背景:在工具的跨文化适应过程中对概念对等的探索通常被忽略,因为它通常认为工具的理论结构在原始文化和目标文化中均以相同的方式概念化。本文试图阐明概念对等评价对适应过程的贡献,和工具开发。为了说明这个前提,介绍了患者护士已知的感觉感知(PPFKN)量表的跨文化适应示例。
方法:SousaandRojjanasrirat的改编版(临床实践评估杂志,2011,17(2),268-274)指南用于翻译PPFKN量表并使其在文化上适应西班牙语和文化。在传统的翻译过程和试点研究中增加了定性的描述性研究,以探索目标文化中的概念并认识概念对等。
方法:工具概念专家,双语翻译者和该工具的作者参与了将原始工具翻译成西班牙语的工作。西班牙版本的试点研究包括44名患者和来自不同领域的6名专家组成的小组,评估了其清晰度和相关性。此外,7例患者参与了一项描述性定性研究,采用半结构化个体访谈,探讨新文化中的这一现象.数英里之后的内容分析,Huberman&Saldaña(定性数据分析,方法原始手册,2014)方法用于分析定性数据。
结果:将PPFKN量表的跨文化翻译和改编为西班牙语需要进行彻底的修订。一半以上的项目需要进行讨论,以便就最适当的西班牙语术语达成共识。此外,该研究证实了在美国背景下确定的概念的四个属性,并允许在这些属性中出现新的见解。这些方面反映了西班牙背景下已知现象的特点,并以10个新项目的形式添加到工具中。
结论:工具的全面跨文化适应应包括,以及语言和语义对等的研究,在两种情况下对现象的概念等效性进行分析。身份证明,承认和研究两种文化之间的概念差异与现象有关,成为深入研究两种文化中现象的机会,为了理解它们的丰富性和深度,并提出可能增强工具内容有效性的变更建议。
结论:在跨文化适应过程中对工具概念对等的评估将使目标文化有可能依赖理论上合理和重要的工具。具体来说,PPFKN量表的跨文化适应促进了西班牙语版本的语言工具的设计,在语义上和理论上与西班牙文化一致。PPFKN量表是一个有力的指标,可以证明护理对患者经验的贡献。
The exploration of conceptual equivalence within the process of the cross-cultural adaptation of tools is usually neglected as it generally assumed that the theoretical construct of a tool is conceptualized in the same way in both the original and target culture. This article attempts to throw light on the contribution of the evaluation of conceptual equivalence to the process of adaptation, and for tool development. To illustrate this premise, the example of the cross-cultural adaptation of the Patients\' Perception of Feeling Known by their Nurses (PPFKN) Scale is presented.
An adapted version of the Sousa and Rojjanasrirat (Journal of Evaluation in Clinical Practice, 2011, 17(2), 268-274) guidelines was used to translate and culturally adapt the PPFKN Scale to Spanish language and culture. A qualitative descriptive study was added to the traditional process of translation and pilot study to explore the concept in the target culture and recognize conceptual equivalence.
Experts in the tool concept, bilingual translators and the author of the tool participated in the translation of the original tool into Spanish. A pilot study of the Spanish version with a sample of 44 patients and a panel of six experts from different fields evaluated its clarity and relevance. In addition, seven patients participated in a descriptive qualitative study using semi-structured individual interviews to explore the phenomenon in the new culture. A content analysis following the Miles, Huberman & Saldaña (Qualitative data analysis, a methods sourcebook, 2014) approach was used to analyze qualitative data.
The cross-cultural translation and adaptation of the PPFKN scale into Spanish required a thorough revision. More than half of the items needed discussions to reach consensus regarding the most appropriate Spanish term. In addition, the study confirmed the four attributes of the concept identified in the American context and allowed for new insights within those attributes to appear. Those aspects reflected characteristics of the phenomenon of being known in the Spanish context and were added to the tool in the format of 10 new items.
A comprehensive cross-cultural adaptation of tools should incorporate, together with the study of linguistic and semantic equivalence, the analysis of the conceptual equivalence of the phenomenon in both contexts. The identification, acknowledgment and study of the conceptual differences between two cultures in relation to a phenomenon becomes an opportunity for deeper study of the phenomenon in both cultures, for understanding of their richness and depth, and for the proposal of changes that may enhance the content validity of the tool.
The evaluation of conceptual equivalence of tools within the process of cross-cultural adaptation will make it possible for target cultures to rely on tools both theoretically sound and significant. Specifically, the cross-cultural adaptation of the PPFKN scale has facilitated the design of a Spanish version of the tool that is linguistically, semantically and theoretically congruent with Spanish culture. The PPFKN Scale is a powerful indicator that evidences nursing care contribution to the patient\'s experience.