Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine
Open accessAbstract
The task of developing a new questionnaire or translating an existing questionnaire into a different language might be overwhelming. The greatest challenge perhaps is to come up with a questionnaire that is psychometrically sound, and is efficient and effective for use in research and clinical settings. This article provides guidelines for the development and translation of questionnaires for application in medical fields, with a special emphasis on perioperative and pain medicine. We provide a framework to guide researchers through the various stages of questionnaire development and translation. To ensure that the questionnaires are psychometrically sound, we present a number of statistical methods to assess the reliability and validity of the questionnaires.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The translation of SNAIL items followed international recommendations for translating psychological measurement instruments.
“To ensure a valid and systematic translation of the SNAIL items, we followed the international recommendations for translating psychological measurement instruments wherever possible [31-33].”
From Evaluating AI Courses: A Valid and Reliable Instrument for Assessing Artificial-Intelligence Learning through Comparative Self-Assessment (2023) · cites this paper as [31]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Coefficient Alpha and the Internal Structure of Tests
Cronbach, L. J. (1951) · Psychometrika · doi:10.1007/bf02310555 · Cited by 43,931 · see citing works
A Coefficient of Agreement for Nominal Scales
Cohen, J. (1960) · Educational and Psychological Measurement · doi:10.1177/001316446002000104 · Cited by 42,398 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
A Paradigm for Developing Better Measures of Marketing Constructs
Churchill, G. A. (1979) · Journal of Marketing Research · doi:10.1177/002224377901600110 · Cited by 16,549 · see citing works
Guidelines for the process of cross-cultural adaptation of self-report measures
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000) · Spine · doi:10.1097/00007632-200012150-00014 · Cited by 14,542 · see citing works
Construct validity in psychological tests.
Cronbach, L. J., & Meehl, P. E. (1955) · Psychological Bulletin · doi:10.1037/h0040957 · Cited by 11,195 · see citing works
A QUANTITATIVE APPROACH TO CONTENT VALIDITY<sup>1</sup>
LAWSHE, C. H. (1975) · Personnel Psychology · doi:10.1111/j.1744-6570.1975.tb01393.x · Cited by 7,313 · see citing works
Guillemin, F., Bombardier, C., & Beaton, D. (1993) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(93)90142-n · Cited by 6,060 · see citing works
Introduction to Classical and Modern Test Theory
Crocker, L. M., & Algina, J. J. (1986) · Cited by 5,090 · see citing works
A First Course in Factor Analysis
Comrey, A. L., & Lee, H. B. (2013) · doi:10.4324/9781315827506 · Cited by 4,546 · see citing works
A Brief Tutorial on the Development of Measures for Use in Survey Questionnaires
Hinkin, T. R. (1998) · Organizational Research Methods · doi:10.1177/109442819800100106 · Cited by 4,095 · see citing works
Starting at the beginning: an introduction to coefficient alpha and internal consistency
Streiner, D. L. (2003) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8001_18 · Cited by 3,794 · see citing works
(1982) · Cited by 3,737 · see citing works
Self-reports: How the questions shape the answers.
Schwarz, N. (1999) · American Psychologist · doi:10.1037/0003-066x.54.2.93 · Cited by 2,846 · see citing works
Statistical methods in psychology journals: Guidelines and explanations.
Wilkinson, L., & Task Force on Statistical Inference (1999) · American Psychologist · doi:10.1037/0003-066x.54.8.594 · Cited by 2,791 · see citing works
(2007) · Sage eBooks · doi:10.4135/9781412952644.n300 · Cited by 2,589 · see citing works
Pain in children: comparison of assessment scales.
