enhance governance operation and quality assessment systems. It is crucial to establish nation-wide medication reconciliation standards across all healthcare facilities so care management remains consistent while minimizing medication errors in the UAE. The adoption of electronic prescribing systems and medication tracking platforms will boost healthcare provider communication by advancing patient protection measures. More research needs to be performed about AI and machine learning integration to expand the range of NSQHS standards and their application in UAE healthcare facilities.

Translation and Cultural Adaptation of the ISTH-Bleeding Assessment Tool to European Portuguese

Introduction: A distinctive bleeding history is the first diagnostic stage of congenital hemorrhagic diseases. Furthermore, since it is in fact an assessment of the patient’s phenotype, it is not a (mere) complementary diagnostic method or test - it is an integral and intrinsic step to establish the patient’s clinical history, which is a medical act. The International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool (ISTH-BAT) is a standardized bleeding assessment tool used during the diagnostic workup of suspected bleeding disorders. This study aimed to translate and culturally adapt the ISTH-BAT questionnaire to the European Portuguese language.Methods: The translation and cultural adaptation were based on the International Society for Pharmacoeconomics and Outcomes Research Guidelines and initiated after obtaining permission from the authors. The process involved three English to European Portuguese independent forward translations and a back translation. Discrepancies were gradually resolved. A harmonized version was presented to hemophilia patients and hemophilia carriers for cognitive debriefing.Results: The forward and back translations did not produce important discrepancies. However, some issues were identified in the cognitive debriefing, which led to the cultural adaptation of medical terms for better understanding.Conclusion: A formal translation and cultural adaptation process ensures that the new version maintains the same concepts as the original. After translation, several changes were necessary to ensure that the questionnaire was understandable by non-medical patients. We propose a European Portuguese version of the ISTH-BAT, which will require validation in further studies.

Reflection Comics: Draw Attention to Intercultural Communication in Context

ABSTRACTMultilingual students learning English face changes in developing intercultural communicative competence outside the classroom. This Classroom Exploration, informed by frameworks of intercultural communicative competence, willingness to communicate, and cultural adaptation, explores the use of reflection comics in a service‐learning course for first‐year international university students. Students created comics depicting key moments during their volunteer work. Analysis of a comic reveals how the medium of a comic with images, speech bubbles, and thought bubbles focuses a student's attention on verbal and nonverbal communication with other participants within a specific social context.

Environmental Ethics in Sub-Saharan African Literature through Myths and Legends

This paper aims to demonstrate how Language, Culture and Environment are linked. It examines the relationship between the Environmental Ethics and the Sub-Saharan African Literature. That is, how do Myths and Legends inspire the respect of the Environmental Ethics in Sub-Saharan Cultures. The method consists of an Anthropological Analysis of some African Myths and Legends from Scholars and other Authors who wrote on African Literature to illustrate the fact that, they carry Rules that govern Environmental Ethics and values that deals with our relationship with the physical milieu around us and how Myths permit to avoid pollution and ensure the protection of the endangered species. A Comparative Study of some Myths, in cultural Contexts, different from the Sub-Saharan one, indicates how Anthropocentric and Ecocide, Myths are. The result is the reality that, most of environmental Problems faced by the Humanity nowadays, are Anthropogenic. The Theoretical approach here is the Cultural Ecology to demonstrate how human adaptation to the natural Environment takes place by the Use of Cultural mechanisms. As a Result, the Paper demonstrate how Sub-Saharan African Literature is Environmentalist for Myths and Legends, constitute Charter for societies concerning Nature. They are Cultural Adaptation to natural Environment. They are adaptive Strategies for people to survive in their natural Environment. They convey messages concerning Rules that govern peoples’ behaviour with social and natural environment. There is a harmony or an interdependence between People and their geographical Milieu. Through Myths and Legends, Sub-Saharan African Literature constitute a School of Ecology. Because, the advocate for a Sustainable Management of Natural Resources, through their beliefs systems. Myths and Legends carry Environmental Ethics. They are cultural strategies for the respect of Environmental values; they communicate fundamental conceptions of nature and society and how people ought to relate and behave with natural environment. The paper demonstrates how the perturbation of Sub-Saharan African Language and Beliefs System by the western Imperialism, disturbed the relationships between people and their physical milieu and how the Environmental Ethics has been demoted, as the result of that fact.

