Methodological quality of 100 recent systematic reviews of health-related outcome measurement instruments: an overview of reviews.

PURPOSE: Systematic reviews evaluating and comparing the measurement properties of outcome measurement instruments (OMIs) play an important role in OMI selection. Earlier overviews of review quality (2007, 2014) evidenced substantial concerns with regards to alignment to scientific standards. This overview aimed to investigate whether the quality of recent systematic reviews of OMIs lives up to the current scientific standards. METHODS: One hundred systematic reviews of OMIs published from June 1, 2021 onwards were randomly selected through a systematic literature search performed on March 17, 2022 in MEDLINE and EMBASE. The quality of systematic reviews was appraised by two independent reviewers. An updated data extraction form was informed by the earlier studies, and results were compared to these earlier studies' findings. RESULTS: A quarter of the reviews had an unclear research question or aim, and in 22% of the reviews the search strategy did not match the aim. Half of the reviews had an incomprehensive search strategy, because relevant search terms were not included. In 63% of the reviews (compared to 41% in 2014 and 30% in 2007) a risk of bias assessment was conducted. In 73% of the reviews (some) measurement properties were evaluated (58% in 2014 and 55% in 2007). In 60% of the reviews the data were (partly) synthesized (42% in 2014 and 7% in 2007); evaluation of measurement properties and data syntheses was not conducted separately for subscales in the majority. Certainty assessments of the quality of the total body of evidence were conducted in only 33% of reviews (not assessed in 2014 and 2007). The majority (58%) did not make any recommendations on which OMI (not) to use. CONCLUSION: Despite clear improvements in risk of bias assessments, measurement property evaluation and data synthesis, specifying the research question, conducting the search strategy and performing a certainty assessment remain poor. To ensure that systematic reviews of OMIs meet current scientific standards, more consistent conduct and reporting of systematic reviews of OMIs is needed.

Measuring empowerment in pregnant women: A scoping review of progress in instruments.

BACKGROUND: The empowerment of pregnant women is a meaningful strategy that profoundly impacts the health of women and their children. Despite a significant increase in the empowerment of pregnant women and its measurement, little attention was given to a consensus on the selection and application of assessment instruments used for pregnant women. OBJECTIVE: To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties. METHODS: We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties. RESULTS: A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity. CONCLUSION: There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.

The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC).

Background: Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals. Methods: A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72). Conclusion: The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.

Patient-Reported Outcome Measures in Neuromuscular Diseases: A Scoping Review.

 Patient-reported outcome measures (PROMs) are valuable in comprehensively understanding patients' health experiences and informing healthcare decisions in research and clinical care without clinicians' input. Until now, no central resource containing information on all PROMS in neuromuscular diseases (NMD) is available, hindering the comparison and choice of PROMs used to monitor NMDs and appropriately reflect the patient's voice. This scoping review aimed to present a comprehensive assessment of the existing literature on using PROMs in children and adults with NMD. A scoping methodology was followed using Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines to assess the literature on PROMs in NMDs. Eligibility criteria encompassed articles describing psychometric development or evaluation of generic or disease-specific PROM-based instruments for adults and children with specific NMDs. The data charting process involved extracting measurement properties of included PROMs, comprising validity, reliability, responsiveness, and interpretability information. The review identified 190 PROMs evaluated across 247 studies in individuals with NMDs. The majority of PROMs were disease specific. The physical functioning domain was most assessed. Validity was the most frequently investigated measurement property, with a limited number of PROMs sufficiently evaluated for a range of psychometric characteristics. There is a strong need for further research on the responsiveness and interpretability of PROMs and the development of PROMs on social functioning in NMD.

[Health-related quality of life : Concept, measurement and fields of application]. / Gesundheitsbezogene Lebensqualität : Konzept, Messung und Anwendungsfelder.

Health-related quality of life (HRQoL) is the most important patient-reported outcome in clinical trials and patient care. HRQoL is further considered as target variable in treatment guidelines and as outcome indicator in the evaluation of the quality of care. Numerous validated questionnaires are available for the assessment of HRQoL from the perspective of patients with skin diseases. However, many are of inadequate methodological quality, indicating the need for further research in the development of high-quality measurement instruments. The implementation of routine electronic HRQoL assessments is a promising approach.

Psychometric Properties of General Oral Health Assessment Index Across Ages: COSMIN Systematic Review.

