Authorization Dilemmas and Ethical Governance in the Cross-Cultural Adaptation of Nursing Scales into Chinese

Abstract

Objective: To examine the authorization and ethical issues involved in the cross-cultural adaptation of nursing scales, identify their institutional roots, and propose governance pathways. Methods: Using a deconstructive framework of “ethical foundations—practical dilemmas—authorization barriers—organizational support—governance pathways,” we employed content analysis to explore the ethical tensions and underlying causes in current nursing scale adaptation practice. Results: A scale functions both as a standardized measurement instrument and as a copyrighted intellectual product; its translation and modification fall within the exclusive rights of the copyright holder. Nursing scale research in China faces several structural problems: a heavy reliance on imported instruments, a mismatch between the volume and methodological quality of adaptation studies, redundant adaptations that produce “multiple versions of one scale,” and polarized ethical review standards. Four core barriers impede authorization practice: undervaluing the copyright status of scales, difficulty in identifying the rights holder, poor access channels and timeline mismatches, and the cost barrier of commercial licensing. Conclusion: To resolve the institutional tensions among research ethics, publication ethics, and intellectual property, an ethical governance strategy based on “obtain authorization before initiation, multi-party review, and registration and public disclosure of the Chinese version” is needed.