Forward Translation Research Articles

Danish translation and linguistic validation of the GENDER-Q, a patient-reported outcome measure for use in gender-affirming care

BackgroundGlobally, the number of individuals identifying as transgender and gender-diverse [TGD] has grown in the last decade. This study aimed to perform a Danish linguistic translation and cultural adaptation of the GENDER-Q, a new patient-reported outcome measure [PROM] designed to evaluate outcomes of gender-affirming care.MethodsThe field test version of the GENDER-Q (959 items) was translated into Danish using guidelines from the International Society of Pharmacoeconomics and Outcomes Research and the World Health Organization to ensure accuracy, cultural relevance, and validity. This included two forward translations, a backward translation, an expert panel meeting, and two rounds of patient cognitive interviews.ResultsThe forward translations resulted in revisions of 142 items, which were then harmonized to form the backward translation version. A comparison of the back translation to the original questionnaire led to a total of 43 changes to items and response options. The revised version was reviewed in an expert panel meeting and minor changes were made with 28 patient participants using cognitive debriefing interviews. The translated version was proofread, resulting in the Danish translation of the GENDER-Q.ConclusionsThe GENDER-Q was translated and culturally adapted for use in the Danish TGD adult population. The GENDER-Q has the potential to enhance the understanding and improvement of treatment and health-related quality-of-life outcomes for adults seeking gender-affirming care.Level of Evidence:Not gradable.

Question the promise: validating the interprofessional attitudes scale in Vietnamese health students

ABSTRACT The Interprofessional Attitudes Scale (IPAS) is a promising tool for assessing interprofessional education (IPE) attitudes, especially in community-oriented initiatives. To meet the need for validated IPE tools in Vietnam, we translated the IPAS into Vietnamese (Viet-IPAS) and evaluated its psychometric properties. The preparatory phases included forward and backward translation, expert consultations, and student feedback, resulting in strong content validity, face validity, linguistic comprehensibility, and test-retest reliability. During the 2020–2021 academic year, health students from the University of Medicine and Pharmacy at Ho Chi Minh City were invited for the main phase. A total of 282 students from medical, nursing, pharmacy, and rehabilitation science programs completed an online survey using the Viet-IPAS. Cronbach’s alphas for the Teamwork, roles and responsibilities (TRR), Patient-centeredness, Interprofessional biases (IB), Diversity and ethics, and Community-centeredness subscales were .84, .79, .56, .86, and .81, respectively. Confirmatory factor analysis indicated an acceptable fit (normed χ2: 2.618, RMSEA: .076, CFI: .874, AGFI: .77). Factor loadings were above .70, except for IB3 and TRR8 items. Modified models by removing IB subscale and TRR8 item showed slightly improved fit. We recommend using the Viet-IPAS with modifications in Vietnamese health student populations and encourage further review and refinement of the instrument.

Cross-Cultural Validation of Knowledge About Atrial Fibrillation and Stroke Prevention Questionnaire: A Cross-Sectional Study Among Chinese Patients With Atrial Fibrillation.

To cross-culturally adapt the Knowledge about Atrial Fibrillation and Stroke Prevention Questionnaire (KAFSP-Q) for Chinese AF patients and validate its effectiveness. Instrument adaptation and cross-sectional validation. The KAFSP-Q was translated into Chinese by using the forward and back translation method. Experts and patients were invited to revise the questionnaire domains and items. The psychometric properties of the Chinese version of the KAFSP-Q were evaluated, that is, its construct validity, discriminant validity, convergent validity, internal consistency and test-retest reliability. The Chinese version of the KAFSP-Q consists of 41 items and six domains, namely, bleeding knowledge, AF complications, stroke risk and stroke prevention, stroke symptoms, AF symptoms and general AF knowledge. The Chinese version of the KAFSP-Q demonstrated acceptable content validity (scale-content validity index = 0.859). The exploratory factor analysis revealed six factors, which accounted for 65.725% of the total variance, and the confirmatory factor analysis revealed acceptable fit indices. The convergent validity was poor, because the average variance extracted coefficient of the six domains was lower than 0.500. The square root of the average variance extracted coefficients was higher than the bivariate correlation between the domains, which indicated an acceptable discriminant validity. Meanwhile, the internal consistency and test-retest reliability were satisfactory (Cronbach's α coefficient = 0.973, intraclass correlation coefficient = 0.872). The Chinese version of the KAFSP-Q demonstrates acceptable validity and reliability and can be used as a valuable instrument for AF and stroke prevention knowledge evaluation. In clinical practice, the Chinese version of the KAFSP-Q can be used to help patients increase their disease management knowledge and engage in effective disease management behaviour. Future research is necessary to confirm the psychometric properties of the questionnaire with samples that are highly representative. No patient or public contribution.