Cross-cultural adaptation, reliability, validity and responsiveness of the hand assessment tool (HAT-Sp) in Spain.

The HAT is a questionnaire designed to measure activity limitations in patients with hand and wrist injuries, without assistance. This study aimed to translate, culturally adapt, and validate the psychometric properties of the HAT-validity, reliability, and responsiveness-for different hand conditions in Spain. Cultural adaptation followed recommendations from the American Academy of Orthopaedic Surgeons (AAOS). Validation adhered to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines and involved 262 hand patients. Reliability was assessed with Cronbach's alpha and intraclass correlation coefficient (ICC) (2,1), for test-retest reliability, the standard error of measurement (SEM) and the smallest detectable change (SDC) were used to assess measurement error. Confirmatory factor analysis (CFA) and construct validity using Pearson's correlation coefficient evaluated validity. Responsiveness was measured using effect size (ES) and standardised response mean (SRM). The adaptation process showed no significant changes, with strong expert agreement (Kendall's W=0.81, p<0.001) and patient difficulty below 15%. Reliability was confirmed with an excellent Cronbach's alpha of 0.91, ICC values of 0.99, and low measurement error (SEM of 0.72 and SDC of 1.41). CFA showed a good model fit (RMSEA of 0.04, SRMR of 0.05). HAT showed a high correlation with DASH (r=0.78, p<0.001) and a weak correlation with EQ-5D (r=-0.07, p>0.05). Responsiveness, assessed in 222 patients, yielded a moderate ES of -0.62 and an SRM of -0.72. The HAT-Sp is a well-adapted and widely accepted tool among both Spanish patients and experts. The study demonstrated its strong reliability, validity, and responsiveness in activity limitation without assistance in patients with various hand and wrist injuries following physiotherapy.

Translation, cross-cultural adaptation and validation of the Persian version of the physical workload questionnaire (PWQ)

BackgroundMusculoskeletal disorders in manual workers are often linked to physical workload factors such as heavy lifting, repetitive movements, and awkward postures. These factors can negatively impact health and work efficiency. Simple tools like questionnaires are essential for studying physical workload. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Physical Workload Questionnaire for Persian-speaking populations (PWQ-Pr).MethodsThe study involved 255 participants and followed standard guidelines for translation and cultural adaptation. Various psychometric properties were assessed, including face validity through interviews, construct validity via hypothesis testing and factor analysis, content validity using the Content Validity Index (CVI), convergent validity through Pearson’s correlation with the Spine Functional Index (SFI), internal consistency using Cronbach’s alpha, and test-retest reliability assessed through the intra-class correlation coefficient (ICC) and standard measurement error over a 10-day period.ResultsGood internal consistency (α = 0.89) and high test-retest reliability (ICC = 0.90, 95% confidence interval: 0.81–0.94) were obtained. Convergent validity was indicated by a correlation of r = 0.41 (P < 0.001) with the SFI questionnaire. Content Validity (CVI = 0.93) was approved. Factor analysis identified two distinct factors within the PWQ-Pr, explaining 52.07% of the variance. Hypothesis testing indicated significant differences in physical workload across job types and among individuals with and without spinal musculoskeletal disorders (MSDs), with eight hypotheses confirmed out of twelve tested.ConclusionsThe Persian version of the Physical Workload Questionnaire (PWQ-Pr) is a reliable and valid tool for assessing physical workload among Persian-speaking individuals. It is effective in evaluating workload across various job tasks.

The Turkish validity and reliability of Addenbrooke's Cognitive Examination III.

