Acceptance and Privacy Perceptions Toward Video-based Active and Assisted Living Technologies: Scoping Review.

BACKGROUND: The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized. OBJECTIVE: With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology. METHODS: A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review. RESULTS: Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies. CONCLUSIONS: This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user- and real life-targeting research is needed to assess the acceptance of proposed solutions.

Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain.

PURPOSE: The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). METHODS: We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. RESULTS: GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53-31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42-17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. CONCLUSIONS: GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.

Development of a predictive inpatient falls risk model using machine learning.

AIM: The aims of this study were to create a model that detects the population at risk of falls taking into account a fall prevention variable and to know the effect on the model's performance when not considering it. BACKGROUND: Traditionally, instruments for detecting fall risk are based on risk factors, not mitigating factors. Machine learning, which allows working with a wider range of variables, could improve patient risk identification. METHODS: The sample was composed of adult patients admitted to the Internal Medicine service (total, n = 22,515; training, n = 11,134; validation, n = 11,381). A retrospective cohort design was used and we applied machine learning technics. Variables were extracted from electronic medical records electronic medical records. RESULTS: The Two-Class Bayes Point Machine algorithm was selected. Model-A (with a fall prevention variable) obtained better results than Model-B (without it) in sensitivity (0.74 vs. 0.71), specificity (0.82 vs. 0.74), and AUC (0.82 vs. 0.78). CONCLUSIONS: Fall prevention was a key variable. The model that included it detected the risk of falls better than the model without it. IMPLICATIONS FOR NURSING MANAGEMENT: We created a decision-making support tool that helps nurses to identify patients at risk of falling. When it is integrated in the electronic medical records, it decreases nurses' workloads by not having to collect information manually.

Socioeconomic inequalities in the place of death in urban small areas of three Mediterranean cities.

BACKGROUND: Dying at home is the most frequent preference of patients with advanced chronic conditions, their caregivers, and the general population. However, most deaths continue to occur in hospitals. The objective of this study was to analyse the socioeconomic inequalities in the place of death in urban areas of Mediterranean cities during the period 2010-2015, and to assess if such inequalities are related to palliative or non-palliative conditions. METHODS: This is a cross-sectional study of the population aged 15 years or over. The response variable was the place of death (home, hospital, residential care). The explanatory variables were: sex, age, marital status, country of birth, basic cause of death coded according to the International Classification of Diseases, 10th revision, and the deprivation level for each census tract based on a deprivation index calculated using 5 socioeconomic indicators. Multinomial logistic regression models were adjusted in order to analyse the association between the place of death and the explanatory variables. RESULTS: We analysed a total of 60,748 deaths, 58.5% occurred in hospitals, 32.4% at home, and 9.1% in residential care. Death in hospital was 80% more frequent than at home while death in a nursing home was more than 70% lower than at home. All the variables considered were significantly associated with the place of death, except country of birth, which was not significantly associated with death in residential care. In hospital, the deprivation level of the census tract presented a significant association (p < 0.05) so that the probability of death in hospital vs. home increased as the deprivation level increased. The deprivation level was also significantly associated with death in residential care, but there was no clear trend, showing a more complex association pattern. No significant interaction for deprivation level with cause of death (palliative, not palliative) was detected. CONCLUSIONS: The probability of dying in hospital, as compared to dying at home, increases as the socioeconomic deprivation of the urban area of residence rises, both for palliative and non-palliative causes. Further qualitative research is required to explore the needs and preferences of low-income families who have a terminally-ill family member and, in particular, their attitudes towards home-based and hospital-based death.

Association of the global activity limitation indicator with specific measures of disability in adults aged below 65.

BACKGROUND: health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH. METHODS: We used the subsample of adults aged 16-64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables. RESULTS: The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9-32.7), domestic life (OR = 16.3, 95% CI: 13.6-19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3-57.8; prolonged sick leave: OR = 10.7, 95% CI: 9-12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI. CONCLUSIONS: The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.

