Pandemic-related pregnancy stress assessment-Psychometric properties of the Polish PREPS and its relationship with childbirth fear

PURPOSE

The aim of the study was to create and to validate the Polish version of the original English version of the Pandemic-Related Pregnancy Stress Scale (PREPS) developed by Preis and colleagues (2020a; 2020b) We additionally investigated the association of maternal obstetrical and pandemic related factors with the PREPS in order to test its sensitivity.

METHODS

A cross-sectional study design with nonrandom sampling was used. The sample consisted of a total of 1148 pregnant women in various trimesters. They were recruited via social media and completed an online study questionnaire in April-May 2020.

RESULTS

The results of the present research indicate satisfactory psychometric properties of the Polish version of the PREPS. Our findings confirm the factor structure found by the authors of the original English version of the PREPS. The scale consists of two stress subscales: perinatal infection stress and preparedness stress and one additional positive appraisal scale. Pandemic-related pregnancy stress is significantly associated with fear of childbirth and with non-pandemic pregnancy-specific stress, which bolsters its convergent validity. Higher levels of pandemic-related pregnancy stress are experienced by primiparas, those in their second or third trimester, women who received infertility treatment, and those with a high-risk pregnancy.

CONCLUSIONS

The Polish version of the PREPS has sound psychometric properties and replicates the structure of the original English PREPS. This stress scale can be used to investigate additional impacts of the COVID-19 pandemic and to identify women at risk of high stress and those who need intervention.

Cross-Cultural Adaptation and Validation of the Quality of Life Questionnaire for Caregivers of Patients with Schizophrenia (S-CGQoL) in Latin America

OBJECTIVES

The aim of this study was to adapt and validate the Schizophrenia Caregiver's Quality of Life Questionnaire (S-CGQoL) for use in the Hispanic-American population from the caregiver's perspective.

METHODS

A cross-sectional instrumental model was used, with a sample of 253 caregivers of patients suffering of Schizophrenia in Bolivia, Peru and Chile. The psychometric properties of the S-CGQoL were tested through construct validity, reliability and some aspects of external validity. In addition, in order to assess the nature of the different items across the three countries, a Differential Performance Analysis (DPA) was conducted.

RESULTS

A confirmatory factor analysis showed that the scale structure was well correlated to the initial structure of the QoL-MDS. The results confirmed the existence of adequate reliability indicators (α>.70 and ω>.80) and the absence of FIDs supporting the invariance of item calibrations among the three Latin American countries.

CONCLUSIONS

The adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.

Psychometric properties of a condition-specific PROM for the psychosocial consequences of Labelling hypertension by using Rasch analysis

Background

A previous qualitative assessment of the psychosocial consequences of labelling hypertension describes the diagnosis of hypertension as a labelling event with potential unintended negative long-term psychosocial consequences (labelling effects). Until now, the benefits of diagnosing hypertension have been far more reported than the harms. To obtain the net result of the preventive interventions for cardiovascular disease, such as diagnosing and treating mild hypertension, assessing benefits and harms in the most comprehensive way possible is necessary, including the psychosocial consequences of labelling. When measuring psychosocial consequences of labelling hypertension, a questionnaire with high content validity and adequate psychometric properties is needed.

Objectives

The aim of this study was to describe the psychometric parameters of face and content-validated pool of items. Other objectives were also to screen the item pool by using Rasch model analysis and confirmatory factor analysis (CFA) for identifying such items with sufficient fit to the hypothesised models.

Methods

We surveyed the pool of items as a draft questionnaire to Brazilians recruited via social networks, sending e-mails, WhatsApp® messages and posting on Facebook®. The inclusion criteria were to be older than 18 years old, to be healthy and to have only hypertension.

We used Rasch model analysis to screen the item pool, discarding items that did not fit the hypothesised domain. We searched for local dependence and differential item functioning. We used CFA to confirm the derived measurement models and complementarily assessed reliability using Cronbach’s coefficient alpha.

Results

The validation sample consisted of 798 respondents. All 798 respondents completed Part I, whereas 285 (35.7%)—those with hypertension—completed Part II. A condition-specific questionnaire with high content validity and adequate psychometric properties was developed for people labelled with hypertension. This measure is called ‘Consequences of Labelling Hypertension Questionnaire’ and covers the psychosocial consequences of labelling hypertension in two parts, encompassing a total of 71 items in 15 subscales and 11 single items.

Conclusion

We developed a tool that can be used in future research involving hypertension, especially in scenarios of screening, prevention, population strategies and in intervention studies. Future use and testing of the questionnaire may still be required.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41687-021-00291-4.

