Zheng Xuejiao, Zhao Juanjuan, Mayland Catriona R, Dong Lei, Cong Feixue, Zhang Xijia, Wen Ya, Xie Dong, Miyashita Mitsunori
Department of Palliative Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan.
Changchun Humanities and Science College, Changchun, China.
BMC Palliat Care. 2025 May 6;24(1):128. doi: 10.1186/s12904-025-01772-9.
Culturally appropriate assessments are needed to improve care during the last days of life. One way of assessment is to use a tool with bereaved family members after death. The aim of this study was to translate and cross-culturally adapt the International 'Care Of the Dying Evaluation' questionnaire (i-CODE) into Mandarin Chinese.
Translation and cultural adaptation process was performed according to the Brislin Classical Backtranslation Model and the principles of the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life group translation procedure. Fifteen bereaved family members, 5 palliative care experts and 4 translators were involved in the process, which followed 10 steps: a) Preparation; b) Forward translation; c) Reconciliation; d) Backward translation; e) Reconciliation; f) Backward translation review; g) Expert consultation; h) Cognitive interview; i) Cognitive interview review; h) Final proofreading.
The translation and cultural adaptation followed established guidelines. items 1 ("washing"), 2 ("giving medicines"), 14 ("noisy rattle"), 18 ("giving fluids through a 'drip'") emerged divergence and reached a consensus among the research team, translators, and original author. In the cultural adaptation, demographic items were restructured to align with Chinese context. Gender-neutral terminology was employed by using "they/them". Inconsistent subject, terminology "healthcare team" and Items 4 ("had adequate privacy"), 14 ("noisy rattle"), 27 ("in the right place"), and 28 ("at the actual time of his/her death") was modified based on experts' assessments and bereaved families' comments. Linguistic, cultural, and conceptual equivalence was achieved in the process of translation and cultural adaptation.
A questionnaire allowing for international comparisons related to quality of care for dying individuals has been developed in Mandarin Chinese. Key cultural adaptations were required to ensure that the Chinese version of the i-CODE was suitable for use. It has proved content and face validity. Future work will focus on psychometric testing assessing the validity and reliability of questionnaire and its use in assessing and improving care.
需要进行符合文化背景的评估，以改善临终关怀。一种评估方法是在患者去世后与丧亲家庭成员一起使用某种工具。本研究的目的是将国际“临终关怀评估”问卷（i-CODE）翻译成中文普通话并进行跨文化调适。
翻译和文化调适过程按照布里斯林经典回译模型以及欧洲癌症研究与治疗组织（EORTC）生活质量小组翻译程序的原则进行。15名丧亲家庭成员、5名姑息治疗专家和4名翻译人员参与了该过程，该过程遵循10个步骤：a）准备；b）正向翻译；c）核对；d）反向翻译；e）核对；f）反向翻译审核；g）专家咨询；h）认知访谈；i）认知访谈审核；h）最终校对。
翻译和文化调适遵循既定指南。条目1（“洗漱”）、2（“给药”）、14（“发出嘎嘎声”）、18（“通过‘点滴’输液”）出现分歧，并在研究团队、翻译人员和原作者之间达成共识。在文化调适过程中，对人口统计学条目进行了重新构建，以使其符合中国国情。通过使用“他们/她们”采用了中性性别术语。根据专家评估和丧亲家庭的意见，对不一致的主语、术语“医疗团队”以及条目4（“有足够隐私”）、14（“发出嘎嘎声”）、27（“在合适的地方”）和28（“在其实际死亡时”）进行了修改。在翻译和文化调适过程中实现了语言、文化和概念上的等效。
已开发出一份允许对临终个体护理质量进行国际比较的中文问卷。需要进行关键的文化调适，以确保中文版的i-CODE适合使用。它已证明具有内容效度和表面效度。未来的工作将集中在心理测量测试上，评估问卷的效度和信度及其在评估和改善护理方面的应用。