Translation and validation of the 8-item contact lens dry eye questionnaire (CLDEQ-8) among Chinese soft contact lens wearers.

To develop a Chinese version of the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) with cross-cultural adaption and clinical validation among soft contact lens wearers (SCL) in China. The translation and adaptation of the Chinese CLDEQ-8 (C-CLDEQ-8) followed a rigorous methodological process based on cross-cultural research guidelines consisting of three main phases: 1) forward and backward translation of original CLDEQ-8 into Chinese, 2) cross-cultural adaptation performed by medical advising committee, and 3) clinical validation and repeatability test of the translated questionnaire on Chinese SCL wearers. Rasch analysis was also performed to investigate the psychometric properties of C-CLDEQ-8. 134 experienced SCL wearers aged 18-45 completed the C-CLDEQ-8. C-CLDEQ-8 score was linearly related to the overall opinion of SCLs (beta=2.16, p=0.002), gestalt eye dryness response (beta=2.90, p<0.001), and sensitivity response (beta=1.83, p=0.001). The questionnaire showed excellent test-retest repeatability with an intra-class correlation coefficient (ICC) of 0.95 and great internal consistency with a Cronbach's alpha of 0.83. The corrected index of homogeneity for each item was more significant than 0.5. In Rasch analysis, the infit and outfit values for eight items were all within 0.6-1.4, suggesting a good fit for the Rasch model. Martin-Löf test result indicated that the Rasch model was unidimensional (p=1.0). Item characteristics curves suggested combining categories 3-4 and 5-6 in item 5 of C-CLDEQ-8. This study produced a Chinese version of CLDEQ-8 with great validity and reliability and proved capable of evaluating SCL-related symptoms.

Hummingbirds use compensatory eye movements to stabilize both rotational and translational visual motion.

To maintain stable vision, behaving animals make compensatory eye movements in response to image slip, a reflex known as the optokinetic response (OKR). Although OKR has been studied in several avian species, eye movements during flight are expected to be minimal. This is because vertebrates with laterally placed eyes typically show weak OKR to nasal-to-temporal motion (NT), which simulates typical forward locomotion, compared with temporal-to-nasal motion (TN), which simulates atypical backward locomotion. This OKR asymmetry is also reflected in the pretectum, wherein neurons sensitive to global visual motion also exhibit a TN bias. Hummingbirds, however, stabilize visual motion in all directions through whole-body movements and are unique among vertebrates in that they lack a pretectal bias. We therefore predicted that OKR in hummingbirds would be symmetrical. We measured OKR in restrained hummingbirds by presenting gratings drifting across a range of speeds. OKR in hummingbirds was asymmetrical, although the direction of asymmetry varied with stimulus speed. Hummingbirds moved their eyes largely independently of one another. Consistent with weak eye-to-eye coupling, hummingbirds also exhibited disjunctive OKR to visual motion simulating forward and backward translation. This unexpected oculomotor behaviour, previously unexplored in birds, suggests a potential role for compensatory eye movements during flight.

