Translation of scales in cross-cultural research: issues and techniques

Authors

  • Eun-Seok Cha,

    1. Eun-Seok Cha MPH PhD RN Instructor Chung-Ang University School of Medicine, Department of Nursing, Seoul, South Korea
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  • Kevin H. Kim,

    1. Kevin H. Kim PhD Assistant Professor, Statistician University of Pittsburgh School of Education, Department of Psychology in Education, Pittsburgh, Pennsylvania, USA
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  • Judith A. Erlen

    1. Judith A. Erlen PhD RN FAAN Professor and Doctoral Program Coordinator University of Pittsburgh School of Nursing, Department of Health Promotion & Development, Pittsburgh, Pennsylvania, USA
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Eun-Seok Cha: e-mail: euc6@cau.ac.kr

Abstract

Aims.  This paper is a report of a study designed to: (i) describe issues and techniques of translation of standard measures for use in international research; (ii) identify a user-friendly and valid translation method when researchers have limited resources during translation procedure; and (iii) discuss translation issues using data from a pilot study as an example.

Background.  The process of translation is an important part of cross-cultural studies. Cross-cultural researchers are often confronted by the need to translate scales from one language to another and to do this with limited resources.

Method.  The lessons learned from our experience in a pilot study are presented to underline the importance of using appropriate translation procedures. The issues of the back-translation method are discussed to identify strategies to ensure success when translating measures.

Findings.  A combined technique is an appropriate method to maintain the content equivalences between the original and translated instruments in international research. There are several possible combinations of translation techniques. However, there is no gold standard of translation techniques because the research environment (e.g. accessibility and availability of bilingual people) and the research questions are different.

Conclusions.  It is important to use appropriate translation procedures and to employ a combined translation technique based on the research environment and questions.

What is already known about this topic

  • The back-translation method is generally recommended for instrument validation for cross-cultural research.
  • There are several translation methods to maintain the content equivalence between two language versions of the instruments.
  • Brislin's back-translation model is a popular method that is widely used by cross-cultural researchers.

What this paper adds

  • A combination of translation techniques is ideal for successful translation.
  • Researchers need to identify how to combine translation techniques based on the nature and environment of their research.
  • A combined technique which needs a small number of bilingual people is presented as an example.

Introduction

In cross-cultural studies, using previously developed instruments with good psychometric properties can save time and effort. However, these instruments need to be culturally acceptable and appropriately translated to be valid; the potential benefits of cross-cultural research can be obtained only when cross-cultural researchers use appropriate instruments for their studies. For this reason, the process of translation becomes an important part of cross-cultural studies. Generally, direct translation of an instrument from one language to another does not guarantee content equivalence of the translated scale (Brislin 1970, Sechrest & Fay 1972). Researchers agree that back-translation of an instrument is essential for its validation and use in a cross-cultural study (McDermott & Palchanes 1992, Jones et al. 2001, John et al. 2006).

Among translation methods, Brislin's back-translation model is a popular one that is widely used by cross-cultural researchers. However, cross-cultural researchers may have limited resources (e.g. qualified bilingual translators) when applying Brislin's classic back-translation model. Thus, often, researchers will use a combination of techniques without the back-translation method or a team approach that is modified from the classic back-translation model of Brislin as alternatives to Brislin's classic back-translation model (Thato et al. 2005). Unfortunately, these researchers may not obtain a valid translated measure which has content equivalence with the original version of the instrument because they may have employed inappropriate translation techniques or unqualified translators. Therefore, cross-cultural researchers need to be familiar with strategies to obtain valid instruments before conducting their studies.

In this paper, we describe issues related to translation of standard measures for use in a cross-cultural research. The techniques of translation which were used for maintaining the content equivalence between two versions of the instruments are discussed to identify strategies to ensure a valid translated scale. A combined translation technique that successfully dealt with the problems related to translation confronted in a pilot study is provided as an example to overcome the disadvantages of Brislin's classic translation model (Figure 1) and other translation techniques. Discussion is presented to demonstrate the importance of using appropriate translation procedures and to suggest employing a combined translation technique based on the research environment and questions.

Figure 1.

 Brislin's translation model (Triandis & Brislin 1984, p. 1009).

