Severe Mental Illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged 50 and above: retrospective cohort study using UK primary care data.

BACKGROUND: Severe Mental Illness (SMI) has been associated with reduced bone density and increased risk of fractures, although some studies have shown inconsistent results. AIM: Examine the association between SMI and recorded diagnosis of osteoporosis (OP) and fragility fracture (FF) in people aged ≥50years. DESIGN AND SETTING: Population-based cohort study; UK Primary care. METHOD: We used anonymised primary care data (IQVIA Medical Research Database). Patients with a diagnosis of SMI aged 50-99y (2000-2018) were matched to individuals without SMI. We used Cox Proportional Hazards models to estimate Hazard Ratios (HR) and 95% Confidence Intervals (95%CI). We stratified analyses by sex and age, accounting for social deprivation, year, smoking, alcohol, and Body Mass Index (BMI). RESULTS: In total 444,480 people were included (SMI N=50,006; unexposed N=394,474). In men, diagnosis of SMI increased the likelihood of OP diagnosis, with differences mainly observed amongst the youngest (50-54y:HR=2.12;95%CI 1.61-2.79) and oldest (85-99y:HR=2.15;95%CI 1.05-4.37), and also increased the risk of FF across all ages. In women, SMI increased the risk of OP diagnosis only in those aged 50-54y:HR=1.16;95%CI 1.01-1.34, but increased the risk of FF across all ages. There were more than twice as many men with SMI with FF records than with OP diagnosis: FF:OP=2.10, compared to FF:OP=1.89 in men without SMI. The FF:OP ratio was 1.56 in women with SMI vs.1.11 in women without SMI. CONCLUSION: SMI is associated with increased likelihood of fragility fractures and osteoporosis underdiagnosis. Interventions should be considered to mitigate the increased risk of fractures in people with SMI.

Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru.

BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

Exploring the co-occurrence of depression, anxiety and insomnia symptoms, diagnoses and treatments in primary care: observational study using UK primary care data.

BACKGROUND: Depression, anxiety and insomnia often co-occur. However, there is a lack of research regarding how they cluster and how this is related to medication used to treat them. AIMS: To describe the frequencies and associations between depression, anxiety and insomnia, and treatment for these conditions in primary care. METHOD: A retrospective cohort study using UK electronic primary care records. We included individuals aged between 18 and 99 years old with one or more records suggesting they had a diagnosis, symptom or drug treatment for anxiety, depression or insomnia between 2015 and 2017. We report the conditional probabilities of having different combinations of diagnoses, symptoms and treatments recorded. RESULTS: There were 1 325 960 records indicative of depression, anxiety or insomnia, for 739 834 individuals. Depression was the most common condition (n = 106 117 records), and SSRIs were the most commonly prescribed medication (n = 347 751 records). Overall, individuals with a record of anxiety were most likely to have co-occurring symptoms and diagnoses of other mental health conditions. For example, of the individuals with a record of generalised anxiety disorder (GAD), 24% also had a diagnosis of depression. In contrast, only 0.6% of those who had a diagnosis of depression had a diagnosis or symptom of GAD. Prescribing of more than one psychotropic medication within the same year was common. For example, of those who were prescribed an SNRI (serotonin-norepinephrine reuptake inhibitor), 40% were also prescribed an SSRI (selective serotonin reuptake inhibitor). CONCLUSIONS: The conditional probabilities of co-occurring anxiety, depression and insomnia symptoms, diagnoses and treatments are high.

Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis.

OBJECTIVE: Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. METHODS: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982-November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48 h and (3) median cohort age over 65 years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346). RESULTS: Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39-3.30), movement (OR 1.30; 95% CI 0.66-2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09-5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08-0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2 = 0%-77%) and continuous analyses (I2 = 85%). CONCLUSION: An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium.

Risk of Parkinson's disease in people aged ≥50 years with new-onset anxiety: a retrospective cohort study in UK primary care.