Cultural adaptation process of six stigma assessment scales among Kannada speaking population in South India

Abstract For several years stigma researchers in India have relied on Western instruments or semi-structured stigma scales in their studies. However, these scales have not been rigorously translated and adapted to the local cultural framework. In the current study, we describe the cultural adaptation of six stigma scales with the purpose of using it in the native language (Kannada) based on translation steps of forward translation, expert review and synthesis, cultural equivalence, back translation and cognitive interview processes. Several items were modified in the target language at each stage of the cultural adaptation process as mentioned in the above steps across all scales. Cultural explanations for the same have been provided. Concepts such as “community forest” and “baby sitting" was replaced with equivalent native synonyms. We introduced native cultural and family values such as “joint family system” and modified the item of housing concept in one of the tools. The concept of “privacy” in the Indian rural context was observed to be familial than individual-based and modification of corresponding items according to the native context of “privacy”. Finally, items from each scale were modified but retained without affecting the meaning and the core construct.

Translation and Cross Language Validation of Submissive Behavior Scale in Urdu Language

This study aimed to translate the Submissive Behavior Scale (SBS) into Urdu and validate its psychometric properties within the Pakistani context. Conducted in three phases, Phase I involved translating the scale into Urdu by two psychologists and a bilingual expert, following Brislin's (1976) standard translation procedure, which included forward translation, item reconciliation, and back translation. In Phase II, cross-language validity was assessed with 30 adults (15 women and 15 men) aged 18-45 years, showing significant correlations between the original and translated versions, with coefficients ranging from .62 to .84. Phase III involved validating the translated scale with a larger sample of 200 adults (82 men and 118 women), revealing that the Urdu-translated SBS is empirically equivalent to the English version. Confirmatory factor analysis initially indicated a need for model improvement, with CFI = .71, TLI = .66, χ² = 198.78, p &lt; .01, and RMSEA = .10. After applying modification indices, the final model showed improved fit indices: TLI = .90, CFI = .91, χ² = 118.22, p = .04, and RMSEA = .05, confirming an acceptable model fit. The test-retest reliability of the Urdu-translated scale was high, with internal consistency (α = .78) and test-retest reliability (r = .82). The results demonstrate that the Urdu version of the SBS is a reliable and valid instrument for assessing submissive behavior in Pakistani populations.

Validity and Reliability Assessment of the Arabic Version of the Social and Emotional Competencies Questionnaire in a Moroccan Nursing Student Population

Objective: The Social and Emotional Competencies Questionnaire (SEC-Q) represents one of the existing tests for assessing these competences in students. The purpose of the present research was to examine the psychometric properties of the SEC-Q in Moroccan nursing students. Method: A sample of 320 Moroccan nursing students, including 190 women and 130 men, was selected using a stratified convenience sampling method. Methodology consisted of forward and backward translations, linguistic adaptation, and pilot revision. Structural validity was investigated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed through test-retest analysis using Pearson's correlation. Results: Factor analyses produced a four-factor version of 16 items with a range of factor loadings from 0.72 to 0.89. Cronbach's alpha values were 0.92 for the self-awareness factor, 0.91 for the self-management factor, 0.90 for the social awareness factor, and 0.92 for the decision-making factor. These high values indicate excellent reliability. The test-retest coefficient for a 20-day interval between two assessments gave an rtt value of 0.92, demonstrating excellent response reliability. A strong correlation between the SECQ-AV, WLEIS and PSS-CP was found, demonstrating satisfactory convergent and divergent validity (P &lt; 0.05). Conclusion: The Arabic version of SECQ demonstrated its validity and reliability for assessing social and emotional competencies in Moroccan nursing students. However, the sample selected was drawn from a single nursing training institute, which limits the representativeness of the entire student population, and makes it difficult to generalize the results. A cross-sectional study will therefore produce much more varied results, by including a very large sample from different regions and different nursing training institutes in Morocco.

