This guidance summarises the three main, evidence-based approaches that can be used for the translation and cross-cultural adaptation of the SPICTTM into different languages and for diverse healthcare systems internationally.

Download (PDF, opens in new window): Translating & Adapting SPICT April 2018

  • A multi-disciplinary team approach and clear process recording are essential.
  • Select the method which best fits your circumstances and resources.

World Health Organisation: Process of translation and adaptation of instruments.
Beaton DE et al: Guidelines for the process of cross-cultural adaptation of self-report measures.
Mohler P et al: TRAPD Team Translation Model – Guidelines for Best Practice in Cross-Cultural Surveys. 

All methods incorporate 3 phases and 7 structured steps:-

Phase I

Step 1: Translation Step 2:
Expert review

Phase II

Step 3:
Back-translation and revision
Step 4:
Pre-testing (e.g. standardized case vignettes, or examples from small clinical practice tests)

Phase III

Step 5:
Final version
Step 6:
Process appraisal and documentation
Step 7:
Implementation and review


  • Bergenholtz H, Weibull A, Raunkiær M. Supportive and palliative care indicators tool (SPICT™) in a Danish healthcare context: translation, cross-cultural adaptation, and content validation. BMC Palliat Care 21, 41 (2022).
  • Sripaew, S., Fumaneeshoat, O. & Ingviya, T. Systematic adaptation of the Thai version of the Supportive and Palliative Care Indicators Tool for low-income settings (SPICT-LIS). BMC Palliat Care 2035 (2021).
  • Alonso Fachado A, Sansó Martínez N, Martín Roselló M, et al. Spanish adaptation and validation of the supportive & palliative care indicators tool – SPICT-ES. Rev Saude Publica; 52. Epub ahead of print 2018. DOI: 10.11606/S1518-8787.2018052000398.
  • Afshar K, Feichtner A, Boyd K, et al. Systematic development and adjustment of the German version of the Supportive and Palliative Care Indicators Tool (SPICT-DE). BMC Palliat Care 2018; 17: 27. DOI: 10.1186/s12904-018-0283-7
  • Casale G, Magnani C, Fanelli R, et al.Supportive and Palliative Care Indicators Tool (SPICT™): content validity, feasibility and pre-test of the Italian version. BMC Palliative Care  19, 79 (2020).

Presentations from SPICT Conference 2018: Workshop on translation and adaptation of SPICT

If your translation is prepared in this way and you would like to have it converted to the standard SPICT format and uploaded to a page for your country/ language, please contact us.