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.
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Background and Objectives: Various interventions aim to reduce obesity and promote healthy lifestyles among different cultural groups.Methods: We have conducted a systematic literature review, following PRISMA guidelines (registered at https://doi.org/10.17605/OSF.IO/HB9AX), to explore profiles of cultural adaptation and parenting approach of lifestyle interventions for families with young children (1-4 years).Results: Our search (in CINAHL, ERIC, PsycINFO, PubMed, Scopus, and SSCI) yielded 41 studies reporting 31 interventions. Drawing on Intervention Mapping, we applied a newly developed framework with various indicators of cultural adaptation and a parenting approach to analyze interventions. Our review shows clear differences in the level of cultural adaptation. A categorical principal component analysis revealed 6 different empirical profiles of cultural adaptation.Conclusions: Based on our profiles, we discuss how cultural adaptation can be strengthened in the design of future early interventions aimed at promoting a healthy lifestyle.
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The Northern Netherlands is like many delta’s prone to a wide range of climate change effects. Given the region its long history with floods and adaptation, there are numerous initiatives to be found that tried to battle these effects. As part of the Climate Adaptation Week Groningen, an inventory was made of these initiatives. The most inspiring ones were coined ‘best practices’, and analysed in order to learn lessons. A distinction was made between 4 regional landscape types. The first consists of the coastline itself, where the effects of the rising sea level begin to show. The second covers the farmlands near the coastlines, where challenges such as salinisation and the loss of biodiversity prevail. A third landscape covers the historically compact cities, which have to deal with rising temperatures and heavy rainfall in increasingly limited spaces. The fourth and final landscape comprises the wetlands surrounding the cities, where the natural capacity to retain and store rainwater is undermined by its agriculture usage. Most of these challenges form a risk for maintaining a liveable region. The best practices that were collected show a diverse set of innovations and experiments, both on small and large scales. Three main characteristics could be distinguished that illustrate trends in climate adaptation practices. First, many best practices were aimed at restoring and embracing the natural capacity of the different landscapes, giving more and more room for the building with nature concept as part of building resilience. Second, climate adaptation is seldomly focussed on as the sole function of a spatial intervention, and is almost always part of integrated plans in which biodiversity, agriculture, recreation or other themes are prolonged with it. A third and last characteristic shows that many projects embed a strong focus on the historical context of places as a source of inspiration and cultural identity. The best practices show how different ways of adapting are emerging and can inspire planners across the world.
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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.
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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.
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PURPOSE: Malnutrition is frequent in hospitalized patients and is related to functional decline and poorer clinical outcomes. The Patient-Generated Subjective Global Assessment (PG-SGA) is a globally implemented malnutrition tool. We aimed to perform a linguistic and content validation of the translation and cultural adaptation of the PG-SGA for the Spanish language setting.METHODS: This study was conducted in Mexico and Spain. Cancer patients and healthcare professionals (HCPs) of both countries were enrolled. We followed the 10 steps of the International Society for Pharmacoeconomics and Outcomes Research Principles. Patients and HCPs evaluated comprehensibility (Item: I-CI, Scale: S-CI) and difficulty (Item: I-DI, Scale: S-DI) of the Spanish version of the PG-SGA. HCPs also evaluated content validity (i.e., relevance) of the Spanish PG-SGA (Item: I-CVI, Scale: S-CVI). The data were collected by a questionnaire.RESULTS: The study enrolled 84 HCPs and 196 cancer patients from both countries. HCPs rated comprehensibility and difficulty of the professional component as excellent (S-CI = 0.95, S-DI = 0.92), and content validity of the full PG-SGA also as excellent. Patients rated comprehensibility (S-CI) and difficulty (S-DI) of the patient-generated component, that is, the PG-SGA Short Form, as "excellent" (S-CI = 0.98 and S-DI = 0.98).CONCLUSION: Translation and cultural adaptation of the PG-SGA to the Spanish setting according to the International Society for Pharmacoeconomics and Outcomes Research Principles resulted in an instrument perceived as clear and easy to complete by cancer patients and relevant by HCPs to assess the nutritional status.