Psychometric validation of the Brazilian Portuguese version of Bandura's exercise self-efficacy scale in diabetes patients

Purpose

The management of diabetes comprises diet, pharmacological therapy, lifestyle counseling, patient education, and physical exercising, to achieve change in health behavior and control of the disease. However, a large proportion of diabetes patients does not adhere to treatment recommendations, mainly in the lifestyle aspect, which remains sedentary. Considering that self-efficacy is an essential determinant of health behaviors such as exercise practicing, the objective of the study was to investigate the psychometric properties of the Brazilian Portuguese version of Bandura's Exercise Self-Efficacy Scale (BESES) to be used in diabetes patients.

Methods

The BESES was initially completed by thirty diabetes patients to confirm the feasibility of the answers be provided by themselves. The psychometric properties (i.e., internal consistency, test-retest reproducibility, convergent validity, and ceiling and floor effects) were tested in other two-hundred diabetes patients (≥18 years old).

Results

The BESES achieved significant internal consistency (Cronbach's alpha coefficient = 0.92), substantial test-retest reproducibility (intraclass correlation coefficient = 0.83). The convergent validity was confirmed by negative correlations between BESES total scores and barriers to exercise total scores (ρ = -0.333; P = 0.018) and rate of perception exercise corrected by distance covered in the incremental shuttle walking test (ρ = -0.426; P = 0.002). Ceiling and floor effects were not found. In addition, physically active patients had BESES total scores higher compared to sedentary (56.8 ± 21.4 vs. 47.9 ± 20.0; P = 0.003).

Conclusion

The Brazilian Portuguese version of the BESES showed adequate psychometric properties and proved to be valid for assessing the exercise self-efficacy in diabetes patients in Brazil.

Structural validity, measurement invariance, reliability and diagnostic accuracy of the Italian version of the Yale Food Addiction Scale 2.0 in patients with severe obesity and the general population

PURPOSE

To examine the structural validity, measurement invariance, reliability, and some other psychometrical properties of the Italian version of the Yale Food Addiction Scale 2 (I-YFAS 2.0) in patients with severe obesity and the general population.

METHODS

704 participants-400 inpatients with severe obesity and 304 participants enrolled from the general population-completed the I-YFAS 2.0 and questionnaires measuring eating disorder symptoms. A first confirmatory factor analysis (CFA) tested a hierarchical structure in which each item of the I-YFAS 2.0 loaded onto one of the twelve latent symptoms/criteria which loaded onto a general dimension of Food Addiction (FA). The second CFA tested a first-order structure in which symptoms/criteria of FA simply loaded onto a latent dimension. Measurement invariance (MI) between the group of inpatients with severe obesity and the sample from the general population was also tested. Finally, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed.

RESULTS

CFAs confirmed the structure for the I-YFAS 2.0 for both the hierarchical structure and the first-order structure. Configural MI and strong MI were reached for hierarchical and the first-order structure, respectively. Internal consistencies were shown to be acceptable. Prevalence of FA was 24% in the group of inpatients with severe obesity and 3.6% in the sample from the general population.

CONCLUSIONS

The I-YFAS 2.0 represents a valid and reliable questionnaire for the assessment of FA in both Italian adult inpatients with severe obesity and the general population, and is a psychometrically sound tool for clinical as well as research purposes.

LEVEL OF EVIDENCE

Level V, descriptive study.

Psychometric properties of the German version of the Fear of Falling Questionnaire-revised (FFQ-R) in a sample of older adults after hip or pelvic fracture

BACKGROUND

Identifying patients with maladaptive fear of falling (FOF) is important in the rehabilitation phase after serious fall. The 6-item Fear of Falling Questionnaire-revised (FFQ-R) was seen as promising measurement instrument as it evaluates FOF in a broader way than the one-item-question and independent of physical activities.

AIM

The purpose of the analysis was to evaluate the psychometric properties of the translated German FFQ-R.

METHODS

Back-translation method was applied. Confirmatory factor analysis (CFA) with diagonally weighted least square estimation was used to verify the two-factor structure. Data were collected during inpatient rehabilitation from hip and pelvic fracture patients [age 84.3 ± 6.2, Mini-Mental State Examination (MMSE) scores > 23] participating in an RCT (N = 112) and a cross-sectional survey (N = 40).

RESULTS

Internal consistency was 0.78 (Cronbach´s alpha). No floor or ceiling effects were found. Discriminatory power on item level was moderate to good (r = 0.43-0.65). CFA revealed a good model fit and confirmed the two-factor structure. The German FFQ-R was moderately correlated (r = 0.51) with the Short Falls Efficacy Scale-International (Short FES-I) used as a proxy measure for FOF. Missing rates up to 9% for specific items were because some individuals, independent of cognitive level or age, had problems to rate items with conditional statements on possible negative consequences of a fall.

CONCLUSIONS

Results demonstrated moderate to good psychometric properties similar to the original English version in a comparable sample of fracture patients.