Place of death and associated factors: a population-based study using death certificate data.

BACKGROUND: Although studies suggest that most people prefer to die at home, not enough is known about place of death patterns by cause of death considering sociodemographic factors. The objective of this study was to determine the place of death in the population and to analyze the sociodemographic variables and causes of death associated with home as the place of death. METHODS: Cross-sectional population-based study. All death certificate data on the residents in Spain aged 15 or over who died in Spain between 2012 and 2015 were included. We employed multinomial logistic regression to explore the relation between place of death, sociodemographic variables and cause of death classified according to the International Classification of Diseases, 10th revision, and to conditions needing palliative care. RESULTS: Over half of all deaths occurred in hospital (57.4%), representing double the frequency of deaths that occurred at home. All the sociodemographic variables (sex, educational level, urbanization level, marital status, age and country of birth) were associated with place of death, although age presented the strongest association. Cause of death was the main predictor with heart disease, neurodegenerative disease, Alzheimer's disease, dementia and senility accounting for the highest percentages of home deaths. CONCLUSIONS: Most people die in hospital. Cause of death presented a stronger association with place of death than sociodemographic variables; of these latter, age, urbanization level and marital status were the main predictors. These results will prove useful in planning end-of-life care that is more closely tailored to people's circumstances and needs.

Availability and perceived usefulness of guidelines and protocols for subcutaneous hydration in palliative care settings.

AIMS AND OBJECTIVES: To evaluate the availability of, adherence to, and perceived usefulness of guidelines and protocols for managing hydration and subcutaneous hydration in palliative care settings. BACKGROUND: Hydration at the end of life and the use of a subcutaneous route to hydrate generate some controversy among health professionals for different reasons. Having guidelines and protocols to assist in decision-making and to follow a standard procedure may be relevant in clinical practice. DESIGN: Cross-sectional telephone survey, with closed-ended and open-ended questions designed specifically for this study. METHODS: Data were obtained from 327 professionals, each from a different palliative care service. Mean, standard deviation, minimum and maximum were calculated for continuous variables; frequency distributions were obtained for categorical variables. A qualitative content analysis was performed on the open-ended questions. The article adheres to the STROBE guidelines for reporting observational studies. RESULTS: Only 24.8% of the participants had guidelines available to assist in making decisions regarding hydration, and 55.6% claimed to follow them 'always or almost always'. Of the participants, 38.8% had subcutaneous hydration protocols available, while 78.7% stated that they 'always or almost always' followed these protocols. The remaining participants considered the protocols as useful tools despite not having them available. CONCLUSIONS: Only 25% of the participants' services had guidelines for hydration, and less than 40% had protocols for subcutaneous hydration. However, adherence was high, especially in cases where protocols existed. Among the participants who did not have guidelines and protocols, attitudes were mostly favourable, but mainly as a reference and support for an individualised clinical practice. RELEVANCE TO CLINICAL PRACTICE: Guidelines and protocols on hydration in palliative care may be more useful as a solid reference and support for individualised practice than as instruments for standardising care. From this perspective, their development and availability in palliative care services are recommended.

Perceptions of health professionals on subcutaneous hydration in palliative care: A qualitative study.

BACKGROUND: Evidence indicates that hypodermoclysis is as safe and effective as intravenous rehydration in the treatment of the symptomatology produced by mild to moderate dehydration in patients for whom oral route administration is not possible. However, the knowledge about the use of the subcutaneous hydration and its correlates is still limited. AIM: To explore the perceptions, attitudes and opinions of health professionals in palliative care on the administration of subcutaneous hydration. DESIGN: This is a qualitative focus group study with health professionals of palliative care. Four focus groups were carried out until data saturation. A qualitative content analysis was performed. SETTING/PARTICIPANTS: A total of 37 participants, physicians and nurses, were recruited from different services of palliative care in Spain. RESULTS: In all, 856 meaning units were identified, from which 56 categories were extracted and grouped into 22 sub-themes, which were distributed among four themes: 'factors which influence the hydration decision', 'factors related to the choice of the subcutaneous route for hydration', 'the subcutaneous hydration procedure' and 'performance guidelines and/or protocols'. CONCLUSIONS: Variables which most often influence the use of subcutaneous route to hydration are those that are linked to the characteristics of the patient, the team and the family, and other like the context and professionals' subjective perceptions about this medical practice.

