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Chiowchanwisawakit P, Orawongpaisarn A, Katchamart W. Construct validity, reliability, and threshold value for treatment goals of the Thai version of the 12-item Psoriatic Arthritis Impact of Disease Questionnaire for patients with psoriatic arthritis. Int J Rheum Dis 2024; 27:e15139. [PMID: 38610096 DOI: 10.1111/1756-185x.15139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/21/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To determine the construct validity, reliability, and treatment goal threshold of a Thai-language version of the 12-item Psoriatic Arthritis Impact of Disease (Thai-PsAID) questionnaire in patients with psoriatic arthritis (PsA). METHODS This cross-sectional study involved administering the proposed Thai-PsAID to 117 Thai patients with PsA. Reliability was assessed by Cronbach's α test and intraclass correlation coefficient (ICC). Construct validity was assessed using Spearman correlation with clinical disease activity index for psoriatic arthritis (cDAPSA), the Health Assessment Questionnaire (HAQ), EQ-5D index, and the patient-acceptable symptom state (PASS). The optimal cutoff score of the Thai-PsAID for minimal disease activity (MDA) was determined by receiver operating characteristic curves. RESULTS Participants had a mean age of 49.5 years, 61 (52.1%) were female, and the median disease duration was 5 years. The median Thai-PsAID score was 2.1, with a Cronbach's α coefficient of .95 and an ICC of 0.77. The mean time to complete the Thai-PsAID was 2.1 min, with no missing data. The Thai-PsAID score demonstrated a moderate correlation with the cDAPSA, HAQ, and EQ-5D with indices (Spearman's rho of .64, .54, and -.55, respectively). The cutoff of 2.7 has 81%-84% sensitivity and 69%-85% specificity for classifying patients with MDA, satisfied PASS, and indicating no need to escalate medication. CONCLUSIONS The Thai-PsAID is a valid, reliable, and feasible tool for measuring PsA prognosis. A cutoff of 2.7 accurately discriminates MDA and PASS and indicates no need for medication escalation. The Thai-PsAID may be used as a standalone measure.
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Affiliation(s)
- Praveena Chiowchanwisawakit
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Annop Orawongpaisarn
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanruchada Katchamart
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Hashempour R, MirHashemi S, Mollajafari F, Damiri S, ArabAhmadi A, Raei B. Economic burden of diabetic foot ulcer: a case of Iran. BMC Health Serv Res 2024; 24:363. [PMID: 38515182 PMCID: PMC10958898 DOI: 10.1186/s12913-024-10873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is known as a serious complication of diabetes mellitus in patients with diabetes, imposing heavy medical costs on healthcare systems due to its chronic nature. patients with severe diabetic foot ulcer are often disabled to work, and some of them may even die, leading to associated productivity losses. Since no previous study has investigated the economic burden of DFU in Iran, this study is to estimate the economic burden of diabetic foot disease in Iran. METHODS In this descriptive cross-sectional study, randomly selected samples consisted of 542 patients with DFU, hospitalized in the hospitals of Shahid Beheshti University of Medical Sciences. The demographic profile and cost data used in this analysis were derived from a researcher-designed checklist. Lost productivity was calculated based on Human Capital Approach, and the total economic cost of DFU was determined using patient-level data on costs and prevalence data from the global burden of diseases reports. All analyses were performed using SPSS software (Version 23), and Microsoft Excel (Version 19). RESULTS The economic burden of DFU in Iran in two scenarios of discounting future costs and not discounting them was about $8.7 billion and $35 billion, respectively (about 0.59 and 2.41% of GDP). 79.25% of the estimated costs in this study were indirect costs and productivity losses, of which 99.34% (7,918.4 million Dollars) were productivity losses due to premature death. 20.75% (2,064.4 million dollars) of the estimated costs in this study were direct costs. The average length of stay (LOS) was 8.10 days (SD = 9.32), and 73.3% of patients recovered and were discharged after hospitalization and 7.6% died. The majority of the costs are imposed on the age group of 60-69 year (53.42% of the productivity lost due to hospital length of stay, 58.91% of the productivity lost due to premature death & 40.41% of direct costs). CONCLUSIONS DFU represents a heavy burden to patients, Iran's health system, and the economy. Early prevention strategies need to be prioritized in making public health policies. These policies and decisions can be in the area of changing lifestyle, health education, changing people's behavior, and encouraging physical activity that targeted high-risk populations in order to reduce the prevalence of diabetic foot and resulting substantial economic burden.
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Affiliation(s)
- Reza Hashempour
- Department of Health Economics and Statistics, Vice-Chancellor's Office in Treatment Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - SeyedHadi MirHashemi
- Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Mollajafari
- Department of Health Economics and Statistics, Vice-Chancellor's Office in Treatment Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Damiri
- Health Economics, Management, and Policy Department, Virtual School of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali ArabAhmadi
- Department of Public Health, Qaen School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Behzad Raei
- Razi Educational and Therapeutic Center, Tabriz University of Medical Science, Tabriz, Iran.