Dl, W., & Cm, B. (1988) · PubMed · Cited by 1,619 · see citing works
Developing questionnaires for educational research: AMEE Guide No. 87
Artino, A. R., LaRochelle, J. S., DeZee, K. J., & Gehlbach, H. (2014) · Medical Teacher · doi:10.3109/0142159x.2014.889814 · Cited by 1,542 · see citing works
Psychological Testing: Principles and Applications
Murphy, K. R., & Davidshofer, C. O. (1988) · Cited by 1,174 · see citing works
Anthoine, E., Moret, L., Regnault, A., Sebille, V., & Hardouin, J.-B. (2014) · Health and Quality of Life Outcomes · doi:10.1186/s12955-014-0176-2 · Cited by 1,149 · see citing works
Selecting, designing, and developing your questionnaire
Boynton, P., & Greenhalgh, T. (2004) · BMJ · doi:10.1136/bmj.328.7451.1312 · Cited by 1,087 · see citing works
Handbook of Organizational Measurement
Aldrich, B. C., Price, J. L., & Mueller, C. W. (1989) · Teaching Sociology · doi:10.2307/1317948 · Cited by 976 · see citing works
Reeve, B. B., Wyrwich, K. W., Wu, A. W., Velikova, G., Terwee, C. B., Snyder, C. F., Schwartz, C. E., Revicki, D. A., Moinpour, C. M., McLeod, L., et al. (2013) · Quality of Life Research · doi:10.1007/s11136-012-0344-y · Cited by 865 · see citing works
Sample size and subject to item ratio in principal components analysis
Osborne, J. W., & Costello, A. B. (2020) · ScholarWorks@UMassAmherst (University of Massachusetts Amherst) · doi:10.7275/ktzq-jq66 · Cited by 817 · see citing works
Sample size for pre-tests of questionnaires
Perneger, T., Courvoisier, D. S., Hudelson, P. M., & Gayet‐Ageron, A. (2014) · Quality of Life Research · doi:10.1007/s11136-014-0752-2 · Cited by 645 · see citing works
Factors Defined by Negatively Keyed Items: The Result of Careless Respondents?
Schmitt, N., & Stuits, D. M. (1985) · Applied Psychological Measurement · doi:10.1177/014662168500900405 · Cited by 536 · see citing works
Recommendations for the Cross-Cultural Adaptation of the DASH & QuickDASH Outcome Measures
Beaton, D., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2007) · Cited by 468 · see citing works
Research methods in organizational behavior
Stone, E. F. (1978) · Medical Entomology and Zoology · Cited by 324 · see citing works
Designing and testing questionnaires for children
Bell, A. (2007) · Journal of research in nursing · doi:10.1177/1744987107079616 · Cited by 271 · see citing works
Reading Ability of Parents Compared With Reading Level of Pediatric Patient Education Materials
Davis, T. C., Mayeaux, E. J., Fredrickson, D. D., et al. (1994) · PEDIATRICS · doi:10.1542/peds.93.3.460 · Cited by 249 · see citing works
A Generalization of Cohen's Kappa Agreement Measure to Interval Measurement and Multiple Raters
Berry, K. J., & Mielke, P. W. (1988) · Educational and Psychological Measurement · doi:10.1177/0013164488484007 · Cited by 240 · see citing works
Measurement Theory in Action: Case Studies and Exercises
Shultz, K. S., & Whitney, D. J. (2005) · Sage eBooks · doi:10.4135/9781452224749 · Cited by 235 · see citing works
Method Effects: The Problem With Negatively Versus Positively Keyed Items
Lindwall, M., Barkoukis, V., Grano, C., Lucidi, F., Raudsepp, L., Liukkonen, J., & Thøgersen‐Ntoumani, C. (2012) · Journal of Personality Assessment · doi:10.1080/00223891.2011.645936 · Cited by 217 · see citing works
Harrison, D. A., & McLaughlin, M. E. (1993) · Journal of Applied Psychology · doi:10.1037/0021-9010.78.1.129 · Cited by 159 · see citing works
Leung, W. (2001) · BMJ · doi:10.1136/sbmj.0106187 · Cited by 138 · see citing works
Unidimensionality and Bandwidth in the Center for Epidemiologic Studies Depression (CES–D) Scale
Stansbury, J. P., Ried, L. D., & Velozo, C. A. (2006) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8601_03 · Cited by 120 · see citing works
Grootscholten, C., Bajema, I. M., Florquin, S., et al. (2007) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfm555 · Cited by 98 · see citing works
Hendricson, W. D., Russell, I. J., Prihoda, T. J., Jacobson, J. M., Rogan, A., Bishop, G. D., & Castillo, R. (1989) · Arthritis & Rheumatism · doi:10.1002/anr.1780320915 · Cited by 90 · see citing works