Validation of a mobility item bank for older patients in primary care.

BACKGROUND: To develop and validate an item bank to measure mobility in older people in primary care and to analyse differential item functioning (DIF) and differential bundle functioning (DBF) by sex. METHODS: A pool of 48 mobility items was administered by interview to 593 older people attending primary health care practices. The pool contained four domains based on the International Classification of Functioning: changing and maintaining body position, carrying, lifting and pushing, walking and going up and down stairs. RESULTS: The Late Life Mobility item bank consisted of 35 items, and measured with a reliability of 0.90 or more across the full spectrum of mobility, except at the higher end of better functioning. No evidence was found of non-uniform DIF but uniform DIF was observed, mainly for items in the changing and maintaining body position and carrying, lifting and pushing domains. The walking domain did not display DBF, but the other three domains did, principally the carrying, lifting and pushing items. CONCLUSIONS: During the design and validation of an item bank to measure mobility in older people, we found that strength (carrying, lifting and pushing) items formed a secondary dimension that produced DBF. More research is needed to determine how best to include strength items in a mobility measure, or whether it would be more appropriate to design separate measures for each construct.

[Short physical performance battery reference values for patients 70 years-old and over in primary health care]. / Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud.

OBJECTIVE: To provide new reference values for the Short Physical Performance Battery (SPPB) for patients 70 years-old and over in primary health care (PHC), and analyse their relationship with demographic data, physical function, health and clinical status. DESIGN: Baseline interviews and observations of a longitudinal study on physical function and adverse health results. SETTING: Five Primary Care Centres in the provinces of Alicante and Valencia. PARTICIPANTS: A total of 593 persons 70 years-old and over. MAIN MEASUREMENTS: The SPPB was applied using direct observation, and the rest of the variables by interview. Reference values were calculated according to sex and three age groups (70-75, 76-80, > 80 years), and the validity of the Battery was analysed using association statistics with the demographic, clinical, and function data. RESULTS: The reference values showed a poor performance in women, and a gradually poorer performance through the three age groups. The SPPB was significantly associated (P < 0.01) with age, sex, number of drugs taken, morbidity, body mass index, dependency in basic activities of daily living (BADL), instrumental activities of daily living (IADL) for health reasons, the 10-item Physical Functioning Scale (PF-10), depression and health perception. CONCLUSIONS: The reference values of the complete SPPB by age and sex are provided, based category scores in Primary Care patients 70 years-old and over. The Battery results can give a rapid and valid assessment of the functional state of elderly patient in Primary Care.

Predicting exclusive breastfeeding in maternity wards using machine learning techniques.