Addenbrooke's Cognitive Examination III (ACE-III) was developed as a screening tool for cognitive disorders. Many countries have proven the cultural adaptation, reliability and validity of ACE-III. To make cultural adaptations of ACE-III for the Turkish population and to examine its validity and reliability. First, ACE-III was translated and adapted into Turkish (ACE-III-TR), then its validity and reliability were examined. The study included 234 people: 93 with dementia (78 Alzheimer's disease (AD) and 15 frontotemporal dementia (FTD)), 46 with mild cognitive impairment (MCI) and 95 healthy. Two blinded speech and language therapists rated the ACE-III-TR simultaneously for interrater validity. The same practitioner retested the same participants 2 weeks later for test-retest reliability. The construct validity of the culturally adapted test was assessed by analysing subsection correlations with the ACE-III-TR total score. The association between the Mini-Mental State Examination (MMSE) total score, relevant subsections and ACE-III-TR total score was examined for criterion validity. Intergroup differences for healthy, MCI and dementia were studied for ACE-III-TR subsections and total score, and cut-off scores were calculated for total score with sensitivity and specificity in differential diagnosis. Attention, memory and ACE-III-TR total scores showed a statistically significant difference between the three groups of dementia, MCI and healthy (p<0.001). Statistically significant positive correlations ranging from 0.571 to 0.929 were found between ACE-III-TR subsections and total scores (p<0.05). A highly significant positive correlation was found between MMSE total score and ACE-III-TR total score (r=0.870). Between the second and first measurements, positive, moderately significant correlations were found for all subsections and ACE-III-TR total (ICC=0.508-0.784, r=0.477-0.646). A high level of agreement was found between two raters for all ACE-III-TR subsections and the ACE-III-TR total score (alpha=0.9296-0.99995). The total ACE-III-TR cut-off score was 79.5 for healthy and MCI and 69.5 for MCI and mild stage dementia. This study found that ACE-III-TR is a sensitive and specific screening test for the diagnosis of MCI and dementia that has high validity and reliability. ACE-III-TR was found to be a valid and reliable tool in dementia, including AD and FTD, and in mild, moderate and advanced dementia. By providing a more comprehensive assessment of a person's cognitive profile, it can help the clinician make a differential diagnosis of MCI and dementia. ACE-III-TR may be useful in monitoring the progression of cognitive deficits in clinical practice, research studies and therapy follow-up processes. What is already known on the subject ACE was used as a screening tool to detect MCI and to differentiate AD from FTD. ACE was revised by Hsieh etal. in 2013 and updated as ACE-III, which has the advantages of assessing five cognitive domains, not requiring the use of additional materials, and providing an effective and sensitive measurement in a short time. However, the validity and reliability study of the ACE-III in Turkish has not been conducted. What this study adds to the existing knowledge This study demonstrates the validity and reliability of the Turkish ACE-III (ACE-III-TR), which is a sensitive and specific screening test for the diagnosis of MCI and dementia. What are the practical and clinical implications of this work? The ACE-III-TR can provide clinicians and patients with a quick and brief general cognitive screening, indicating both the patient's overall cognitive profile and the measures of each of the assessed domains. By providing a more comprehensive assessment of a person's cognitive profile, it can help the clinician make a differential diagnosis of MCI and dementia. ACE-III-TR may be useful in monitoring the progression of cognitive deficits in clinical practice, research studies and therapy follow-up processes.

Arts Sector Research in Development

Despite good intentions, academic research often reflects an extractive model and is not always seen as useful within the Canadian arts sector. Mass Culture is a non-profit organization that aims to bring together cultural workers and academics in support of collaborative research and better knowledge mobilization. To that end, their Research in Residence (RinR) initiative involved complex collaborations between the arts sector and academia to explore five applied research projects on a topic of shared importance to participants - that is, articulating the value of the arts through qualitative rather than quantitative measurements. To learn from the experimental research design, participants conducted a developmental evaluation with five lines of inquiry: benefits and effects, program design adaptations, values alignment, efficacy and potential, and knowledge mobilization and research engagement. The evaluation had three purposes: (1) to gather data and facilitate analysis of the key questions that the initiative was trying to understand; (2) to inform Mass Culture's implementation and adaptation of the initiative; and (3) to generate insights on principles and practices that could inform the design of future initiatives. This article considers the second and third purposes, outlining key lessons learned that shaped the initiative and/or should inform future projects.

