Learning Objective #1: be familiar with the short Lithuanian version of NOC for identification of nursing care outcomes in national nursing and supportive care hospitals.

Learning Objective #2: understand the mixed methods design for research instrument translation and cultural adaptation.

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This study presents translation of the Nursing Outcomes Classification (NOC), third edition, into Lithuanian and adaptation to the Eastern European culture and professional work practices. The translated instrument is a start point for quality of care measurement in nursing and supportive care. Lithuanian nurses seek best nursing practices, research development and important changes in management and policy making. Mixed methods were used in the translation process and a clinical validation study was performed to ensure the accuracy of translation. Principle challenges were complexity and extent of material in the NOC, limited access to fluent English language experts and professionals, and lack of equivalencies in methodological terminology in the Lithuanian language. Original NOC translations have been hampered by linguistic differences between English and Lithuanian, one of the last two Baltic languages remaining in the world. In addition, developmental inequalities between professional nursing in Lithuania and the West as well as differences in management styles have lead to inaccurate interpretation and semantic errors. This study attempted to correct errors and accurately translate terms in the NOC for use in Lithuania. Primary attention was given to instrument applicability and comprehensiveness. Native English speakers aided in understanding the finer points of professional nursing language and specific American English terms. Coping, self-care, welfare and well-being, personal identity and family care provider are examples of the frequently used nursing terms in other cultures, but were unfamiliar for Lithuanians. Even the instrument key word “outcome” has two different Lithuanian translations and both them are seldom used in nursing. Despite scientific publications introducing Lithuanian instrument development and comprehensive analysis of psychometric measures, translation and cultural adaptation of instruments are imprecise. This study attempts to accurately translate and adapt NOC for implementation in Lithuanian nursing research and practice.