Background

Issues related to translation

Cross-cultural researchers can use instruments that were originally constructed in two or more languages. Or, they can use measures that need to be translated as they were not initially developed for cross-cultural research. Some issues of translation overlap; others occur because of the type of instrument. In other words, realistic problems in the translation procedure by cross-cultural researchers may differ according to the nature of their studies and the characteristics of instruments.

Wording of questionnaire in source language

The clear use of words in a question may help to guarantee conceptually equivalent versions of a measure when two languages are needed for cross-cultural research. Brislin et al. (1973) suggested 10 empirically based rules which are useful for obtaining clarity when designing questionnaires for cross-cultural equivalence. These rules include using short, simple sentences (e.g. using fewer than 16 words), active voice, nouns rather than pronouns and specific terms. Also, they suggested avoiding colloquialisms, the subjective mode, adverbs and prepositions indicating time or position, possessive forms, vague terms and sentences with more than one suggested variable action (Brislin et al. 1973).

However, when a scale has already been developed and was not originally intended for use in cross-cultural research, Brislin et al.s’ (1973) suggestions of short, simple sentences may not be appropriate. Furthermore, direct translations may not be required as long as the content and meaning in the translated version is the same as the original (Brislin et al. 1973). Therefore, it is necessary for cross-cultural researchers to be meticulous when translating measures and apply decentering to maintain cross-cultural equivalence (Sechrest & Fay 1972).

Decentering

Decentering is a translation procedure that does not require direct translation if the original content and meaning can be kept in translated version (Brislin et al. 1973). The qualifications of bilingual experts are important for maintaining content equivalence as the emic–etic distinction is critical for decentering translated measures (Brislin 1976). ‘Emic,’ coming from a phonemic analysis in linguistics, is the documentation of meaningful sounds in a specific language of culture-specific concepts, and ‘etic’, coming from a phonetic analysis in linguistics, refers to culture-common concepts (Brislin 1976, Triandis & Brislin 1984).

Sechrest and Fay (1972) introduced five problems of equivalence in translation: vocabulary, idiomatic, grammatical–syntactical, experiential and conceptual equivalences. These problems were considered in the translation process used in our study (see ‘decentering applied in the study’).

Translation techniques

Four strategies for maintaining content equivalence: advantages and disadvantages

Importing a scale for use in another language or culture often requires considerable effort by researchers to maintain the quality of translation (Brislin 1970, Sechrest & Fay 1972, Wang et al. 2006). Brislin (1970) offered four techniques for maintaining the equivalence between the original and translated measures: (i) back-translation method; (ii) bilingual technique; (iii) committee approach; and (iv) pretest procedure.

Back-translation is a well-known method to maintain equivalence between the original and translated versions (Behling & Law 2000); Brislin's classic back-translation model (1970) is widely used for instrument validation. Brislin recommended an iterative process of repeated independent translation and back-translation by a team of translators. This approach requires several independent bilingual translators (Triandis & Brislin 1984). A bilingual translator blindly translates an instrument from the original language to the target language; a second bilingual translator independently back-translates the instrument from the target language to the original language. Next, the two versions of the instrument (original language and back-translated version) are compared for concept equivalence. When an error is found in the back-translated version, another translator attempts to retranslate the item. This procedure continues until a team of bilingual translators agrees that the two versions of the instruments are identical and have no errors in meaning (Table 1).

The major weakness related to Brislin's classic translation model is that researchers cannot estimate how many independent bilingual translators are needed to get content equivalence between the original and the translated versions; accessibility and availability of qualified bilingual people who have knowledge of the original (source) and target languages, both cultures, and the focal area of the research is a key when using this method. As an alternative, researchers often use a team approach with two independent bilingual translators (Yam et al. 2004, Thato et al. 2005); yet, this method may amplify the problems of the translated measures when the original and target languages have different structures, the original instrument includes metaphorical or emotional terms, and translation is conducted by unqualified bilingual experts (Brislin 1970, Dunnigan et al. 1993, Russell & Sato 1995, Jones et al. 2001).

