Table 1.

Steps of translation, adaptation and validation of instruments

Steps	Definition
Step 1	Translation of the original instrument into the target language (forward translation or one-way translation)
Step 2	comparison of the two translated versions of the instrument (TL1 and TL2): synthesis
Step 3	blind back-translation (blind backward translation or blind double translation) of the preliminary initial translated version of the instrument
Step 4	comparison of the two back-translated versions of the instrument (B-TL1 and B-TL2): synthesis II
Step 5	pilot testing of the pre-final version of the instrument in the target language with a monolingual sample: cognitive debriefing
Step 6	preliminary psychometric testing of the pre-final version of the translated instrument with a bilingual sample. This step is rarely used
Step 7	full psychometric testing of the pre-final version of the translated instrument in a sample of the target population