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Background and aims: Patients with cancer frequently present with disease-related malnutrition and functional decline. The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a malnutrition screening and assessment tool commonly used in patients with cancer. The aim of the current study was to translate and culturally adapt the original English PG-SGA for the Greek setting, including assessment of comprehensibility, difficulty and content validity in patients and healthcare professionals. Methods: Our study was conducted according to the ten steps of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles of Good Practice for Translation and Cultural Adaptation. Comprehensibility and difficulty of the Greek translation were assessed in 100 patients and 100 healthcare professionals (HCPs) from Greece. Content validity of the translation was assessed among HCPs. Item and scale indices were calculated for comprehensibility (I–CI; S–CI), difficulty (I-DI; S-DI), and content validity (I-CVI; S-CVI). Results: Patient perceived comprehensibility and difficulty of the PG-SGA were considered to be excellent (S–CI = 0.97, S-DI = 0.97). HCPs perceived content validity for the patient component was also excellent (S-CVI = 0.95). The perceived content validity, comprehensibility and difficulty for the professional component of the PG-SGA, as perceived by the HCPs, was excellent (S-CVI = 0.94, S–CI = 0.94, S-DI = 0.90), with the physical exam being perceived as most difficult (I-DI = 0.78–0.92). Conclusions: Our study resulted in the successful translation and cross-cultural adaptation of the original English PG-SGA for the Greek setting. The Greek language version of the PG-SGA is characterized by high comprehensibility, low difficulty, and is considered relevant for use in Greece.
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This study empirically examines individual and organizational factors that influence expatriates’ cross-cultural adjustment and job performance. The study was a quantitative research from 117 Thai expatriates who work in Thai multinational companies (MNC) located in Indonesia. The results of the study indicated that financial perceived organizational support influence positively towards Thai expatriates’ overall cross-cultural adjustment in Indonesia. This study found that cross-cultural training influenced positively towards Thai expatriates’ adjustment. A causal relationship between the predicting variables of crosscultural adjustment and Thai expatriates’ job performance was not found. Results suggest important consequences for management strategies providing support to Thai expatriate employees increasing their adjustment in Indonesia. Keywords: Cross-Cultural Adjustment; Job
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BACKGROUND: Assessment of malnutrition is important in cancer patients. The Scored Patient-Generated Subjective Global Assessment (PG-SGA), an instrument that enables interdisciplinary assessment of malnutrition and its risk factors, was not available in Dutch.OBJECTIVE: Translation and cultural adaption of the original English PG-SGA to the Dutch setting.METHODS: The PG-SGA was translated and culturally adapted, following the International Society for Pharmacoeconomics and Outcomes Research principles. Perceived content validity, comprehensibility, and difficulty were explored among a multidisciplinary sample of healthcare professionals and their cancer patients. Content validity, comprehensibility, and difficulty were operationalized by calculating item and scale indices. On scale level, indices of 0.80 to 0.90 were considered acceptable, and indices of 0.90 or greater were considered excellent.RESULTS: Consensus was reached on 91 and 8 differences in the forward and back translations, respectively. Scale Content Validity Index was 0.89. Scale Comprehensibility Index and Scale Difficulty Index of the patient-generated component of the PG-SGA were 0.99 and 0.96, respectively. Scale Comprehensibility Index and Scale Difficulty Index of the professional component were 0.81 and 0.55, respectively.CONCLUSIONS: Translation and cultural adaptation of the PG-SGA according to the International Society for Pharmacoeconomics and Outcomes Research principles resulted in a Dutch version that maintained the purpose, meaning, and format and have acceptable content validity. Now a Dutch version of the PG-SGA is available that is considered comprehensible and easy by patients, and comprehensible and relevant by professionals. However, the professional component was considered difficult by the PG-SGA-naive professionals, which indicates a need for training.IMPLICATIONS FOR PRACTICE: A similar systematic approach for future translations of the PG-SGA is recommended, to safeguard cultural equivalence.
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This article describes the translation and cultural adaptation process of the WRITIC (Writing Readiness Inventory Tool in Context) into European Portuguese. We examined the content and convergent validity, test-retest, and interrater reliability on the norm-referenced subdomain of the Portuguese (PT) WRITIC Task Performance (TP). To establish content validity, we consulted six experts in handwriting. Internal consistency was found with 70 children, test-retest reliability with 65, inter-rater reliability with 69, and convergent validity with 87. All participants were typically developing kindergarten children. Convergent validity was examined with the Beery–Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI-6) and the Nine Hole Peg-Test (9-HPT). On content validity, we found an agreement of 93%, a good internal consistency with Cronbach’s alpha of 0.72, and an excellent test-retest and inter-rater reliability with ICCs of 0.88 and 0.93. Correlations with Beery™VMI-6 and 9-HPT were moderate (r from 0.39 to 0.65). Translation and cross-cultural adaptation of WRITIC into European Portuguese was successful. WRITIC-PT-TP is stable over time and between raters; it has excellent internal consistency and moderate correlations with Beery™VMI-6 and 9-HPT. This analysis of the European Portuguese version of WRITIC gives us the confidence to start the implementation process of WRITIC-PT in Portugal.
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