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A systematic survey instrument translation process for multi-country, comparative health workforce studies

Squires A, Aiken L H, Van den Heede K, Sermeus W, Bruyneel L, Lindqvist R, Schoonoven L, Stromseng I, Busse R, Brozstek T, Ensio A, Moreno-Casbas M, Rafferty A M, Schubert M, Zikos D, Matthews A
International Journal of Nursing Studies 50(2): 264-273 (DOI 10.1016/j.ijnurstu.2012.02.015)




Background: As health services research (HSR) expands across the globe, researchers willadopt health services and health worker evaluation instruments developed in one countryfor use in another. This paper explores the cross-cultural methodological challengesinvolved in translating HSR in the language and context of different health systems.

Objectives: To describe the pre-data collection systematic translation process used in atwelve country, eleven language nursing workforce survey.Design and settings: We illustrate the potential advantages of Content Validity Indexing(CVI) techniques to validate a nursing workforce survey developed for RN4CAST, a twelvecountry (Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway,Poland, Spain, Sweden, and Switzerland), eleven language (with modifications for regionaldialects, including Dutch, English, Finnish, French, German, Greek, Italian, Norwegian, Polish, Spanish, and Swedish), comparative nursing workforce study in Europe.

Participants: Expert review panels comprised of practicing nurses from twelve Europeancountries who evaluated cross-cultural relevance, including translation, of a nursingworkforce survey instrument developed by experts in the field.

Methods: The method described in this paper used Content Validity Indexing (CVI)techniques with chance correction and provides researchers with a systematic approachfor standardizing language translation processes while simultaneously evaluating thecross-cultural applicability of a survey instrument in the new context.

Results: The cross-cultural evaluation process produced CVI scores for the instrumentranging from .61 to .95. The process successfully identified potentially problematic surveyitems and errors with translation.Conclusions: The translation approach described here may help researchers reducethreats to data validity and improve instrument reliability in multinational healthservices research studies involving comparisons across health systems and languagetranslation.

2012 Elsevier Ltd. All rights reserved.

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