Translation and Cultural Adaption of the Revised ICU Family Satisfaction Questionnaire (FS-ICU-24R) Into Danish

Systematic assessment of family satisfaction is essential for improving the quality of care in intensive care units (ICUs). The Family Satisfaction with Care in the Intensive Care Unit questionnaire (FS-ICU-24R) is internationally used but has not previously been available in Danish. This study aimed to translate and culturally adapt the FS-ICU-24R into Danish and to evaluate its face and content validity.

The translation followed a standardized multistep procedure involving forward translation by six bilingual ICU nurses and researchers, reconciliation through consensus, and blinded back-translation by another bilingual ICU nurse. The Danish version was compared with the original to resolve discrepancies and ensure conceptual equivalence. Face and content validity was assessed through cognitive interviews with six relatives, who completed the questionnaire while verbalizing their understanding of each item. Comments were reviewed by the translator team, and problematic items were revised.

The translation process identified linguistic and cultural issues requiring adaptation. Key challenges concerned the Danish legal framework for decision-making, necessitating adjustments to Items #21, #22, and #24 to avoid implying that relatives act as surrogate decision-makers. Item #23 was modified by replacing "control" with "overview/oversight" to reflect the intended meaning without suggesting authority over patient care. Additional adjustments improved clarity and relevance to the Danish context. Cognitive interviews confirmed that the revised items were understandable and acceptable to relatives.

The FS-ICU-24R was successfully translated and culturally adapted into Danish using a systematic approach. The Danish version is culturally appropriate and demonstrated good face and content validity. Psychometric evaluation is now warranted to establish its reliability and construct validity in Danish ICU settings.