OBJECTIVES: To systematically review the psychometric properties of the Geriatric Oral Health Assessment Index (GOHAI) across age groups using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. METHODS: Data: English peer-reviewed articles reporting studies of the development, translation, or validation of GOHAI. SOURCES: PubMed, Web of Science, and EMBASE from Jan 1990 until December 31, 2023. Methodological evaluation: based on COSMIN methodology. The results are presented overall and for 4 age groups (≥60 years, all ages, <60 years, ≤45 years). Structural validity was summarized qualitatively. Internal consistency and reliability were synthesized via random-effects meta-analysis of T-transformed Cronbach α values, and Fisher's Z transformed correlation coefficients. Construct validity and responsiveness were assessed using effect sizes. RESULTS: Four hundred ninety-seven records were identified, 72 underwent full-text assessment, resulting in 60 included reports. Structural validity was inconsistent across all age groups and overall. Internal consistency was sufficient with overall α = 0.81, and high evidence quality. Test-retest reliability was consistently sufficient across age groups with overall r = 0.84. For construct validity 361 hypotheses were assessed (37.4% for convergent-, 62.6% for known-groups validity). The percentage of confirmed hypotheses in ≥60-years, all ages, <60-years and ≤45-years were 75.5%, 66.7%, 78.9%, and 88.9%, respectively. Responsiveness was not assessed in the <60-years and ≤45-years age groups, leading to indeterminate overall rating with very low evidence quality. CONCLUSIONS: This review affirms that GOHAI has sufficient psychometric properties as an oral health-related quality of life instrument in various age groups, but its responsiveness is scarcely researched and its utility for individual-level follow-up is limited. The measurement properties of oral health-related quality of life tools must be scrutinized in the changing demands of personalized and value-based dental care. (PROSPERO registration: CRD42022384132).

Measurement Instruments Assessing Multi-Faceted Stigma Regarding Sexual and Gender Minorities: A Systematic Review of Psychometric Properties.

Stigma against sexual and gender minorities (SGM) populations has serious negative health effects for SGM populations. Despite the growing need for accurate stigma measurement in SGM, there are insufficient valid measurement instruments. Moreover, the lack of consistency in construct usage makes comparisons across studies particularly challenging. A critical review and comparative evaluation of the psychometric properties of the various stigma measures for SGM is necessary to advance our understanding regarding stigma measurement against/among SGMs. Based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive search was conducted in 4 bibliographic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science) for empirical articles published from 2010 to 2022 that evaluated the psychometrics properties of measurement instruments assessing stigma against SGMs. The screening, extraction, and scoring of the psychometric properties and methodological quality of selected instruments were performed by following the established standards and COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) checklist, respectively. Of the 2031 studies identified, 19 studies were included that reported psychometric properties of 17 measurement instruments. All instruments, except two, were developed for SGMs (n = 15/17). Most instruments included men who have sex with men (MSM) or gay men (n = 11/15), whereas less than half of the instruments assessed stigma among SGM women (n = 6/15). Internal consistency (Cronbach's alpha) and content validity was reported for all instruments (n = 17); construct and structural validity was also reported for majority of the instruments (n = 15 and 10, respectively). However, test-retest reliability and criterion validity was reported for very few instruments (n = 5 each). Based on the COSMIN checklist, we identified the most psychometrically and methodologically robust instruments for each of the five stigma types: combined stigma, enacted stigma, internalized stigma, intersectional stigma, and perceived stigma. For each stigma type, except anticipated stigma, at least one instrument demonstrated strong promise for use in empirical research; however, the selection of instrument depends on the target population and context of the study. Findings indicated a growing use of instruments assessing multiple stigma types. Future studies need to develop intersectional stigma instruments that account for the multiple and intersecting social identities of SGMs. Additionally, most existing instruments would benefit from further psychometric testing, especially on test-retest reliability, criterion validity, adaptability to different LGBTQIA + populations and cultures.

Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity: A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology.

Background: Patient-reported outcome measures have become crucial in the clinical evaluation of patients. Appropriate selection, in a young population, of the instrument is vital to providing evidence-based patient-centered healthcare. This systematic review applies the COnsensus-based Standards for selection of health Measurement INstruments methodology to provide a critically appraised overview of patient-reported outcome measures targeted at pediatric orthopedic patients with lower limb impairment. Method: A systematic search of electronic databases was performed to identify original studies reporting the development and/or validation of patient-reported outcome measures evaluating children with impairment of the lower extremity. Data extraction, quality assessment, and risk of bias evaluation were performed following the COnsensus-based Standards for selection of health Measurement INstruments guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Results: A total of 6919 articles were screened. Thirty-three studies were included, reporting evidence on the measurement properties of 13 different patient-reported outcome measures and 20 translations. Four studies reported on content validity and patient-reported outcome measure development. The methodological quality of studies on structural validity, content validity, or patient-reported outcome measure development was mostly rated as "doubtful" or "very good." The quality of evidence on measurement properties varied noticeably, with most studies needing to perform improve their methodological quality to justify their results. Conclusion: This review provides an extensive overview of all available patient-reported outcome measures for patients with lower extremity impairment within pediatric orthopedics. We cautiously advise the use of four patient-reported outcome measures. However, the scarce availability of research on content validity and patient-reported outcome measure development highlights an area for future research endeavors to improve our knowledge on the currently available patient-reported outcome measures. Level of evidence: Diagnostic level 1.