Assessing ambulance staff attitudes toward mental health conditions: translation and psychometric evaluation of the medical condition regard scale among ambulance staff

IntroductionAmbulance staff play a crucial role in responding to mental health crises. However, negative regard toward patients with mental health conditions can hinder care. The Medical Condition Regard Scale (MCRS) assesses regards or attitudes but has not previously been validated for educated ambulance staff and has never been translated into Norwegian. This study aims to translate the instrument into Norwegian, test it on a population of ambulance staff, explore the psychometric properties of the Norwegian version, and measure regard for patients with psychosis.MethodThe MCRS is an 11-item instrument with a Likert scale of 1–6. Possible sum scores range from 11 to 66 (higher score = more positive regards). We chose “psychosis” as the condition to investigate. Translation followed eight steps: (1) preparation, (2) forward translation, (3) backward translation, (4) first expert panel review, (5) harmonisation, (6) cognitive debriefing, (7) second expert panel review, and (8) writing of the final version. The instrument was tested and re-tested regarding the condition “psychosis” on a representative sample of 114 Norwegian ambulance staff in 2023, with a temporal gap of one month. We explored item scores and distribution, as well as floor and ceiling effects. We tested the internal consistency of the items using Cronbach’s Alpha and consistency in answers over time (test and re-test) using the Paired Sample-T test. We used factor analyses to explore the inter-item relationships of the items.ResultsThe 114 participants had a mean sum score of 47, which is mid-range. The scale has a ceiling effect on five items, which was not described in detail earlier. Two items regarding the monetary spending on patients with the given condition had the largest ceiling effects. However, the Norwegian translation showed adequate internal consistency (Cronbach’s Alpha = 0.82) and is reliable over time. Test and re-test showed no significant differences in the scale’s total score (Paired sample T-test, p > 0.05). Exploratory and confirmatory factor analyses indicate that the scale should be used as a one-dimensional instrument in a Norwegian setting in ambulance staff populations.ConclusionThe Norwegian translation of the MCRS is a reliable instrument for ambulance staff measuring medical condition regards. However, the ceiling effect limits the ability to discern differences among high-scoring individuals. Ambulance staff’s regard for patients with psychosis is medium positive (mid-range level), but slightly more positive than what is reported in the international literature regarding patients with mental health issues.

Italian version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability.

To translate and cross-culturally adapt the Headache Disability Inventory (HDI) into Italian and study its reliability and validity. A total of 132 participants with primary and secondary headaches were included. The translation was performed following international guidelines with forward and back translation procedures. Structural validity, internal consistency, test-retest reliability, measurement error, and construct validity were studied. Test-retest reliability and measurement error were tested on a subsample of 32 participants. The cross-cultural adaptation into Italian was performed without issues. Confirmatory factor analysis supports the structural validity partially (comparative fit index = 0.963; Tucker-Lewis index = 0.959; root mean square error of approximation = 0.051; standardized root mean square residual = 0.084), showing a two-factor structure (i.e., emotional and functional). Each subscale presented high internal consistency (α = 0.87 and 0.87 for the emotional and functional subscales, respectively), excellent and good test-retest reliability (intraclass correlation coefficient = 0.93 and 0.88 for the emotional and functional subscales, respectively), and acceptable measurement error (standard error of the measurement [SEM] = 3.6 points, minimal detectable change [MDC] = 10.0 points for the emotional subscale; SEM = 3.8 points, MDC = 10.7 points for the functional subscale). Construct validity was satisfactory for the emotional subscale and moderate for the functional subscale, as 85.7% (6/7) and 57.1% (4/7) of a priori hypotheses were met, respectively. The HDI was successfully translated into Italian and has acceptable psychometric properties. The Italian version of the HDI can be used in daily clinical practice and research to assess the functional and emotional impact of primary and secondary headaches. Further research should study other psychometric properties (i.e., content validity, responsiveness, and reliability in a larger sample).

Cross‐Cultural Translation of the Adolescent Menstrual Bleeding Questionnaire (AMBQ)

