Cross-cultural Instrument Translation and Adaptation: Challenges and Strategies


  • Sutthida Phongphanngam RN, PhD, APN Medicalsurgical Nursing, University of Phayao School of Nursing, Thailand.
  • Helen W. Lach RN, PhD, CNL, FGSA, FAAN, Professor Saint Louis University School of Nursing, Missouri, USA.


Back translation, Cross-cultural, Falls Efficacy Scale, Fear of Falling, Testing, Translation



                 Over the decades, cross-cultural research has been conducted to increase understanding of health and illness phenomena across different cultures and populations. However, researchers are faced with issues of translation from the source language to the target language, even with instruments developed for use in cross-cultural research. Therefore, the process of translation is a crucial one in order to maintain the conceptual, content, semantic, and construct equivalences across the two languages and cultures which is essential for credibility of the measurement results. The purpose of this article is to describe the process of the translation and cross-cultural adaptation of the Falls Efficacy Scale-International. It was translated into Thai using ten steps, including translation and back-translation as well as checking with experts and the target audience to assure cultural equivalence. Challenges with some wordings and cultural differences in daily life were identified and addressed with strategies to manage them so that an appropriate version of the tool was developed and ready for future research with community-dwelling Thai older adults.


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How to Cite

Phongphanngam S, Lach HW. Cross-cultural Instrument Translation and Adaptation: Challenges and Strategies. PRIJNR [Internet]. 2019 Mar. 27 [cited 2024 Mar. 2];23(2):170-9. Available from:



Original paper