Norwegian translation and adaptation of the INT4 version of the Adult Social Care Outcomes Toolkit (ASCOT)

PURPOSE: In Norway, no standardized instrument has been available to measure outcomes of long-term care (LTC) from the perspective of the service users. The Adult Social Care Outcomes Toolkit (ASCOT), developed in England, was designed for this purpose. ASCOT is a suite of tools designed that assess outcomes from the perspective of different groups receiving LTC. This article describes the translation and cultural adaptation of the four-level interview version (INT4) for use in Norwegian LTC services. METHODS: The translation followed international guidelines and included two forward translations and two back translations conducted by a professional translation company. These were followed by discussions involving the translators, the original developers, and the Norwegian in-country expert team to ensure conceptual equivalence with the original. Cognitive debriefing interviews were conducted with LTC users. The introduction and instructions for interviewers and respondents were adapted to fit the Norwegian context. RESULTS: The initial translations were overly literal. Based on extensive team discussions and findings from cognitive interviews, the text was revised to achieve fluent, simple, everyday Norwegian language in the instructions, questions and response options. Any superfluous text was removed. CONCLUSION: The Norwegian version of the ASCOT INT4 is a carefully translated and culturally adapted instrument that closely reflects the constructs of the original English version.