Abstract
Background
Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland.
Methods
Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence.
Results
Results show adaptations mainly focused on experiential and conceptual equivalence. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect typical ones in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions.
Conclusion
This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. As participation and environment are both complex concepts to measure, conceptual equivalence posed the highest challenges for this cultural adaptation. A culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.