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Universidade Federal De Santa Catarina Pós-Graduação Em Estudos Da Tradução UNIVERSIDADE FEDERAL DE SANTA CATARINA PÓS-GRADUAÇÃO EM ESTUDOS DA TRADUÇÃO Robert James Coulthard RETHINKING BACK-TRANSLATION FOR THE CROSS- CULTURAL ADAPTATION OF HEALTH-RELATED QUESTIONNAIRES: EXPERT TRANSLATORS MAKE BACK-TRANSLATION UNNECESSARY Tese submetido(a) ao Programa de Pós-Graduação stricto sensu em Estudos da Tradução da Universidade Federal de Santa Catarina para a obtenção do Grau de Doutor em Estudos da Tradução Orientador: Prof. Dr. Markus Weininger Florianópolis 2009 – 2013 Robert James Coulthard RETHINKING BACK-TRANSLATION FOR THE CROSS- CULTURAL ADAPTATION OF HEALTH-RELATED QUESTIONNAIRES: EXPERT TRANSLATORS MAKE BACK- TRANSLATION UNNECESSARY Esta tese foi julgada adequada para a obtenção do título de DOUTOR EM ESTUDOS DA TRADUÇÃO e aprovada em sua forma final pelo curso de Pós-graduação em Estudos da Tradução da Universidade Federal de Santa Catarina. Florianópolis, 25 de setembro de 2013. _________________________ Profa. Dra. Andréia Guerini Coordenadora do curso Banca examinadora: _________________________ _________________________ Prof. Dr. Markus Johannes Profa. Dra. Maria José Weininger Bocorny Finatto Orientador e Presidente Universidade Federal de Rio Grande Universidade Federal de Santa do Sul Catarina _________________________ _________________________ Prof. Dr. Fabio Alves Prof. Dr. Lincoln Fernandes Universidade Federal de Minas Universidade Federal de Santa Gerais Catarina _________________________ _________________________ Profa. Dra. Maria Lúcia Prof. Dr. Werner Heidermann Vasconcellos (Suplente) Universidade Federal de Santa Universidade Federal de Santa Catarina Catarina ACKNOWLEDGMENTS My greatest debt is to my parents, Elizabeth and Malcolm. If I were to list all of the efforts and sacrifices they have made to help me reach this point there would be no space left for the thesis. I shall therefore simply thank them both for everything and state the obvious fact that I could never have got here without them. Second, and only so in terms of numbers of years, is my wife. Once more, listing the reasons is impractical. I would therefore simply like to thank Regina for (still) being my wife. I also need to thank Tommy for keeping me company while I wrote this thesis. I am indebted to Claudia Buchweitz and her team at Scientific Linguagem Ltda. for their generosity in donating translation services and their dedication in carrying them out and for all the help and advice they have given me since I was a novice translator more than ten years ago. I am particularly grateful to Denise Arend and Janisa Antoniazzi, both of Scientific Linguagem Ltda., for letting me take advantage of their skill and expertise. I would also like to thank CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) for the maintenance grant that made this research project possible. CONTENTS CONTENTS..............................................................................................................7 ABSTRACT............................................................................................................13 RESUMO ................................................................................................................17 LIST OF TABLES AND FIGURES .....................................................................21 PRELIMINARY NOTES ......................................................................................23 1 INTRODUCTION.................................................................................25 1.1 Background .............................................................................................25 1.2 Health-related questionnaires and cross-cultural adaptation....................26 1.3 Back-translation for cross-cultural adaptation .........................................30 1.4 Objectives................................................................................................31 1.5 The structure of this thesis.......................................................................33 2 BACK-TRANSLATION LITERATURE............................................39 2.1 Overview.................................................................................................39 2.2 Richard Brislin ........................................................................................40 2.2.1 The classic study: Richard Brislin’s “Back-translation for cross-cultural research” (1970) .....................................................................................40 2.2.2 Later work by Brislin...............................................................................75 2.3 Beyond Brislin: contemporary use of back-translation for cross-cultural adaptation of health-related questionnaires .............................................90 2.3.1 The Sperber cross-cultural translation procedure...................................92 2.3.2 The IQOLA project cross-cultural translation procedure .....................100 2.3.3 The AAOS cross-cultural translation procedure ...................................105 2.4 Contemporary critical evaluation of back-translation............................110 2.4.1 Grunwald and Goldfarb (2006).............................................................111 2.4.2 Ozolins (2009) .......................................................................................115 2.4.3 Perneger, Leplège and Etter (1999) ......................................................126 3 TRANSLATION STUDIES THEORY..............................................137 3.1 Meaning and language...........................................................................138 3.2 Source versus target orientation.............................................................140 3.3 Translation and cultures ........................................................................144 3.4 Translators.............................................................................................149 3.4.1 The status of translators and translations .............................................149 3.4.2 Translation as an expert activity........................................................... 153 4 ANALYSIS OF BACK-TRANSLATION......................................... 159 4.1 Overview and preliminary assertions.................................................... 159 4.1.1 The value added by back-translation has never been demonstrated ..... 161 4.1.2 Back-translation can lead to dysfunctional translations: an example with race, skin colour and ethnicity categories............................................. 187 4.2 Meaning and equivalence: Back-translation is founded on a simplistic concept of language .............................................................................. 206 4.2.1 Back-translation is based on a simplistic view of language and of translation............................................................................................. 207 4.2.2 Back-translation is inherently pessimistic............................................. 219 4.2.3 Back-translation enacts a self-fulfilling prophecy ................................ 226 4.3 Cultural issues....................................................................................... 238 4.3.1 Brislin studied cultural differences, but cross-cultural adaptation views them as obstacles .................................................................................. 239 4.3.2 Contemporary back-translation methods are source-anchored............ 245 4.3.3 Cultural colonisation and asymmetrical power relations ..................... 251 4.3.4 Patronage and use of back-translation ................................................. 259 4.4 Back-translation and translators............................................................ 268 4.4.1 Back-translation procedures do not treat translators as professionals; this is corrosive..................................................................................... 270 4.4.2 Back-translation as a means of giving translators a voice?.................. 285 4.5 Conclusions and discussion .................................................................. 289 5 THE PARALLEL, COOPERATIVE, CONSENSUS-BASED TRANSLATION METHOD FOR QUESTIONNAIRES ................ 295 5.1 Basic principles of the Parallel, Cooperative, Consensus-based Translation Method for Questionnaires................................................ 295 5.2 Demonstration of the Parallel, Cooperative, Consensus-based Translation Method for Questionnaires.................................................................... 298 5.2.1 The instrument ...................................................................................... 299 5.2.2 The translators...................................................................................... 299 5.2.3 The translation brief and translation protocol...................................... 300 5.2.4 Analysis of translations......................................................................... 302 5.2.5 Forward translations ............................................................................ 302 5.2.6 Back-translation.................................................................................... 315 5.2.7 Conclusions and discussion .................................................................. 326 6 STREAMLINED TRANSLATION PROTOCOL ........................... 329 6.1 Demonstration of the Streamlined Translation Method for Questionnaires.......................................................................................329 6.1.1 The instrument.......................................................................................329
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