The use of the bilingual technique requires the administration of the instrument in both the original and target languages to bilingual participants (Brislin 1970). The responses of the participants to the two versions are compared. When researchers identify a different response, they need to consider the potential reasons for this discrepancy. Yet, bilingual participants’ responses may be different from those of monolinguals (target population) because bilingual people are acculturated to their host culture. This acculturation places them in a separate population from the monolingual population (McDermott & Palchanes 1992, Sperber et al. 1994) and enable them to report different responses even though the two versions of the measure (original and target versions) have content equivalence (Lee et al. 2002).

The committee approach uses a group of bilingual experts to translate from the original to the target language (Brislin 1970). This approach provides a clearer version of the translated instrument as one committee member's mistake can be more readily identified by the other committee members (Brislin 1970). This method may be appropriate to use when bilingual translators have a preference for a target language and a limited number of persons are available for the back-translation procedure. However, this method requires more than three bilingual people and the accessibility of bilingual people as translators is a key issue when applying this approach.

The fourth method used for translation is the pretest procedure (Brislin 1970). The pretest refers to a pilot study. This procedure helps researchers identify potential problems when the population, study conditions, and measures that will be used for a larger study are the same as the pilot study. Accurate information about the potential problem regarding equivalence of translated measures can be obtained according to the level of similarities of the study conditions. While the back-translation method has frequently been used to maintain content equivalence in the translated version, there are limitations when using Brislin's classic back-translation model. Suggested remedies include combining translation techniques and modifying Brislin's translation models (Jones et al. 2001).

Jones et al. (2001) introduced a combined translation technique which uses a group approach when applying the back-translation method and bilingual technique. Firstly, two bilingual experts prepare two translated versions of an instrument from the source (original) to the target language. Secondly, each target language version is blindly translated to the source language by two other bilingual people. Thirdly, the four bilingual people have a group discussion to identify any differences between the target and source versions; they come to a consensus regarding these differences and develop a new version of the instrument. Fourthly, the new version is independently back-translated by two more bilingual people. Fifthly, the new back-translated versions are reviewed in the second meeting of the bilingual people. When the bilingual experts identify any differences between the translated version and source version, the fourth and fifth steps are repeated until the bilingual experts reach a consensus agreement. Lastly, the reliability and equivalence of the two versions is tested on a sample of bilingual participants. The combined back-translation technique, nonetheless, has several weaknesses.

The first weakness of Jones’et al. (2001) approach is the availability of bilingual people. In their study, new bilingual translators join their project at each translation and back-translation steps. Thus, if bilingual translators fail to reach agreement with a translated version, two additional bilingual translators are needed to perform the second translation and back-translation. The required number of translators increases as the process is continued; researchers cannot estimate at the outset how many bilingual translators will be required. In addition, a sample of bilingual people is needed to validate the instrument.

The second weakness is the nature of ‘bilingual technique,’ which was explained earlier; acculturation makes bilingual people different from monolingual people. Thus, another approach may be needed to obtain appropriate translated measures.

The study

Aims

The aims of this study were to: (i) describe issues and techniques of translation of standard measures for use in international research; (ii) identify a user-friendly and valid translation method when researchers have limited resources during translation procedure; and (iii) discuss translation issues using data from a pilot study as an example.

Instruments translated

We have chosen two instruments, the Sexual Abstinence Efficacy Scale (SAES) and the modified Premarital Sexual Attitude Scale (mPSAS), to illustrate the use of the combined translation technique and the decentering applied in this study. Both scales were translated from English to Korean in order to use them in the pilot study identifying potential predictors of sexual behaviour among Korean college students. The combined translation technique included the back-translation method, committee approach, and pretest procedure using a monolingual sample. We applied decentering to obtain vocabulary, idiomatic, grammatical–syntactical, experiential and conceptual equivalences between English and Korean versions.