Generating a list of potentially important contextual factors covering randomized trials, cohorts, and measurement property studies: An OMERACT initiative.

OBJECTIVES: To generate candidates for contextual factors (CFs) for each CF type (i.e., Effect Modifying Contextual Factors (EM-CFs), Outcome Influencing Contextual Factors (OI-CFs), and Measurement Affecting Contextual Factors (MA-CFs)) considered important within rheumatology. METHODS: We surveyed OMERACT working groups and conducted a Special Interest Group (SIG) session at the OMERACT 2023 meeting, where the results were reviewed, and additional CFs suggested. RESULTS: The working groups suggested 44, 49, and 21 generic EM-CFs, OI-CFs, and MA-CFs, respectively. SIG participants added 49, 44, and 55 factors, respectively. CONCLUSION: Candidate CFs were identified, next step is a consensus-based set of endorsed (important) CFs.

Baseline Data and Measurement Instruments Reported in Observational Studies in Inflammatory Bowel Disease: Results from a Systematic Review.

BACKGROUND: Heterogeneity in demographic and outcomes data with corresponding measurement instruments [MIs] creates barriers to data pooling and analysis. Several core outcome sets have been developed in inflammatory bowel disease [IBD] to homogenize outcomes data. A parallel Minimum Data Set [MDS] for baseline characteristics is lacking. We conducted a systematic review to develop the first MDS. METHODS: A systematic review was made of observational studies from three databases [2000-2021]. Titles and abstracts were screened, full-text articles were reviewed, and data were extracted by two reviewers. Baseline data were grouped into ten domains: demographics, clinical features, disease behaviour/complications, biomarkers, endoscopy, histology, radiology, healthcare utilization and patient-reported data. Frequency of baseline data and MIs within respective domains are reported. RESULTS: From 315 included studies [600 552 subjects], most originated from Europe [196; 62%] and North America [59; 19%], and were published between 2011 and 2021 [251; 80%]. The most frequent domains were demographics [311; 98.7%] and clinical [289; 91.7%]; 224 [71.1%] studies reported on the triad of sex [306; 97.1%], age [289; 91.7%], and disease phenotype [231; 73.3%]. Few included baseline data for radiology [19; 6%], healthcare utilization [19; 6%], and histology [17; 5.4%]. Ethnicity [19; 6%], race [17; 5.4%], and alcohol/drug consumption [6; 1.9%] were the least reported demographics. From 25 MIs for clinical disease activity, the Harvey-Bradshaw Index [n = 53] and Mayo score [n = 37] were most frequently used. CONCLUSIONS: Substantial variability exists in baseline population data reporting. These findings will inform a future consensus for MDS in IBD to enhance data harmonization and credibility of real-world evidence.

OMERACT Core outcome measurement set for shared decision making in rheumatic and musculoskeletal conditions: a scoping review to identify candidate instruments.

OBJECTIVES: Shared decision making (SDM) is a central tenet in rheumatic and musculoskeletal care. The lack of standardization regarding SDM instruments and outcomes in clinical trials threatens the comparative effectiveness of interventions. The Outcome Measures in Rheumatology (OMERACT) SDM Working Group is developing a Core Outcome Set for trials of SDM interventions in rheumatology and musculoskeletal health. The working group reached consensus on a Core Outcome Domain Set in 2020. The next step is to develop a Core Outcome Measurement Set through the OMERACT Filter 2.2. METHODS: We conducted a scoping review (PRISMA-ScR) to identify candidate instruments for the OMERACT Filter 2.2 We systematically reviewed five databases (Ovid MEDLINE®, Embase, Cochrane Library, CINAHL and Web of Science). An information specialist designed search strategies to identify all measurement instruments used in SDM studies in adults or children living with rheumatic or musculoskeletal diseases or their important others. Paired reviewers independently screened titles, abstracts, and full text articles. We extracted characteristics of all candidate instruments (e.g., measured construct, measurement properties). We classified candidate instruments and summarized evidence gaps with an adapted version of the Summary of Measurement Properties (SOMP) table. RESULTS: We found 14,464 citations, read 239 full text articles, and included 99 eligible studies. We identified 220 potential candidate instruments. The five most used measurement instruments were the Decisional Conflict Scale (traditional and low literacy versions) (n=38), the Hip/Knee-Decision Quality Instrument (n=20), the Decision Regret Scale (n=9), the Preparation for Decision Making Scale (n=8), and the CollaboRATE (n=8). Only 44 candidate instruments (20%) had any measurement properties reported by the included studies. Of these instruments, only 57% matched with at least one of the 7-criteria adapted SOMP table. CONCLUSION: We identified 220 candidate instruments used in the SDM literature amongst people with rheumatic and musculoskeletal diseases. Our classification of instruments showed evidence gaps and inconsistent reporting of measurement properties. The next steps for the OMERACT SDM Working Group are to match candidate instruments with Core Domains, assess feasibility and review validation studies of measurement instruments in rheumatic diseases or other conditions. Development and validation of new instruments may be required for some Core Domains.

