Translation and Linguistic Validation of the Multidimensional Dyspnoea Profile into Telugu in a Palliative Care Setting

Objectives: Dyspnea, or breathlessness, is a frequent and distressing symptom among patients with heart and lung diseases, particularly in advanced cancer stages, where it affects up to 90% of lung cancer cases. This symptom considerably diminishes quality of life, leading to physical deconditioning, increased levels of anxiety and depression, repeated hospitalizations, and elevated mortality rates. The Multidimensional Dyspnea Profile (MDP), developed in 2011, allows assessment of both the sensory experience and emotional response to dyspnea. While the MDP has been translated into multiple languages, a Telugu version has not been developed, underscoring the need for a validated tool in this under-resourced and primarily illiterate patient population in palliative care. Our aim was to translate and linguistically validate the MDP for use in Telugu-speaking populations in an Indian palliative care setting, where illiteracy rates are high. Materials and Methods: The MDP was translated and adapted into Telugu through collaboration with the Mapi Institute, which specializes in culturally relevant translation and validation of patient-reported outcome (PRO) measures. A structured translation process included both forward and backward translations by two certified independent translators. The translated version was refined through feedback from two Indian palliative care physicians and four healthcare workers. In-depth interviews with 24 Telugu-speaking cancer patients were conducted to evaluate the tool's clarity and suitability for this patient population. Results: The Telugu version of the MDP was adapted specifically for palliative care settings that serve socioeconomically disadvantaged populations with high levels of illiteracy. The translation adhered closely to international PRO standards set by the Mapi Institute. The MDP facilitated healthcare providers' understanding of dyspnea's impact on this group of palliative care patients. Conclusion: Applying the MDP in a palliative care context improved clinicians' insights into factors that contribute to dyspnea. However, given the instrument's length, selective use of its sections may be more practical in time-constrained settings.