A case study of translating “Intolerance of Uncertainty Short form” (IUS-12) into Bahasa Malaysia – Part 1: unveiling a novel translation and cross-cultural adaptation approach for multi-ethnolinguistic population

Abstract

Background: Questionnaire translation is vital for high-quality research, requiring more than simple language conversion. Inaccurate translations can alter question meanings and compromise the intended message, necessitating cross-cultural adaptation, particularly in multi-ethnic, multi-lingual contexts. The aim of this project is to translate the "Intolerance of Uncertainty Short form" (IUS-12) into Bahasa Malaysia for multiethnolinguistic individuals using a novel process. Methods: Recognizing that respondents may interpret questions in their mother tongue, we devised a systematic translation method. Forward and backward translations were conducted by trilingual individuals from each ethnic group, refined by an expert committee to assess semantic, conceptual, idiomatic, and experiential equivalence. A pilot study with 30 dental patients confirmed comprehension, resulting in the finalized IUS-12 BM. The results revealed how some words and expressions lack direct equivalents, resulting in subtle differences that may be overlooked in the usual translation approach. Malaysia's unique multilingual environment further complicates matters, with people's mother tongues evolving within this diverse setting and extensive borrowing of words and concepts from other languages. Conclusion: This research uniquely involves multiple ethnic groups at every stage, producing a translated instrument while gathering contextual data on how different cultures interpret concepts like "uncertainty." Based on our experience, we propose the MELT toolkit to enhance translation and adaptation processes. In conclusion, our novel approach offers a unique method for developing ethnolinguistically relevant instruments that foster inclusive and diverse research practices. This methodology emphasizes the importance of cultural sensitivity and linguistic accuracy, ensuring research outcomes reflect the perspectives of varied ethnic groups.