BACKGROUND: A history of anxiety is more common in people with Parkinson's disease (PD). The prospective risk of PD in those newly presenting with anxiety and factors that increase the risk of PD in patients with anxiety have not been investigated. AIM: To investigate the incidence of PD in people with anxiety aged ≥50 years and clinical features associated with later diagnosis of PD in people with anxiety. DESIGN AND SETTING: A retrospective cohort study using UK primary care data between 2008 and 2018, assessing patients with new-onset anxiety aged ≥50 years. METHOD: Weibull survival regression models were fitted and hazard ratios (HRs) for modelling time-to-PD was estimated in those with and without anxiety, and when determining the risk of developing PD in those with anxiety. Results were adjusted for sociodemographic and lifestyle factors, and relevant physical and mental health conditions. RESULTS: The risk of PD increased two-fold compared with the non-anxiety group after adjustment for age, sex, social deprivation, lifestyle factors, severe mental illness, head trauma, and dementia (HR 2.1, 95% confidence interval = 1.9 to 2.4). In those with anxiety, the presence of depression, hypotension, tremor, rigidity, balance impairment, constipation, sleep disturbance, fatigue, and cognitive impairment were associated with an increased risk of developing PD. CONCLUSION: The risk of developing PD was at least doubled in people with anxiety compared with those without. The clinical features of those who developed PD can help identify patients presenting with anxiety who are in the prodromal phase of PD.

Cultural adaptation to Bolivian Quechua and psychometric analysis of the Patient Health Questionnaire PHQ-9.

OBJECTIVE: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.

COVID-19-Related Experiences and Perspectives of Peruvian College Students: A Descriptive Study.

The COVID-19 pandemic drastically affected higher education and higher education students around the world, but few studies of college students' experiences during the COVID-19 pandemic have been conducted in Latin America. This study describes the COVID-19-related experiences and perspectives of Peruvian college students. We surveyed 3,427 full-time college students (average age: 23 years) attending a multi-campus Peruvian university in fall 2020. Participants were recruited through the digital platform of the learning management system at their university, email, and social media. We asked participants how they were managing risks related to COVID-19; the continuity of social, educational, and work activities; and the psychological and economic impacts of the pandemic on their lives. Since March 2020, 73.0% of participants reported COVID-19-related symptoms, but only 33.9% were tested for COVID-19. During the national quarantine imposed by the Peruvian government (March 15-June 30, 2020), 64.3% of participants remained in their house. Furthermore, while 44.0% of participants were working in February 2020 (95% CI: [41.7%, 46.4%]), only 23.6% (95% CI: [21.7%, 25.7%]) were working immediately after the pandemic began (i.e., at the end of April 2020). Participants were more stressed about the health and educational implications of COVID-19 for Peruvian society and their families than about themselves. The public health, economic, and educational implications of COVID-19 on college students are continuing to unfold. This study informed Peruvian higher education institutions' continued response to the COVID-19 pandemic, the progressive return to postpandemic activities, as well as other future pandemics and other crises.

Adaptación cultural al Quechua y análisis psicométrico del Patient Health Questionnaire (PHQ-9) en población peruana / Cultural adaptation to Quechua and psychometric analysis of the Patient Health Questionnaire PHQ-9 in a peruvian population

Objetivo . Traducir y adaptar culturalmente el Patient Health Questionnaire (PHQ-9) a tres variedades del quechua y analizar su validez, confiabilidad e invarianza. Materiales y métodos . 1) Fase de adaptación cultural: el PHQ-9 fue traducido del inglés a tres variantes del quechua (Central, Chanca, Cuzco-Collao) y traducido nuevamente al inglés, posteriormente expertos y grupos focales permitieron adaptar culturalmente las traducciones. 2) Fase psicométrica: se evaluó la uni-dimensionalidad del PHQ-9 adaptado mediante un Análisis Factorial Confirmatorio (CFA), la confiabilidad se evaluó mediante consistencia interna (Alpha y Omega), y la invarianza de medida según variedades del quechua y variables sociodemográficas se evaluó empleando CFA multigrupos y modelos MIMIC (Múltiples Indicadores y Múltiples Causas). Resultados . Cada una de las adaptaciones del PHQ-9 a las tres variedades de quechua reportaron ítems claros y culturalmente equivalentes. Posteriormente, con 970 datos de quechuahablantes adultos varones y mujeres, el modelo general unidimensional reportó un ajuste adecuado (índice de ajuste comparativo: 0,990, índice de Tucker-Lewis: 0,987, residuo estandarizado cuadrático medio: 0,048, raíz del error cuadrático medio de aproximación: 0,071), lo mismo ocurrió para cada variedad del quechua. La confiabilidad fue alta para todas las variedades (α = 0,865 - 0,915; ω = 0,833 - 0,881). Los resultados del CFA multigrupos y modelos MIMIC confirmaron invarianza de medida según variante del quechua, sexo, residencia, edad, estado civil y nivel educativo. Conclusiones . Las adaptaciones del PHQ-9 a Quechua Central, Chanca y Cuzco-Collao ofrecen una medición válida, confiable e invariante, confirmando que se pueden hacer comparaciones en los grupos evaluados. Su uso beneficiará a la investigación y a la atención en salud mental de poblaciones quechuahablantes.

