This systematic review examines the complexities involved in translating qualitative data in cross-cultural health science research, with a focus on the challenges faced in Malaysia’s multilingual and multicultural context. As globalization continues to shape migration patterns, Malaysia’s diverse linguistic landscape poses significant challenges for researchers conducting qualitative health-related studies. The accuracy of data interpretation in such contexts is crucial, as misinterpretations during translation can distort findings and affect outcomes. This study systematically reviews 78 qualitative health research studies conducted in Malaysia between 2022 and 2024. Drawing on a three-level analytical framework — macro, meso, and micro epistemological analysis — the review examines translation practices and their implications for data accuracy and meaning construction. The review finds that 81% of studies employed translation by research teams, with 9% using professional translators. Quality control measures, such as cross-checking or forward/back-translation, were reported in 13% and 9% of studies, respectively. The review also identified gaps in the transparent reporting of translation methods and the absence of participant validation in the translation process. This study emphasises the need for standardised translation practices and greater methodological transparency in qualitative health research. It also proposes practical recommendations, such as early planning for translation, inclusion of bilingual researchers with sociocultural competence, and adoption of rigorous quality control measures to enhance the reliability and trustworthiness of translated qualitative data.

Keywords: translation; qualitative research; health science; cross-cultural; Malaysia

Abd Hadi, N. H., Midin, M., Tong, S. F., Chan, L. F., Mohd Salleh Sahimi, H., Ahmad Badayai, A. R., & Adilun, N. (2023). Exploring Malaysian parents’ and teachers’ cultural conceptualization of adolescent social and emotional competencies: A qualitative formative study. Frontiers in Public Health, 11, 992863.

Abdullah, N., Kueh, Y. C., Kuan, G., Yahaya, F. H., & Lee, Y. Y. (2022). A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study. The Malaysian Journal of Medical Sciences: MJMS, 29(6), 77.

Abfalter, D., Mueller-Seeger, J., & Raich, M. (2021). Translation decisions in qualitative research: A systematic framework. International Journal of Social Research Methodology, 24(4), 469-486. https://doi.org/10.1080/13645579.2020.1805549

Abu Hassan Shaari, A., & Waller, B. (2023). Self-help group experiences among members recovering from substance use disorder in Kuantan, Malaysia. Social Work with Groups, 46(1), 51-67.

Al‐Amer, R., Ramjan, L., Glew, P., Darwish, M., & Salamonson, Y. (2015). Translation of interviews from a source language to a target language: Examining issues in cross‐cultural health care research. Journal of clinical nursing, 24(9-10), 1151-1162.

Ang, W., Khadir, N., Lahazir, N., & Baharudin, A. (2024). Understanding Halal pharmaceuticals: Views from outpatients in a Malaysian state hospital. The Medical Journal of Malaysia, 79(5), 512-516.

Arunasalam, N. (2019). Transcription, analysis, interpretation and translation in cross-cultural research. Nurse researcher, 27(2).

Chen, H.-Y., & Boore, J. R. (2010). Translation and back-translation in qualitative nursing research: Methodological review. Journal of Clinical Nursing, 19(1-2), 234-239.

Chew, C.-C., Lim, X.-J., Low, L.-L., Lau, K.-M., Kari, M., Shamsudin, U. K., & Rajan, P. (2022). The challenges in managing the growth of indigenous children in Perak State, Malaysia: A qualitative study. PLoS One, 17(3), e0265917.

Dahlan, A., Dzaki, N. M., Adeli, I. S., & Nurhidayah, N. (2024). Reasons behind providing care for older persons. The Medical Journal of Malaysia, 79(3), 251-256.

Danes-Daetz, C., Wainwright, J. P., Goh, S. L., McGuire, K., Sinsurin, K., Richards, J., & Chohan, A. (2024). Perceptions of stigma associated with chronic knee pain: voices of selected women in Thailand and Malaysia. Physiotherapy Theory and Practice, 41(2), 405-419.

Djatmika, Mohamad, B., Santosa, R., & Wibowo, A. H. (2024). Intercultural communicative competence among Indonesian migrant workers in Malaysia: A qualitative exploration. Frontiers in sociology, 9, 1321451.