ABSTRACTAimHeavy menstrual bleeding (HMB) affects up to 37% of adolescents. Given the paucity of available tools to assess health‐related quality of life (HRQoL) in adolescents with HMB, we developed the adolescent menstrual bleeding questionnaire (aMBQ), a valid and reliable measure of bleeding‐related quality of life. The aim of this study was cross‐cultural translation and adaptation of the English aMBQ into French to ensure accessibility for more Canadian adolescents who menstruate.MethodsA five‐step process was followed: (1) forward translation from English to Canadian French; (2) backward translation from French to English; (3) review of source and translated aMBQ to create a reconciled version; (4) cognitive debriefing to ensure linguistic and clinical equivalence and (5) review of cognitive debriefings to produce the final version of the French aMBQ. Results of cognitive debriefings were reviewed after every three participants; items were revised if presented as an issue by ≥2 participants. These changes were implemented and tested in cognitive debriefings until saturation was reached.ResultsLinguistic changes were made to nine (33%) of the questions and one (3.7%) answer options. Major changes were made to four of the 27 questions (15%), and minor changes were made to five of the 27 questions (19%).ConclusionProfessional translators, clinical experts and patient input through cognitive debriefing are pivotal to successful cross‐cultural translation. Results of cognitive debriefing interviews suggest the French aMBQ is easily understood and confirms its face validity.

Voice Handicap Index-Throat: Translation and Cross-Cultural Adaptation to the Arabic Language.

This study aims to validate and assess the reliability of the Arabic version of the Voice Handicap Index-Throat (VHI-TA), as a self-reported questionnaire for patients with throat difficulties. A prospective, observational, cross-sectional, and descriptive study was performed in the ear, nose, and throat department of Kafr El-Sheikh University hospitals from October 2023 to July 2024. The preliminary VHI-TA was obtained through forward and backward translation. All participants were asked to fill out the Arabic version of VHI-T twice, 2 weeks apart, to test reliability. We tested the Arabic version for internal consistency, reliability, validity, sensitivity, and specificity to produce an Arabic-validated patient questionnaire. The questionnaire's internal consistency was assessed using Cronbach's alpha coefficient. Cronbach's alpha coefficient was calculated for each of the 10 items and for the total score to assess the reliability. Cronbach's alpha coefficient ranged from 0.961 to 0.986 for the 10 items (acceptable to excellent internal consistency) and 0.997 for total score (excellent internal consistency). The corrected item-total correlation values varied between 0.951 and 0.978. There was a significant difference between all domains and the total score of the VHI-TA tool (significantly higher among case group). Our results showed that the VHI-TA is a trustworthy and valid questionnaire for estimating self-perceived throat issues. In clinical practice, the VHI-TA is anticipated to identify a group of throat discomforts that are prevalent in our patients and that are only tangentially addressed by other instruments.

Empowering informal caregivers and nurses to take a person-centred view: adaptation and clinical utility of the Integrated Palliative Outcome Scale (IPOS-Dem) for use in acute and community care settings

BackgroundDementia is a progressive and terminal illness. Symptoms are present for people with dementia across all stages, leading to poor quality of life and considerable carer burden. In acute and community care services, no holistic, person-centred outcome tools are available for nurses and informal caregivers to measure symptoms and needs from the person`s with dementia point of view. We therefore undertook validation (exploring semantic/conceptual equivalence, content validity, and views on clinical utility) for a measure (IPOS-Dem) in the community and acute care setting in Switzerland.MethodsThis was a rigorous, multi-step, cross-sectional, multi-method study conducted with nurses and relatives caring for people with dementia in the community and acute care setting. Multiple components were aligned: 1) forward and backward translation from German to Swiss German to achieve semantic equivalence; 2) focus groups to explore clinical utility and conceptual equivalence; 3) cognitive debriefing to review content validity. An expert review was included at the end of each phase.ResultsSix people from the public and 24 nurses/relatives were included. Semantic equivalence was achieved after making 14 changes to the wording of items. Participants judged the IPOS-Dem (CH) as a clinically useful intervention in the domains of appropriateness, accessibility, practicability, and acceptability for the following reasons: (1) it enables support for informal caregivers, (2) it provides an overview of the priorities of care, thus supporting symptom review, (3) it allows nurses with different qualifications to contribute critical observations, thus fostering communication and teamwork, and (4) it increases an awareness of change in symptoms throughout the disease trajectory. In the cognitive debriefing interviews, setting and respondent-dependent differences in the conceptual understanding of item descriptors were observed for 11 of 31 items.ConclusionIn this novel work, we demonstrate the newly-translated and culturally-adapted IPOS-Dem (CH) is a relevant and comprehensive measure for persons with mild to severe dementia. It can aid a generalist workforce across settings to assess palliative care-relevant symptoms and concerns.