Objective . To translate and culturally adapt the Patient Health Questionnaire (PHQ-9) to three varieties of Quechua and analyse their validity, reliability, and measurement invariance. Materials and methods . 1) Cultural adaptation phase: the PHQ-9 was translated from English into three variants of Quechua (Central, Chanca, Cuzco-Collao) and translated again into English. Then, experts and focus groups allowed the translations to be culturally adapted. 2) Psychometric phase: the unidimensionality of the adapted PHQ-9 was evaluated by using Confirmatory Factor Analysis (CFA), reliability was evaluated by internal consistency (Alpha and Omega), and measurement invariance according to Quechua varieties and sociodemographic variables was evaluated by using CFA, multigroups and MIMIC models (Multiple Indicator Multiple Cause). Results . Each of the adaptations of the PHQ-9 to the three Quechua varieties reported clear and culturally equivalent items. Subsequently, data from 970 Quechua-speaking adult men and women were analyzed. The general one-dimensional model reported an adequate fit (Comparative fit index = 0.990, Tucker-Lewis index = 0.987, Standardized root mean squared residual= 0.048, Root mean squared error of approximation=0.071); each of the Quechua varieties also showed an adequate fit. Reliability was high for all varieties (α = 0.865 - 0.915; ω = 0.833 - 0.881). The results of the multigroup CFA and MIMIC models confirmed measurement invariance according to Quechua variant, sex, residence, age, marital status and educational level. Conclusions . The PHQ-9 adaptations to Central Quechua, Chanca and Cuzco-Collao offer a valid, reliable and invariant measurement, confirming that comparisons can be made between the evaluated groups. Its use will benefit mental health research and care for Quechua-speaking populations.

Development of a Mobile Health Application Based on a Mixed Prenatal Care in the Context of COVID-19 Pandemic

Abstract Objective We describe the development and structure of a novel mobile application in a mixed model of prenatal care, in the context of the COVID-19 pandemic. Furthermore, we assess the acceptability of this mobile app in a cohort of patients. Methods First, we introduced a mixed model of prenatal care; second, we developed a comprehensive, computer-based clinical record to support our system. Lastly, we built a novel mobile app as a tool for prenatal care. We used Flutter Software version 2.2 to build the app for Android and iOS smartphones. A cross-sectional study was carried out to assess the acceptability of the app. Results A mobile app was also built with the main attribute of being connected in real-time with the computer-based clinical records. The app screens detail information about activities programmed and developed in the prenatal care according to gestational age. A downloadable maternity book is available and some screens show warning signs and symptoms of pregnancy. The acceptability assessment was mostly rated positively regarding the characteristics of the mobile app, by 50 patients. Conclusion This novel mobile app was developed as a tool among pregnant patients to increase the information available about their pregnancies in the provision of a mixed model of prenatal care in the context of the COVID-19 pandemic. It was fully customized to the needs of our users following the local protocols. The introduction of this novel mobile app was highly accepted by the patients.

Propiedades psicométricas del Inventario de Hábitos de Estudio CASM-85: un estudio multicéntrico con estudiantes de secundaria peruanos / Psychometric properties of the Inventory of Study Habits CASM-85: a multicenter study with Peruvian high school students

Objetivo: evaluar la estructura interna, invarianza de medida, validez de criterio y confiabilidad del CASM-85 en estudiantes de secundaria peruanos. Materiales y Métodos: se evaluaron 2075 estudiantes de ambos sexos, entre 11 y 18 años, provenientes de colegios nacionales y particulares de Arequipa, Chimbote, Lima y Pucallpa. Se realizó un análisis de la correlación ítem-ítem e ítemresto para cada dimensión del CASM-85, un análisis factorial confirmatorio y modelos MIMIC (Multiple Indicator, Multiple Cause) para evaluar la invarianza de medida a través de grupos según sexo, edad, colegio y ciudad. La confiabilidad fue estimada mediante los coeficientes Alpha y Omega. La validez de criterio entre el CASM-85 y el rendimiento académico se revisó a través de la r de Pearson y modelos de regresión. Resultados: se eliminaron ítems heterogéneos y se obtuvo una forma reducida de 45 ítems a compararse con su original de 53 ítems. Para la forma original el CFI y TLI fue < .9 en todas las ciudades, mientras que para la forma reducida fue < . 9 solo en Chimbote. Los SRMR y RMSEA fueron ≤ .10 y ≤ .09 para las formas original y reducida respectivamente. Los modelos MIMIC confirmaron invarianza para todas las variables excepto para la variable ciudad con la forma original (│ΔCFI│ = .09, │ΔTLI│ = .08). La confiabilidad fue moderada tanto para la forma original (Ω ≥ .68; α ≥ .81) como para la reducida (Ω ≥ .77; α ≥ .84). La r de Pearson mostró una relación positiva y de fuerza débil para la forma original (r = .17) y reducida (r = .18). Conclusión: la forma reducida del CASM-85 (45 ítems) ha mostrado mejores propiedades psicométricas que su forma original.