Internal Rotation Measurement of the Knee with Polymer-Based Capacitive Strain Gauges versus Mechanical Rotation Measurement Taking Gender Differences into Account: A Comparative Analysis.

With the conventional mechanical rotation measurement of joints, only static measurements are possible with the patient at rest. In the future, it would be interesting to carry out dynamic rotation measurements, for example, when walking or participating in sports. Therefore, a measurement method with an elastic polymer-based capacitive measuring system was developed and validated. In our system, the measurement setup was comprised of a capacitive strain gauge made from a polymer, which was connected to a flexible printed circuit board. The electronics integrated into the printed circuit board allowed data acquisition and transmission. As the sensor strip was elongated, it caused a change in the spacing between the strain gauge's electrodes, leading to a modification in capacitance. Consequently, this alteration in capacitance enabled the measurement of strain. The measurement system was affixed to the knee by adhering the sensor to the skin in alignment with the anterolateral ligament (ALL), allowing the lower part of the sensor (made of silicone) and the circuit board to be in direct contact with the knee's surface. It is important to note that the sensor should be attached without any prior stretching. To validate the system, an in vivo test was conducted on 10 healthy volunteers. The dorsiflexion of the ankle was set at 2 Nm using a torque meter to eliminate any rotational laxity in the ankle. A strain gauge sensor was affixed to the Gerdii's tubercle along the course of the anterolateral ligament, just beneath the lateral epicondyle of the thigh. In three successive measurements, the internal rotation of the foot and, consequently, the lower leg was quantified with a 2 Nm torque. The alteration in the stretch mark's length was then compared to the measured internal rotation angle using the static measuring device. A statistically significant difference between genders emerged in the internal rotation range of the knee (p = 0.003), with female participants displaying a greater range of rotation compared to their male counterparts. The polymer-based capacitive strain gauge exhibited consistent linearity across all measurements, remaining within the sensor's initial 20% strain range. The comparison between length change and the knee's internal rotation angle revealed a positive correlation (r = 1, p < 0.01). The current study shows that elastic polymer-based capacitive strain gauges are a reliable instrument for the internal rotation measurement of the knee. This will allow dynamic measurements in the future under many different settings. In addition, significant gender differences in the internal rotation angle were seen.

Validación interna de un instrumento de medición de la calidad de atención percibida con la metodología rendimiento del servicio para la aplicación en una clínica odontológica universitaria / Internal validation of an instrument for measuring perceived quality using the service performance methodology for application in a dental clinic university

Objetivo: Validar la estructura interna de un instrumento de medición de la calidad de atención percibida con la metodología rendimiento del servicio (Service Performance ­ SERVPERF) para la aplicación en una clínica odontológica universitaria. Método: El estudio se encuentra bajo el diseño de investigación exploratorio secuencial (DEXPLOS) orientado a la validación de instrumentos documentales, establecida en las siguientes fases; Primera fase, dio inicio con la revisión bibliográfica para definir las perspectivas teóricas; Segunda fase, se prosiguió a la selección del panel de expertos; Tercera fase, selección de la muestra para la prueba piloto y la administración del instrumento; Cuarta fase, se procedió a la validación psicométrica del instrumento. Resultados: El instrumento elegido para la adaptación fue el SERVPERF, validado respecto a su contenido a través de la ronda de cuatro expertos odontólogos. Instrumento definido con 20 ítems agrupados en cinco dimensiones, con cuatro ítems en cada dimensión. Instrumento de medición para la calidad de atención percibida, válido en su contenido, constructo y confiable con un alfa de Cronbach de buena aceptabilidad con un valor de 0,802. Conclusiones: Sé válido la estructura interna del instrumento SERVPERF, adaptado a las características propias y específicas del servicio odontológico que brindan la clínica docente asistencial de la Carrera de Odontología de la Universidad Pública de El Alto (UPEA).