Foley, S., Keene, D. E., Shrestha, R., Brown, S.-E., Gautam, K., Sutherland, R. A., Maviglia, F., Saifi, R., & Wickersham, J. A. (2024). Exploring attitudes toward pre-exposure prophylaxis for HIV prevention prior to implementation among female sex workers in Malaysia: results from a qualitative study. Patient preference and adherence, 797-807.

Gill, S. K. (2013). Language policy challenges in multi-ethnic Malaysia (Vol. 8). Springer Science & Business Media.

Goh, S. S. L., Lai, P. S. M., Ramdzan, S. N., & Tan, K. M. (2023). Weighing the necessities and concerns of deprescribing among older ambulatory patients and primary care trainees: a qualitative study. BMC Primary Care, 24(1), 136.

Goroh, M. M. D., van den Boogaard, C. H., Lukman, K. A., Lowbridge, C., Juin, W. K., William, T., Jeffree, M. S., & Ralph, A. P. (2023). Factors affecting implementation of tuberculosis contact investigation and tuberculosis preventive therapy among children in Sabah, East Malaysia: A qualitative study. PLoS One, 18(5), e0285534.

Hennink, M., Hutter, I., & Bailey, A. (2020). Qualitative research methods. Sage.

Khoo, E. M., Abdullah, A., Liew, S. M., Hussein, N., Hanafi, N. S., Lee, P. Y., Abdullah, K. L., Vengidasan, L., Abu Bakar, A. I. B., Pinnock, H., & Jackson, T. (2022). Psychological health and wellbeing of primary healthcare workers during COVID-19 pandemic in Malaysia: a longitudinal qualitative study. BMC Primary Care, 23(1), 261.

Kiew, S. J., Majid, H. A., & Mohd Taib, N. A. (2022). A qualitative exploration: Dietary behaviour of Malaysian breast cancer survivors. European Journal of Cancer Care, 31(1), e13530.

Lapchmanan, L. M., Hussin, D. A., Mahat, N. A., Ng, A. H., Bani, N. H., Hisham, S., Teh, W. S., A Aziz, M. A., Maniam, S., Dollah, P., Hasbullah, N. A., Manimaran, S., Hassan, H., & Zulkernain, F.. (2024). Developing criteria for a profession to be considered as profession of allied health in Malaysia: a qualitative study from the Malaysian perspective. BMC health services research, 24(1), 165.

Lee, W. Y., Tan, J. T. A., & Kok, J. K. (2022). The struggle to fit in: A qualitative study on the sense of belonging and well-being of deaf people in Ipoh, Perak, Malaysia. Psychological Studies, 67(3), 385-400.

Leong, E. L., Chew, C. C., Ang, J. Y., Lojikip, S. L., Devesahayam, P. R., & Foong, K. W. (2023). The needs and experiences of critically ill patients and family members in intensive care unit of a tertiary hospital in Malaysia: a qualitative study. BMC Health Services Research, 23(1), 627.

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of internal medicine, 151(4), W-65-W-94.

Lim, X. J., Chew, C. C., Chang, C. T., Supramaniam, P., Ding, L. M., Devesahayam, P. R., & Low, L. L. (2023). Perceived unmet needs of an age-friendly environment: A qualitative exploration of older adults’ perspectives in a Malaysian city. PloS one, 18(6), e0286638.

Lin, G. S. S., Tan, W. W., & Foong, C. C. (2023). A phenomenological study on East and Southeast Asian dental educators: perceived importance, challenges, and strategies in teaching dental materials science. BMC Oral Health, 23(1), 571.

Lopez, G. I., Figueroa, M., Connor, S. E., & Maliski, S. L. (2008). Translation barriers in conducting qualitative research with Spanish speakers. Qualitative health research, 18(12), 1729-1737.

Maneesriwongul, W., & Dixon, J. K. (2004). Instrument translation process: A methods review. Journal of Advanced Nursing, 48(2), 175–186. https://doi.org/10.1111/j.1365-2648.2004.03185.x

Manoharan, A., Koh, W. M., K, M., & Khoo, E. M. (2023). Facilitators and barriers to latent tuberculosis infection treatment among primary healthcare workers in Malaysia: a qualitative study. BMC Health Services Research, 23(1), 914.

