Table 1 The cross-cultural adaptation procedure in six steps according to Brislin [17] and Delphi technique procedure [18] for translating the 51-item Flodén ATODAS [Swedish version] to the 46-item Flodén ATODAI [North American version]

Step 1: Initial translation by an English-speaking interpreter.

Step 2: Back-translation by a Swedish-speaking interpreter.

Step 3: Review and synthesis of these translations by an International committe of experts.

Step 4:Expert panel of seven designated ICU nurses rating the instrument; Followed by data analysis I (I-CVI and S-CVI).

Step 5: Test and retest of the prefinal version with 2 weeks in between; Followed by data analysis II (ICC, ҡ_Weight, sign test, and Cronbach’s alpha coefficient). In total, 50 ICU nurses from two hospitals in the greater Los Angeles area participated in the test and retest.

Step 6: A preselected panel (N = 15) performed an additional Delphi technique procedure for items that showed an ICC < 0.70 in step five. The researchers also made adjustments guided by the panel’s feedback.