Table 3.
Example of discrepancies and changes in the translation process
| Name of scale | Forward translation | Backward translation | Changes after comparison of the original and back translated version | Expert panel meeting | Cognitive patient interviews | Further cognitive patient interviews |
|---|---|---|---|---|---|---|
| Appearance Body contouring scars | ||||||
| These questions ask about your body contouring scars. For each question circle only one answer. With your body contouring scars in mind, in the past 2 weeks, how much have you been bothered by: | “Bothered” was a difficult word to translate into Danish. | These questions deal with your body contouring scars. Circle one answer for each question. With your body contouring scars in mind, how much have you during the last 2 weeks been troubled by: | The importance of securing a conceptual translation of “bothered” was highlighted. Remaining discrepancies were found with the same conceptual meaning. | It was ensured that the Danish translation for “bothered” was conceptually the same. Remaining discrepancies were also found to be with the same conceptual meaning. | Several patients post-body contouring revealed that they found “body contouring scars” strange and that they instead would suggest “surgical scars,” which make more sense in Danish. Patients explained that they found the Danish translation of “bothered” easily understandable and interviewing confirmed a correct conceptual translation. | No changes. Patients found “surgical scars” easily understandable and interviewing confirmed a correct conceptual translation. |
| 1. Having to dress in a way to hide your scars? | In Danish, there are two very similar ways of saying “having to” with one being a bit more demanding than the other. The least demanding option was chosen to get as close to a conceptual translation as possible | That you must dress in a way that hides your scars? | No changes. “Having to” and “must” were found with the same conceptual meaning. | No changes | No changes. Patients explained that they found the item easily understandable and interviewing confirmed a correct conceptual translation. | No changes |
| 2. How wide your scars look? | Straightforward | How wide your scars look? | No changes | No changes | No changes | No changes |
| 3. Location of your scars? | Straightforward | The position of your scars? | No changes. “Location” and “position” were found with the same conceptual meaning. | No changes | No changes | No changes |
| 4. The length of your scars? | Straightforward | The length of your scars? | No changes | No changes | No changes | No changes |
| 5. How noticeable your scars are? | Straightforward | How visible your scars are? | The importance of securing a conceptual translation of “noticeable” was highlighted. “Noticeable” was not found to be with the same conceptual meaning. | “Visible” was changed, so that the conceptual meaning of “noticeable” was ensured. | No changes. Patients explained that they found the item easily understandable and interviewing confirmed a correct conceptual translation. | No changes |
| 6. The color of your scars? | Straightforward | The color of your scars? | No changes | No changes | No changes | No changes |
| 7. How thick your scars look (i.e., raised or bumpy)? | In Danish, the words “raised and bumpy” are seldom used about scars. The conceptual meaning was thought easily understandable, and it was straightforward to find Danish words to replace. | How thick (i.e., swollen or uneven) your scars look? | No changes. Together “swollen and uneven” was by the authors found to be conceptually equivalent with the original version. | The expert panel found a better Danish word for “raised” leading to improved conceptual translation. | No changes. Patients explained that they found the item easily understandable, and especially the translation for “raised or bumpy” in brackets confirmed the meaning. | No changes |
| 8. Your scars looking crooked (i.e., not in a straight line)? | Straightforward | That your scars look crooked (i.e. not in a straight line)? | “Your scars looking crooked” and “That your scars look crooked” were defined as two different ways of expressing the same meaning. | No changes | No changes | No changes |
| 9. People seeing your scars? | Straightforward | That people see your scars? | “People seeing” and “That people see” were defined as two different ways of expressing the same meaning. | No changes | No changes | No changes |
| 10. How your scars look when they are not covered by clothes? | Straightforward | How your scars look when they are not covered by clothes? | No changes | No changes | No changes | No changes |