Translation and Cross-Cultural Adaptation of the Quality Maternal and Newborn Care Framework Index for Its Use in...

The Quality Maternal and Newborn Care Framework index (QMNCFi) is a 44-item tool that assesses service users' perspectives of the quality of maternal and newborn care. Transforming a survey tool for use in another language requires both linguistic and cultural adaptation. This study aimed to translate and cross-culturally adapt the QMNCFi into standard Chinese.

A standard translation and adaptation model was used, including independent translation, back translation, checking of the items' wording, applicability, and relevance by a senior panel. This was followed by purposive sampling of 30 mothers to participate in cognitive interviews and then verification of back translations by the original lead authors of QMNCFi. Finally, a further 16 mothers were purposively selected to participate in two rounds of cognitive interviews. Data were analyzed using content analysis to assess item, semantic, operational, conceptual, and measurement equivalence, ultimately resulting in a culturally adapted Chinese version.

Adaptations were made to the QMNCFi covering item, semantic, operational, and conceptual equivalence. The item-level content validity index from the panel consultations ranged from 0.813 to 1.000 (first round) to 0.933 to 1.000 (second round). The average scale-level content validity index was 0.990 and 0.998, respectively, indicating strong content validity, so no revisions were made for measurement equivalence.

This study achieved cultural equivalence through cross-cultural translation and adaptation of QMNCFi. The adapted Chinese version of QMNCFi will now be formally validated.