Translation and linguistic validation of the international standards to document autonomic function following spinal cord injury (ISAFSCI) for Japanese healthcare professionals.

Abstract

Forward and backward translation processes were conducted first, followed by cognitive interviews for validation within a cross-sectional study design. To translate the second edition (2021) of the International Standards to document Autonomic Function after Spinal Cord Injury (ISAFSCI) from English to Japanese using established translation guidelines. Department of Rehabilitation Medicine, University of Washington. Cognitive interviews were conducted in person or via secure video conferencing. The second edition (2021) of the ISAFSCI was translated into Japanese by two groups of bilingual Japanese healthcare professionals, and then back translated to English independently. After iterative review and confirmation by the developer, a pre-final version was created. Cognitive interviews were conducted with 15 Japanese healthcare professionals practicing spinal cord injury (SCI) care. All aspects of the ISAFSCI were translated including survey items (n = 114) and instructional items (n = 111). During back-translation, 10.7% of items showed language discrepancies. These were resolved through a second round of expert committee review and developer evaluation. Cognitive interviews revealed that most items were well understood. Modifications (n = 19) were required to clarify expressions related to autonomic function and anatomical terminology. Following a rigorous translation process, the Japanese version of the second ISAFSCI edition 2021 demonstrated linguistic clarity, cultural relevance, and broad comprehensibility among Japanese healthcare professionals. In addition to its clinical and research utility, this survey could address the knowledge gap about autonomic dysfunction after SCI by promoting awareness and education in the Japanese healthcare community.