Measuring autonomy and respect: a qualitative, cross-cultural adaptation of the Mothers Autonomy in Decision Making scale and Mothers on Respect index instruments in Danish

ObjectiveDecision-making is important in user-involved maternity care and patient experience instruments Mothers Autonomy in Decision Making scale (MADM) and Mothers on Respect index (MORi) are used internationally to measure the user involvement quality and users’ experiences of autonomy and respect. This study aimed to translate and qualitatively adapt the original MADM and MORi instruments to the Danish language and culture. MethodsA forward and backward translation using a standard guideline. Subsequently, qualitative interviews to refine the translation and cultural adaptation by pilot testing the scales. ResultsThe translation process showed cultural differences linked to linguistic variations between Danish and English. Cognitive interviews with 14 diverse pregnant women revealed challenges in women's understanding of decision-making in maternity care. Changes in wording and assisting descriptive texts were made. Further, the order of the MADM items was changed to improve the understanding of decision-making. DiscussionPrimarily, the discussion concerns how decision-making can be understood in the context of maternity care and why women's understanding of decision-making in Danish maternity care in the MADM scale items was challenged. ConclusionThe qualitative pilot test using cognitive interviews after translation of the instruments was a valuable method for cultural adaptation providing important knowledge on women's understanding and perceptions of item contents. The cognitive interviews provided a comprehensive understanding of decision-making and contributed to a thoroughly worked Danish version of the MADM and MORi instruments.

Development and cultural adaptation of text messages for promoting healthy eating among Amazonian schoolchildren.

To develop text messages for a mHealth intervention promoting healthy eating among Amazonian schoolchildren. Two rounds of expert panel analysis and formative research interviews. Western Brazilian Amazon, Cruzeiro do Sul, Acre, Brazil. Included 17 healthcare professionals and 40 caregivers of school-aged children enrolled in the Maternal and Child Health and Nutrition in Acre birth cohort study. Evaluation focused on messages' cultural appropriateness, comprehensibility, and relevance, along with caregivers' understanding and intention to adhere to the recommendations. Quantitative analysis employed the modified Cohen Kappa, the Scale-Content Validity Index Average (S-CVI-Ave), frequency calculations, and a ranking system. Fifty-five text messages were drafted. In the initial stage, eight messages did not achieve a sufficient score and were subsequently revised and reevaluated, ultimately gaining approval. The S-CVI-Ave for each domain was as follows: cultural appropriateness=0.97, comprehensibility=0.96, and relevance=0.97. Formative research indicated a 92% understanding rate and a 70% intention rate to adhere to the proposed suggestions. The final set of messages was successfully culturally adapted and will contribute to the translation and dissemination of Dietary Guidelines for Brazilian Population recommendations to Western Amazon families.

Translating Paratexts in Digital Media: Exploring Problems and Strategies

This study aimed to explore the problems and strategies of translating paratexts in digital media through content analysis, comparing the English and Arabic paratextual elements of six media digital sources, including the BBC News website, Al Arabiya blog, and Reuters forum. The study identified several translation problems, including culturally specific terms, cultural references, conflicting verbal and paratextual components, and reframing the narrative functions of paratexts. The emergent themes revealed that 97% of the problems were attributed to terminology and lexical choices, whereas 83% were related to the integration of visual elements. Themes of cultural adaptation for governing the content of paratextual elements and reframing the narrative functions of paratexts each reached 80%. The emergent themes also revealed the strategies that translators use to address the translation of paratexts. These strategies include employing the translation adaptation approach (95%), applying functional translation (90%), using thematic analysis for intralinguistic subtitles (87%), using multimodal transcription (85%), and using transposition (82%). The study recommends replacing cultural references, idioms, or symbols with equivalents that resonate with the target audience. Functional equivalence ensures that translated paratexts serve the same purpose in the target language, adhering to cultural norms. The study highlights the distinction between traditional criteria for identifying paratexts and the functionality of translation in identifying digital paratexts. Understanding functional equivalence dynamics can help translators produce high-quality translations for the digital era. Thus, the study contributes to the fields of translation studies, translation and culture studies, and translation and information technology.

Translation, validation, and reliability of the Modified Occupational Questionnaire into Bahasa Melayu among older persons in Malaysia.

