Translation and Adaptation of the Self Assessment of Communication (SAC) and Significant Other Assessment of Communication (SOAC) into Afrikaans

Master Thesis

2022

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Abstract The Self Assessment of Communication (SAC) and Significant Other Assessment of Communication (SOAC) are self-report outcome measures that are based on the World Health Organization's (WHO) International Classification of Functioning in Disability and Health (ICF) framework. The SAC and SOAC focus on hearing-related activity limitations, participation restrictions, quality of life, hearing aid use, and satisfaction from the perspective of the hearingimpaired individual and the communication partner or significant other (SO). The SAC is administered to the hearing-impaired individual, while the SOAC is the companion questionnaire that is administered to the SO. The SOAC focuses on the hearing disability and handicap of the hearing-impaired individual from the perspective of the SO. The SAC and SOAC were initially developed in English and standardised for a developed country population, the United States of America (USA). Thus, to make the outcome measures more relevant to a multicultural and multilingual country like South Africa (SA), the most practical solution is to translate and adapt the measure for the SA population. In SA, few audiological outcome measures have been translated and adapted. Therefore, to add value to the limited research available, the study aimed 1) to adapt and translate the SAC and SOAC into Afrikaans using the American Association of Orthopaedic Surgeons (AAOS) guidelines; and 2) to describe the usability of the Afrikaans SAC and SOAC by South African audiologists through surveys and verbal feedback interviews. The AAOS translation and adaptation guideline is a multi-step translation method that involves five stages: (i) Forward Translation from the source language (English) to the target language (Afrikaans); (ii) Synthesis of the forward translations; (iii) Backward Translation from the target language (Afrikaans) back to the source language (English); (iv) Expert Committee Review by analysing all the translations to create a pre-final Afrikaans SAC and SOAC measure; and (v) Field testing the pre-final Afrikaans SAC and SOAC. The field testing stage involved the target population (Afrikaans speaking hearing-impaired individuals and SOs) who analysed the pre-final Afrikaans SAC and SOAC. The participants in the field testing stage were sampled using purposive, convenience, and snowball sampling methods within the Western Cape Province in private practice. For the second aim of the study, 16 bilingual Afrikaans and English audiologists (referred to as audiologist participants) were sampled using purposive and snowball sampling. The audiologist participants were invited to use the Afrikaans SAC and SOAC in their practice for one to two months. Following implementation, the audiologist participants were required to comment on the usability of the Afrikaans SAC and SOAC by completing a survey. Three audiologists agreed to do a verbal feedback interview reporting their experience with the Afrikaans SAC and SOAC. Overall, audiologist participants' responses (survey and verbal feedback interview) indicated positive feedback regarding the translated Afrikaans SAC and SOAC. Most felt that the measure was a useful counselling tool, was user friendly and provides valuable information on the perception of hearing loss. However, some implementation challenges were reported such as (i) limited time available, which caused a delay in appointments with other patients, and (ii) patients' SO were not always present in consultation, as such, the SOAC could not be administered. In conclusion, findings revealed that following a multi-step approach when translating and adapting a measure is valuable, as it allows researchers to identify inaccuracies and discrepancies during the translation process to achieve a good quality translation. Furthermore, based on audiologists' perspectives, the Afrikaans SAC and SOAC can be used in clinical practice by South African audiologists. However, it is recommended that further research is necessary to explore psychometric properties such as criterion and concurrent validity.
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