Objective: To assess the internal structure, measurement invariance, criterion validity and reliability of the CASM-85 in Peruvian high school students. Materials and methods: Two thousand seventy-five (2075) students of both sexes, aged 11 to 18 years, from public and private high schools of Arequipa, Chimbote, Lima and Pucallpa were evaluated. An item-item and item-rest correlation analysis for each dimension of the CASM- 85, a confirmatory factorial analysis and MIMIC (Multiple Indicator, Multiple Cause) models were used to evaluate the measurement invariance across the groups according to their sex, age, school and city. Reliability was estimated using alpha and omega coefficients. The criterion validity between the CASM-85 and academic performance was determined using Pearson’s r and regression models. Results: The heterogeneous items were removed, obtaining a 45-item short form compared to the original 53-item form. In the original form, CFI and TLI were < .9 in all the cities, whereas in the short form, CFI and TLI were < .9 only in Chimbote. SRMR and RMSEA were ≤ .10 and ≤ .09 in the original and short forms, respectively. The MIMIC models confirmed the measurement invariance in all variables, with the exception of the original form between cities (│ΔCFI│ = .09, │ΔTLI│= .08). Reliability was moderate for both the original (Ω ≥ .68; α ≥ .81) and short forms (Ω ≥ .77; α ≥ .84). Pearson’s r showed a positive and weak correlation in the original (r = .17, p < .001) and short (r = .18, p < .001) forms. Conclusion: The CASM-85 short form (45 items) has shown better psychometric properties than its original full form.

Adaptación y validación al español del Institutional Review Board Researcher Assessment Tool (IRB-RAT) / Spanish adaptation and validation of The Institutional Review Board Researcher Assessment Tool (IRB-RAT)

RESUMEN Objetivo. Evaluar la confiabilidad y validez del Institutional Review Board Researcher Assessment Tool (IRB-RAT) traducido y adaptado culturalmente para los comités de ética en investigación (CEI) peruanos. Materiales y métodos. El IRB-RAT es un instrumento que determina como son percibidos los CEI por los investigadores en función a ocho factores, mediante dos formatos: 1) importancia en el trabajo del investigador y 2) descriptivo del CEI evaluado. Su versión original en inglés se tradujo y adaptó culturalmente al español, con el apoyo de expertos y representantes de la población objetivo. Luego, según las respuestas de 113 usuarios, se identificaron y eliminaron los ítems heterogéneos hasta obtener una versión final de 29 ítems. La confiabilidad de esta versión se revisó mediante α de Cronbach y coeficiente omega, su validez de estructura interna mediante un análisis factorial confirmatorio con el método de mínimos cuadrados no ponderados. Resultados. La traducción y adaptación cultural cumplió con los pasos recomendados internacionalmente. La confiabilidad a nivel de los ocho factores fue moderada para el formato 1 (0,67<α<0,89; 0,71<ω<0,89) y alta para el formato 2 (0,83<α<0,92; 0,85<ω<0,92). La validez de contenido fue alta a nivel de ítems y moderada para los factores. La validez de estructura interna fue buena para el formato 1 (AGFI=0,97, GFI=0,97, NFI=0,97, RMR=0,04) y moderadamente buena para el formato 2 (AGFI=0,99, GFI=0,99, NFI=0,99, RMR=0,10). Conclusión. Nuestra adaptación al español del IRB-RAT tiene confiabilidad y validez suficientes para asistir en la mejora continua de los CEI del medio peruano y otros similares de habla hispana.

