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Guidelines for the translation and cross-cultural adaptation of survey questionnaires have been published, and cognitive interviewing is recommended to evaluate survey questionnaires and improve their design (Willis, 2005). However, although cognitive interviews might detect the presence of problems, they cannot identify the source of the problems and quantify them. Without hard evidence concerning the best way to conduct cognitive interviews, the strategies applied have varied from person to person, and different analysis methods have been used based on qualitative methodologies. Studies on the combination of qualitative and quantitative methods in cognitive interviewing for cross-cultural adaptation are needed (Andersen et al., 2014). | BACKG ROU N DCognitive interviewing represents an interdisciplinary fusion of the survey methodology and cognitive psychology. This method may

Purpose This study aimed to translate the Post-stroke Checklist into Mandarin, validate its content, and cross-culturally adapt the Mandarin version of the Post-stroke Checklist (M-PSC) in line with expert review and cognitive interviewing. Patients and Methods After translating into Mandarin, the M-PSC was modified and content validated using expert review, which resulted in a pilot version for cognitive interviewing among stroke survivors inclusive of subjects from an outpatient unit (n = 7), a rehabilitation department using traditional Chinese medicine (n = 10), and a community (n = 10). The interviews were transcribed and analyzed according to the four-stage cognitive model. A set of nine practice rounds where the number of rounds of iteration was determined based on the saturation of information was conducted. Data analysis was performed concurrently with data collection. Recommendations for changes to the M-PSC were made based on the analyses in the iteration. Results We successfully developed an initial M-PSC, back-translated it into English, reviewed the discrepancies and performed a three-step expert review to modify the M-PSC and validate its excellent content. Twenty-seven interviews were carried out, and a wide range of sources of error primarily related to the comprehension, retrieval of information, and judgment was reported, and each item of the M-PSC was rectified accordingly. Conclusion The Post-stroke Checklist was translated into Mandarin and cross-culturally adapted based on expert review and cognitive interviewing. Adaptations were made to support that the Mandarin version can be implemented in clinical practice for long-term post-stroke care.