Translation and validation of a quality of life instrument for Hispanic American cancer patients: methodological considerations.

The increasing diversity of the US population has drawn attention to the need for the development of quality of life tools that are appropriate for special populations, including Hispanic Americans, Asian Pacific Islanders, and Native Americans. The Hispanics are one of the fastest growing of these special populations, and this group includes persons who have lived in the USA for many generations, as well as recent immigrants. Both language and culture are important to consider when developing a quality of life tool for Hispanics. The initial aims of this study were to develop a Spanish translation of the CAncer Rehabilitation Evaluation System (CARES), perform content and construct validation of the Spanish CARES in Spanish-speaking and bilingual patients with cancer, and provide descriptive data on the rehabilitation needs and quality of life of these patients. However, in performing this study we encountered a number of methodological problems that had not been previously described in the literature, including the need for idiomatic translations, lack of familiarity with questionnaires, low acculturation and low literacy rates among Hispanic cancer patients in the southwestern USA. We suggest a number of practical considerations for future investigators planning to develop quality of life tools for this special population.