Objective: To validate the internal structure of an instrument for measuring the perceived quality of care with the Service Performance (SERVPERF) methodology for application in a dental clinic university. Method: The study is under the exploratory sequential research design (DEXPLOS) oriented to the validation of documentary instruments, established in the following phases; First phase, began with the bibliographic review to define the theoretical perspectives; Second phase, followed by the selection of the panel of experts; Third phase, selection of the sample for the pilot test and the administration of the instrument; Fourth phase, proceeded to the psychometric validation of the instrument. Results: The instrument chosen for adaptation was the SERVPERF, validated with regard to its content through the round of four dental experts. The instrument was defined with 20 items grouped into five dimensions, with four items in each dimension. Measurement instrument for perceived quality of care, valid in its content, construct and reliability with a Cronbach's alpha of good acceptability with a value of 0.802. Conclusions: The internal structure of the SERVPERF instrument is valid, adapted to the specific characteristics of the dental service provided by the teaching clinic of the Dentistry Career of El Alto Public University (UPEA)

Problemas comportamentales en la infancia: conceptualización, evaluación e impacto / Behavioral Problems during Childhood: conceptualization, evaluation and impact

Los problemas comportamentales en la infancia suponen todos aquellos comportamientos persistentes en los que se repiten conductas que no respetan las normas o las reglas sociales propias de la edad. La detección temprana de estas dificultades permite controlar en cierto modo la gravedad del asunto ya que, de no trabajarse sobre la sintomatología del niño, las posibilidades de desarrollar un trastorno mental severo son mayores. Así, la identificación y el diagnóstico de los problemas conductuales se ha vuelto una meta de gran significación para la disciplina psicológica. El objetivo de este estudio fue realizar una revisión de la literatura reciente para sistematizar la información referida a las diferentes conceptualizaciones teóricas que existen sobre los problemas comportamentales desde diversas escuelas psicológicas y las respuestas terapéuticas que ofrecen, identificar los instrumentos de medición validados para su evaluación en Argentina, y describir la importancia de su detección temprana y posibles áreas de incidencia(AU)

Behavioral problems in childhood involve all those persistent actions in which activities that do not respect the norms or social rules of the age are repeated. Early detection of these problems makes it possible to control the severity of the problem to a certain extent. If the child's symptoms are not elaborated, the chances of developing a severe mental disorder are greater. Thus, the identification and diagnosis of behavioral problems has become a goal of great significance for the psychological discipline. The objective of this article was to carry out a review of the recent literature to systematize the information referring to the different theoretical conceptualizations that exist on behavioral problems from various psychological schools and the therapeutic responses they offer. Also,to identify the measurement instruments validated for their evaluation in Argentina and describe the importance of its early detection and possible areas of incidence(AU)

Diagnostic test accuracy of assessment tools for detecting delirium in patients with acute stroke: commentary of a systematic review.

Delirium is a common presentation after acute stroke. Post-stroke delirium is related to poor recovery, higher rates of mortality, falls, and longer hospital stays. Delirium can lead to challenging behaviour such as anger, aggression, and confusion. As such, it is important to identify delirium promptly for early management and to reduce the negative impact on post-stroke recovery and outcomes. An important aspect of identifying delirium depends on the use of efficient, easy to use and validated assessment tools. A wide range of tools are available, although it is not known how accurately they can identify post-stroke delirium. This article critically appraises a systematic review which identified delirium screening tools for patients with acute stroke, and summarised their accuracy.

Instruments for measuring cognitive reserve: a systematic review / Instrumentos de medida de reserva cognitiva: uma revisão sistemática / Instrumentos de medida de reserva cognitiva: una revisión sistemática

The Cognitive Reserve (CR) construct seeks to explain the brain's ability of compensate for degeneration caused by age or neuropathology. However, standardized measures of CR are incipient. Through a systematic review, this study aimed to investigate the instruments in the form of scales and questionnaires used as objective measures of CR, through the measurement of multiple variables related to activities conducted throughout the lifetime. The search for articles was conducted in the PubMed, Scopus, Science Direct, PsycINFO, VHL and Cochrane databases. Seven studies were selected after applying the inclusion and exclusion criteria. The existence of five scales/questionnaires that measure CR was verified. The instruments present a short duration, however, they vary in the items/variables measured, there being a lack of in-depth studies with large and diversified samples. Further studies are needed to improve the validity evidence and to conduct cross-cultural adaptations of the CR scale/questionnaires.