ABSTRACT Objective. To assess the reliability and validity of the translated and culturally-adapted Institutional Review Board Researcher Assessment Tool (IRB-RAT) for Peruvian research ethics committees (RECs). Materials and Methods. The IRB-RAT is an instrument that determines how RECs are perceived by researchers based on eight factors, using two formats: 1) importance in the work of the researcher and 2) descriptive of the REC being evaluated. Its original English version was translated and culturally adapted into Spanish, with the support of experts and representatives of the target population. Then, according to the responses of 113 users, the heterogeneous items were identified and eliminated until a final version of 29 items was obtained. The reliability of this version was reviewed using Cronbach's α and omega coefficient, its internal structure validity through a confirmatory factor analysis with the unweighted least squares method. Results. Translation and cultural adaptation complied with internationally recommended steps. Reliability at the level of the eight factors was moderate for format 1 (0.67<α<0.89; 0.71<ω<0.89) and high for format 2 (0.83<α<0.92; 0.85<ω<0.92). Content validity was high at item level and moderate for factors. Internal structure validity was good for format 1 (AGFI=0.97, GFI=0.97, NFI=0.97, RMR=0.04) and moderately good for format 2 (AGFI=0.99, GFI=0.99, NFI=0.99, RMR=0.10). Conclusions. Our Spanish adaptation of the IRB-RAT has sufficient reliability and validity to assist in the continuous improvement of the RECs in Peru and other Spanish-speaking countries.

Propiedades psicométricas de la escala de funcionalidad familiar FACES-III: un estudio en adolescentes peruanos / Psychometric properties of the third version of family adaptability and cohesion evaluation scales (FACES-III): a study of peruvian adolescents

RESUMEN Objetivos. Evaluar las propiedades psicométricas del FACES-III en una población de estudiantes adolescentes peruanos. Materiales y métodos. El presente estudio es transversal, de tipo psicométrico. El muestreo aplicado fue probabilístico, definido en tres etapas: primer estrato (colegio), segundo estrato (grado), conglomerado (sección). Los participantes fueron 910 estudiantes adolescentes de ambos sexos, entre los 11 y 18 años. El instrumento es, a la vez, el objeto de estudio: el FACES-III de Olson. El análisis incluyó la revisión de la validez de estructura/constructo mediante análisis factorial y de la confiabilidad por consistencia interna (índices alpha, theta y omega). Resultados. La escala cohesión-real tiene confiabilidad moderadamente alta (Ω=0,85) mientras que la escala flexibilidad-real tiene confiabilidad moderada (Ω=0,74). Para la escala cohesión-ideal la confiabilidad es moderadamente alta (Ω=0,89), lo mismo que para la escala de flexibilidad-ideal (Ω=0,86). La validez de constructo se confirmó en la bondad de ajuste del modelo de dos factores (cohesión y flexibilidad) con 10 ítems cada uno [índice ajustado de bondad de ajuste (AGFI)=0,96; índice de validación cruzada esperada (ECVI)=0,87; índice de ajuste normado (NFI)=0,93; índice de bondad de ajuste (GFI)=0,97; raíz del error cuadrático medio de aproximación (RMSEA)=0,06]. Conclusiones. El FACES-III tiene confiabilidad y validez suficientes como para ser utilizado en población adolescente peruana con fines de evaluación grupal o individual.

ABSTRACT Objetives. Our aim was to evaluate the psychometric properties of the FACES-III among Peruvian high school students. Materials and Methods. This is a psychometric cross-sectional study. A probabilistic sampling was applied, defined by three stages: stratum one (school), stratum two (grade) and cluster (section). The participants were 910 adolescent students of both sexes, between 11 and 18 years of age. The instrument was also the object of study: the Olson's FACES-III. The analysis included a review of the structure / construct validity of the measure by factor analysis and assessment of internal consistency (reliability). Results. The real-cohesion scale had moderately high reliability (Ω=.85) while the real-flexibility scale had moderate reliability (Ω=.74). The reliability found for the ideal-cohesion was moderately high (Ω=.89) like for the scale of ideal-flexibility (Ω=.86). Construct validity was confirmed by the goodness of fit of a two factor model (cohesion and flexibility) with 10 items each [Adjusted goodness of fit index (AGFI) = 0.96; Expected Cross Validation Index (ECVI) = 0.87; Normed fit index (NFI) = 0.93; Goodness of fit index (GFI) = 0.97; Root mean square error of approximation (RMSEA) = 0.06]. Conclusions. FACES-III has sufficient reliability and validity to be used in Peruvian adolescents for the purpose of group or individual assessment.