Translating the patient perception of integrated care survey to measure integrated care in The Netherlands: Combining equivalence and contextualization approaches for optimal results

Maike V. Tietschert*, Federica Angeli, Arno J.A. van Raak, Sara J. Singer, Dirk Ruwaard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: An increase in initiatives to improve integration of care provides the need for instruments that assess the degree of integrated care as perceived by patients across cultural contexts. This article aims to explain the relevance of equivalence and contextualization approaches in translating and adapting the Patient Perception of Integrated Care Survey developed in the US for use in the Netherlands. Theory and methods: The World Health Organization guidelines guided the translation and adaptation, including a forward-backward translation and patient-feedback through informal contacts (N4) and cognitive interviews (N14). Results: The forward-backward translation produced a Dutch version of the Patient Perception of Integrated Care Survey with minor adaptations. Patients evaluated the survey as very relevant. Alterations resulted from structural and cultural differences and specificities of patients with chronic conditions. Conclusions and discussion: A context-sensitive translation process is key to developing instruments for cross-cultural health research. Our results show that equivalence- and contextualization methods provide equally relevant, yet substantially different contributions to the translation outcome and should both be incorporated when translating instruments for different cultural contexts. The results support the applicability of the Patient Perception of Integrated Care Survey in the Netherlands and are promising for its adoption in other cultural contexts.

Original languageEnglish
Article number11
Number of pages9
JournalInternational Journal of Integrated Care
Issue numberJuly-September
Publication statusPublished - 23 Aug 2016

Bibliographical note

© 2016 The Author(s).


  • Cross-cultural
  • Integrated care
  • Patient perception
  • Survey translation
  • Translation method

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