BACKGROUND AND OBJECTIVE: Adequate support in maternity wards is decisive for breastfeeding outcomes during the first year of life. Quality improvement interventions require the identification of the factors influencing hospital benchmark indicators. Machine Learning (ML) models and post-hoc Explainable Artificial Intelligence (XAI) techniques allow accurate predictions and explaining them. This study aimed to predict exclusive breastfeeding during the in-hospital postpartum stay by ML algorithms and explain the ML model's behaviour to support decision making. METHODS: The dataset included 2042 mothers giving birth in 18 hospitals in Eastern Spain. We obtained information on demographics, mothers' breastfeeding experiences, clinical variables, and participating hospitals' support conditions. The outcome variable was exclusive breastfeeding during the in-hospital postpartum stay. We tested algorithms from different ML families. To evaluate the ML models, we applied 10-fold stratified cross-validation. We used the following metrics: Area under curve receiver operating characteristic (ROC AUC), area under curve precision-recall (PR AUC), accuracy, and Brier score. After selecting the best fitting model, we calculated Shapley's additive values to assign weights to each predictor depending on its additive contribution to the outcome and to explain the predictions. RESULTS: The XGBoost algorithms showed the best metrics (ROC AUC = 0.78, PR AUC = 0.86, accuracy = 0.75, Brier = 0.17). The main predictors of the model included, in order of importance, the pacifier use, the degree of breastfeeding self-efficacy, the previous breastfeeding experience, the birth weight, the admission of the baby to a neonatal care unit after birth, the moment of the first skin-to-skin contact between mother and baby, and the Baby-Friendly Hospital Initiative accreditation of the hospital. Specific examples for linear and nonlinear relations between main predictors and the outcome and heterogeneity of effects are presented. Also, we describe diverse individual cases showing the variation of the prediction depending on individual characteristics. CONCLUSION: The ML model adequately predicted exclusive breastfeeding during the in-hospital stay. Our results pointed to opportunities for improving care related to support for specific mother's groups, defined by current and previous infant feeding experiences and clinical conditions of the newborns, and the participating hospitals' support conditions. Also, XAI techniques allowed identifying non-linearity relations and effect's heterogeneity, explaining specific cases' risk variations.

Rasch-Validated Italian Scale for Diagnosing Digital Eye Strain: The Computer Vision Syndrome Questionnaire IT©.

The use of digital devices affects eye health; this can influence the performance of workers. To assess this impact, validated patient-reported outcome questionnaires are needed. The purpose of this study was to validate the psychometric properties of the Italian version of the Computer Vision Syndrome Questionnaire (CVS-Q©) using Rasch analysis. Two hundred and forty-one Italian workers completed an ad hoc questionnaire on anamnesis and exposure to digital devices, and the Italian version of the CVS-Q©. Subsequently, a battery involving three clinical ocular surface and tear tests was performed. The reliability and validity of the scale was assessed using the Andrich Rating Scale Model, and the prevalence of computer vision syndrome (CVS) was calculated. A good fit of both items and persons to the predictions of the Rasch model was observed, with acceptable reliability, unidimensionality, and no or minimal severe differences as a function of gender or age; moreover, good test-retest repeatability, adequate values of sensitivity, reliability, and area under the curve, and adequate construct validity based on clinical tests were obtained. Workers with a questionnaire score ≥ 7 were found to present with CVS. The prevalence of CVS was 76.6%. The CVS-Q IT© is a valid and reliable scale to assess CVS in Italian workers who use digital devices.

Effectiveness of the implementation of an evidence-based nursing model using participatory action research in oncohematology: research protocol.

AIM: To generate changes in nursing practice introducing an evidence-based clinical practice (EBCP) model through a participatory process. To evaluate the effectiveness of the changes in terms of nurse-sensitive outcome (NSO). BACKGROUND: For international nursing science, it is necessary to explore the reasons for supporting EBCP and evaluate the real repercussions and effectiveness. METHODS: A mixed methods study with a sequential transformative design will be conducted in the bone marrow transplant unit of a tertiary-level Spanish hospital, in two time periods >12 months (date of approval of the protocol: 2006). To evaluate the effectiveness of the intervention, we will use a prospective quasi-experimental design with two non-equivalent and non-concurrent groups. NSO and patient health data will be collected: (a) impact of psycho-social adjustment; (b) patient satisfaction; (c) symptom control; (d) adverse effects. All patients admitted during the period of time will be included, and all staff working on the unit during a participatory action research (PAR). The PAR design will be adopted from a constructivist paradigm perspective, following Checkland's "Soft Systems" theoretical model. Qualitative techniques will be used: 2-hour group meetings with nursing professionals, to be recorded and transcribed. Field diaries (participants and researchers) will be drawn up and data analysis will be carried out by content analysis. DISCUSSION: PAR is a rigorous research method for introducing changes into practice to improve NSO.

The impact of volunteering in mental health settings on nursing students' attitudes.

