Translation and Cultural Adaptation of the Cerebral Palsy Quality of Life-Child Primary Caregiver (CP QOL-CPC) to Filipino

Background. Cerebral palsy (CP) is a prevalent cause of childhood disability. Its impact is significantly higher in low- to moderate-income countries like the Philippines, with a disease burden 5 to 10 times greater. The Cerebral Palsy Quality of Life for Children - Primary Caregiver Questionnaire (CP QOL-CPC) is a self-report measure that assesses the quality of life (QOL) of children with CP. It has excellent psychometric properties and remarkable representa- tion of the International Classification of Functioning, Disability and Health. The validity and reliability of the English tool may be affected when used in a different-speaking population. 

Objective. The objectives of this research were to: 1) translate the CP QOL-CPC to Filipino, and 2) determine conceptual equivalence, understandability, and acceptability of the translated version.

Methods. Translation was conducted in five steps: 1) forward translation (conversion of the original instrument to Filipino, the target language, by two [2] translators); 2) reconciliation of forward translations; 3) conduct of an initial validation by backward translation (translating back to the original language); 4) determination of cross-cultural equivalence by a panel of experts; and 5) pre-testing the translated tool with subsequent cognitive interviews of participants. Ten (10) target participants, selected using a maximum variation approach, participated in the pre-testing. The interviews gave further insight into the understandability of the items based on the responses given. In the panel discussion, the percentage of agreement on conceptual equivalence was determined, and thematic analysis was conducted. For pretesting, cognitive interviews were evaluated according to the understandability of items and appropriateness of responses.

Results. The panel review determined 62 items with full agreement (100%), 13 items with moderate agreement (80%), and 36 items with low agreement (≤60%) on conceptual equivalence between the BT and the original. The considerations for revisions were 1) grammar, 2) colloquialism, and 3) culture. Difficulties in understanding the translation during pre-testing were attributed to unfamiliarity with terms, concepts, and formatting. Participants’ feedback was incorporated into the final Filipino version. 

Conclusion. The Filipino translation of the CP QOL-CPC appears to be understandable and culturally appro- priate based on the expert panel and pre-testing participants. This version can be used to establish the tool’s psychometric properties.