title: Cross-Cultural Validation of the Definition of Multimorbidity in the Bulgarian Language.
abstract: Multimorbidity is a health issue with growing importance. During the last few decades the populations of most countries in the world have been ageing rapidly. Bulgaria is affected by the issue because of the high prevalence of ageing population in the country with multiple chronic conditions. The AIM of the present study was to validate the translated definition of multimorbidity from English into the Bulgarian language.
  
  
  
  The present study is part of an international project involving 8 national groups. We performed a forward and backward translation of the original English definition of multimorbidity using a Delphi consensus procedure.
  
  
  
  The physicians involved accepted the definition with a high percentage of agreement in the first round. The backward translation was accepted by the scientific committee using the Nominal group technique.
  
  
  
  Some of the GPs provided comments on the linguistic expressions which arose in order to improve understanding in Bulgarian. The remarks were not relevant to the content. The conclusion of the discussion, using a meta-ethnographic approach, was that the differences were acceptable and no further changes were required.
  
  
  
  A native version of the published English multimorbidity definition has been finalized. This definition is a prerequisite for better management of multimorbidity by clinicians, researchers and policy makers.
authors.affiliation: Section of General Practice, Medical University - Plovdiv, Bulgaria
authors.forename: Radost S
authors.initials: RS
authors.lastname: Assenova
authors.affiliation: Department of General Practice, Université de Bretagne occidentale, Brest, France
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Le Reste
authors.affiliation: Section of General Practice, Medical University - Plovdiv, Bulgaria
authors.forename: Gergana H
authors.initials: GH
authors.lastname: Foreva
authors.affiliation: Section of General Practice, Medical University - Plovdiv, Bulgaria
authors.forename: Daniela S
authors.initials: DS
authors.lastname: Mileva
authors.affiliation: Department of Family Doctor, Nicolaus Copernicus University, Torun, Poland
authors.forename: Slawomir
authors.initials: S
authors.lastname: Czachowski
authors.affiliation: Department of English, Nicolaus Copernicus University, Torun, Poland
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sowinska
authors.affiliation: Department of General Practice, Université de Bretagne occidentale, Brest, France
authors.forename: Patrice
authors.initials: P
authors.lastname: Nabbe
authors.affiliation: The Greek Association of General Practitioners (ELEGEIA), Thessaloniki, Greece
authors.forename: Stella
authors.initials: S
authors.lastname: Argyriadou
authors.affiliation: Department of Family Medicine, School of medicine, Univesity of Zagreb, Croatia
authors.forename: Djurdjica
authors.initials: D
authors.lastname: Lazic
authors.affiliation: Association of Family Physicians from the FBIH
authors.forename: Melida
authors.initials: M
authors.lastname: Hasaganic
authors.affiliation: Allgemein Medizin Hochschule Hannover, Hannover, Germany
authors.forename: Heidrun
authors.initials: H
authors.lastname: Lingner
authors.affiliation: President of Vasco da Gama Movement, General Practitioner, Bologna Area, Italy
authors.forename: Harris
authors.initials: H
authors.lastname: Lygidakis
authors.affiliation: Institut Català de la Salut-IDIAP Jordi Gol, Barcelona, Spain
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Muñoz
authors.affiliation: Xerencia de atención primaria de Vigo, Vigo, Spain
authors.forename: Ana
authors.initials: A
authors.lastname: Claveria
authors.affiliation: Institut für Allgemeinmedizin UMG Göttingen, Göttingen, Germany
authors.forename: Chista
authors.initials: C
authors.lastname: Doerr
authors.affiliation: Department of General Practice, VU University Medical Center, Amsterdam, The Nederland
authors.forename: Harm
authors.initials: H
authors.lastname: Van Marwijk
authors.affiliation: Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, Universiteit Antwerpen, Belgium
authors.forename: Paul
authors.initials: P
authors.lastname: Van Royen
authors.affiliation: Department of General Practice, Université de Bretagne occidentale, Brest, France
authors.forename: Claire
authors.initials: C
authors.lastname: Lietard
mesh_terms: D000328:Adult; D002031:Bulgaria; D015897:Comorbidity; D005260:Female; D058005:General Practitioners; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D011634:Public Health