Psychometric properties of the Chinese version of the family accommodation scale for obsessive-compulsive disorder interviewer-rated

BACKGROUND

Family accommodation (FA) in obsessive-compulsive disorder (OCD) means that the relatives of patients are involved in, help or facilitate patients' ritual behaviors and avoidance, which is a frequent occurrence and underresearched phenomenon in China. Recent studies have suggested that FA is adversely associated with treatment response, contradictory to the goal of cognitive behavior therapy, a contributor to the maintenance of symptoms and increased symptom severity, and associated with low levels of family and social functioning. There is increasing interest and focus on establishing a family-based intervention for OCD treatment based on the inclusion of relatives by decreasing FA. The present study explored the psychometric properties of the Chinese version of the Family Accommodation Scale for OCD Interviewer-Rated (FAS-IR).

METHOD

A total of 109 patients with OCD and 91 primary relatives were assessed in corresponding patient and family measures, and the FAS-IR was administered to relatives by trained interviewers.

RESULTS

More than 90% of the relatives accommodated patients' symptoms with at least one kind of FA behavior over the previous week, and the incidence of extreme or everyday routines was as high as 59.3%. Exploratory factor analysis demonstrated two-factor structure for the whole scale, including (1) modification and facilitation, and (2) participation. Cronbach's alpha was 0.798 for the whole scale, and the interrater and test-retest reliability coefficients were 0.835 (95%CI: 0.603-0.937) and 0.882 (95%CI: 0.685-0.959), respectively. Convergent validity was supported in exploring FA and was associated with symptom severity, level of functional impairment and family functioning related to OCD. The FA was not significantly correlated with depressive symptoms rated by the patients, as evidence of acceptable divergent validity. There was no significant difference in FA total score based on patient gender, patient age, or relationship with patients.

CONCLUSIONS

The Chinese version of the FAS-IR demonstrated excellent psychometric properties for assessing the degree of FA, suggesting that it is a useful and valuable instrument in clinical and research settings.

Development and Validation of the Ethicotherapy Quality of Life Questionnaire

At present, no standardized tool to measure therapeutic outcomes of a central European traditional healing system called Ethicotherapy exists. Ethicotherapy focuses on the relationship between physical health and moral health. The aim was to develop and validate the Ethicotherapy quality of life questionnaire (EQLQ) using a sequential exploratory mixed-method study design. An EQLQ with good psychometric properties was developed. An exploratory factor analysis identified eight domains consisting of 30 items. Future research investigating a relationship between EQLQ, health, and physical illness in different populations and cultural settings is recommended.

Cross-cultural adaptation, reliability, and validity of the Turkish version of the SymptoMScreen

PURPOSE

The study aimed to translate and cross-culturally adapt the SymptoMScreen into Turkish and evaluate its reliability and validity.

METHODS

One hundred nine MS patients were included in the study. SymptoMScreen was translated into Turkish according to the standardized guidelines and cross-culturally adapted. For construct validity, SymptoMScreen was compared with the Expanded Disability Status Scale (EDSS), Multiple Sclerosis-Related Symptom Checklist (MS-RS), and Beck Depression Scale (BDS) by Spearman's correlation coefficient. Thirty patients refilled SymptoMScreen one week later, and the test-retest reliability was analyzed by the Intraclass Correlation Coefficient (ICC). Internal consistency was evaluated with Cronbach's alpha coefficient. The standard error of measurement (SEM₉₅) and the minimum detectable change (MDC₉₅) were calculated.

RESULTS

Test-retest reliability and internal consistency of the SymptoMScreen were excellent (ICC = 0.925, α = 0.914). SEM₉₅ and MDC₉₅ were 3.28 and 9.29, respectively. There was a strong correlation between the SymptoMScreen with the MS-RS and EDSS (r₁= 0.908, p < 0.00; r₂= 0.511, p < 0.001). Besides, the SymptoMScreen was moderately correlated with BDS (r = 0.584, p < 0.001).

CONCLUSION

The Turkish version of the SymptoMScreen is a reliable and valid questionnaire for multiple sclerosis patients.

Psychometric properties of chronic low back pain diagnostic classification systems: a systematic review

OBJECTIVES

To identify and critically appraise studies evaluating psychometric properties of functionally oriented diagnostic classification systems for Non-Specific Chronic Low Back Pain (NS-CLBP).

METHODS

This review employed methodology consistent with PRISMA guidelines. Electronic databases and journals: (PubMed, EMBASE, Cochrane, PEDro, CINAHL, Index to chiropractic literature, ProQuest, Physical Therapy, Journal of Physiotherapy, Canadian Physiotherapy and Physiotherapy Theory and Practice) were searched from inception until January 2020. Included studies evaluated the validity and reliability of NS-CLBP diagnostic classification systems in adults. Risk of bias was assessed using a Critical Appraisal Tool.

