JAN

RESEARCH METHODOLOGY

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

Eun-Seok Cha, Kevin H. Kim & Judith A. Erlen
Accepted for publication 10 January 2007

Eun-Seok Cha MPH PhD RN

Instructor
Chung-Ang University School of Medicine,
Department of Nursing, Seoul, South Korea
Kevin H. Kim PhD
Assistant Professor, Statistician
University of Pittsburgh School of Education,
Department of Psychology in Education,
Pittsburgh, Pennsylvania, USA
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
Correspondence to Eun-Seok Cha:
e-mail: euc6@cau.ac.kr

C H A E . - S . , K I M K . H . & E R L E N J . A . ( 2 0 0 7 ) Translation of scales in cross-cultural

research: issues and techniques Journal of Advanced Nursing 58(4), 386395
doi: 10.1111/j.1365-2648.2007.04242.x

Abstract
Title. Translation of scales in cross-cultural research: issues and techniques
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.
Keywords: back-translation, bootstrapping statistics, instrument validation, International research, nursing, translation issues, translation techniques

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
386

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

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JAN: RESEARCH METHODOLOGY

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, Brislins 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 Brislins 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 Brislins 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 Brislins 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.

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.

Techniques and issues of translation

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 crosscultural 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 emicetic 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, grammaticalsyntactical, 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

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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); Brislins 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 backtranslated 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 Brislins 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 members 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 Brislins classic back-translation

Table 1 Equivalent issues related to translation and decentering applied in the exemplar
Issues for maintaining content equivalence

Problems confronted

Applied solutions

Vocabulary equivalence
Idiomatic equivalence
Grammatical-syntactical equivalence

Korean does not have the same term

Did not apply
The longest sentences included 52 words

Experiential equivalence

A word which had different meaning in

between linguistic translation and cultural
translation was identified
Words having potential problem were
identified in the pretest

Using several words instead of one word

Did not apply
The sentence was clear enough to be translated
into Korean
Bilingual committee had discussion to achieve
cultural translation

Conceptual equivalence

388

Pretest procedure was applied; responses were

carefully reviewed

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JAN: RESEARCH METHODOLOGY

model. Suggested remedies include combining translation

techniques and modifying Brislins 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 backtranslation 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.

Techniques and issues of translation

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 080 to 083 (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,
fiance/fiancee). The internal consistency reliability of the PSAS
was 089 (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,

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E.-S. Cha et al.

we could not use Brislins 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 2207 188; range 1824). We examined the
reliabilities of the translated measures using Cronbachs
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 researchers 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
120 (SPSS Inc., Chicago, IL, USA) to estimate empirical
distributions of the internal consistency and provide the
ranges of Cronbachs 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 instructors 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 instructors 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 selfaddressed 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
researchers 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

Figure 1 Brislins translation model

(Triandis & Brislin 1984, p. 1009).
390

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JAN: RESEARCH METHODOLOGY

Techniques and issues of translation

Figure 2 Modified translation model in

the study. GD, Group discussion.

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).
Secondly, a bilingual KoreanAmerican, 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 backtranslated 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 backtranslate 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 KoreanAmerican 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 backtranslated 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

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E.-S. Cha et al.

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.
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 grammaticalsyntactical equivalence
occurs during translation because each language has its own
unique rules of grammar and syntax; each language presents
different problems. The problem of grammaticalsyntactical
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 grammaticalsyntactical 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
392

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 crosscultural 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
ones level of cultural knowledge. A violation of experiential
equivalence often occurs when translators have insufficient
knowledge about the emicetic 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

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Techniques and issues of translation

Table 2 Internal consistency in English and Korean versions of the instruments in the exemplar
English version

Modified Premarital
Attitude Scale (mPSAS)
Sexual Abstinence
Efficacy Scale (SAES)

SD ,

Korean version

Sample description

Alpha

Alpha

Bootstrap statistics

High school and college aged female students

(n 267)
Boys and girls, African-American seventh-grade
students (n 113); middle and upper income
college students

089

095

080083

083

Mean: 0942 (SD : 0013)

CI: 09130959
Mean: 0817 (SD : 0053)
CI: 06850889

standard deviation; CI, 95% confidence interval.

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).
Cronbachs alpha for the mPSAS was 095 which was higher
than the original English version. The internal consistency
reliability of the SAES was consistent with the original
English version (a 083). The bootstrap method also
supported the good reliabilities and stabilities of the translated instruments (see Table 2).

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 Cronbachs 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). Itemtotal 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.

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E.-S. Cha et al.

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.
Brislins 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.

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 per394

formed 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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