Validated translation makes assessment tool for ICU-delirium even better

This work's purpose is to highlight the importance of using validated methods to translate instruments from one language to another and to make CAM-ICU-7 ready for use in Denmark. The delirium condition is internationally recognized with a growing amount of validated delirium checklists and screening instruments, but the conceptual equivalent can be difficult to translate. WHO describes the process of translating an instrument from English into another language while staying conceptually equivalent in the target culture. Two Danish ICU nurses fluent in English independently did forward translations and discussed differences between the two translations until reaching an agreement. For the expert back-translation, the combined Danish version was sent to a native English-speaking ICU nurse who has worked in Denmark for many years. This nurse was unfamiliar with the English version of CAM-ICU-7. Pretests with skilled ICU nurses revealed no problems, whereas nurses less familiar with delirium screening had relevant comments about face validity and elucidated language and conceptual considerations leading to further adaption of the Danish version of the CAM-ICU-7. Although CAM-ICU-7 is a short and relatively simple instrument, the process showed several translation details that might influence the instrument's validity if the WHO guidelines are not used.