Translation, Cross-Cultural Adaptation, and Validation of Measurement Instruments: A Practical Guideline for Novice Researchers
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Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from "CINAHL with Full Text" (via EBSCO) and "MEDLINE with Full Text". A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines.
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Adaptation and testing of measurement instruments across different international contexts saves time, facilitates quantitative comparisons between cultures over time, increases the generalizability of data, and contributes evidence for evaluating outcomes and developing effective interventions.
“The adaptation and testing of measurement instruments across different international contexts not only saves time required to develop a new measurement, but also facilitates quantitative comparisons between cultures over time. This helps to increase the generalizability of data and contribute to evidence for evaluating outcomes and developing effective interventions [27–29].”
From Turkish adaptation of the clinical reasoning evaluation simulation tool (CREST-TR): a validity and reliability study (2025) · cites this paper as [29]
The Introduction (page unavailable) says cross-cultural adaptation facilitates comparisons between cultures, measurement of outcomes over time, and identification of factors relevant to effective interventions. It does not say adaptation saves time compared with developing a new instrument or specifically increases the generalizability of data. (LLM, conf=0.84)
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Cited by
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Bayzat, C., & Dinc, L. (2025) · BMC Nursing · doi:10.1186/s12912-025-03503-0 · Cited by 1 · see citing works
- Authors
- Cruchinho, P., López-Franco, M. D., Capelas, M. L., Almeida, S., Bennett, P. M., Miranda da Silva, M., Teixeira, G., Nunes, E., Lucas, P., & Gaspar, F.
- Affiliations
- Nursing Research, Innovation and Development Centre of Lisbon (PT)
- Universidad de Jaén (ES)
- Universidade Católica Portuguesa (PT)
- University of Lisbon (PT)
- Corresponding author
- Cruchinho, Paulo
- ORCID
- Venue
- Journal of Multidisciplinary Healthcare
- Publisher
- Informa UK Limited
- Published
- 2024-05
- Volume
- Volume 17
- Pages
- 2701-2728
- ISSN
- 1178-2390 (ISSN-L)
- PMC
- PMC11151507
- OpenAlex
- W4399245583
- Cited by
- 469
- References
- 17
- Citations by year
- 2026: 294 · 2025: 167 · 2024: 8
- FWCI
- 587.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Multidisciplinary Healthcare (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc)
- Topics
- Social Sciences › Education › Health Education and Validation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- cross-cultural adaptation, cross-cultural validation, forward translation, back-translation, pretest, field testing, psychometric validation, psychometric properties, methodological recommendations, health sciences
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