Translation and psychometric properties of the comfort behavioral scale-Persian version

BackgroundManaging pain and the level of sedation of critically ill children admitted to the intensive care unit is a complex process and one of the most basic problems of nurses, which requires the use of an available valid, and reliable scale. The present study aimed to translate the comfort behavioral scale into Persian and check its validity and reliability.MethodsThis methodological research was carried out in the children’s hospitals of Tehran Province (Iran) from Nov 2023 to Apr 2024. After forward and backward translation, face validity was performed qualitatively and quantitatively. Then, qualitative content validity was checked and the content validity ratio and content validity index were measured. The discriminant validity method was used to determine construct validity, and the nurse interpretation sedation scale and nurse report pain scale were used to check the criterion validity. The concordance correlation coefficient method was used to determine reliability.ResultsIn quantitative face validity, all 30 items received an impact score of more than 1.5. In qualitative content validity, some words were replaced with more concrete words. In the content validity ratio, considering the minimum value of 0.62 for 10 experts, none of the items were excluded. The content validity index for all items was higher than 0.8 and S-CVI/Ave for the whole scale was 0.96. There was a significant difference between the pain score in the painful state (24.87 ± 2.5) and the resting state (20.9714 ± 2.4) (P = 0.000). The correlation between Comfort and criterion instruments (NISS and NRS) in a resting state and during a painful procedure was positively significant (P < 0.05). The kappa agreement coefficient showed values higher than 0.4 and reliability was confirmed.ConclusionsThe Persian version of the COMFORT behavioral scale has good validity and reliability and can be used as a suitable tool for pain management of hospitalized children with a low level of consciousness and lack of verbal communication. The use of this tool not only helps the clinical, educational, and research process but also leads to an increase in the quality of care and satisfaction of the child and her parents in Iranian hospitals.

Swedish translation and content evaluation of the Empowerment Audiology Questionnaire (EmpAQ-15).

Translating the newly developed Empowerment Audiology Questionnaire, EmpAQ-15 to Swedish, and performing content validation on the Swedish version. Best-practice principles using forward and back translations which were revised by a committee prior to field testing. Field testing was conducted by cognitive interviews with hearing-aid users talking through and rating the items in the translated questionnaire. Content validation was assessed by examining equivalence, accessibility, acceptability, comprehensiveness, and relevance of interview data. Questionnaire introduction and scoring instructions were evaluated by Swedish audiologists. Ten adult native speaking Swedish hearing aid users, recruited with purposive sampling. Maximum variation based on age, gender, hearing aid usage, and degree of hearing loss. Seven Swedish audiologists assessing instructions for result calculations. The conceptual equivalence between the Swedish translation and the English original questionnaire was judged to be high overall. The instructions and majority of items were experienced as accessible, acceptable, comprehensive, and relevant. The audiologists showed that they could follow scoring instructions and reason about the results. This content validity study was the first step towards a Swedish version of a self- report measure of Empowerment for people with hearing loss.

Validation of the Japanese version of the Esophageal Hypervigilance and Anxiety Scale for esophageal symptoms.

The Esophageal Hypervigilance and Anxiety Scale (EHAS) is an English questionnaire created in the USA to assess these factors in all patients with esophageal diseases. The aim of this study was to develop and validate the Japanese version of EHAS and investigate the relationship between EHAS scores and symptoms in untreated disorders of esophagogastric junction (EGJ) outflow. This prospective study recruited patients who underwent high-resolution manometry (HRM) at six tertiary centers in Japan. The EHAS was translated to Japanese using standard forward and backward translation methods. Patients completed the following questionnaires: the Japanese EHAS, Eckardt score, Gastroesophageal Reflux Disease Questionnaire, and Hospital Anxiety and Depression Scale for assessment of construct validity. Logistic regression analysis identified factors associated with esophageal symptom severity in untreated disorders of EGJ outflow. Overall, we analyzed 432 patients. Their main symptoms were dysphagia and reflux. The most common HRM diagnosis was normal (35.9%), followed by achalasia (29.4%). The Japanese EHAS demonstrated excellent reliability, and construct validity, with two subscales similar to the original EHAS. Total EHAS score moderately correlated to Eckardt score (r = 0.545, p < 0.001). In 113 patients with untreated disorders of EGJ outflow, multivariable analysis demonstrated that younger age, type II achalasia, and higher EHAS score were independently associated with higher Eckardt score. The Japanese EHAS is a reliable and valid questionnaire. Its subscale scores can be used as in the original version with some caution. Future studies are warranted to assess the appropriateness of factor loading.

