How to translate and validate a scale for a nursing dissertation: get permission, translate forward and back with independent translators, have an expert panel rate every item, test the pre-final version on a small group, and report reliability for the translated version. That sequence is what turns an English tool into a defensible Hindi, Marathi, Tamil or other regional-language instrument, and it is what an examiner is looking for when they ask, “How did you validate this tool?”
Most M.Sc and B.Sc Nursing dissertations in India collect data from patients, caregivers, students or staff whose first language is not English, while the published tools they want to use are in English. A tool you simply translate yourself and hand out has no validity evidence at all. This guide gives you the steps, a worked content validity calculation you can reuse, and a methodology paragraph you can adapt. The numbers in the worked example are invented for illustration.
Step 1: Decide whether you really need a translation
Translate only if your participants cannot reliably answer in English. If they can read English but prefer another language, a translated version still may be worth it, but then you must also decide how to administer it: self-completed or read aloud by you. Read-aloud administration to low-literacy participants changes the data, and you must say so in the methodology. Write down your participants’ language, literacy level and the mode of administration before you touch a single item.
Step 2: Get permission before you translate
A published scale belongs to its author or publisher. Before translating, write to the author or the publisher, state your study and the target language, and ask for permission to translate and to use the tool. Keep the reply; it goes in your appendix. Some authors ask to see the translation or the back-translation; some ask to be sent the validation results. If a tool is under licence, the licence terms may decide whether you can translate it at all. Our guide to validated scales for a psychology dissertation shows what permission checks look like for common instruments.
Step 3: Translate forward, then back, with a committee in between
The framework most often cited for this process is by Beaton, Bombardier, Guillemin and Ferraz (2000), published in Spine, 25(24), 3186–3191. It sets out six stages: initial translation, synthesis of the translations, back-translation, review by an expert committee, testing of the pre-final version and submission of documentation to the committee that oversees the process. For a dissertation, you will normally do the first five and describe them; the sixth is for instrument developers.
- Forward translation. At least two independent translators render the English tool into the target language. Ideally one knows the concepts the tool measures and one does not, so the second brings a plain-language reading.
- Synthesis. You and the two translators compare the two versions, resolve differences and write one reconciled version, keeping a note of each decision.
- Back-translation. Two further translators, who have not seen the English original, translate the reconciled version back into English. Differences between the back-translation and the original point to items that may have shifted in meaning.
- Expert committee. A committee, including bilingual clinicians or nurse educators, reviews the original, both forward translations and the back-translations and agrees a pre-final version. Idioms and examples are replaced with equivalents that mean the same thing in your participants’ setting.
Three things commonly go wrong at this stage. Response options such as “sometimes” and “often” do not map one-to-one into every language, so check that the order and spacing of the options survive. Clinical terms may have a hospital word and a household word, and your participants may know only the second. And examples written for one setting, such as a named food or festival, may mean nothing in another state. Record each such decision with the reason, because the committee’s notes are part of your evidence.
Step 4: Content validity with an expert panel
Content validity asks whether the items cover what they should. The standard way to report it in nursing research is the content validity index (CVI). Each expert rates every item for relevance on a four-point scale, for example from 1 (not relevant) to 4 (highly relevant). The item-level index, the I-CVI, is the proportion of experts who rate the item 3 or 4. Polit, Beck and Owen (2007), in Research in Nursing & Health, 30(4), 459–467, concluded that items with an I-CVI of .78 or higher for three or more experts could be considered evidence of good content validity.
There are two ways to compute the scale-level index (S-CVI). One requires universal agreement among experts on every item; the other averages the item-level indexes. Polit and Beck (2006) showed that nurse researchers use both methods, that the two can give different values, and that you should state which method you used. Report both if you can.
Choose panel members for the content they know, not for their titles. A mix of clinical nurses, nurse educators in your specialty and, where the tool touches medicine or psychology, a physician or psychologist gives the ratings real coverage. Send each expert the same package: the purpose of the study, the construct definition, the items and the rating instructions, with space for comments on wording. Ask for the ratings back by a set date and keep the originals.
A worked example with invented numbers
Suppose seven experts rate eight items of a translated caregiver-knowledge tool. The counts below are illustrative.
| Item | Experts rating 3 or 4 (of 7) | I-CVI | At or above .78? |
|---|---|---|---|
| 1 | 7 | 1.00 | Yes |
| 2 | 7 | 1.00 | Yes |
| 3 | 6 | .86 | Yes |
| 4 | 7 | 1.00 | Yes |
| 5 | 5 | .71 | No: revise or drop |
| 6 | 6 | .86 | Yes |
| 7 | 7 | 1.00 | Yes |
| 8 | 4 | .57 | No: revise or drop |
The counts sum to 49 out of a possible 56 ratings (7 experts times 8 items), so the S-CVI by the averaging method (S-CVI/Ave) is 49 divided by 56, which is .875, reported as .88. Four of the eight items (1, 2, 4 and 7) were rated relevant by all seven experts, so the universal-agreement method (S-CVI/UA) gives 4 divided by 8, which is .50. The two methods disagree sharply here, which is exactly why you must say which one you report.
