Equivalence of Chinese version of the Cohen-Mansfield Agitation Inventory

This paper is a report of a study undertaken to translate the Cohen-Mansfield Agitation Inventory from the original English into a Chinese language version and to establish the content, semantic and technical equivalence of the Chinese version.

Ensuring the equivalence of a translated Chinese version of the Cohen-Mansfield Agitation Inventory for patients with dementia is an essential requirement for identifying culturally specific expressions of agitated behaviours.

In Phase I, five experts scrutinized the Inventory items to determine whether the behaviour described was relevant to the agitated behaviours present in the Taiwanese culture. In Phase II, experts did the initial translation into Chinese and then back-translated it into English. Four bilingual observers rated 31 residents with dementia to determine semantic equivalence across versions. In Phase III, the agitated behaviours of 32 residents were assessed by four observers using staff ratings and direct observation to determine the technical equivalence of the Chinese version. The study was carried out in Taiwan from August 2004 to April 2005.

In Phase I, the rating of behaviours described on the Cohen-Mansfield Agitation Inventory was relevant to the agitated behaviours based on Taiwanese culture with a content validity index (CVI) value of 0.993. In Phase II, intra-class coefficients for all items on the Chinese version and split-halves of Chinese and English versions ranged from 0.69 to 0.74. In Phase III, six possible results for estimation of reliability across methods and raters for the Chinese version ranged from 0.63 to 0.86.

The Chinese Cohen-Mansfield Agitation Inventory had modest psychometric properties. Further studies are needed to assess criterion and conceptual equivalence.