The Incivility in Nursing Education Revised (INE-R) Instrument: Translation and Validation in Indonesian

Background: Professionalism is one important thing in the educational process as in the learning objectives of nursing. Nurses are required to form a professional behavior and achieve it starting from the educational stage. Thus, the process in nursing education needs to be able to identify patterns of students and teacher’s behavior that are not professional or against the norms of decency. The Incivility in Nursing Education – Revised (INE-R) instrument, was first developed by Clark et al. in 2015. It is designed to assess incivility within nursing education, and there has been no Indonesian translated version recently. Inadequate translation quality can hinder researchers’ capacity to gather and interpret data accurately, resulting in errorneous measurement. The broader impact can also result in failing to recognize or identify disrespectful behavior that may potentially lead to incivility behavior in nursing education. The purpose of this study is to produce an accurate research instrument of Incivility in Nursing Education Revised (INE-R) which is translated from English into Indonesian considering the cultural background and relevant issues in Indonesian context. Method: The method used in the translation process refers to the World Health Organization (WHO) instrument protocol, consist of forward translation, expert panel discussion, back translation, pre-testing, and cognitive interviewing until the final version. Result: This study found that the Incivility in Nursing Education Revised (INE-R) instrument is valid and reliable with Cronbach’s alpha value of 0.745 and S-CVI 0.993. The result of the I-CVI score for each part of the questionnaire of student and teacher behavior assessment mostly have a score of 1 (one). Conclusion: This study translated the INE-R instrument formulated and developed by Clark. From the result of the I-CVI categorized, the translated instrument indicates a high content of validity.

Cross-cultural adaptation and validation of the Arabic version of the Stay Independent Brochure as part of the CDC’s STEADI initiative among community-dwelling older adults

BackgroundThe Stay Independent Brochure (SIB) is part of the CDC’s STEADI initiative and is a fall risk screening self-report tool. This study aimed to translate and cross-culturally adapt the Arabic version of the SIB (AR-SIB) and evaluate its psychometric properties among community-dwelling older adults.MethodsThe translation and cross-cultural adaptation process followed standard guidelines, including forward and backward translation, expert committee review, and pretesting to ensure semantic and conceptual equivalence, clarity, and cultural relevance of the Arabic version of the SIB. Internal consistency was assessed using the Kuder-Richardson formula (KR-20), and test–retest reliability was evaluated with the intraclass correlation coefficient (ICC2,1). Convergent validity of the AR-SIB was evaluated using Spearman’s rank correlation coefficients (rs) with the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS) and point-biserial correlation coefficients (rpb) with the three key questions. Floor and ceiling effects and the operating characteristic (ROC) curve were also calculated.ResultsA total of 104 community-dwelling older adults participated in the study. The majority of participants were female (52.9%) and had a mean age of 63.77 ± 4.74 years. The AR-SIB demonstrated good internal consistency with an overall KR-20 of 0.73 and excellent test–retest reliability (ICC2,1 = 0.96). The AR-SIB showed moderate correlations with the TUG (rs = 0.51, 95% CI: 0.35 to 0.64) and the BBS (rs = -0.56, 95% CI: -0.69 to -0.41), and a high correlation with the three key questions (rpb = 0.75, 95% CI: 0.65 to 0.82). No floor or ceiling effects were observed. The cutoff point of the AR-SIB was determined to be 4.5.ConclusionsThe AR-SIB is a reliable and valid tool to discriminate falls and screen for fall risk among Arabic-speaking community-dwelling older adults. The AR-SIB can facilitate the implementation of evidence-based fall prevention initiatives tailored to Arabic-speaking older adults.

