Cross-Cultural Adaptation of the Toronto Empathy Questionnaire to Sinhalese for Implementation among Nursing Students in Sri Lanka

Abstract

The Toronto Empathy Questionnaire (TEQ) is a valuable tool for assessing empathy in nursing students. This study aimed to translate the 16-item TEQ into Sinhalese and cross-culturally adapt it to Sri Lanka. The process of cross-cultural adaptation consisted of five distinct stages: (I) initial translation, (II) synthesis of the translation, (III) back translation, (IV) Expert Committee Delphi review, and (V) testing of the pre-final version after obtaining permission from its developer. The content and consensual validity of the translated version were assessed by a two-round Delphi procedure involving a panel of five experts. Evaluation metrics included Content Validity Index (CVI) parameters such as I-CVI, Universal Agreement (S-CVI/UA), and Average CVI (S-CVI/Ave). Administered to 197 nursing undergraduates at General Sir John Kotelawala Defence University in Sri Lanka, the finalized Sinhalese TEQ demonstrated exceptional content validity (I-CVI = 1.0 for each item) and the highest overall content validity indices (S-CVI/UA = 1.0; S-CVI/Ave = 1.0). The high internal consistency, as indicated by Cronbach's alpha coefficient of 0.732, underscores the Sinhalese TEQ's reliability. In conclusion, this cross-culturally adapted assessment tool proves valid and reliable for evaluating empathy levels among nursing students in Sri Lanka.