Sabapathy S1, Srikesavan C2, Ramalingam T3, Krishnamoorthy A4
1Oxford University Hospitals NHS Foundation Trust, Physiotherapy, Oxford, United Kingdom, 2University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, United Kingdom, 3Sarvajanik College of Physiotherapy, Department of Physiotherapy, Surat, India, 4Tamil Nadu Dr. M.G.R. Medical University, Physiotherapy, Chennai, India
Background: Tamil is one of the classical languages of the world and spoken by millions of people in the southern states of Tamil Nadu and Puducherry in India. Tamil is the official language in Singapore and Srilanka and spoken by the Tamil migrants in UK, Australia, South Africa, and Canada.
We are a seven-member team (five physiotherapists and two non-medical) composed of a team coordinator, a methodologist, two forward translators, two backward translators, and a proof-editor. Four of us have experience of translating hundreds of Cochrane plain language summaries and Physiotherapy Evidence Database (PEDro) website in Tamil. We expanded our work towards Tamil translation of patient-reported outcome measures.
Purpose: To describe our experiences of translating patient questionnaires in Tami.l
Methods: We are currently being involved in different stages of translation, adaptation, and psychometric evaluation of the following measures: Neck Disability Index (NDI), Disabilities of Arm, Shoulder, Hand (DASH), Oxford Knee Score (OKS), Musculoskeletal Health Questionnaire (MSK-HQ), Global Rating of Change scale (GRC), and the Hip disability and osteoarthritis outcome score (HOOS).
We present a brief example of how we translated and cross-culturally adapted the DASH questionnaire here: Two translators independently translated the original DASH questionnaire into Tamil. Both translators produced a synthesis version by resolving any discrepancies between their translations. Synthesised version was back-translated into English by two backward translators who were not aware of the original questionnaire. We reviewed all translation reports and closely worked with the questionnaire developers to agree on the cross-cultural adaptations for Tamil speaking population. An example, we replaced 'playing golf' with a culturally-relevant 'cricket' sport. We then tested the pre-final version and received feedback from 30 people with upper limb conditions. The final version was approved by the developers.
Results: With our experience of translating Cochrane summaries, we set realistic timelines to complete each step of the process. Active and passionate contribution as a team and continued support from the participating study sites in India are our other strengths.
One challenge was involving backward translators with English as their mother-tongue as per the guidelines. This is practically difficult and therefore, we delegated backward translators with Tamil as their mother tongue and who also had postgraduate education in English language. Another challenge was to produce a simple Tamil translation understood by people from diverse literacy backgrounds. So, we carefully considered simplifying the language of the final questionnaire by getting it proof-read by a layperson.
Conclusion(s): To our knowledge, we are the first full-fledged translation team in patient outcome measures in India. The MSK-HQ and OKS measures have been pilot-tested and we are currently piloting the NDI and the GRC scales. The HOOS measure is in the final stages of our team review. Our next steps are towards psychometric testing of the measures in a large sample.
Implications: It is important that widely used reliable and valid outcome measures are available in other languages too. Translated questionnaires should undergo further evaluation to demonstrate adequate psychometric properties for clinical and research use in the target population.
Keywords: Cross-cultural adaptation, Tamil, Experiences
Funding acknowledgements: None
We are a seven-member team (five physiotherapists and two non-medical) composed of a team coordinator, a methodologist, two forward translators, two backward translators, and a proof-editor. Four of us have experience of translating hundreds of Cochrane plain language summaries and Physiotherapy Evidence Database (PEDro) website in Tamil. We expanded our work towards Tamil translation of patient-reported outcome measures.
Purpose: To describe our experiences of translating patient questionnaires in Tami.l
Methods: We are currently being involved in different stages of translation, adaptation, and psychometric evaluation of the following measures: Neck Disability Index (NDI), Disabilities of Arm, Shoulder, Hand (DASH), Oxford Knee Score (OKS), Musculoskeletal Health Questionnaire (MSK-HQ), Global Rating of Change scale (GRC), and the Hip disability and osteoarthritis outcome score (HOOS).
We present a brief example of how we translated and cross-culturally adapted the DASH questionnaire here: Two translators independently translated the original DASH questionnaire into Tamil. Both translators produced a synthesis version by resolving any discrepancies between their translations. Synthesised version was back-translated into English by two backward translators who were not aware of the original questionnaire. We reviewed all translation reports and closely worked with the questionnaire developers to agree on the cross-cultural adaptations for Tamil speaking population. An example, we replaced 'playing golf' with a culturally-relevant 'cricket' sport. We then tested the pre-final version and received feedback from 30 people with upper limb conditions. The final version was approved by the developers.
Results: With our experience of translating Cochrane summaries, we set realistic timelines to complete each step of the process. Active and passionate contribution as a team and continued support from the participating study sites in India are our other strengths.
One challenge was involving backward translators with English as their mother-tongue as per the guidelines. This is practically difficult and therefore, we delegated backward translators with Tamil as their mother tongue and who also had postgraduate education in English language. Another challenge was to produce a simple Tamil translation understood by people from diverse literacy backgrounds. So, we carefully considered simplifying the language of the final questionnaire by getting it proof-read by a layperson.
Conclusion(s): To our knowledge, we are the first full-fledged translation team in patient outcome measures in India. The MSK-HQ and OKS measures have been pilot-tested and we are currently piloting the NDI and the GRC scales. The HOOS measure is in the final stages of our team review. Our next steps are towards psychometric testing of the measures in a large sample.
Implications: It is important that widely used reliable and valid outcome measures are available in other languages too. Translated questionnaires should undergo further evaluation to demonstrate adequate psychometric properties for clinical and research use in the target population.
Keywords: Cross-cultural adaptation, Tamil, Experiences
Funding acknowledgements: None
Topic: Musculoskeletal; Disability & rehabilitation; Disability & rehabilitation
Ethics approval required: No
Institution: Not Required
Ethics committee: Not Required
Reason not required: In this abstract we are outlining our experiences. The studies mentioned in this abstract are being conducted after obtaining ethics committee permission from those hospitals where data is being collected.
All authors, affiliations and abstracts have been published as submitted.