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Ruiz-Muñoz M, Fernández-Torres R, Formosa C, Gatt A, Gijón-Noguerón G, Navarro-Flores E, González-Sánchez M. Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation. Front Public Health 2024; 11:1326439. [PMID: 38332943 PMCID: PMC10851747 DOI: 10.3389/fpubh.2023.1326439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/30/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease. Methods The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase. Results An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach's α =0.889-0.981), and reliability was excellent (ICC = 0.854-0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752. Conclusion DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.
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Affiliation(s)
- María Ruiz-Muñoz
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | - Raúl Fernández-Torres
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | - Cynthia Formosa
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Alfred Gatt
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Gabriel Gijón-Noguerón
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | - Emmanuel Navarro-Flores
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Valencia, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
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Aksoy M, Büyükbayram Z, Özüdoğru O. Reliability and validity of the Diabetic foot self-care questionnaire in Turkish patients. Prim Care Diabetes 2023; 17:513-517. [PMID: 37302937 DOI: 10.1016/j.pcd.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/26/2023] [Accepted: 06/07/2023] [Indexed: 06/13/2023]
Abstract
AIM This study was conducted to examine the psychometric, properties of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire. METHODS This was a descriptive- methodological study conducted on 193 diabetes patients. Data were collected, using Descriptive, Information Form and Diabetic Foot Self-Care Questionnaire. Data were analyzed using exploratory factor analysis, item-total score correlation, Cronbach's alpha, and test-retest analysis. RESULTS The Diabetic, Foot Self-Care, Questionnaire consists of 16 items and three sub-dimensions. The three sub-dimensions recorded a variance of 58.137%. The total Cronbach's alpha coefficient of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire was 0.87, and Cronbach's alpha values of its sub-dimensions were 0.71 and 0.88. The two-month test-retest credibility interpreted with intra-class correlation was 0.97. CONCLUSIONS It has been shown that the questionnaire is a valid and reliable tool for assessing foot self-care behavior in diabetic patients.
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Affiliation(s)
- Meyreme Aksoy
- Siirt University, Faculty of Health Sciences,Department of Nursing Fundamentals, Siirt, Turkey.
| | - Zeliha Büyükbayram
- Siirt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Siirt, Turkey
| | - Osman Özüdoğru
- Siirt University, Medical Faculty, Department of Internal Medicine, Siirt, Turkey
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Ahmadnezhad L, López-López D, Becerro-de-Bengoa-Vallejo R, Jiménez-Cebrián AM, Gómez-Salgado J, Losa-Iglesias ME, Andreo-García MV, Navarro-Flores E. "Translated and adaptation into Persian of the podiatric health questionnaire (PHQ)". J Tissue Viability 2023; 32:255-261. [PMID: 36841714 DOI: 10.1016/j.jtv.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/03/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
The Podiatric Health Questionnaire (PHQ) is a foot health psicometric tool consisting of six items for measuring foot health status. Currently, PHQ has been adapted into Spanish. Thus, this research focused on develop the Persian translation and adaptation of the PHQ. The translation into Persian and test-retest reliability methods were applied from english version questionnarie. As regards to the total mark for each sub-scale, internal consistency and reliability were determined by the Cronbach α and intraclass correlation coefficient (ICC) with a confidence interval (CI) of 95%. High internal consistency was shown for the six sub-scales: a) walk with a Cronbach α of 0.775; b) hygiene and c) nail care with 0.789 and 0.796 respectively; d) foot on pain with 0.779; e) concern domain with 0.788; and f) quality of life with 0.798; and g) visual analogic scale with 0.803. Excellent test-retest reliability (ICC = 0.912 [95% CI = 0.845-0.950]) was shown for the total score. Conclusions: The persian version of the PHQ was shown to be a valid and reliable tool for an acceptable use in the Iran population.
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Affiliation(s)
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain.
| | | | - Ana María Jiménez-Cebrián
- Department Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa 3, Ampliación de Campus de Teatinos, 29071, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain.
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Universidad de Huelva, Huelva, Spain; Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, 092301, Ecuador.
| | | | - Maria Victoria Andreo-García
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403, Ferrol, Spain.
| | - Emmanuel Navarro-Flores
- Department of Nursing, Faculty of Nursing and Podiatry, Frailty Research Organized Group, University of Valencia, Valencia, Spain.