Nursing faculties are working to improve students' attitudes towards mental illness and people with severe mental illness, given the repercussions a lack of knowledge and negative attitudes may have on the quality of care. Complementing undergraduate programmes with volunteering activities affords students the opportunity to interact with people with a severe mental illness, and allow them to develop positive attitudes and overcome prejudice. Aim: to explore and deepen in nursing students attitudes prior to and following volunteering on an Acute Mental Health Inpatient Unit. By means of mixed methods approach, students were assessed at two time points by questionnaires including "Community Attitudes to Mental Illness" and "Semantic Differential", and by testimonies gathered from interviews. Positives changes in attitudes were identified and monitored over time capturing a destigmatizing tendency. The participation in educational strategies such as volunteering in Acute Mental Health Inpatient Unit, complementary to undergraduate programmes and clinical placements in mental health, allows nursing students to develop more diversified and positive attitudes towards mental illness and people with severe mental illness. The impact of an interventional education strategy is not as powerful in nursing students as it might be in students of other non-healthcare oriented university degrees due to their baseline attitudes.

The Spanish version of the Psychiatric/Mental health clinical placement survey and an assessment of Spanish student attitudes towards mental health.

WHAT IS KNOWN ON THE SUBJECT?: The Psychiatric/Mental Health Clinical Placement Survey preplacement, validated in English and widely used, assesses nursing student attitudes towards the mental health field. There are no validated scales in Spanish to assess students' attitudes towards mental health, nor is there evidence of attitudes in Spanish students. WHAT DOES THIS ARTICLE ADD TO EXISTING KNOWLEDGE?: The present study was the first to address the validity of a scale which evaluates nursing student attitudes towards mental health issues, in Spanish. Until now, no knowledge was available on nursing student attitudes towards mental health issues in the Spanish context. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results provide faculty professors with a validated tool to use to assess attitudinal changes in students, following theoretical and practical training in mental health. To have an up-to-date perspective on student attitudes towards both the field of mental health and people with severe mental illness, thereby providing the opportunity to focus on those aspects requiring improvement. Abstract Introduction The encouragement of positive attitudes towards mental health is necessary in order to improve the quality of healthcare assistance. The attitudes of nursing students towards mental health are unknown, and there are no validated scales for their assessment. Aims To adapt the Psychiatric/Mental Health Clinical Placement Survey (PMHCPS) to Spanish and examine its psychometric properties; to describe the attitudes of nursing students towards the mental health field. Method Confirmatory factorial analysis (CFA), internal consistency and construct validity were performed. An assessment of the students' attitudes was also conducted. Results The CFA showed appropriate fit, and total internal consistency was adequate. With regard to construct validity, knowledge was associated with practicum mark. The students achieved above mid-range scores for all subscales, except negative stereotypes. Gender differences were observed. Discussion The PMHCPS, translated to Spanish, enables the students' attitude towards the mental health field to be assessed, thus identifying those areas of student attitudes and competencies requiring improvement. Implications for practice To provide Spanish nursing faculties with access to a scale, with which to assess changes in student attitudes. The assessment results may then be utilized to formulate teaching methods in order to improve the quality of health care the students might provide as future nursing professionals.

Validation of the Spanish Version of the Beginning Breastfeeding Survey-Cumulative: A Follow-up Study.