RESULTS

Twenty-two studies were eligible: Five investigated inter-rater reliability, and 17 studies analyzed validity of O'Sullivan's classification system (OCS, n = 15), motor control impairment (MCI) test battery (n = 1), and Pain Behavior Assessment (PBA, n = 1). Evidence from multiple low risk of bias studies demonstrates that OCS has moderate to excellent inter-rater reliability (kappa > 0.4). Also, two low risk of bias studies support of OCS-MCI subcategory. Three tests within the MCI test battery show acceptable inter- and intra-rater reliability for clinical use (the "sitting knee extension," the "one leg stance," and the "pelvic tilt" tests). Evidence for the reliability and validity of the PBA is limited to one high bias risk study.

CONCLUSIONS

Multiple low risk of bias studies demonstrate strong inter-rater reliability for OCS classification specifically OCS-MCI subcategory. Future studies with low risk of bias are needed to evaluate reliability and validity of the MCI test battery and the PBA.

Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population

Background

The World Health Organization’s Quality of Life Questionnaire (WHOQOL-Bref) is a frequently used instrument to assess the quality of life in both healthy and ill populations. Inquiries of the psychometric properties of the WHOQOL-Bref report that the validity and reliability is generally satisfactory. However, some studies fail to support a four-factor dimensionality; others report poor reliability of the social and environmental domain; and there may be some challenges of supporting construct validity across age. This paper evaluates the psychometric properties of the Norwegian WHOQOL-Bref and extends previous research by testing for measurement invariance across age, gender and education level. In addition, we provide updated normative data for the Norwegian population.

Methods

We selected a random sample of the Norwegian population (n = 654) aged 18–75 years. Participants filled out the WHOQOL-Bref, the Utrecht Work Engagement Scale and various sociodemographic variables.

Results

We found an acceptable convergent and discriminate validity and internal consistency of the physical, psychological and environmental domains, but a marginal reliability was found for the social domain. The factor loadings were invariant across gender, education and age. Some items had low factor loadings and explained variance, and the model fit for the age group 60–75 years were less satisfactory.

Conclusions

The original four-factor dimensionality of the WHOQOL-Bref displayed a better fit to the data compared to the one-factor solution and is recommended for use in the Norwegian population. The WHOQOL-Bref is suitable to use across gender, education and age, but for assessment in the oldest age group, the WHOQOL-Old module could be a good supplementary, but further studies are needed.

3-Dimensional printing in rehabilitation: feasibility of printing an upper extremity gross motor function assessment tool

Background

Use of standardized and scientifically sound outcome measures is encouraged in clinical practice and research. With the development of newer rehabilitation therapies, we need technology-supported upper extremity outcome measures that are easily accessible, reliable and valid. 3‐Dimensional printing (3D-printing) has recently seen a meteoric rise in interest within medicine including the field of Physical Medicine and Rehabilitation. The primary objective of this study was to evaluate the feasibility of designing and constructing a 3D printed version of the Toronto Rehabilitation Institute-Hand Function Test (TRI-HFT). The TRI-HFT is an upper extremity gross motor function assessment tool that measures function at the intersection of the International Classification of Function’s body structure and function, and activity domain. The secondary objective was to assess the preliminary psychometrics of this test in individuals with stroke.

Results

3D design files were created using the measurements of the original TRI-HFT objects. The 3D printed objects were then compared to the original test objects to ensure that the original dimensions were preserved. All objects were successfully printed except the sponge and paper which required some modification. The error margin for weight of the objects was within 10% of the original TRI-HFT for the rest of the objects. Nine participants underwent the following assessments: the Chedoke Arm and Hand Activity Inventory (CAHAI), Fugl Meyer Assessment-Hand (FMA-Hand), Chedoke McMaster stages of recovery of the arm (CMSA-Arm) and Chedoke McMaster stages of recovery of the hand (CMSA-Hand) and the 3D TRI-HFT for assessment of psychometric properties of the test. The video recorded assessment of the 3D TRI-HFT was used for reliability testing. Construct validity was assessed by comparing the scores on 3D TRI-HFT with the scores on CAHAI, CMSA-Arm, CMSA-Hand and FMA-Hand. The 3D TRI-HFT had high inter-rater reliability (Intra-Class Correlation Co-efficient (ICC) of 0.99; P < 0.000), high intra-rater reliability (ICC of 0.99; P < 0.000) and moderate-to-strong correlation with the CMSA-Arm, CMSA-Hand and FMA-Hand scores.

Conclusions

The TRI-HFT could be successfully 3D printed and initial testing indicates that the test is a reliable and valid measure of upper extremity motor function in individuals with stroke.

