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. 2025 Mar 10;22(3):399.
doi: 10.3390/ijerph22030399.

Cross-Cultural Adaptation and Patient Evaluations of a Question Prompt List for Danish-Speaking Patients at the Orthopaedic Surgery Department, Odense University Hospital

Nina Høy Chodkiewicz  1   2 , Emma Weiss Christensen  1 , Meg Chiswell  3 , Peter Martin  3 , Christina Louise Lindhardt  1   2   3
Affiliations

Cross-Cultural Adaptation and Patient Evaluations of a Question Prompt List for Danish-Speaking Patients at the Orthopaedic Surgery Department, Odense University Hospital

Nina Høy Chodkiewicz et al. Int J Environ Res Public Health. .

Abstract

Objectives: The Question Prompt List (QPL) enhances patients' consultation preparation by improving health literacy and communication with healthcare professionals. A validated tool for this context is not yet available. We adapted and translated an Australian QPL to ensure its validity. This study seeks to improve patient-centred communication and health literacy through the QPL. This study aims to conduct a translation and cross-cultural adaptation of the QPL.

Study design: Cross-cultural adaptation.

Methods: Beaton's five-step guide inspired the cross-cultural adaptation, which involved forward and back translations from the Australian to Danish versions. Patients at the orthopaedic department tested the final version, evaluating the QPL for clarity, usefulness, and context. Four semi-structured interviews supplemented this process. Feedback from patients led to the refinement and finalisation of the QPL.

Results: The translations revealed some contradictions, indicating a need for QPL adjustments to fit the Danish context. Most patients were satisfied with the QPL, finding it beneficial and comprehensive. They noted that the QPL would have been helpful in previous consultations. Minor criticisms of specific questions were also raised, leading to further discussion and refinement.

Conclusions: This cross-cultural adaptation has ensured the validity and quality of a Danish QPL, and implementation strategies are now ready for investigation.

Keywords: 5-point Likert scale; QPL; Question Prompt List; cross-cultural adaptation; health literacy; patient-centred communication; semi-structured interviews.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Clarity: The patients rated the clarity of each question on a 5-point Likert scale. Option 1 (dark purple) and 2 (light purple) are expressed on the low end, Option 3 (pink) on medium, and Option 4 (light green) and Option 5 (dark green) on high.
Figure 2
Figure 2
Usefulness. The patients rated the usefulness of each question on a 5-point Likert scale. Option 1 (dark purple) and 2 (light purple) are expressed on the low, option 3 (pink) on medium, and option 4 (light green) and 5 (dark green) on high.
Figure 3
Figure 3
Context. The patients rank the relevance of the context with each question on a 5-point Likert scale. Option 1 (dark purple) and 2 (light purple) are expressed on the low, option 3 (pink) in medium, and option 4 (light green) and 5 (dark green) in high.
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