I used a semi-structured interview method for several reasons. First, the interview guide included a mix of more and less structured interview questions (Merriam 2009), allowing for flexibility to change and add possible relevant questions that were not strictly scripted (Yin 2016). Second, this method does not follow word usage or phrases directly; rather the prepared questions are more flexibly worded. This method allows researchers to respond to the situation at hand to the participant’s view, and to the new ideas on the phenomenon studied (Merriam 2009). The sample of interview questions is provided in Appendix 9.
To accommodate participants’ common conversation language in Malaysia, which can be English, Malay or sometimes mixed, the interview questions that were in English were also prepared in Malay. I used a combination of back translation with the bilingual technique suggested by Brislin (1970) as an approach for instrument validation. This meant that the instruments were translated into the target language by a bilingual expert and blindly back translated by the next bilingual expert. The back-translated versions were compared with the original (source language) versions and re-translated where errors in meaning were found. The process continued until congruence of meaning between the original and target versions in Malay was reached. To develop an easily understood Malay version of the instruments involved three bilingual individuals. They produced a translation that used conversational Malay.
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This research used a back-translation technique, compared the original and second- source versions of the instrument, and tested both source and target-language versions among bilingual subjects administered by the bilingual judge (Jones et al. 2001). Other methods, such as the committee approach, requires more than three bilingual people, and the accessibility of bilingual people as translators is a vital issue in this approach (Cha, Kim & Erlen 2007). Moreover, previous studies recommend multiple techniques should be used for instrument translation (Maneesriwongul & Dixon 2004). This is because previous studies found no standard guideline for instrument translation, and the quality of processes used for instrument translation varies widely among researchers (Cha, Kim & Erlen 2007; Maneesriwongul & Dixon 2004).
Thus, I selected a combination of back translation and Brislin’s (1970) bilingual approach because of its benefits and some other factors that fit the research. The key benefit of conducting a combination of Brislin’s (1970) back translation with the bilingual technique is that it allows for comparison of the source-language version with the version that is back translated into the source language. The bilingual technique is used to test the validity of the instruments on the bilingual subject (Maneesriwongul & Dixon 2004).
Moreover, I selected these techniques after considering several factors: first, the availability of three bilingual translators; second, the availability of the administrators and bilingual subjects who are required to check and review the instrument so that it is within the field of research and are tested to the subjects; and third, the translation required budget and time to complete the instruments.
I had difficulty finding a bilingual translator knowledgeable in the field of research. To address the problem, two administrators, or bilingual judges, were selected. A bilingual judge can make a rigorous comparison between the source and target language (Maneesriwongul & Dixon 2004). The administrator or judge is a person who is knowledgeable about the field of research. The first administrator reviewed the Malay (translated) version and the source (English) version to ensure the meaning of the words and sentences could deliver the research objectives. The second administrator was a retiree with vast experience working in a public health institution. Her role was
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to help review the translated Malay version and its back translation (to English) to ensure the meaning in Malay was in line with the healthcare environment.
Some problems regarding the translation were detected and solved. First, there are words that have many meanings when translated into Malay. For example, the word use can be defined as apply or practice in English, but when translated into Malay, use can be known as wear (pakai), which does not make sense. Therefore, words had to be carefully chosen to give the most accurate meaning when used in a sentence in the research. Moreover, after discussion with Administrator 1, several words were used instead of one, so the right meaning was provided (Cha, Kim & Erlen 2007). Second, some terms are difficult to translate into Malay. For example, the term bundling, leveraging, administrative efficiency in the interview question were also difficult to translate to mean the same as in English. This problem was solved by translating the terms into a few words, defining them and placing them in a glossary. The administrator then reviewed the terms in discussion with Translator 2 to ensure they still reflected the meaning within the context of the research (Cha, Kim & Erlen 2007).
The translation was conducted by three qualified bilingual experts and two administrators. Translator 1 is a professional translator with more than 15 years experience working as a translator. She is a certified translator who is a translator for a company. Translator 2 received English education from an established university in Malaysia, and has 25 years’ experience communicating in English and Malay. Translator 3 has vast experience communicating in English and Malay. She obtained her college education in Malay and furthered her degree in an English university. She has almost 25 years’ experience in teaching English and Malay in high schools and private companies, and is familiar with Malaysian culture. She is a native speaker of Malay and an expert user of English. Administrator 1 was educated abroad, where she lived for more than 10 years. She speaks English and is fluent in Malay. Administrator 2 is a retiree from a public health institution. She has more than 20 years’ experience working as a healthcare practitioner. She speaks Malay and is fluent in English. Figure 3.2 shows the steps involved during the translation process, adapted from Jones et al. 2001. Translator 1 translated the interview questions from English to Malay (Step A) and then Translator 2 blindly translated them back to English (Step B).
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Administrator 1 then reviewed this back-translated version in discussion with Translator 2 to check for any differences in meaning between the two English versions (Step C). They resolved any differences by referring back to the Malay version as originally translated in Step A. This achieved the most culturally equivalent meaning and resulted in a revised Malay version. In Step D, Translator 3 independently translated the revised Malay version back to English. Administrator 2 then reviewed this next back-translated English version in discussion with Translator 3 (Step E). This process continued until the bilingual experts, and I agreed on the equivalent meaning in the source- and target-language versions of the interview questions. A final revised version of the questions in Malay was produced, and Step F proved validity by testing for reliability and equivalence using a sample of bilingual subjects.
Figure 3.2: Instrument translation model (adapted from Brislin 1970; Jones et al. 2001)
Note: SL = source language; TL = target language; BT = back translation: AR = administrator review