Methods: The MDQ-K was developed in four steps: (1) obtaining permission to translate, (2) forward-and-backward translation, (3) expert review, and (4) pilot testing with bilingual students (Che, Hairi, & Chong, 2017; Squires et al., 2013). The expert review was performed by five professors from Korean nursing schools whose research focus is menstrual health. The pilot testing included 102 bilingual Korean female students who were studying in the U.S. The students were recruited between July and October of 2015 through online communities and were asked to answer both the original MDQ and the MDQ-K. In addition, the participants were asked questions related to menstrual health (e.g., age at menarche, gravidity, menstrual patterns) and degrees of acculturation using the Suinn-Lew Asian Self Identity Acculturation Scale. Descriptive analyses were reported using frequency, percentage, mean, and standard deviation. The reliability of the MDQ-K was calculated by analyzing its internal consistency using Cronbach’s alpha, and the construct validity was assessed using a paired t-test.
Results: Content validity was achieved based on the expert review of the initial version of the Korean translated MDQ. The items “affectionate” (item 36) and “orderliness” (item 37) received low scores; therefore, they required revision of their Korean translation. The revised questionnaire was named the Korean version of the MDQ (MDQ-K). Through the pilot testing of the MDQ-K, the reliability of the questionnaire was determined using Cronbach’s alpha, which was .96. From the findings of a paired t-test, the means of three items in the MDQ and MDQ-K were significantly different (p < .05): “restlessness” (item 22), “bursts of energy and activity” (item 40), and “blind spots and fuzzy vision” (item 46). There were significant correlations (p < .001) between each of the 46 items and the total scores of the MDQ and MDQ-K, with scores ranging between .572 (“dizziness and faintness”) and .985 (“Total score”).
Conclusion: The MDQ-K demonstrated acceptable psychometric properties, while three of the items (items 22, 40, and 46) may be open to further modification. Possible explanations for discrepancies on these three items between the MDQ and the MDQ-K include the following: (a) participants’ English proficiency levels being too low to fully understand those items in the original English version, (b) confusion regarding some of the medical terminologies used, (c) occurrence of survey bias, including either down-reporting or over-reporting, which is often seen when translating a single word, and (d) response bias, especially regarding demand characteristics, which were often observed in the survey participants. This study poses several implications for future nursing research and practice. First, in addition to the steps suggested in this study, a comprehensive validation process, following a rigorous translation process, is necessary before administering a translated questionnaire. Second, various factors should be carefully considered when administering either English or translated versions of a questionnaire to participants whose first language is not English (e.g., participants’ English proficiency level. equivalence of translated questionnaire to the original language). Because we live in an era of supra-territoriality, where physical place is no longer meaningful, the importance of cross-cultural and international nursing studies will continue to grow. This study will serve as a guideline for researchers who intend to either conduct a study using either English or previously translated questionnaire to non-English speakers or plan to personally translate an English questionnaire for use in their study.