Problems Encountered During the Adaptation of the Geriatric Depression Scale for Use 11.2.09
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1) The researchers aimed to adapt the Geriatric Depression Scale (GDS) for use among Laotian elderly patients but found issues with simple translation and back-translation. 2) Through an iterative process involving research staff, translators, and community outreach workers, they addressed problems of semantic and content equivalence to develop a valid translated instrument. 3) Key issues involved translating words like "helpless" and adapting the yes/no response format in a way that was clear and accurate for the Laotian elderly population.
Problems Encountered During the Adaptation of the Geriatric Depression Scale for Use 11.2.09
- 1. Problems encountered during the adaptation of the Geriatric Depression Scale (GDS) for use among Laotian elderly Jin Hui Joo, MD MA 1 ; Giang T Nguyen MD MPH MSCE 2 ; Elaine J Yuen PhD 3 ; Ethan T Nguyen BA 2 ; Yuko Sakata 4 ; Shong Chai Hang 4 ; Somsanith Phommachanh 4 1 Dept. of Psychiatry (Univ. of Pennsylvania), 2 Dept. of Family Medicine & Community Health (U. of Pennsylvania), 3 School of Population Health (Thomas Jefferson University), 4 Southeast Asian Mutual Assistance Associations Coalition (SEAMAAC); Philadelphia, PA. Background . Validation of depression screening instruments for use among Laotian elderly are lacking. Objectives. Using an iterative process, we adapted the Geriatric Depression Scale (GDS) for use among Laotian elderly. We will describe how cultural and linguistic factors impacted the process. Methods . The GDS was back-translated by outreach workers but did not result in a valid instrument. As a result, issues in semantic and content equivalence inherent in translation were addressed before validity could be achieved. Results . Certain words like “helpless” were difficult to translate to achieve equivalence in Laotian. The yes/no formal also resulted in inaccurate interpretation and response by the elderly. Problems of achieving a valid translation were overcome by engaging research staff and translators in an iterative process. Conclusions . Simple translation and back-translation should be used with caution. In order to provide a valid GDS adaptation for Laotian elderly, cultural and linguistic differences should be taken into account in an iterative and collaborative process. Abstract Elderly Cambodians, the majority of whom are refugees, are at increased risk for mental health problems. The values reflected by an instrument and the meanings of its component constructs may vary from one culture to another. Instruments and procedures that are relevant for culturally different groups need to be developed. Background The GDS short version was translated and back-translated into Lao by bilingual outreach workers. Research staff and translators in an iterative fashion worked in a committee to arrive at a translation which took into account issues of equivalent meaning and semantics. The final translated instrument was tested for face validity and test/retest validity. Methods Initial translation/back-translation seemed adequate at first, but closer investigation to determine deeper meanings revealed critical inconsistencies. The following translations were most challenging: Are you basically satisfied with your life? Have you dropped many of our activities and interests Do you often get bored Do you often feel helpless Do you feel pretty worthless the way you are now? Translation was repeated multiple times using real-time feedback until content equivalence was reached. In Lao, the use of a yes/no format made responses hard to interpret in the context of typical sentence structure (“Are you stultified with your life or not?” – “Yes.”). Therefore, the format was changed for clarity ( “satisfied” vs. “not satisfied”). Results Simple translation and back-translation should be used with caution when working with survey instruments, particularly if the investigator is not fluent in the other language. In order to provide a valid GDS screening instrument, cultural and linguistic differences should be taken into account through an iterative and collaborative process. Conclusions / Implications Geriatric Depression Scale (GDS): To describe the cultural and linguistic problems encountered in the translation and validation of the GDS for use among Laotian elderly. Objective