The cross-cultural adaptation of the Toronto Empathy Questionnaire (TEQ) from the English language to the Sinhala language to use with nursing students in Sri Lanka

Abstract

Background: Empathy is defined as understanding another person's experience by imagining oneself in that other person's situation. There is paramount importance to assess empathy at the student level in Nursing. Toronto Empathy Questionnaire (TEQ) has been identified as a successful tool to evaluate and measure empathy. Aim: This study aimed to translate and cross-culturally adapt the TEQ from the English language to the Sinhala language. Methodology: Permission to use this Questionnaire was obtained from the original author. The translation process and the cross-cultural adaptation were conducted under five stages I) Initial stage of translation, II) Synthesis of the translations, III) Back translation, IV) Delphi review and V) Test of the pre-final version. The Delphi review panel included a consultant psychiatrist, two clinical psychologists, a sociology educator, a nurse educator, and a nurse manager. The Delphi ratings from stage one were summarised, resent for a second round, and evaluated by a degree of consensus. If 70% or more of the re-ratings were in categories 0–3, that component was eliminated or reworded to make it allowable. If reworded, the Delphi process was re-conducted for that component, and (ii) if 70% or more of the re-ratings were over 4 or above, that item was conserved. The Content Validity Index (CVI) was calculated through the Delphi review. Results: There were no disagreements on any of the items. All the items were in categories 7-9 and conserved. According to experts' suggestions, some items were reworded to retain their conceptual meaning. Sinhalese version of TEQ showed maximum content validity of all the individual items (I-CVI=1.0) and maximum overall content validity (S-CVI/UA = 1.0; S-CVI/Ave = 1.0). Conclusion: The TEQ Sinhala version has shown good content validity and needs to be further examined for rest of the validity and reliability testing.