Translation and cultural adaptation of the Communication Assessment Tool (CAT), developing a Danish and Norwegian version.

Objective: To translate and cultural adapt the 14-item Communication Assessment Tool (CAT) into Norwegian and Danish, making them as similar as possible.
Design: This was a translation and validation study including individual interviews for content and face validity and a patient survey for internal consistency and floor-ceiling effect.
Setting: Outpatient clinic at the Department of Internal Medicine, Lillebaelt Hospital, Denmark and a Norwegian general practice.
Participants: Ten patients were included for individual interviews and 440 participants completed the survey.
Main Outcome Measure: Translation and validation of the CAT.
Results: Despite minor differences in the use of words in the translated versions of CAT, the final versions were very similar. Based on the content and face validation and after agreement with the developers, it was decided to include a 'non-applicable' answering option, not a part of the original version. The use of 'non-applicable' for each item ranged from 0% to 30% in Norway and from 0% to 6.1% in Denmark. The overall CAT score, i.e. items rated excellent, were 55.5% in Norway and 50.3% in Denmark. For each item, the CAT score ranged between 31.3% and 69.8% in Norway and 33.7% and 57.4% in Denmark.
Conclusion: The translated and validated CAT can be used to measure patients' perspectives on clinicians' communication skills in Denmark and Norway.
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