Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline

Rationale, aims and objectives  The diversity of the population worldwide suggests a great need for cross‐culturally validated research instruments or scales. Researchers and clinicians must have access to reliable and valid measures of concepts of interest in their own cultures and languages to conduct cross‐cultural research and/or provide quality patient care. Although there are well‐established methodological approaches for translating, adapting and validating instruments or scales for use in cross‐cultural health care research, a great variation in the use of these approaches continues to prevail in the health care literature. Therefore, the objectives of this scholarly paper were to review published recommendations of cross‐cultural validation of instruments and scales, and to propose and present a clear and user‐friendly guideline for the translation, adaptation and validation of instruments or scales for cross‐cultural health care research. Methods  A review of highly recommended methodological approaches to translation, adaptation and cross‐cultural validation of research instruments or scales was performed. Recommendations were summarized and incorporated into a seven‐step guideline. Each one of the steps was described and key points were highlighted. Example of a project using the proposed steps of the guideline was fully described. Conclusions  Translation, adaptation and validation of instruments or scales for cross‐cultural research is very time‐consuming and requires careful planning and the adoption of rigorous methodological approaches to derive a reliable and valid measure of the concept of interest in the target population.