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Table 1 English to Spanish translation process

From: Translation and cultural adaptation of the pectus excavatum evaluation questionnaire to Spanish and Catalan

Type

Item

3 discrepancies in forward translation

Forward translation explanation

Changed meaning post back translation

Solution

Difficulties for patient to understand

Solution

1. Child

How do you feel about the way you look in general?

No

Yes

(about your appearance in general?)

Keep the Spanish equivalent for “about your appearance in general?”

No

2. Child

How do you feel about the way you look with your shirt or your top off?

No

Yes

(when you don't wear a shirt?)

Change for Spanish equivalent for “when you are with your shirt or your top off”

No

3. Child

If you had to spend the rest of your life with your chest as it looks now, how would you feel?

No

No

(with your chest as you have it now?)

No

4. Child

How often do other kids do fun about you because of your chest?

No

Change for Spanish equivalent for “laugh at you”

Yes

(the shape of your chest?)

Change again for Spanish equivalent for “do fun about you” and omit “the shape”

No

5. Child

How often do you avoid doing things, like spending the night at a friend’s house, because of the way your chest looks?

No

Change “doing things” for Spanish equivalent for “making plans”

Yes

(Do you avoid making plans with your friends, like sleep over at their house; because of the shape of your chest?)

Change again for Spanish equivalent for “doing things”

1

6. Child

How often do you try to hide your chest to keep people from knowing about it?

No

Yes

(so that people do not know how you have it?)

Keep the Spanish equivalent for “people do not know how you have it?”

No

7. Child

How often are you bothered because of the way your chest looks?

No

Use the Spanish equivalence for “worried” instead of “bothered”

Yes

(Are you worried about the appearance of your chest?)

Change again for the Spanish equivalent for “are you bothered”

2

Add the Spanish equivalent for “by other people”

8. Child

How often does your chest make you feel shy or self-conscious?

Yes (shy)

Exclude “shy” from Spanish version

Yes

(Do you feel ashamed about the shape of your chest?)

Keep the Spanish equivalent for “self-conscious”

7

Add again the Spanish equivalent for “shy”

9. Child

How often do you feel bad about yourself because of the way your chest looks?

No

Yes

(Does the appearance of your chest make you feel bad?)

No

10. Child

Have trouble running around or exercising because it made your chest hurt?

No

No

(Problems when running or exercising because your chest hurt)

No

11. Child 

Have shortness of breath

Yes

Use the Spanish equivalent for “feeling shortness of breath”

No

(Feeling short of breath)

Remove the Spanish equivalent for “feeling”

3

Add the Spanish equivalent for “breathing problems”

12. Child

Be tired

No

No

No

13. Child

Not be able to participate in gym class

No

Change for the Spanish equivalent for “to do physical education class”

Yes

(to do physical education class)

Change for the Spanish equivalent for “participate”

No

14. Child

Miss school

No

No

No

15. Child  before surgery

How much do you want the surgery to make your chest look different?

Yes

Use the Spanish equivalent for “would you like to undergo surgery to change how your chest looks?”

Yes

(Would you like to operate to have a different breast?)

Keep the Spanish equivalent for “would you like to undergo surgery to change how your chest looks?”

No

15. Child after surgery

How did the surgery change how your chest looks?

No

Yes

(Do you think the operation has changed the appearance of your chest?)

Keep the Spanish equivalent for “Do you think the operation has changed the appearance of your chest?”

No

16. Child after surgery

How did the surgery change how you feel about your chest?

No

Yes

(After the operation, how do you feel about your chest?)

Keep the Spanish equivalent for “After the operation, how do you feel about your chest?”

No

17. Child after surgery

How happy are you that you had the surgery?

No

No

(Are you happy to have gone through the surgery?)

 

No

1. Parents

How often has your child’s pectus excavatum caused him/her to have trouble being physically active?

No

Change for the Spanish equivalent for “difficulties in physical activity”

Yes

(Difficulties in physical activity)

Change for the Spanish equivalent for “trouble”

No

2. Parents

How often has your child’s pectus excavatum caused him/her to have chest pain when physically active, such as running or playing sports?

No

No

(Chest pain during physical activity -running, playing sports-)

No

3. Parents

How often has your child’s pectus excavatum caused him/her to have shortness of breath?

No

Add the Spanish equivalent for “feeling”

Yes

(Feeling short of breath)

Omit the equivalent for “feeling” in the Spanish version

No

4. Parents

How often has your child’s pectus excavatum caused him/her to become tired?

No

No

(tiredness)

 

No

5. Parents

How often has your child’s pectus excavatum caused him/her to have problems gaining weight?

No

No

(Problems to gain weight)

No

6. Parents

How often has your child’s pectus excavatum caused him/her to be irritable?

No

Change for the Spanish equivalent for “irritability”

No

(Irritability)

 

No

7. Parents

How often has your child’s pectus excavatum caused him/her to be frustrated?

No

Add the Spanish equivalent for “feeling”

Yes

(Feeling frustrated)

Omit the equivalent for “feeling” in the Spanish version

No

8. Parents

How often has your child’s pectus excavatum caused him/her to be sad or depressed?

No

Add the Spanish equivalent for “feeling”

Yes

(Feeling sad or depressed)

Omit the equivalent for “feeling” in the Spanish version

No

9. Parents

How often has your child’s pectus excavatum caused him/her to be restless?

No

Add the Spanish equivalent for “sensation”

Yes

(Sensation of anxiety)

Omit the equivalent for “sensation” and keep the Spanish equivalent for “restlessness” in the Spanish version

No

10. Parents

How often has your child’s pectus excavatum caused him/her to be isolated?

No

Add the Spanish equivalent for “sensation”

Yes

(Sensation of isolation)

Omit the equivalent for “sensation” in the Spanish version

No

11. Parents

How often has your child’s pectus excavatum caused him/her to be made fun of?

No

Change for the Spanish equivalent for “be the object of jokes”

Yes

(Be the object of jokes)

Change for the Spanish equivalent for “be made fun of” or “be mocked”

No

12. Parents

How often has your child’s pectus excavatum caused him/her to limit him/her playing sports?

No

Yes

(Limitation to practise sport)

Keep the Spanish equivalent for “limitation to practise sport”

No

13. Parents

How often has your child’s pectus excavatum caused him/her to miss school

No

Change for the Spanish equivalent for “class”

Yes

(Missing class)

Change “class” for the Spanish equivalent for “school”

No

14. Parents

How often has your child’s pectus excavatum caused him/her to be reluctant to wear a bathing suit?

Yes (reluctant)

Keep the Spanish equivalent for reluctant

No

(Show reluctance to use a swimsuit)

No

15. Parents

How often has your child’s pectus excavatum caused him/her to be reluctant to change clothes in front of others?

Yes (reluctant)

Keep the Spanish equivalent for reluctant

No

(Show reluctance to change clothes in front of others)

No

16. Parents

How often have you been concerned about the effects pectus excavatum has on your child’s life?

No

No

(Are you concerned about the effects of pectus excavatum on your child's life?)

No