Cross-cultural adaptation of the Concept of Pain Inventory for South African children

Background: Childhood pain can affect a child’s functioning and participation. The 14-item Concept of Pain Inventory (COPI) in English, assesses a child’s understanding of pain. The COPI has not been adapted or translated for use in South Africa (SA). Aim: This study aimed to cross-culturally adapt and translate the COPI into isiXhosa and Afrikaans for 12-year-old children. Setting: The study was conducted in Gqeberha, Eastern Cape province of SA. Methods: A descriptive study was conducted, using a modified cross-cultural adaptation process comprising two survey rounds, translation and evaluation of the translated COPI and pilot testing. Conceptual, item and semantic equivalence and the possibility of eliciting a negative emotional response were evaluated. A multidisciplinary panel of healthcare providers and educators participated, along with three children from the target population. Results: The panel reached consensus on 10 of the original COPI items. Four items were modified and subsequently approved. The adapted and translated COPI versions were confirmed to be semantically equivalent and the pilot participants found it easy to understand. Conclusion: The COPI was cross-culturally adapted and translated into Afrikaans and isiXhosa for use in the Eastern Cape of SA, ensuring equivalence between the original and adapted versions. Further research is needed to understand how culture influences the concept of pain in the South African context. Contribution: The adapted and translated version of the COPI has broadened its potential use in SA and was found to be easy to read and understand by a sample of 12-year-old children without eliciting a negative emotional response.