Luppo Kuillman

Chapter 2 36 Translation of measurement instruments Questionnaires were translated into Dutch following the procedure proposed by Guillemin and colleagues (Guillemin, Bombardier, & Beaton, 1993). First, two certified translators working independently of each other translated the original English version of the questionnaires into Dutch. Second, two other certified translators each back-translated the Dutch translation into English. The resulting English versions were compared with the originals and discrepancies were discussed and resolved by consensus between the researchers LK, GJ, and BM. Hypotheses regarding convergent and divergent validity We examined the strength of the correlation coefficients as indicators of conceptual overlap between paternalistic and deliberate attitudes according to four concurrent self-report measurements. The following hypotheses were formulated: Divergent validity Although paternalistic and moral deliberate attitudes are usually pictured as two opposites, the traits are nevertheless expected to be independent of each other. This is because the features of both traits are not incompatible with each other. For example, an important feature of a deliberate attitude is valuing to have a relationship with patients. This is not necessarily in contradiction with one’s inclination to follow rules and regulations and base one’s decision on medical practice (which is a feature of a paternalistic attitude). So, even though a healthcare professional may be aimed at having a relationship with a patient and treat the patient with respect (i.e., deliberate attitude), still the healthcare professional can decide to base his/her decision on medical knowledge or regulations, even if that is against the will of a patient (i.e., paternalistic attitude), if he/she really thinks this is in the best interest of the patient. We therefore hypothesize that: ■ H1: There is no correlation between the two scales measuring a deliberate attitude and paternalistic attitude respectively. We further assume that paternalistic and the deliberate attitude are different from moral reasoning. After all, moral reasoning reflects a cognitive, intra-personal process, in which a person engages in a deliberation on what is the moral thing to do. The paternalistic and deliberative attitudes refer more to a person’s general preferences for how they relate to patients. This is more an inter-personal issue and reflect one’s tendencies of how to behave in a patient-professional relationship. We therefore