SAES

The SAES was used to assess sexual abstinence efficacy. The tool, originally developed in Spanish and English, was designed to measure sexual abstinence efficacy among high school and college students (Norris et al. 2003). The scale consists of seven items and one optional item. The optional item is only asked to persons who have engaged in sexual intercourse, but who want to refrain from sexual intercourse. Response options range from 1 = ‘not at all sure’ to 4 = ‘extremely sure’. Internal consistency reliability using seven items ranged from an alpha of 0·80 to 0·83 (Norris et al. 2003).

mPSAS

The original PSAS was used to assess premarital sexual attitude. The PSAS consists of 16 items measured on a 5-point Likert scale (1 = ‘strongly disagree’ to 5 = ‘strongly agree’) assessing adolescent acceptance of sexual behaviour (e.g. kissing, light and heavy petting, sexual intercourse) on four levels of relationships (casual partner, steady partner, lover, fiancé/fiancée). The internal consistency reliability of the PSAS was 0·89 (Treboux & Busch-Rossnagel 1995). For cross-cultural research using Korean college students, we modified the PSAS. ‘Sex worker/prostitute’ was included as the fifth level of relationship assessing acceptance of each sexual behaviour because Asian men are usually infected with STDs from a commercial sex worker (Parish et al. 2003). Thus, the mPSAS contains 20 items using a 5-point Likert scale.

Translation technique used in the study

A combined translation technique being different from Jones’et al. (2001) approach was used. Because we had difficulty finding individuals who were both fluent in English and Korean and were knowledgeable about the field of the study, we could not use Brislin's team approach, which is generally reported as the way to develop translated scales (Brislin 1970). Instead, we applied a combined technique which used back-translation method, the committee approach and the pretest procedure using a monolingual sample. A pilot study was conducted to assess the appropriateness of the translated measures for use in a larger study on sexual behaviour of Korean college students.

Data analysis

Participants who completed the instruments were included in the final data analyses (male = 15, female = 21; mean age = 22·07 ± 1·88; range = 18–24). We examined the reliabilities of the translated measures using Cronbach's alpha and bootstrap statistics which allows an examination of stability of parameters with small samples. The bootstrapping method is a way to test the reliability of the data set with pseudo-replicate datasets by re-sampling. This method regards the researcher's original sample as the population and allows the researcher to obtain evaluated errors and to evaluate estimated reliabilities (Opperdoes 1997). Cases from the original data file are randomly selected with replacements to generate other data sets (Bollen & Stine 1993). One thousand bootstrap replications were conducted using spss 12·0 (SPSS Inc., Chicago, IL, USA) to estimate empirical distributions of the internal consistency and provide the ranges of Cronbach's alphas for the pilot study.

The translated instruments were used in a study designed to assess the appropriateness of the measures for use in a larger study on sexual behaviour of Korean college students. Although researchers are working on the development of effective sex education programmes for late adolescents, these efforts are primarily focused on promoting consistent condom use rather than sexual abstinence practice because of their age and an existing high prevalence of sexual behaviour among this population. However, a sexually abstinent person not only includes a virgin but also a person who has experienced sexual intercourse and subsequently decides to become abstinent (Norris et al. 2003). Therefore, sexual abstinence programme is not only applicable to virgins; the programmes are also important for late adolescents who engaged in sex.

Researchers agree that a sex education programme can succeed when it is culturally appropriate; there is a need to consider the prevalence of sexual behaviour, scripted gender role and cultural norm of sexual behaviour when designing the educational programme. Given these factors, developing and implementing a sexual abstinence programme may be an efficient and effective approach in Korea where premarital sexual behaviour is not accepted as an adolescent norm and the behaviour is not prevalent among college students, especially females (John et al. 2006). No culturally and theoretically appropriate Korean instruments existed for measuring the variables relevant to understanding sexual behaviour related to sexual abstinence. Thus, we needed to translate instruments originally written in English and translated into Korean.

The potential participants were recruited from a university in 2003 through either a flyer which was posted in the entrance of the student health service centre or an announcement which was made about the study during class time with the instructor's cooperation. Inclusion criteria were: (i) 18–24 years of age and (ii) attending a college or a university in Seoul, Korea. Non-Korean students and married students were excluded. Eighty potential participants received a study questionnaire packet either through the distribution of the study packet after a class with the instructor's approval (n = 29), or the potential participants picked up a study packet in the student health service center (n = 51).

Potential participants were asked to complete the instruments and return the packet to the researcher using a self-addressed envelope or to a collection box in the student health service center within a week. Each instrument in the packet was assigned a unique subject identifier. Anonymity of responses was stressed on the informational letter. The informational letter detailed the purpose of study, confidentiality of data, right to withdraw, risk/benefit ratio and the researcher's contact information.

