Adaptation of the Experimental Version of EQ-5D-Y-5L Into Bahasa Indonesia

The EQ-5D-Y-5L has been developed to provide an appropriate version of EQ-5D for children. This article reports the EQ-5D-Y-5L adaptation process into Bahasa Indonesia.

Forward and backward translations were performed to produce equal qualifiers between EQ-5D-Y-5L English and Bahasa versions. Unresolved issues were addressed in a cognitive debriefing, conducted with 10 children aged 8 to 15. A linguist proofread the final stage of the translation.

Differences were found in wordings, headings, font styles, and qualifiers in EQ-5D English versions that require consideration when translating the English version into other languages. Two issues arose: first, levels 1, 2, and 4 in EQ-5D-Y-5L Bahasa matched the levels 1, 2, and 3 of EQ-5D-Y-3L, rather than levels 1, 3, and 4, as is the case in the English versions. Second, the translated words for "pain" and "worried," used in the other EQ-5D Bahasa, were difficult to comprehend. Hence, we replaced these words with alternative Bahasa words at the cost of breaking consistency between the EQ-5D-Y-3L and EQ-5D-Y-5L Bahasa. There was an indication that the extensive cognitive debriefing caused response fatigue in children.

The adaptation process resulted in a comprehensible EQ-5D-Y-5L Bahasa Indonesia for children aged 8 to 16. Our findings suggest a need to review the existing EQ-5D-Y-3L and EQ-5D-3L in Bahasa Indonesia. While awaiting this review, research related to these 2 measures should be interpreted with caution in the context of international comparisons. Furthermore, we propose consideration of a more user-friendly approach to cognitive debriefing tailored for children.