Items 5 and 8 fall below .78. You either rewrite them, return them to the panel, or remove them, and you say which. Do not delete low items silently. This example is for learning; the thresholds and panel size your department expects may be different, so confirm with your guide.
Step 5: Pre-test the pre-final version
Give the pre-final version to a small group drawn from the same kind of participants as your main sample, and ask them not only to answer but to tell you what they understood each item to mean. Note items that were skipped, misread or asked about. This group is not part of your main sample, and you should say so. Revise the wording, then freeze the tool; changes after data collection starts invalidate the evidence you have built.
Step 6: Reliability of the translated version
Reliability evidence belongs to your version, not to the original paper. Choose the method according to the item type:
- Likert-type attitude or practice items: Cronbach’s alpha for internal consistency.
- Right-or-wrong knowledge items: an internal-consistency coefficient suited to dichotomous items such as KR-20, since alpha is built for scaled items.
- Stability over time: test-retest, administering the tool twice to the same pilot group after an interval you justify.
Report the coefficient from the pilot and again from the main sample. What counts as acceptable, and what to write when a value is lower than you hoped, is in our guide to the acceptable Cronbach’s alpha for a thesis.
Step 7: What to write in the methodology chapter
Examiners want the process described, the evidence summarised and the documents in the appendix. A labelled template, to be filled with what you actually did:
The [name of tool] by [author, year] was translated into [language] with the written permission of [author or publisher] (Appendix [n]). Two independent translators produced forward translations, which were reconciled into one version by [who]. Two further translators, who had not seen the original, back-translated it into English. An expert committee of [number and roles] reviewed all versions and agreed a pre-final version. Content validity was established by [number] experts who rated each item for relevance on a four-point scale; the item-level index ranged from [x] to [y] and the scale-level index (averaging method) was [z], following Polit, Beck and Owen (2007). Items below [threshold] were [revised or removed]. The pre-final version was tested on [number] participants not included in the main sample. Reliability in the pilot was [coefficient and value] and in the main sample [coefficient and value].
Where this paragraph goes, and how the surrounding methodology chapter is built for a nursing study, is shown in our annotated sample M.Sc nursing thesis. For building a tool from scratch rather than translating one, see our guide to tool construction and validation. If the tool measures a construct such as burnout, our comparison of scales for a nursing thesis on burnout shows what permission and licensing look like for real instruments. Whichever route you take, you will need clearance before you use the tool on patients; see our guide to ethics committee clearance for an Indian thesis.
Five mistakes in a nursing tool translation
- A single translator and no back-translation. Nothing then shows whether meaning survived.
- No permission letter. Examiners ask for it, and it belongs in the appendix.
- Quoting the original paper’s reliability. Your version needs its own.
- Deleting low-rated items without saying so. Report what changed and why.
- Changing the tool after pilot testing. Freeze it before the main data collection.
Keeping the evidence trail organised
A translated tool generates documents: permission, translations, committee notes, expert ratings, pilot sheets. Tesify helps you structure the methodology chapter and assists you as you write your own account of the validation steps. More than 9,000 students have used it, it has supported 15,000+ chapters, and every word of your dissertation stays 100% written by you.
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Frequently asked questions
Do I need to translate a standard scale for my nursing dissertation?
Only if your participants cannot reliably respond in English. If you translate, you must show how the translation was checked, because a translated tool does not inherit the validity of the original.
Do I need permission to translate a published scale?
Yes. Write to the author or publisher, state your study and target language, and keep the reply for your appendix.
What is back-translation?
It is translating the translated version back into the original language by translators who have not seen the original, then comparing the result with the original to find items whose meaning changed.
How many experts do I need for content validity?
Your guide and department set the panel size. Polit, Beck and Owen (2007) discussed items rated by three or more experts. State the number you used and how you chose them.
What is the I-CVI and what value is acceptable?
The I-CVI is the proportion of experts rating an item 3 or 4 on a four-point relevance scale. Polit, Beck and Owen (2007) concluded that .78 or higher for three or more experts could be considered evidence of good content validity.
What is the difference between S-CVI/Ave and S-CVI/UA?
S-CVI/Ave averages the item-level indexes; S-CVI/UA is the proportion of items rated relevant by every expert. They can give very different values, so state which one you report.
Should I use Cronbach’s alpha or KR-20?
Use alpha for scaled items such as Likert responses and an internal-consistency coefficient for dichotomous items, such as KR-20 for right-or-wrong knowledge questions.
Should the pilot group be part of the main sample?
No. Draw the pilot group from similar participants and exclude them from the main study, and say so in the methodology.
Can I use a tool translated by someone else?
Yes, if a published translation exists with validation evidence and permission. Cite the translation study, and still report reliability in your own sample.
Where do I put the translation documents?
In the appendix: the permission letter, the translated tool, the committee’s notes, the expert rating sheet and the pilot results.