Before beginning the pilot study, we obtained permission from the authors of the instruments to use, modify and translate the instruments into Korean. We received a letter of permission to conduct the study from a university administrator in Seoul, Korea as there was no university ethics committee. After that, the study was approved by the University of Pittsburgh Institutional Review Board. Because the study was anonymous, no written consent was necessary.

Findings

New combined translation technique

The SAES and mPSAS were translated from English to Korean. Firstly, three independent bilingual people, including one of the researcher team, independently translated the instruments. Each translated instrument was assessed by two other bilingual people. Any differences identified between the reviewed versions and their own translated version were discussed in the committee meeting of the three bilingual people. This procedure was continued until the three translators agreed on the translated instruments (Figure 2).

Figure 2.

 Modified translation model in the study. GD, Group discussion.

Secondly, a bilingual Korean–American, who was an undergraduate student, translated the Korean version measures back into English. Next, a monolingual English-speaking person compared the original English version and the back-translated English version. Additionally, the author of the SAES served as a consultant during this process; she clarified the meaning of items for translation and compared the two English versions of the SAES. When the monolingual reviewers identified a difference between the original and the back-translated versions, they provided the translators with detailed explanations of the usage differences in both versions of the instruments. These differences and the explanations were shared with the three bilingual translators to retranslate the items. Based on the discussion, three translators modified the wording of the instruments in the Korean version. Then, the back-translator translated the modified items from Korean to English again. The process was continued until the two monolingual reviewers agreed that the two English versions were identical (see Figure 2).

Qualification of translators

In all, a total of four bilingual experts were involved in the translation procedures. Three bilingual experts were graduate students who had been studying in the United States of America (USA) from 3 to 5 years. They were two nursing doctoral students and one computer science doctoral student who tutored international students on the Graduate Record Examination. These three bilingual students had adequate knowledge of and experience with translation from English to Korean as they have been trained in translation for more than 18 years for their studies. Their language preferences were Korean; they were less confident in their ability to back-translate the measures. Thus, these three bilingual experts, who made up the committee, were only involved in translating the instruments from English to Korean.

The back-translator was an undergraduate Korean–American student. She was born in Korea and immigrated to the USA when she was 10-years old. She visited Korea every summer during the first 4 years in the USA and spoke with her family in Korean which kept her in touch with many aspects of the Korean culture. Speaking Korean at home and English at school enabled her to communicate fluently in both Korean and English, and helped her understand both cultures. She did not have a language preference. Therefore, she served as a back-translator and translated the instruments from Korean to English.

Qualification of reviewers

Two monolingual experts served as reviewers and consultants to examine the differences between the original and the back-translated English versions. The first monolingual expert was a native English speaker and nursing doctoral student. The second monolingual expert was the developer of the SAES. Thus, when the developer identified a difference between her original scale and the back-translated version of the SAES, she was able to provide a detailed explanation about her intention of the questions and offered suggestions to maintain cross-cultural equivalence of the scale.

Decentering applied in the study

Table 1 shows the equivalent issues related to translation and the decentering applied in the study. The definitions of the problems and how we solved the problems are presented in the followings.

Table 1.   Equivalent issues related to translation and decentering applied in the exemplar
Issues for maintaining content equivalenceProblems confrontedApplied solutions
Vocabulary equivalenceKorean does not have the same termUsing several words instead of one word
Idiomatic equivalenceDid not applyDid not apply
Grammatical-syntactical equivalenceThe longest sentences included 52 wordsThe sentence was clear enough to be translated into Korean
Experiential equivalenceA word which had different meaning in between linguistic translation and cultural translation was identifiedBilingual committee had discussion to achieve cultural translation
Conceptual equivalenceWords having potential problem were identified in the pretestPretest procedure was applied; responses were carefully reviewed

A problem with vocabulary equivalence can happen when a word does not exist in a target language. This problem may be solved with a comparable word or a group of words. For instance, we identified a problem with vocabulary equivalence in the SAES. The SAES includes the word ‘party,’ the Korean language, however, does not have the same term. After discussing this issue with the scale developer (A.E. Norris, personal communication, September 17, 2003), the committee chose to use several words that refer to social and informal meetings to become the equivalent in the Korean version of the instrument instead of just one word.