Myeloproliferative Neoplasm Symptom Assessment Form - Total Symptom Score (MPN-SAF TSS) questionnaire: translation, cultural adaptation and validation to Brazilian Portuguese

Introduction

Constitutional symptoms and thrombohemorrhagic events are common in patients with myeloproliferative neoplasms (MPNs). Hence, the treatment’s primary goal is to control symptoms and improve the quality of life (QoL). In order to assess response to therapy, symptom burden, and QoL among patients with MPN, the “Myeloproliferative Neoplasm Symptom Assessment Form - Total Symptom Score (MPN-SAF TSS)” questionnaire was developed in the USA in 2012. Herein, we translated and validated the MPN-SAF TSS questionnaire to Brazilian Portuguese.

Methods

The ten-item questionnaire was translated from the English language and its psychometric properties (reliability, convergent and construct validities) were evaluated in 101 MPN patients.

Results

There were 41 patients with essential thrombocythemia, 39 with myelofibrosis and 21 with polycythemia vera. The median age of all patients at diagnosis was 68 years and 59% were female. The Cronbach's alpha coefficient for the overall questionnaire was 0.78, ranging from 0.73 to 0.79, if each item was deleted. Validity analyses showed that the strongest item-item correlation were between early satiety and abdominal discomfort. Strong correlations were also found between physician and patient perceptions of itching (r = 0.81) and fatigue (r = 0.70). The Pearson coefficient correlation between the MPN-SAF TSS global score and the EORTC QLQ-C30 functional scales ranged from 0.51 to 0.64. The exploratory factor analysis showed that seven of the ten symptoms loaded into one single factor.

Conclusion

The Brazilian Portuguese version of the MPN-SAF-TSS showed good psychometric properties and can be an available tool to assess symptom burden in this group of patients.

Psychometric Properties of the Greek Version of FCV-19S

As COVID-19 delivered a devastating blow around Europe, unprecedented mental health issues have arisen. This study outlines the Greek translation and validation of the Fear of COVID-19 Scale (FCV-19S) in the general population. A sample of 3029 Greek-speaking individuals completed the FCV-19S, as part of a large online survey reporting on the aftermath of the coronavirus on the psychological health of Greeks. A total of 2970 participants completed all items without missing values, and their responses were included in the statistical analysis. The confirmatory factor analysis suggested an acceptable model fit. The internal consistency measured by Cronbach's alpha = .87 for the whole scale. All hypothesized correlations were as expected, confirming the construct validity of the scale. The results of the analyses suggest that the psychometric properties of the Greek FCV-19S are sufficient.

Psychometric properties of the Czech versions of the Impact of Pediatric Epilepsy Scale (IPES) and Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48)

OBJECTIVE

In order to introduce a complex system of monitoring and evaluation of the heath-related quality of life (HRQoL) of children and adolescents with epilepsy (CWE) and their families in the Czech Republic, we aimed to validate the Czech versions of two appropriate instruments - the Impact of Pediatric Epilepsy Scale (IPES) and the Quality of Life in Epilepsy Inventory for Adolescents (QOLIE-AD-48).

METHODS

The verification of the 11-item IPES was carried out in the group of parents of 248 CWE aged 2-18 years. One hundred and thirty-five CWE from the given group aged 11-18 years then completed the 48-item QOLIE-AD-48. Internal consistency, test-retest reliability (with a three-month interval) and the factorial structure of the Czech versions were determined and compared with the original instruments.

RESULTS

We found that the Czech version of the IPES exhibited very good psychometric properties including high internal consistency (Cronbach's alpha, α, of 0.93), high test-retest reliability (intraclass correlation coefficient, ICC, of 0.76) and the same 3-factor structure as the original instrument. The superiority of this 3-factor solution over the alternate 2-factor model proposed for some language versions of the IPES was determined using confirmatory factor analysis. We found 8 items in the Czech version of the QOLIE-AD-48 belonging to original Attitudes towards epilepsy and Social support subscales that do not fit well with the Czech version due to their low correlation with the total score and insufficient test-retest reliability and should be omitted. For the remaining 40 items, we have determined high internal consistency (α = 0.95) and test-retest reliability (ICC = 0.82). Confirmatory factor analysis revealed that the 6-factor solution derived from the original instrument (without two removed subscales) was appropriate for the Czech version. The individual subscales exhibited high internal consistency with α = 0.61-0.91. The external validation of both instruments was confirmed based on a significant correlation between test results and physicians' reports of the characteristics of the child's epilepsy.

CONCLUSIONS

The Czech versions of both instruments studied are reliable and valid, and can be used in the next research focusing on the effect of different treatment approaches on the HRQoL of CWE and their families.

The "Ankle Instability Instrument": Cross-cultural adaptation and validation in French

BACKGROUND

Functional ankle instability affects 20-40% of individuals who have already suffered from a sprain. Such dysfunctions are difficult to diagnose. Therefore, the information provided by self-administered questionnaires is essential. Thus, the Ankle Instability Instrument (AII) was developed and initially validated in English. Our goal is to create a French version of the instrument, named AII-F, by scrupulously respecting the cultural adaptation phases and to make sure the new instrument has good psychometric properties.