A Modified Occupational Questionnaire (MOQ) is a self-report questionnaire that records the occupational engagement of an individual hourly, focusing on activity category, reason for doing the activity, value to self, and value to society. Understanding the patterns of occupational engagement and meaningful time use in older persons is crucial for predicting physical and psychological health and establishing occupation-based interventions to support healthy aging. However, the MOQ, originally developed in an English-speaking country and may potentially be less suitable for Malaysian older persons, who are predominantly Malay-speaking and have distinct cultural adaptations. This study aimed to translate the MOQ from English to Bahasa Melayu and evaluate its validity and reliability among older persons in Malaysia. The translation, validation, and reliability assessment process followed guidelines from the World Health Organization, with adaptations from Sousa and Rojjanasrirat's recommendations. The process encompassed five steps: forward translation, harmonisation of the forward translation, backward translation, pretesting and cognitive interviews, and psychometric testing to assess the validity and reliability. The Malay version of the MOQ (MOQ-M) demonstrated excellent item-level face validity index (I-FVI) and average scale-level face validity index (S-FVI/Ave), both scoring a perfect 1.00. Additionally, it exhibited excellent item-level content validity index (I-CVI) and average scale-level content validity (S-CVI/Ave), with scores ranging from 0.90 to 1.00 and 0.99 to 1.00, respectively. Internal consistency, measured using Cronbach's alpha, surpassed the minimum threshold for good reliability, with all three average scales in MOQ-M scoring between 0.84 and 0.99. Weighted average Cohen's Kappa coefficient revealed substantial agreement in the test-retest reliability across the three scales. The MOQ-M is a valid and reliable instrument for assessing meaningful time use among Malay-speaking older persons in Malaysia. There was no consumer and community involvement in this study. This study aimed to translate the Modified Occupational Questionnaire (MOQ) into Bahasa Melayu (MOQ-M). The MOQ is a tool used by occupational therapists to understand how unemployed people spend their time and the reasons they are doing it. The translation was necessary because the original version of the MOQ was developed in an English-speaking country and might not be suitable for the Malay-speaking population in Malaysia due to cultural differences. A careful process was followed to make sure the translation was accurate and reliable. The translated version, MOQ-M, was then tested with older persons, most of whom were unemployed, to learn about their daily activities and the reasons for doing them. Understanding their daily routines is important for predicting their health and well-being. The results showed that the MOQ-M worked well, providing useful and consistent information. This means that the tool is reliable and can be trusted to measure how older persons spend their time and what activities are important to them. With this information, programmes can be created to better support older persons, helping them live healthier and happier lives as they age. However, it is important to note that most of the study participants were Malay, so this may not fully represent the different cultural groups in Malaysia.

Reliability and validity of the Spanish version of the Breastfeeding Motivation Scale (BMS). An approach to maternal mental health through psychological factors

BackgroundThe decision to breastfeed can be complex due to the significant benefits of breastfeeding and the various barriers that mothers have to face. In this context, it is important to have adequate instruments that provide insight into a mother's motives for breastfeeding. AimGiven the absence of instruments in this language, this study focuses on translating and validating the Breastfeeding Motivation Scale (BMS) in Spanish mothers. MethodAfter cultural adaptation and an item clarity assessment with a pilot sample (n = 28), exploratory factor analysis was conducted with a preliminary sample (n = 118). The main study involved 193 Spanish primiparous mothers, aged 24-48 (M = 34.5; SD = 4.2), recruited within two months postpartum, where confirmatory factor analysis, internal consistency, group comparisons, and validity measures were explored. ResultsThe findings (χ2=358.925, df=183, p<0.001, CFI=0.971, TLI=0.967, SRMR=0.079, and RMSEA=0.071 [90% CI: 0.060-0.081]) supported the existence of four motivational factors for breastfeeding: i) external and identified, ii) intrinsic, iii) integrated, and iv) introjected motivation. The four factors of the scale showed excellent internal consistency (ωo ranging from 0.77 to 0.92), as well as good convergent and discriminant validity regarding theoretically-related variables (breastfeeding self-efficacy, positive attitude towards breastfeeding, and postpartum depression). Additionally, the scale showed incremental validity with respect to breastfeeding self-efficacy, but not regarding postpartum depression. DiscussionThe BMS evidenced good psychometric properties in Spanish primiparous mothers. The findings are discussed in the context of Ryan and Deci's self-determination theory, also reviewing the study's limitations and implications.