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[Transcultural translation and adaptation into spanish of the questionnaire "Healthcare task difficulty (hctd) among older-adults with multimorbidity".]

OBJECTIVE
The increase in chronic diseases as a consequence of the rising life expectancy calls for tools that allow us to analyze the difficulty that patients with multimorbidity present when performing healthcare-related tasks. To this end, we carried out a cross-cultural translation and adaptation into Spanish of the questionnaire "Healthcare Task Difficulty (HCTD) among Older Adults with Multimorbidity."


METHODS
Direct translation and back translation were made, followed by a synthesis and adaptation by a third translator and a panel of experts in order to guarantee the conceptual, semantic, and content equivalence between the original questionnaire and the Spanish version. Additionally, an evaluation of the comprehension of the questionnaire in Spanish was carried out in a sample of elderly patients with multimorbidity.


RESULTS
The Spanish version of the HCTD questionnaire (HCTD-E) was obtained. The overall difficulty of the translators to find an equivalent expression between both languages was low. In the synthesis and adaptation part, four discrepancies were resolved (two of them were adapted in order to use a terminology closer to our health system and the other two were completed with different examples). The comprehensibility analysis was conducted in a sample of ten elderly patients with multimorbidity, and they showed an excellent comprehensibility.


CONCLUSIONS
This is the first cross-cultural adaptation to Spanish of the HCTD questionnaire. The methodology used through direct translation, back-translation and adaptation by a third translator and a panel of experts demonstrated a high level of comprehensibility of the HCTD-E, which was measured with cognitive interviews in a sample of patients.