Background: Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland. Methods: Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence. Results: Results show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions. Conclusions: This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
Background: Nutritional assessment is considered to be an important element in the nutrition care process of cancer patients, since nutritional status is positively associated with health outcome. The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is a multidimensional nutritional assessment tool, developed for the oncology setting1. The PG-SGA was originally developed in English and until now an official Dutch translation was not available. We primarily aimed to develop a cross-cultural adaptation of the PG-SGA for the Dutch setting. Methods: The study design was developed conform the " Principles of Good Practice for the Translation and Cultural Adaption Process for Patient Reported Outcomes” by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)2. Results: The patients reported excellent understanding of the Dutch translated PG-SGA and perceived the items as easy to fill in. Comprehensibility of the items completed by the professionals was experienced as 'acceptable’, but they also experienced the items as difficult to complete. Professionals deemed the overall PG-SGA to be relevant and appropriate in the assessment of malnutrition in oncology patients. Overall, the professionals considered layout and time-consuming nature as barriers for applying the Dutch PG-SGA in daily practice. Conclusion: The Dutch cross-cultural adaptation of the PG-SGA was considered easy and was well understood by patients. Professionals evaluated the PG-SGA as relevant, but had some issues with lay out, elaborateness and difficulty of items regarding physical examination. To increase the accessibility and applicability of the PG-SGA for clinicians, training of these professionals is needed.
Background: Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland. Methods: Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence. Results: Results show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions. Conclusions: This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