Secondly, idiomatic equivalence cannot be obtained when researchers employ direct translation with an idiom because it would not make sense (Sechrest & Fay 1972). Therefore, translators and back-translators have to be familiar with the real meanings of the idioms to keep idiomatic equivalence. For instance, ‘hang in there’ which refers to persevere, can not be correctly interpreted when a person has no cultural understanding of the term. Fortunately, idiomatic equivalence, which occurs when an instrument contains an idiom, was not an issue during the translation procedure for the two instruments in the exemplar. That is, this problem can be reduced when scale developers are familiar with problems of equivalence in translation and avoid using idioms, which can lead to mistranslation.

Thirdly, a violation of grammatical–syntactical equivalence occurs during translation because each language has its own unique rules of grammar and syntax; each language presents different problems. The problem of grammatical–syntactical equivalence more often occurs when long passages need to be translated. This kind of problem can be avoided if instruments use simple and short sentences. For instance, violating grammatical–syntactical equivalence is possible when translating instruments from English to Korean because the two languages have a very different grammar, structure and syntax. The major problems are related to the order of words, comma usage and verb nuance and tense. Most of the questions in the selected instruments consisted of <16 words (Brislin et al. 1973). The longest sentence in the SAES had 52 words; however, the sentence explains a situation to measure students’ self-efficacy for maintaining their sexual abstinence. Furthermore, the scale was originally developed in English but translated into Spanish by the scale developer with an intention to conduct cross-cultural study; the scale developer had good knowledge of the use of a translated measure and the back-translation method. Therefore, the written sentence in the original English version had undergone translation and was clear enough so that a committee could translate it into Korean.

Another difficulty is obtaining experiential equivalence because statements can be interpreted differently based on one's level of cultural knowledge. A violation of experiential equivalence often occurs when translators have insufficient knowledge about the emic–etic distinction. Appropriate ‘cultural transition’ is a key for solving this problem (Sechrest & Fay 1972, p. 47). For instance, in Korean, ‘I want to go to a temple’ may indicate that a person wants to go to a temple for a religious activity; yet, the sentence can be also interpreted as a person is very dissatisfied with everyday life and wants to escape from the daily routine. Unlike English, an article cannot provide a suggestion for appropriate translation as Korean does not use an article. Thus, translators need to identify the actual meaning in a sentence, given the context.

The committee approach may help to solve this problem because the mistakes of one committee member are often easily detected by others on the committee. Discussion among the committee helps to identify an appropriate expression (decentering). In the SAES, the term ‘making out’ was discussed to find an appropriate word in Korean. To assure an accurate translation, three independent translators were independently asked the usage of the word to native English speakers. Afterwards, the committee discussed the meaning of the word and agreed on an expression in Korean.

Lastly, the problem of conceptual equivalence can occur when two languages have the same word, but the word has different meanings in a situation (Sechrest & Fay 1972). We encountered this problem in the mPSAS. The mPSAS measured the acceptance of sexual behaviour with different levels of relationships using ‘really like’ and ‘love’ as the third and the fourth levels. However, in Korean ‘love’ can be used interchangeably with ‘really like’ when the object is the same sex, friends or things, and with ‘respect’ when the object is an older person. Therefore, there was a need to identify whether conceptual gaps in words existed between the two language versions. The pretest technique became a helpful way to identify this problem. The responses of the participants in the items were carefully examined for the perceived differences. Participants were also asked to identify the differences between the terms ‘really like’ and ‘love’ in the feedback questionnaire. Because the majority of students reported that they accurately perceived the differences of the relationships intended in the original version, no additional effort was necessary to obtain conceptual equivalence of the instrument.

Reliabilities

Both instruments had good internal consistency when used with this sample of 36 Korean college students (see Table 1). Cronbach's alpha for the mPSAS was 0·95 which was higher than the original English version. The internal consistency reliability of the SAES was consistent with the original English version (α = 0·83). The bootstrap method also supported the good reliabilities and stabilities of the translated instruments (see Table 2).

Table 2.   Internal consistency in English and Korean versions of the instruments in the exemplar
 English versionKorean version
Sample descriptionAlphaAlphaBootstrap statistics
  1. sd, standard deviation; CI, 95% confidence interval.

