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Table 2 Examples of revisions made to address comprehension problems

From: Cross-cultural adaptation and exploratory factor analysis of the Person-centred Practice Inventory - Staff (PCPI-S) questionnaire among Malaysian primary healthcare providers

Main issues Problems encountered Item example Action taken
Require further explanation - Ambiguous
- Grammatical meaning
- Multiple meaning
(A1) I have the necessary skills to negotiate care options
Translated versions were repeatedly misinterpreted despite terminology change and sentence restructuring.
Exemplar scenario added
Cultural discrepancy - Multiple meaning (D13) I take my time to explore why I react as I do in certain situations
Translated term for “to explore why I react” (“menilai semula”) was negatively interpreted as reflection of avoidable mistakes and replaced with “positive self-reflection” (“muhasabah”)
Terminology replaced
- Words bearing emotional weight and action word (E17) I challenge colleagues when their practice is inconsistent with our team’s shared values and beliefs
All possible terms to translate “challenge” were negatively perceived and deemed culturally rude. The original translation (“mempertikai”) was retained.
No modification
Language discrepancy - Words bearing emotional weight and action word (C8) I strive to deliver high quality care to people
The translated phrase for the word ‘strive’ (“berusaha”) did not capture the intensity of enforcing greater effort. Word expanded to emphasize greater effort (“berusaha dengan gigih”).
Expansion of phrase
- Compound words
- Multiple meaning
(I29) The contribution of colleagues is recognized and acknowledged
“Recognised and acknowledged” was translated to a single word “appreciated” (“dihargai”), instead of unnecessarily using 2 words (“dikenalpasti dan diambilmaklum”) which carried no additional meaning in Malay.
Replaced by single word
- No similar word
- Unfamiliarity with subject experience
(F20) I am able to make the case when skill mix falls below acceptable levels
“Skill-mix” has no equivalent and meaningful term in Malay and was retained in English. The definition was added for reference.
Definition added
Require redirection - Complex sentence (M44) I integrate my knowledge of the person into care delivery
Highlighting certain words in “I integrate my knowledge of the person into care delivery” was to emphasise and shift respondents’ focus from the knowledge about “the care and treatment for the person” to knowledge about “a person influencing care and treatment”.
Some words highlighted