Bowling, A., & Windsor, J. (2007) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2006.058214 · Cited by 70 · see citing works
Royse, C. F., Newman, S. P., Williams, Z., et al. (2013) · Anesthesiology · doi:10.1097/aln.0b013e318299f72b · Cited by 53 · see citing works
Self-citationTsang, S., Salekin, R. T., Coffey, C. A., & Cox, J. M. (2017) · Psychological Assessment · doi:10.1037/pas0000481 · Cited by 44 · see citing works
Self-citationRoyse, C. F., Williams, Z., Ye, G., et al. (2014) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.12273 · Cited by 40 · see citing works
Self-citationLee, S.-H., & Schwarz, N. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.301055 · Cited by 36 · see citing works
Royse, C. F., Williams, Z., Purser, S., et al. (2014) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.12264 · Cited by 31 · see citing works
Self-citationHarrison, D. A., & McLaughlin, M. E. (1991) · Academy of Management Proceedings · doi:10.5465/ambpp.1991.4977169 · Cited by 27 · see citing works
Validation of the Arabic Version of the Quebec Back Pain Disability Scale
Alnahhal, A., & May, S. (2012) · Spine · doi:10.1097/brs.0b013e3182765a3f · Cited by 27 · see citing works
Newman, S. P., Wilkinson, D. J., & Royse, C. F. (2013) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.12234 · Cited by 23 · see citing works
Self-citationBarrett, R. S. (1992) · Public Personnel Management · doi:10.1177/009102609202100104 · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [30]Nunnally J Psychometric Theory 1978 New York McGraw-Hill
Cited by
Sorted by citations
Laupichler, M. C., Aster, A., Perschewski, J.-O., & Schleiss, J. (2023) · Education Sciences · doi:10.3390/educsci13100978 · Cited by 48 · see citing works
“To ensure a valid and systematic translation of the SNAIL items, we followed the international recommendations for translating psychological measurement instruments wherever possible [31–33].”
MethodGupta, S., & Jaiswal, R. (2024) · The International Journal of Management Education · doi:10.1016/j.ijme.2024.101070 · Cited by 22 · see citing works
Framework to assess the quality of mHealth apps: a mixed-method international case study protocol
Tan, Y. Y., Woulfe, F., Chirambo, G. B., Henn, P., Cilliers, L., Fadahunsi, K. P., Taylor-Robinson, S. D., & O'Donoghue, J. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062909 · Cited by 10 · see citing works
Mannocci, A., Massimi, A., Scaglietta, F., Ciavardini, S., Scollo, M., Scaglione, C., & La Torre, G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18084066 · Cited by 8 · see citing works
Lim, P. C., Lim, Y. L., Rajah, R., & Zainal, H. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00150-y · Cited by 8 · see citing works
Cappiello, M. C., Durán, A. V., Crystal, Y. O., Bagattoni, S., & Jimeno, F. G. (2025) · Scientific Reports · doi:10.1038/s41598-025-87347-3 · Cited by 5 · see citing works
Bilingual Language Dominance and Code-switching Patterns
Olson, D. J. (2024) · Heritage Language Journal · doi:10.1163/15507076-bja10027 · Cited by 4 · see citing works
- Authors
- Tsang, S., Royse, C., & Terkawi, A.
- Affiliations
- Columbia University (US)
- Corresponding author
- Tsang, Siny
- ORCID
- Tsang, Siny
- Venue
- Saudi Journal of Anaesthesia
- Published
- 2017
- Volume
- 11
- Issue
- 5
- Pages
- 80
- ISSN
- 0975-3125 (ISSN-L)
- 1658-354X
- PMC
- PMC5463570
- OpenAlex
- W2618872266
- Cited by
- 1,692
- References
- 48
- Citations by year
- 2026: 168 · 2025: 245 · 2024: 308 · 2023: 267 · 2022: 270 · 2021: 208 · 2020: 156 · 2019: 53 · 2018: 15 · 2017: 1
- FWCI
- 23.27
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Saudi Journal of Anaesthesia (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Mental Health (T32MH013043)
- Topics
- Social Sciences › Education › Health Education and Validation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- questionnaire development, questionnaire translation, psychometric validation, reliability statistics, validity, perioperative medicine, pain medicine, cross-cultural adaptation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review