METHODS

International recommendations have been rigorously followed for the cultural adaptation and the French-translation phase. Six steps are recommended: I) two initial translations from English to French; II) synthesis of the two versions; III) back-translations from French to English; IV) comparisons between the back-translations and the original questionnaire by the expert committee; V) pretest; and VI) approval of the final French version of the AII. In order to validate this French-translation, 91 subjects suffering from ankle instability matched to 91 healthy subjects were asked to complete the AII-F. The Short Form Health Survey (SF-36) was used as a comparative questionnaire as well as the French Cumberland Ankle Instability Tool (CAIT-F). The psychometric properties of the questionnaire were evaluated by determining the test-retest reliability after a 10-14-day interval, the internal consistency, construct validity, and the floor/ceiling effects.

RESULTS

The French-translation did not pose a problem and could be validated by the expert committee. The AII-F showed a very good test-retest reliability for the total score, with an Intra Class Coefficient of 0.983. The internal coherence is high with an alpha coefficient of Cronbach of 0.861. The association of the AII-F with the CAIT-F was high, for the summary of the physical component of the SF-36, meaning a great convergent validity. The other subscales of the SF-36 (mental health) were weakly correlated with the AII-F, reflecting good divergent validity. An optimal cut-off score was obtained to dissociate pathological patients from healthy subjects: when the subject responded to "yes" 5 times or more, he is considered, with a very high degree of confidence, to be pathological.

CONCLUSION

The AII-F is reliable and valid for evaluating and measuring functional ankle instability.

An item analysis according to the Rasch model of the German 12-item WHO Disability Assessment Schedule (WHODAS 2.0)

PURPOSE

The World Health Organization Disability Assessent Schedule 2.0 (WHODAS 2.0) assesses disability in individuals irrespective of their health condition. Previous studies validated the usefulness of the WHODAS 2.0 using classical test theory. This study is the first investigating the psychometric properties of the 12-items WHODAS 2.0 in patients with cancer using item analysis according to the Rasch model.

METHODS

In total, 350 cancer patients participated in the study. Rasch analysis of the 12-items version of the WHODAS 2.0 was conducted and included testing unidimensionality, local independence, and testing for differential item functioning (DIF) with regard to age, gender, type of cancer, presence of metastases, psycho-oncological support, and duration of disease.

RESULTS

After accounting for local dependence, which was mainly found across items of the same WHODAS domain, satisfactory overall fit to the Rasch model was established (χ² = 36.14, p = 0.07) with good reliability (PSI = 0.82) and unidimensionality of the scale. DIF was found for gender (testlet 'Life activities') and age (testlet 'Getting around/Self-care'), but the size of DIF was not substantial.

CONCLUSION

Overall, the analysis results according to the Rasch model support the use of the WHODAS 2.0 12-item version as a measure of disability in cancer patients.

Psychometric properties of the Polish version of the desire thinking questionnaire in a sample of Internet game players

The Desire Thinking Questionnaire (DTQ) is the main instrument used to measure desire thinking, which is the voluntary cognitive elaboration of a desired target on a verbal or imaginal level. Research has shown that this pattern of thinking occurs in different addictive behaviors. This study aimed to adapt the DTQ for use in research on gaming behavior (DTQ-G) and to validate the Polish version of the DTQ-G in a sample of Internet game players. A sample of 635 gamers were examined via the internet. The psychometric analyses of the DTQ-G yielded good results. The questionnaire proved to be a reliable tool for measuring desire thinking related to gaming. Confirmatory factor analysis provided support for the two-factor solution, with both factors (imaginal prefiguration and verbal perseveration) achieving good internal consistency. The Polish version of the DTQ-G has good psychometric properties and can be considered comparable to the original version.

A systematic review evaluating the clinimetric properties of the Victorian Institute of Sport Assessment (VISA) questionnaires for lower limb tendinopathy shows moderate to high-quality evidence for sufficient reliability, validity and responsiveness-part II

PURPOSE

The evaluation of measurement properties such as reliability, measurement error, construct validity, and responsiveness provides information on the quality of the scale as a whole, rather than on an item level. We aimed to synthesize the measurement properties referring to reliability, measurement error, construct validity, and responsiveness of the Victorian Institute of Sport Assessment questionnaires (Achilles tendon-VISA-A, greater trochanteric pain syndrome-VISA-G, proximal hamstring tendinopathy-VISA-H, patellar tendon-VISA-P).

METHODS

A systematic review was conducted according to Consensus-based Standards for the Selection of Health Measurement Instruments methodology (COSMIN). PubMed, Cochrane, CINAHL, EMBASE, Web of Science, SportsDiscus, grey literature, and reference lists were searched. Studies assessing the measurement properties concerning reliability, validity, and responsiveness of the VISA questionnaires in patients with lower limb tendinopathies were included. Two reviewers assessed the methodological quality of studies assessing reliability, validity, and responsiveness using the COSMIN guidelines and the evidence for these measurement properties. A modified Grading of Recommendations Assessment Development and Evaluation (GRADE) approach was applied to the evidence synthesis.