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He Q, Zhang J, Chen X. An estimation of diabetes foot self-care based on validated scores: A systematic review and meta-analysis. J Tissue Viability 2021; 31:302-308. [PMID: 34844853 DOI: 10.1016/j.jtv.2021.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
A diabetic foot ulcer is a preventable complication of diabetes, which could lead to lower extremity amputation and increased mortality and morbidity. Self-care behaviors play a key role in the prevention of diabetic foot ulcers. This study aimed to estimate the total score of diabetic foot self-care behaviors. We searched databases such as Web of Science, Medline (PubMed), and Scopus using various keywords, including diabetic foot, diabetic feet, diabetic problem, diabetic foot ulcer, and self-care, for relevant articles with no time limit. The heterogeneity of the studies was assessed using Cochran's Q test and I2 statistic. Data were analyzed using STATA software version 12 using the meta-analysis method and a random effects model. In total, eight studies were analyzed with a sample size of 2,493. The pooled score of diabetes foot self-care was 62.84% and this score was higher in the studies conducted on two groups of patients with type I and type II diabetes compared to those performed only on patients with type II diabetes. The results also indicated correlation between the self-care score and year of publication (P < 0.001), and the self-care scores significantly declined during 2015-2021 (P < 0.001). Overall, the diabetic foot self-care score was moderate, which highlights the need to provide self-care education to diabetic patients.
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Affiliation(s)
- Qiuyao He
- Department of respiratory and critical care medicine, West China Hospital, No.37 Guoxue Alley, Chengdu city, Sichuan Province, 610041, China.
| | - Jing Zhang
- Faculty of Nursing and Midwifery, Jiangsu College of Nursing, No.9 Technology Avenue, Huaian City, Jiangsu Province, 223300, China
| | - Xin Chen
- Health Center, University Hospitals Coventry and Warwickshire NHS Trust; Coventry, West Midland, CV1 5QP, UK
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Exploring the Relationship of Health Beliefs and Self-Care Behaviors Related to Diabetic Foot Ulcers of Type II Diabetes Mellitus Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137207. [PMID: 34281144 PMCID: PMC8296960 DOI: 10.3390/ijerph18137207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022]
Abstract
Objective: Diabetic foot ulcers are an invasive complication of diabetes and are increasing. This study investigates the relationship between health beliefs and foot self-care behaviors, among people with type II diabetes. Methods: A cross-sectional design was adopted, and 98 patients were recruited from outpatient clinics of the endocrine department. The questionnaires of Demographic, Diabetes Foot Ulcer Health Belief Scale (Health Beliefs, DFUHBS), and Diabetes Foot Self-Care Behavior Scale (Self Care, DFSBS) were used to collect data. Results: Among the subjects living alone or who had diabetes less than ten years, the score of DFSBS was significantly lower than among those living with families or who had diabetes for ten years or more. The frequency of performing diabetes foot self-care behavior, among males was lower than among females significantly. Although there was no significant difference in the Health Belief total score, there were differences in the benefit subscale. Those who had junior high school level or less or had diabetes less than ten years, their score was significantly lower than those with senior high school level or more or had diabetes ten years or more. In a multivariable regression model, living with family, diabetes duration, and health beliefs explained 42.9% of the variance of diabetic-foot self-care behaviors. Conclusions: Living alone, shorter duration of diabetes, male gender, and lower health belief scores predict less adequate diabetic foot self-care behavior. Health care providers should assess these factors when designing individual care plans.
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Navarro-Flores E, Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, Jiménez-Cebrián AM, Rochdi L, Romero-Morales C, Palomo-López P, López-López D. Repeatability and reliability of the diabetic foot self-care questionnaire in Arabic patients: A transcultural adaptation. J Tissue Viability 2021; 31:62-68. [PMID: 34183224 DOI: 10.1016/j.jtv.2021.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/25/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE The diabetic foot self-care questionnaire is considered a self-care evaluation tool with 16 questions for assessing diabetic foot health disorders. To date, the DFSQ has been validated in different languages, but an Arabic version was lacking. Consequently, the purpose of this study was to translate and validate the Arabic version of the DFSQ (DFSQ-AR). METHOD A suitable method was developed for the translation protocol and cross-cultural validation from Spanish to Arabic. Regarding the total marks from each sub-scale, agreement degrees and confidence were analyzed using Cronbach's α and intraclass correlation coefficient (ICC), respectively. In addition, the mean ± standard deviation differences between pre and post-tests were calculated and completed using Bland-Altman distribution plots. RESULTS Excellent agreement between the two versions was demonstrated based on Cronbach's α. Three sub-scales consisting of knowledge of foot hygiene, the appropriate use of footwear and socks, and podiatric self-care were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the self-care and shoe and socks sub-scales. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (P = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75-102.43] and 97.96 ± 13.88 [94.5-101.86] points, respectively). Bland-Altman plots or clinically pertinent variations were not statistically significantly different. CONCLUSIONS The DFSQ-AR is considered a strong and valid questionnaire with adequate repeatability in the Arabic language population.
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Affiliation(s)
- Emmanuel Navarro-Flores
- Faculty of Nursing and Podiatry, Department of Nursing, University of Valencia, Frailty Research Organizaded Group. (FROG), Spain.
| | | | | | - Ana María Jiménez-Cebrián
- Department Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Spain.
| | - Loubna Rochdi
- Gabinet de Podologie Loubna Rochdi, Avenue Salah Eddine El Ayoubi, Tetouan, Marroco.
| | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain.
| | | | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain.
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