Mohamad Nasri, N., Nasri, N., & Abd Talib, M. A. (2021). Cross-language qualitative research studies dilemmas: A research review. Qualitative Research Journal, 21(1), 15-28.

Mohamed Hussin, N. A., & Mohd Sabri, N. S. (2023). A qualitative exploration of the dynamics of guilt experience in family cancer caregivers. Supportive Care in Cancer, 31(11), 659.

Mokhtar, F. S., Ariff, A. M., Manap, N. A., & Mustaffa, N. M. (2024). A solution towards a viable compensation mechanism for injury from COVID-19 vaccines in Malaysia: A qualitative study. Heliyon, 10(3).

Muhammed Elamin, S., Muhamad Arshad, N. F., Md Redzuan, A., Abdul Aziz, S. A., Hong, J., Chua, X. Y., Bin-Abbas, B. S., Alsagheir, A., & Mohamed Shah, N. (2024). Information needs on type 1 diabetes mellitus (T1DM) and its management in children and adolescents: a qualitative study. BMJ Open, 14(4), e079606.

Naserrudin, N. A., Lin, P. Y. P., Monroe, A., Baumann, S. E., Adhikari, B., Miller, A. C., Sato, S., Fornace, K. M., Culleton, R., Cheah, P. Y., Hod, R., Jeffree, M. S., Ahmed, K., & Hassan, M. R. (2023). Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo. Malaria Journal, 22(1), 343.

Noordin, Z. M., Neoh, C. F., Ibrahim, N. H., & Karuppannan, M. (2023). “A person who do not smoke will not understand a person who smokes and trying to quit…” Insights From Quit Smoking Clinics’ Defaulters: A Qualitative Study. Journal of Patient Experience, 10, 23743735231184690.

Noorulain, F., Kuan, W.-C., Kong, Y.-C., Bustamam, R. S., Wong, L.-P., Subramaniam, S., Ho, G.-F., Zaharah, H., Yip, C.-H., & Bhoo-Pathy, N. (2022). Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study. ecancermedicalscience, 16, 1449.

Rajaratnam, S., & Azman, A. (2024). Violence and trauma encountered by Rohingya women fleeing to Malaysia: a qualitative study. Archives of Women’s Mental Health, 27(2), 233-240.

Rambli, R., Aznida, F. A. A., & Azimatun Noor, A. (2023). Benefits and challenges of teleconsultation service for non-communicable disease follow-up in public healthcare clinics in Malaysia: a qualitative study. The Medical Journal of Malaysia, 78(4), 449-457.

Ramli, R., Hanafi, N. S., Hussein, N., Lee, P. Y., Shariff Ghazali, S., Cheong, A. T., Abu Bakar, A. I., Abdullah, S., Abdul Samad, A., Pinnock, H., Sheikh, A., & Khoo, E. M. (2023). Barriers to and Facilitators of Asthma Care For Malaysian Hajj Pilgrims: A Qualitative Study. Asia Pacific Journal of Public Health, 35(2-3), 179-182.

Rani, M. D. M., Mohamed, N. A., Solehan, H. M., Ithnin, M., Ariffien, A. R., & Isahak, I. (2022). Assessment of acceptability of the COVID-19 vaccine based on the health belief model among Malaysians-A qualitative approach. PLoS One, 17(6), e0269059.

Salim, H., Young, I., Lee, P. Y., Shariff‐Ghazali, S., Pinnock, H., & RESPIRE collaboration. (2022). Insights into how Malaysian adults with limited health literacy self‐manage and live with asthma: A Photovoice qualitative study. Health Expectations, 25(1), 163-176.

Samsudin, N. A., Othman, H., Siau, C. S., & Zaini, Z. I. I. (2024). Exploring community needs in combating aedes mosquitoes and dengue fever: a study with urban community in the recurrent hotspot area. BMC Public Health, 24(1), 1651.

Santos, H. P., Black, A. M., & Sandelowski, M. (2015). Timing of translation in cross-language qualitative research. Qualitative health research, 25(1), 134-144.

