Table 3 Results of the cognitive interviews, which were particularly interesting and resolved in the cross-cultural harmonization process
Domain | English original | German translation | CI issue | Resolution |
|---|---|---|---|---|
CI results, which led to item revisions | ||||
Anger | I felt mad | Ich war zornig | Zornig was not part of everyday language for some children | Translation was changed to “Ich war wütend” |
Depression | I felt alone | Ich habe mich alleine gefühlt | During the CI it became obvious that the tense of the translation was not the same as in the original item | Translation was corrected to “Ich fühlte mich allein” |
Depression | I felt lonely | Ich habe mich einsam gefühlt | See above | Translation was corrected to “Ich fühlte mich einsam” |
Fatigue | I got tired easily | Ich bin leicht müde geworden | Children misunderstood “leicht “ (quickly) as being a little tired | Item was revised to “Ich bin schnell müde geworden “ |
Pain | I had trouble doing schoolwork when I had pain | Ich hatte Schwierigkeiten Schul- und Hausaufgaben zu machen, wenn ich Schmerzen hatte | Children and parents in all three countries did not differentiate well between “Schulaufgaben” (work in class) and “Hausaufgaben” (homework), they understood Schulaufgaben as Hausaufgaben | The concept “Schulaufgaben “ as “Aufgaben “ in der Schule (work at school/in class) was specified in the item translation to “Ich hatte Schwierigkeiten die Aufgaben in der Schule und Hausaufgaben zu machen “ |
Pain | It was hard for me to pay attention when I had pain | Es war schwer für mich aufzupassen, wenn ich Schmerzen hatte | Most of the Swiss kids understood "aufpassen (pay attention)" only relating to school. All kids in all three countries prefer "konzentrieren (concentrate)" rather than "aufpassen (pay attention)" | The translation was revised to “Es ist mir schwergefallen, mich zu konzentrieren, wenn ich Schmerzen hatte.“ |
Pain | It was hard to get along with other people when I had pain | Es ist mir schwergefallen, mit anderen auszukommen, wenn ich Schmerzen hatte | The item was understood well by all children, but nearly all participants would prefer the addition of the word "gut (well)" since this term is more common within German language | The translation was revised to „Es ist mir schwergefallen, gut mit anderen auszukommen, wenn ich Schmerzen hatte “ |
CI results, which did not lead to item revisions | ||||
Pain | It was hard for my child to run when he/she had pain | Es ist meinem Kind schwergefallen, zu joggen oder zu rennen, wenn es Schmerzen hatte | Young children did not understand the word “joggen” | Because children understood the added translation of that word (”rennen”), the translation did not need to be revised |
Pain | Walking a block | Eine kurze Strecke/100 m gehen | Children understood the phrase “kurze Strecke” (short distance), but not the culturally adjusted metric 100 m very well | Because children understood the added translation of the word (= kurze Strecke), the translation did not need to be revised |
Anger | My child felt upset I felt upset | Ich habe mich aufgeregt | One Austrian mother stated that the item could be misunderstood positively as "excited", which is also a meaning of "aufgeregt" Children perceived the word “upset” ambiguous | The ambiguity had been fed back to the test developers, but to maintain the content, the translation was kept as it is |
Peers | During the past 7 days, I was good at making friends | In den letzten 7 Tagen, ist es mir leicht gefallen Freundschaften zu schließen | Children discussed that it took longer than one week to make friends | The item was nevertheless kept to keep the intended content of the original item |