Modified Premarital Attitude Scale (mPSAS)High school and college – aged female students (n = 267)0·890·95Mean: 0·942 (sd: 0·013)
CI: 0·913–0·959
Sexual Abstinence Efficacy Scale (SAES)Boys and girls, African-American seventh-grade students (n = 113); middle and upper income college students0·80–0·830·83Mean: 0·817 (sd: 0·053)
CI: 0·685–0·889

Discussion

A combination of translation techniques is ideal for successful translation (Brislin 1970, McDermott & Palchanes 1992, Jones et al. 2001, John et al. 2006) and several possible combinations of translation techniques exist. Researchers use a combination technique without the back-translation method, or they apply a single back-translation method to obtain appropriate instruments for their studies. Thus, they often report different psychometric properties such as internal consistency from the original studies using the measures. The issue is whether true differences exist between the original measures and the measures used in cross-cultural research.

The strengths of using the combined techniques in the current study were that a small number of bilingual people was needed, and that the translation procedure was shorter because a clearer translated version was obtained by using the committee approach in the beginning. We obtained a more reliable estimate of statistics from the dataset by performing bootstraps. As a result of applying the new approach, we successfully obtained translated content equivalent measures with acceptable internal consistency reliabilities.

Although the translated instruments showed good reliabilities, several implications for future research were identified. Firstly, a translated instrument needs to be revalidated with the target population because of the potential distortions of the items during the translation procedure (Streiner & Norman 1989); however, we only examined the internal consistencies of the instruments in the pilot study. There is insufficient evidence to conclude that the translated measures are valid instruments for assessing Korean college students’ sexual behaviour. According to Paunonen and Ashton (1998), instrument validation in cross-cultural research is evaluated with the assessment of multiple psychometric properties. Scale means, variance, reliabilities, criterion validity and factorial validity are appropriate approaches for instrument validation. The cultural differences and the translation procedure often induce the failure of obtaining invariance of the psychometric properties of the original and the translated version of the instrument in cross-cultural research. Adequate sample size, both within and between cultures, is necessary to reduce sampling error. Thus, there is a need to examine these five suggested psychometric properties of the translated scales with a larger sample for instrument validation in cross-cultural research.

Secondly, high internal consistencies of instruments often occur when there is item redundancy or an increasing number of items (Streiner & Norman 1989, Nitko 2004). In the mPSAS, the Cronbach's alpha may have increased with the inclusion of additional items after the translation procedure. Therefore, further investigation is needed to identify the reasons for this problem (Streiner & Norman 1989). Item-total correlations and inter-item correlations with a larger sample may provide an answer as to whether any items in the Korean version of the scale are redundant (Sechrest & Fay 1972, Streiner & Norman 1989, DeVellis 2003). Lastly, bootstrap statistics have a weakness when the original sample is small and non-representative (Kline 1998). Thus, there is a need to reexamine the internal consistencies with a larger, more representative sample.

Conclusion

Cross-cultural research will help nurses to compare the findings of previous studies and identify potential contributing factors to develop effective nursing intervention programmes with the goals of promoting health. Standardized translated measures, which are crucial to conducting cross-cultural research, can be obtained when researchers are attentive to the translation procedure. However, there is no gold standard for translation techniques because the research environment (e.g. accessibility and availability of bilingual people) and the research questions are different. Our findings give insight into what an appropriate translation approach is when researchers have limited sources.

Acknowledgements

The authors would like to acknowledge Dr A.E. Norris, Associate Professor, Boston College School of Nursing for her guidance about back-translation method. The authors thank to Drs Thelma E. Patrick and Susan M. Sereika for their reviews of a preliminary paper. The authors are grateful to Drs Betty Braxter and Scott Weber, University of Pittsburgh School of Nursing for their supports and helpful guidance in relation to the back-translation method. The authors thank to the translators.

Author contributions

ESC, KK and JE were responsible for the study conception and design and the drafting of the manuscript. ESC performed the data collection and ESC and KK performed the data analysis. ESC, KK and JE made critical revisions to the paper. ESC and KK provided statistical expertise and supervised the study.

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