Schumann, M., Dennis, A., Leduc, J. M., & Peters, H. (2025). Translating cross‐language qualitative data in health professions education research: Is there an iceberg below the waterline? Medical education, 59(6), 589-595.

Sidek, N. N., Kamalakannan, S., Tengku Ismail, T. A., Musa, K. I., Ibrahim, K. A., Abdul Aziz, Z., & Papachristou Nadal, I. (2022). Experiences and needs of the caregivers of stroke survivors in Malaysia—A phenomenological exploration. Frontiers in Neurology, 13, 996620.

Squires, A. (2009). Methodological challenges in cross-language qualitative research: A research review. International Journal of Nursing Studies, 46(2), 277–287. https://doi.org/10.1016/j.ijnurstu.2008.08.006

Sulaiman, I. H., Abdul Taib, N. I., Lim, J. T. Y., Mohd Daud, T. I., & Midin, M. (2024). The role of peer support in recovery among clients with mental illness attending the psychiatric service in a tertiary hospital in Malaysia: a qualitative study. BMC psychiatry, 24(1), 470.

Sulaiman, M. Z., Zainudin, I. S., & Haroon, H. (2025). Can ChatGPT translate like a pro? A pilot benchmarking study of English-Malay translation quality. 3L: Southeast Asian Journal of English Language Studies, 31(4), 259-278.

Tan, H. Y., Hussein, N., Lee, Y. K., & Abdul Malik, T. F. (2023). Adolescents’ experiences and views of the national school-based thalassaemia screening programme in Malaysia: a qualitative study. Journal of Community Genetics, 14(4), 361-369.

Teh, P.-L., Kwok, A. O., Cheong, W. L., & Lee, S. (2024). Insights into the use of a digital healthy aging coach (AGATHA) for older adults from Malaysia: app engagement, usability, and impact study. JMIR Formative Research, 8(1), e54101.

Temple, B., & Young, A. (2004). Qualitative research and translation dilemmas. Qualitative Research, 4(2), 161-178.

Tok, P. S. K., Wong, L. P., Liew, S. M., Razali, A., Mahmood, M. I., Chinnayah, T., Kawatsu, L., Toha, H. R., Mohd Yusof, K., Abd Rahman, R., Che Mat Din, S. N. A., & Loganathan, T. (2023). A qualitative exploration of tuberculosis patients who were lost to follow-up in Malaysia. PLoS One, 18(9), e0289222.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care, 19(6), 349-357.

van Nes, F., Abma, T., Jonsson, H., & Deeg, D. (2010). Language differences in qualitative research: Is meaning lost in translation. European Journal of Ageing, 7(4), 313–316. https://doi.org/10.1007/s10433-010-0168-y

Wong, L. P., Alias, H., Lee, H. Y., AbuBakar, S., Lin, Y., & Hu, Z. (2024). Has Zika been forgotten? A qualitative exploration of knowledge gaps, perceived risk and preventive practices in pregnant women in Malaysia. BMC Women’s Health, 24(1), 190.

World Health Organization. (2021). Refugees and migrants in times of COVID-19: mapping trends of public health and migration policies and practices. World Health Organization.

Yew, S.-Q., Tan, K.-A., Nazan, A. I. N. M., & Manaf, R. A. (2023). Development and validation of a medication non-adherence scale for Malaysian hypertensive patients: a mixed-methods study. Environmental Health and Preventive Medicine, 28, 75.

Yunus, N. A., olde Hartman, T., Lucassen, P., Barton, C., Russell, G., Altun, A., & Sturgiss, E. (2022a). Reporting of the translation process in qualitative health research: a neglected importance. International Journal of Qualitative Methods, 21, 16094069221145282.

Yunus, N. A., Russell, G., Muhamad, R., Barton, C., & Sturgiss, E. (2022b). What is it like to live with obesity in Peninsular Malaysia? A qualitative study. Clinical Obesity, 12(5), e12538.

Zhao, P., Li, P. J., & Qi, W. (2025). Translation of cultures and texts: Envisioning a culturally responsive translational practice in qualitative research. Qualitative Health Research, 35(4-5), 448-461.