O construto reserva cognitiva (RC) busca explicar a capacidade de o cérebro compensar a degeneração causada pela idade ou neuropatologia. Contudo, medidas padronizadas de RC são incipientes. Por meio de uma revisão sistemática, este estudo objetivou investigar os instrumentos em formato de escalas e questionários utilizados como medida objetiva de RC, a partir da mensuração de múltiplas variáveis relacionadas a atividades realizadas ao longo da vida. A busca por artigos foi realizada nas bases de dados PubMed, Scopus, ScienceDirect, PsychINFO, BVS e Cochrane. Sete estudos foram selecionados após a aplicação dos critérios de inclusão e exclusão. Constatouse a existência de cinco escalas/questionários que mensuram RC. Os instrumentos são de curta duração, porém variam quanto aos itens/às variáveis mensuradas e carecem de estudos aprofundados, com amostras amplas e diversificadas. São necessários mais estudos que busquem aprimorar as evidências de validade e realizar adaptações transculturais das escalas/dos questionários de RC.

La Reserva cognitiva (RC) busca explicar la capacidad del cerebro para compensar el declive causado por la edad y neuropatologías. Además, las escalas estandarizadas de RC son aún incipientes. La presente revisión sistemática, tuvo como objetivo investigar los instrumentos utilizados para medir objetivamente la RC, a partir de la evaluación de diversas variables asociadas con actividades realizadas durante el ciclo vital. La búsqueda se realizó en las bases de datos PubMed, Scopus, Science Direct, PsycInfo, Bvs y Cochrane. Después de aplicar los criterios de inclusión y exclusión siete artículos fueron seleccionados. Se identificó cinco instrumentos que miden RC. Dichos instrumentos son de corta duración, pero varían en cuanto a los ítems evaluados y carecen de estudios con muestras más amplias y diversas. Es necesaria la elaboración de estudios que busquen mejorar la validez, así como realizar adaptaciones transculturales de las escalas de RC.

Prevalence of Victimization and Perpetration of Sexual Aggression in Undergraduate Students: A Systematic Review 2008-2018 / Prevalencia de victimización y perpetración de agresión sexual en estudiantes universitarios: una revisión sistemática 2008-2018 / Prevalência de vitimização e perpetração de agressão sexual em estudantes universitários: uma revisão sistemática 2008-2018

Abstract Introduction: Sexual aggression (SA) is a public health problem present throughout the life of people, for this reason it is necessary to know its magnitude and scope. The objective of this study was to conduct a systematic review of empirical studies that include information on the prevalence of sexual aggression in undergraduate students. Materials and Methods: Two authors independently searched for publications between 2008-2018 in the Scopus®, Web of Science®, Scielo®, Redalyc® and Eric® databases. As inclusion criteria, empirical studies that report the prevalence of victimization and/or perpetration of sexual aggression in students since their admission to the university were considered. The evaluation was carried out independently by two evaluators who determined the risk of bias. In total, 35 articles were selected that met the inclusion criteria. Used methodology, sample sizes, measurement instruments, prevalence of victimization-perpetration of sexual aggression and perpetrator-victim relationship are indicated. Results: Although there are differences between the studies analyzed, the results indicate that unwanted sexual contact is the most frequent type of sexual aggression in both victimization and perpetration; however, several studies did not perform this subdivision and showed only general data of some type of sexual aggression. Discussion: The findings of the estimation of prevalence of sexual aggression and its subtypes in undergraduates since they enter university life are discussed, as well as future considerations related to terminology unification that allows to estimate more precise figures of the types of sexual aggression.

Resumen Introducción: la agresión sexual (AS) es un problema de salud pública que está presente en la vida de las personas, motivo por el cual es necesario conocer su magnitud y alcance. El objetivo de este estudio fue realizar una revisión sistemática de estudios que incluyeran información de prevalencia de agresión sexual en estudiantes universitarios. Materiales y métodos: dos autores de manera independiente realizaron la búsqueda de publicaciones entre los años 2008-2018 en las bases de datos Scopus®, Web of Science®, Scielo®, Redalyc® y Eric®. Como criterios de inclusión se consideraron estudios empíricos que reportaran prevalencia de victimización y/o perpetración de agresión sexual en estudiantes desde su ingreso a la universidad. La evaluación fue realizada de manera independiente por dos evaluadores, quienes determinaron el riesgo de sesgo. En total 35 artículos cumplían con los criterios de inclusión. Se indica la metodología empleada, tamaños de muestra, instrumentos de medida, prevalencia de victimización-perpetración de agresión sexual y relación perpetrador-víctima. Resultados: aunque existen diferencias entre los estudios analizados, los resultados indican que el contacto sexual no deseado es el tipo de agresión sexual más frecuente; sin embargo, diversos estudios no realizaron esta subdivisión y mostraron únicamente datos generales de algún tipo de agresión sexual. Discusión: se discuten los hallazgos de la estimación de prevalencia de la agresión sexual y sus subtipos en estudiantes desde que ingresan a la universidad y se plantean consideraciones futuras relacionadas con la unificación de la terminología que permita estimar cifras más precisas de los tipos de agresión sexual.

