Linguistic Forum

Besides providing professional services we open a forum to discuss the most burning issues in cross-cultural linguistics related to Patient-Reported Outcomes measures. We encourage everyone, including developers, translators, researchers and patients alike to provide your examples, share your experience and spread your knowledge here.


“ON/OFF period” in the context of Parkinson’s disease: translating medical terms for a questionnaire intended for patients.

I would like to discuss the problem of translating medical terms for questionnaires intended for patients. I will use the Russian translation of the term “ON/OFF” in the context of Parkinson’s disease as an example. As is the case with many other countries where medical research was done in relative isolation from the international medical community during the Soviet era, in Russia many terms have not been standardized yet. So, one difficulty that Russian translators face is choosing which term is “the most standard.” Another problem is ensuring that our chosen translations are easily understood by patients. (Of course, the same difficulties may arise even in countries that have always been integrated into the international medical community).

Here is the problem:

1. Some medical texts keep the original English phrase ON/OFF; the obvious disadvantage is that patients won’t understand it.

2. ON/OFF is sometimes translated as “период включения/выключения,” which can be back-translated (somewhat awkwardly) as “period of the switch being on/off.” I think the Russian translation of this commonly used term misses the point. Clearly, the primary meaning of the English term is “period when the patient is ON medication/OFF medication.” However, because the effect of medication is such that the patient becomes active and agile during the ON period and passive and immobile during the OFF period, the term acquires a second meaning in English, as if it were a pun. This double meaning is lost in the Russian translation. (I saw the same translation used in another language, French: allumé).

3. It also possible to use a descriptive construction: “период, когда лекарство действует/не действует,” which can be back-translated as “period when the medication has an effect/does not have an effect.” I like this translation because it is foolproof: the meaning is correct, and it is easy for patients to understand.

Which is the best solution? How would you translate this term into your language? How do we decide?

 

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Issues with generic concepts

I have noticed that quite a few respondents react negatively when you ask them to explain how they understand certain generic concepts such as “satisfied with treatment,” “to control life,” “everyday activities,” and “social life.” A typical response would be: “I do not understand what ‘everyday activities’ means. That’s not how people talk!  No, really, what do you mean by ‘everyday activities’? It makes no sense to me at all. Explain to me what you mean here by everyday activities.” But when you ask more specific questions – for instance, you ask the respondent to try to think of some examples of “everyday activities,”  the respondent’s answers show that they understand the concept perfectly well.

What does this mean for translators of questionnaires? How do we interpret the results meaningfully and how do we avoid making misleading conclusions? Importantly, the respondent’s first reaction does not actually show how they understand the translated item. It shows that the respondent feels uncomfortable having to explain a word/ expression that means different things to different people. Indeed, interpretation of generic concepts depends entirely on the respondent’s personal experience. Also, these concepts might be difficult to rephrase.  So I think it is not necessary to record verbatim what such a respondent says during a Cognitive Debriefing report; it is not informative for the developer. I think it is enough to record only the evidence of respondents’ actual understanding of a word/expression, for instance, the examples they provide.

 

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Introduction

To encourage discussion, may we propose the first topic: how do we render the notion of “Social Activities” in various languages?

There are several translation difficulties: first, the word “activity” has no direct equivalent in many languages; second, if we do find an equivalent (for example, something like “interacting with friends and others”) how do we make sure it covers the same range of activities as its English original?

For example, in the US, “social activities” include “volunteer work,” which is usually not the case in Russia and many other countries where most people might not have time to spare on volunteer work. How do we make sure that the translation accurately reflects the intended meaning?

We may study the context of the questionnaire – it is likely that we will need different solutions for different health conditions. Sometimes, the intended goal is to assess whether the respondent can communicate and maintain friendship with others. In that case, even chatting on the phone for hours is considered a social activity. Other questionnaires put emphasis on physical limitations. In this, the goal is to find out whether or not one is able to get around to engage in social activities such as going out, socializing with others outside one’s home, etc.

Please share with us your thoughts on this issue. What is the common perception of “social activities” in your culture?

 

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