RESULTS

There is moderate-quality evidence for sufficient VISA-A, VISA-G, and VISA-P reliability. There is moderate-quality evidence for sufficient VISA-G and VISA-P measurement error, and high-quality evidence for sufficient construct validity for all the VISA questionnaires. Furthermore, high-quality evidence exists with regard to VISA-A for sufficient responsiveness in patients with insertional Achilles tendinopathy following conservative interventions.

CONCLUSIONS

Sufficient reliability, measurement error, construct validity and responsiveness were found for the VISA questionnaires with variable quality of evidence except for VISA-A which displayed insufficient measurement error.

LEVEL OF EVIDENCE

IV.

REGISTRATION DETAILS

Prospero (CRD42018107671); PROSPERO reference-CRD42019126595.

Validity, responsiveness and minimal important change of the EQ-5D-5L in patients after rotator cuff repair, shoulder arthroplasty or thumb carpometacarpal arthroplasty

PURPOSE

The aim was to investigate the measurement properties of the EQ-5D-5L utility index in patients after arthroscopic rotator cuff repair (RCR), total shoulder arthroplasty (TSA) or thumb carpometacarpal (CMC I) arthroplasty.

METHODS

In this prospective study, all patients completed the EQ-5D-5L before surgery and 6 months and 1 year after surgery. In addition, RCR patients completed the Oxford Shoulder Score (OSS), TSA patients completed the Shoulder Pain and Disability Index (SPADI) and CMC I patients completed the brief Michigan Hand Outcomes Questionnaire (brief MHQ) at each designated time point. Construct validity (Pearson's correlation coefficient, r), responsiveness (effect size), minimal important difference (MID), minimal important change (MIC), and floor and ceiling effects of the EQ-5D-5L were determined. To test discriminative ability, EQ-5D-5L utility indices of patients who were in a patient acceptable symptom state (PASS) or not at follow-up were compared using the Mann-Whitney U test.

RESULTS

We included 153 RCR, 150 TSA, and 151 CMC I patients. The EQ-5D-5L utility index correlated with the OSS (r = 0.73), SPADI (r = - 0.65) and brief MHQ (r = 0.61). The effect sizes were 1.3 (RCR and CMC I group) and 1.1 (TSA). The MID and MIC ranged from 0.027 to 0.209. Ceiling effects were found. The EQ-5D-5L utility index differed significantly between patients being in a PASS versus patients who were not in a PASS.

CONCLUSION

The EQ-5D-5L utility index shows good construct validity, responsiveness and discriminative ability in patients after arthroscopic RCR, TSA and CMC I arthroplasty and is suitable to quantify quality of life.

CLINICAL TRIAL REGISTRATION

This auxiliary analysis is part of a primary study that was originally registered at ClinicalTrials.gov (NCT01954433) on October 1, 2013.

Using the five to fifteen-collateral informant questionnaire for retrospective assessment of childhood symptoms in adults with and without autism or ADHD

Due to lack of previous studies, we aimed at evaluating the use of the Five to Fifteen (FTF) questionnaire in adults with neurodevelopmental disorders (NDD) and in controls without NDD. The NDD group consisted of adults with autism spectrum disorder ASD (n = 183) or attention-deficit/hyperactivity disorder (ADHD) (n = 174) without intellectual disability, recruited from a tertiary outpatient clinic. A web survey was used to collect data from general population adult control group without NDD (n = 738). The participants were retrospectively rated by their parents regarding childhood symptoms, using five to fifteen-collateral informant questionnaire (FTF-CIQ). Adults with NDD had higher FTF-CIQ domain and subdomain scores than controls, and displayed similar test profiles as children with corresponding diagnosis in previous studies. Based on the FTF-CIQ domain scores, 84.2% of the study participants (93% of the controls; 64% of the adults with NDD) were correctly classified in a logistic regression analysis. Likewise, Receiver Operating Characteristic (ROC) curve analysis on FTF-CIQ total sum score indicated that a cut-off value of 20.50 correctly classified 90% of the controls and 67% of the clinical cases, whilst a cut-off value of 30.50 correctly classified 84% of the controls and 77% of the clinical cases. The factor analysis revealed three underlying components: learning difficulties, cognitive and executive functions; social skills and emotional/behavioural symptoms; as well as motor and perceptual skills. Whilst not designed as a diagnostic instrument, the FTF-CIQ may be useful for providing information on childhood symptoms and associated difficulties in individuals assessed for NDD as adults.

Psychometric properties of the Arabic version of the bullying behaviours instrument in nursing education

Objectives

This study assesses the psychometric properties of the Bullying Behaviors in Nursing Education Arabic (BBNE-A) version when used among nursing students.

