Table 1.

The cross-cultural adaptation procedure in six steps according to Brislin [17] and Delphi technique procedure [18] for translating the 51-item Flodén ATODAS [Swedish version] to the 46-item Flodén ATODAI [North American version]

Step 1: Initial translation by an English-speaking interpreter.

Step 2: Back-translation by a Swedish-speaking interpreter.

Step 3: Review and synthesis of these translations by an International committe of experts.

Step 4:Expert panel of seven designated ICU nurses rating the instrument; Followed by data analysis I (I-CVI and S-CVI).

Step 5: Test and retest of the prefinal version with 2 weeks in between; Followed by data analysis II (ICC, ҡWeight, sign test, and Cronbach’s alpha coefficient). In total, 50 ICU nurses from two hospitals in the greater Los Angeles area participated in the test and retest.

Step 6: A preselected panel (N = 15) performed an additional Delphi technique procedure for items that showed an ICC < 0.70 in step five. The researchers also made adjustments guided by the panel’s feedback.