Danish translation, cultural adaptation and initial validation of the Clinical Assessment of Modes Questionnaires

Introduction: Occupational therapists (OTs) use the Intentional Relationship Model (IRM) as a framework to facilitate communication with clients, using six distinct ways of relating, termed therapeutic modes. Using the three Clinical Assessment of Modes Questionnaires (CAMQs) the modes are determined; CAM-C1: clients' preferential modes for therapy, CAM-C2: clients’ perception of modes used during therapy, CAM-T: OTs perception of modes used. To provide access to valid CAMQs for Danish OTs and clients, a rigorous translation and cultural adaptation process is required.

Objective: To translate and culturally adapt the CAMQs into Danish, examining the face validity in terms of relevance and comprehensiveness in a Danish context.

Method: A 10-step process was followed: 1) Preparation, 2) Forward translation, 3) Reconciliation, 4) Back translation, 5) Back-translation review, 6) Harmonization, 7) Cognitive debriefing interviews (CDI), including the Content Validity Index (CVI) and inter-rater agreement using Kappa statistics, 8) Review of CDIs’ and finalization, 9) Proof reading, 10) Final report.

Results: After translation, seven OTs and seven clients participated in the CDIs, another eight clients filled in the CVI. Overall, the CAMQs were rated to have a high level of agreement on the cultural relevance of the items. Modifications regarding titles, layouts, instructions, wording and response categories were performed in several parts of all the CAMQs.

Conclusion: The translated versions of the CAMQs have been culturally adapted into Danish. Thus, the current Danish versions seem culturally equivalent to the original American versions and useable in a Danish occupational therapy.