Methods

We adopted a quantitative, descriptive, and cross-sectional study design and selected a convenience sample of 189 nursing students in a governmental university in KSA. We utilised an online survey to collect data between January and March 2020. The item-level content validity index and scale-level content validity index utilising the averaging method were used for content validity. The Cronbach's alpha and the intra-class correlation coefficient for the test-retest reliability were used for statistical analysis. We performed a principal component analysis with varimax rotation for construct validity. ANOVA and Tukey HSD tests were utilised to determine the association of variables.

Results

The analysis revealed three distinct factors explaining 59.7% of the variance. The overall Cronbach's alpha of BBNE-A was 0.886. The three factors ranged from 0.716 to 0.847. For the test-retest reliability, the ICC of the overall scale was 0.939. There was a significant difference in the BBNE-A overall scores in different years of study (F = 3.57, p = .030). A significant difference was also observed in the BBNE-A scores regarding positions in the family.

Conclusion

In our study, the BBNE-A demonstrated acceptable content and constructed psychometric properties. This tool can be utilised to accurately assess the bullying behaviours experienced by nursing students in KSA. The results can provide a basis for developing an anti-bullying guideline to make an optimistic, harmless clinical learning milieu in promoting nursing students' self-esteem and professional engagement.

Validation and psychometric properties of the Spanish version of the questionnaire for assessing the childbirth experience (QACE)

OBJECTIVE

When evaluating childbirth experience, some of the factors considered by women include their previous births experience, pain management during birth, and companion and healthcare professional support received. The objective of this paper is to validate the Questionnaire for Assessing the Childbirth Experience (QACE) into the Spanish population by assessing its psychometric properties.

METHODS

Due to the differences between the Spanish and English languages, a careful translation process was the first step to making the QACE useable to Spanish speaking cohorts, once thoroughly translated their conceptual equivalence was evaluated by a group of experts and tested later via interviews with postpartum women for comprehensibility evaluation. Secondly, the validation process was obtained throughout the factorial analysis, internal consistency, test-retest evaluation and convergent and discriminant validity.

RESULTS

A total of 268 postpartum women participated in the validity study. The KMO (0.84) and Bartlett test (p < 0.001) confirmed the adequacy of factor analysis and the Screen plot showed four factors with the predictive power of 52.63%, which supported total variance. Confirmatory factor analysis indicated an adequate/good fitness for the new model (χ²/df = 1.47, GFI = 0.979, RMSEA = 0.052, CFI = 0.889, NFI = 0.727, NNFI = 0.873, and SRMR = 0.155). Internal consistency was confirmed with McDonal's Omega level of 0.818. Test-retest evaluation supported test stability (r = 0.79, p < 0.01). Convergent and discriminant validity were obtained with 0.803 and 0.475 Pearson coefficients respectively.

CONCLUSIONS

The Spanish version of QACE is a relevant tool for measuring childbirth experience into the Spanish context with acceptable validity and stability.

Development and validation of the peptic ulcer scale under the system of quality of life instruments for chronic diseases based on classical test theory and generalizability theory

BACKGROUND

Quality of life (QOL) for patients with Peptic ulcer disease (PUD) is of interest worldwide and disease-specific instruments are needed for clinical research and practice. This paper focus on the development and validation of the PUD scale under the system of quality of life instruments for chronic diseases (QLICD-PU) by the modular approach and both classical test theory and Generalizability Theory.

METHODS

The QLICD-PU is developed based on programmatic decision-making procedures, including multiple nominal and focus group discussions, in-depth interviews, and quantitative statistical procedures. Based on the data of 153 PUD inpatients, correlation analysis, factor analysis, t-test, and Generalizability Theory analysis (including generalizability study and decision study, ie. G-study and D-study) were used to assess the validity, reliability, and responsiveness of the scale.

RESULTS

When the popular scale health survey short form (SF-36) was used as the standard, correlation and factor analysis confirmed good construct validity and criterion-related validity of QLICD-PU. Except for the social domain (0.62), the internal consistency α of all domains is higher than 0.70. The overall score and the test-retest reliability coefficients (Pearson r and intra-class correlation ICC) in all domains are higher than 0.80 (0.77 in the social domain). After treatments, the overall score and scores of all domains have statistically significant changes (P < 0.01), except for social impact and sexual function scores. The SRM (Standardized response mean) of domain-level scores ranges from 0.34 to 1.03. The G coefficient and reliability index (Ф coefficient) further confirm the reliability of the scale through more accurate variance components and decision-making information about changes in the number of items.

CONCLUSIONS

The QLICD-PU can be used as a useful measurement to assess the quality of life of PUD patients with good psychometric characteristics and multiple advantages.

Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents

INTRODUCTION

Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used.

METHODS

We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10).

RESULTS

The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item one). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group.

CONCLUSIONS

The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.