Resumo Introdução: a agressão sexual (A.S.) é um problema de saúde pública que está presente ao longo da vida das pessoas, motivo pelo qual é necessário conhecer sua magnitude e alcance. O objetivo deste estudo foi realizar uma revisão sistemática dos estudos empíricos que incluíram informação de prevalência de agressão sexual em estudantes universitários. Materiais e métodos: dois autores de maneira independente realizaram a busca de publicações entre os anos 2008-2018 nas bases de dados Scopus®, Web of Science®, Scielo®, Redalyc® e Eric®. Como critérios de inclusão consideraram-se estudos empíricos que reportaram prevalência de vitimização e/ou perpetração de agressão sexual em estudantes desde seu ingresso à universidade. A avaliação foi realizada de maneira independente por dois avaliadores quem determinaram o risco de sesgo. Em total foram selecionados 35 artigos que cumpriam com os critérios de inclusão. Indica-se a metodologia empregada, tamanhos de amostra, instrumentos de medida, prevalência de vitimização-perpetração de agressão sexual e relação perpetrador-vítima. Resultados: ainda que existem diferenças entro os estudos analisados, os resultados indicam que o contato sexual não desejado é o tipo de agressão sexual mais frequente tanto em vitimização como perpetração; no entanto, diversos estudos não realizaram esta subdivisão e mostraram unicamente dados gerais de algum tipo de agressão sexual. Discussão: discutem-se os resultados da estimação de prevalência da agressão sexual e seus subtipos em estudantes, desde que ingressam à vida universitária e se apresentam considerações futuras relacionadas com a unificação da terminologia que permita estimar cifras mais precisas dos tipos de agressão sexual.

Validez aparente, de contenido y confiabilidad Inicial del Instrumento CICAA para medir la comunicación entre el profesional de salud y el paciente / Initial apparent, content and reliability validity of the ICCAT Instrument to measure communication between the health professional and the patient

La comunicación es un elemento fundamental en la relación que tiene lugar entre el personal de salud y el paciente en un ambiente clínico; por esta razón es importante definir su impacto en la toma de decisiones. Actualmente las instituciones prestadoras de salud buscan incorporar modelos de atención centrados en el paciente, cuyo objetivo es brindar atención basada en el respeto a la dignidad humana, en donde el paciente sea partícipe de su cuidado. Las entidades de salud requieren herramientas que generen estrategias para el desarrollo de habilidades de comunicación en los profesionales de salud. En Colombia no hay una escala validada que permita medir la relación personal de salud y paciente, lo cual motivó la búsqueda de un instrumento que se pudiera adaptar y validar. El contenido de esta investigación explica las fases de validación inicial de la escala CICAA. El diseño de este estudio es de tipo metodológico, constituido por tres fases; validez aparente y de contenido, consistencia interna medida con el alpha de Cronbach y concordancia entre observadores por medio del Kappa de Fleiss. Para la fase de validez aparente y de contenido intervinieron 10 expertos, quienes midieron dos variables: pertinencia y relevancia a partir del diligenciamiento de una escala tipo Likert. A partir de los datos obtenidos se generaron observaciones semánticas, que permitieron mayor entendimiento del instrumento. Se determinó su consistencia global con un IVC de 0,91 para relevancia y un IVC de 0,92 para pertinencia. En la fase de confiabilidad y concordancia entre observadores se utilizaron los datos obtenidos de 10 profesionales de la salud que aplicaron la escala a 5 consultas videograbadas, con una confiabilidad elevada obtenida mediante el alpha de Cronbach. Para la fase de concordancia entre observadores los valores de Kappa de los ítems fueron 0,8 en 6; valor de 1 en 1. Estos resultados permiten concluir que la escala CICAA es un instrumento que cuenta con una validez aparente, de contenido y confiabilidad inicial elevada, que contribuye como el primer paso en el proceso de validación general del instrumento.