The Italian version of the Surgical Fear Questionnaire: validation of its measurement properties.

Surgical fear is present in many patients awaiting surgery. However, a validated Italian version of the Surgical Fear Questionnaire (SFQ) was not available yet. Therefore, the aim of this study was to translate the SFQ into Italian and to test its reliability and validity. Design: prospective cohort study on Italian-speaking Swiss patients scheduled for a minimally invasive spinal procedure or spinal surgery. After forward and back translation and a pilot test, reliability and validity of the 8-item SFQ was assessed using the intraclass correlation coefficient, (ICC), Cronbach's alpha, confirmatory factor analysis (CFA), and Spearman's correlation coefficient. Results on 63 patients revealed median SFQ-total scores of 22 (minimum-maximum: 0-68) at inclusion and 22.5 (0-70) one week before surgery. Test-retest reliability between first and second SFQ-total score was high, ICC=0.947 (95% CI: 0.912-0.968). Internal consistency of the SFQ-total score at both assessment times were high, Cronbach's alphas 0.916 and 0.931 respectively. This was also the case for the subscale short-term fear, item 1-4 and long-term fear, item 5-8 (range 0.853-0.909). CFA-results for a one-factor and a two-factor model favored the two-factor model. Correlations with pain catastrophizing, other anxiety measures, and health status were weak and only state anxiety assessed by PROMIS reached statistical significance. We conclude that the Italian version of the SFQ is suitable for use in practice and has a high reliability. Validity and sensitivity need additional testing on a larger population.

Translation and Validation of the Spanish Version of the Banff Patellofemoral Instability Instrument 2.0.

The Banff Patellofemoral Instability Instrument (BPII) 2.0 is a patient-reported outcome measure (PROM) tailored specifically for patellofemoral instability. The BPII 2.0 was developed in English and has been validated for adolescents and translated into several languages, but not into Spanish. This investigation involved translating the BPII 2.0 into Spanish and evaluating and validating its psychometric properties. It was hypothesized that there would be a moderate correlation between the Spanish BPII 2.0 and the Spanish version of the Kujala score. Cohort study (diagnosis); Level of evidence, 3. The BPII 2.0 underwent forward and backward translations into Colombian Spanish according to the Consensus-Based Standards for the Selection of Health Measurement Instrument guidelines. Colombian patients aged 9 to 18 years who experienced knee symptoms after a primary or recurrent patellar dislocation were recruited from a hospital-based orthopaedic clinic. Participants completed the Spanish BPII 2.0 and the Kujala score during their initial visit (t0) and the Spanish BPII 2.0 again 1 week later (t1). Internal consistency and test-retest reliability were assessed using the intraclass correlation coefficient (ICC). Concurrent validity of the Spanish BPII 2.0 with the Kujala score was explored through Pearson correlation analysis. A total of 46 participants (31 [67%] female; mean age, 15.1 ± 2.0 years) were included. The mean time since first patellofemoral dislocation was 22 ± 28 months. Of the 4 participants who received operative treatment for patellar instability, the mean time since surgery was 12 months (range, 7-18 months). All patients completed the BPII 2.0 at t0 and at t1, a mean of 7 days later (range, 6-7 days), and 45 (98%) participants completed the Kujala score at t0. Five Spanish BPII 2.0 items exhibited floor or ceiling effects, however no subscales demonstrated these effects. Th Spanish BPII 2.0 demonstrated excellent internal consistency at both t0 (ICC, 0.94; 95% CI, 0.92-0.96) and t1 (ICC, 0.96; 95% CI, 0.93-0.97), along with excellent test-retest reliability (ICC, 0.98; 95% CI, 0.97-0.99). Concurrent validity of the Spanish BPII 2.0 with the Spanish Kujala score was good to strong (r = 0.74; 95% CI, 0.57-0.85). The Spanish BPII 2.0 had excellent internal consistency and test-retest reliability, suggesting this PROM is a reliable and valid questionnaire.