Communication is a fundamental element in the relationship between health personnel and the patient in a clinical environment; for this reason it is important to define its impact on decision making. Currently, health care institutions seek to implement models of patientcentered care, whose objective is to provide care based on respect for human dignity, where the patient is a participant in his/her care. Health entities require tools that generate strategies for the development of communication skills in health professionals. In Colombia there is no validated scale to measure the relationship between health personal and patient, which motivated the search for an instrument that could be adapted and validated for the Colombian context. The content of this research explains the initial validation phases of the "CICAA" scale. This study is methodological in nature, constituted by three phases; apparent validity and content validity, internal consistency measured with the Cronbach's alpha and agreement between observers by Fleiss Kappa. For the apparent validity and content validity phase, 10 experts intervened, who measured two variables: pertinence and relevance from the accomplishment of a Likert scale. From the obtained data, semantic observations were generated, which allowed understanding of the instrument in a more excellent manner. The global consistency was determined with an IVC of 0.91 for relevance and an IVC of 0.92 for pertinence. In the phase of reliability and concordance between observers, the data obtained from 10 health professionals who applied the scale to 5 videotaped consultations, with high reliability obtained using Cronbach's alpha, were used. For the inter-observer concordance phase, the Kappa values of the items were 0.8 in 6; value of 1 in 1. These results allow concluding that the CICAA scale is an instrument that has an apparent validity, content and high initial reliability, that contributes to the process of general validation of the instrument.

Qualidade de Vida Familiar na Deficiência Intelectual: Revisão Sistemática de Estudos / Family Quality of Life in Intellectual Disability: A Systematic Review of Studies

Resumo A qualidade de vida familiar (QdVF) em famílias de pessoas com deficiência intelectual (DI) tem interessado investigadores, sugerindo potencialidades em termos de avaliação e intervenção. O presente artigo realizou uma revisão sistemática dos estudos empíricos que analisam a QdVF em famílias de pessoas com DI. Efetuou-se uma pesquisa bibliográfica num portal de bases de dados e recorreu-se a critérios de inclusão previamente definidos. Do total de 32 estudos selecionados, 15 recorreram ao instrumento FQOLS-2006, focando-se na análise das dimensões e domínios da mesma; 11 ao Beach Center FQOL Survey, relacionando o constructo com diversas variáveis; e seis a outras formas de avaliação, essencialmente qualitativas. Assim, a QdVF mostra-se pertinente para compreender e intervir com famílias de pessoas com DI.

Abstract Family quality of life (FQoL) for families with members who have an intellectual disability (ID) has recently captured the interest of researchers and demonstrated potential for evaluation and intervention. This paper intends to revise systematically empirical studies that analyze FQoL in families with members having ID. A bibliographic search was carried out in a database and previously defined inclusion criteria were used. From a total of 32 studies, 15 used the FQOLS-2006 that focused on the analysis of their dimensions and domains, 11 the Beach Center FQOL Survey that related the construct to other individual and family variables and six other methods to evaluate FQoL. Thus, FQoL is relevant to understand and intervene with families of persons with ID.

Psychometric properties of Multidimensional Health Locus of Control - A and General Self-Efficacy Scale in civil servants: ELSA-Brasil Musculoskeletal Study (ELSA-Brasil MSK)

Abstract Background Health-related control and self-efficacy beliefs can be assessed in the general population using Multidimensional Health Locus of Control-A subscales (MHLC-A) and the General Self-Efficacy Scale (GSES), respectively. Objective To test construct validity, internal consistency, reliability (test-retest) and ceiling and floor effects of Portuguese-Brazil versions of MHLC-A and GSES. Method Civil servants (N=2901) enrolled in a large Brazilian cohort were included. A new version of the GSES was produced (GSES-Brazil). Procedures for cross-cultural adaptation and testing of psychometric properties followed well-accepted international guidelines. Results Confirmatory factor analyses yielded the following indices: MHLC-A (tridimensional model): χ2[df]=223.45[132], p-value <0.01; CFI=0.87; TLI=0.85; RMSEA=0.07 (0.07-0.08); WRMR=3.00. GSES-Brazil (unidimensional model): χ2[df]=788.60[35], p-value <0.01; CFI=0.95; TLI=0.94; RMSEA=0.09 (0.08-0.09); WRMR=2.50. Cronbach’s alpha coefficients and Intraclass Correlation Coefficients (ICC2,1) ranged from 0.57 (0.54-0.59) and 0.57 (0.47-0.65) for MHLC-A internality to 0.80 (0.79-0.81) and 0.71 (0.66-0.77) for GSES-Brazil, respectively. There was no evidence of ceiling and floor effects. Convergent validity analyses provided further support for construct validity of both scales. Conclusion These findings support the use of the newly developed version of GSES-Brazil for the assessment of general self-efficacy of adult Brazilians. Internal consistency was lower than ideal for MHLC-A, indicating these subscales may need further refinements to provide a more psychometrically sound measure of control beliefs.