BACKGROUND: The Beginning Breastfeeding Survey-Cumulative (BBSC) is an instrument that assesses the overall maternal perception of breastfeeding effectiveness during the early postpartum period. RESEARCH AIMS: The aims of this study were to adapt and validate a Spanish version of the BBSC and provide new evidence regarding its validity. METHODS: A standard forward and back-translation process was used to obtain the Spanish version of the questionnaire (BBSC-E). A sample of 793 breastfeeding mothers was used. Data were obtained from clinical records and questionnaires self-administered at discharge and at 1-4 months postpartum. The factorial structure of the BBSC-E was examined with both an exploratory and confirmatory approach. Internal consistency, comparisons between known groups, and correlations with other variables were also assessed, and receiver operating characteristics (ROC) curves were used to determine its predictive validity. RESULTS: Analysis revealed a two-dimensional structure, with infant and maternal subscales, and adequate fit statistics. The Root Mean Squared Error of Approximation (RMSEA) was .067. The Cronbach's α of the overall scale was .91. There were statistically significant associations between the BBSC-E and (1) previous breastfeeding experience, early skin-to-skin contact, exclusive breastfeeding, breastfeeding difficulty and self-efficacy, and infant weight loss during hospitalization and (2) at 1-4 months postpartum, with the breastfeeding status, the intensity of breastfeeding problems, and satisfaction with breastfeeding. The total BBSC-E area under the ROC curve for any breastfeeding at 60 days postpartum was .73, and a score of 88 was the most discriminative cut-off point for maximum performance. CONCLUSION: The BBSC-E is a reliable and valid instrument for measuring breastfeeding effectiveness during early postpartum.

Adjusted linguistic validation and psychometric properties of the Colombian version of KIDSCREEN-52.

In health and clinical studies, health-related quality of life is often assessed using the well-established KIDSCREEN-52 questionnaires as well as the Vécu et Santé Perçue de l'Adolescent (VSP-A). The purpose of this study was twofold: to perform an adjusted linguistic validation of the Colombian version of the KIDSCREEN-52 and to assess its psychometric properties in children and adolescents. A total of 146 children and adolescents completed the KIDSCREEN-52, adolescents ( n = 48) additionally completed the VSP-A. Psychometric analyses focused on the internal consistency as well as the convergent and discriminant validity of the KIDSCREEN-52 Colombian version. Syntactic and semantic modifications were made to 19 items in the adapted version of the KIDSCREEN-52. Cronbach's α ranged from .74 to .89 for eight dimensions, while α < .70 was obtained for self-perception and social acceptance. We found evidence of good convergent validity with the VSP-A dimensions. Regarding known-groups validity, children aged between 8 and 10=years, male, with a high socioeconomic level and no chronic health condition obtained higher scores compared to the other categories. The developed Colombian version of the KIDSCREEN-52 showed acceptable reliability and validity. This study provides a cultural adaptation of the Spanish version of the KIDSCREEN-52 for Colombian children and adolescents.

Validity and Reliability of the Spanish Version of the Pregnancy-Related Thoughts Scale.

OBJECTIVE: To adapt the Pregnancy-Related Thoughts Scale into Spanish (Spanish PRTS) and evaluate its psychometric properties. DESIGN: Instrument translation (Phase 1), validation, and psychometric testing (Phase 2). SETTING: Phase 2 was conducted in three general hospitals in eastern Spain. PARTICIPANTS: A convenience sample of 180 women during the third trimester of pregnancy participated in Phase 2. METHODS: After a standard process of linguistic validation in Phase 1, we used the Spanish PRTS with other instruments to evaluate its psychometric properties in Phase 2. The participants completed a battery of questionnaires during prenatal visits in the third trimester (28-42 weeks gestation) at health care centers. Responses to the postnatal depression questionnaire were obtained through an online questionnaire between the first and third months after childbirth. We evaluated the factor structure; reliability; and convergent, discriminant, and predictive validity of the Spanish PRTS. RESULTS: The Spanish PRTS had a Cronbach's alpha coefficient of .81 and McDonald's omega coefficient of .82. The confirmatory factor analysis showed that the best adjustment of the scale was one factor with two pairs of correlated residuals. The Spanish PRTS scores were positively correlated to scores on pregnancy worries, state and trait anxiety, fatigue, symptoms of postnatal depression, and poor quality of life and inversely correlated to scores on self-efficacy for coping with stress. CONCLUSION: The findings support the validity and reliability of the Spanish PRTS to evaluate pregnancy-related anxiety; this tool can be used to measure outcomes of interventions for the prevention or treatment of women's anxiety during pregnancy.

[Structured review of activities of daily living measures in older people]. / Revisión estructurada de las medidas de actividades de la vida diaria en personas mayores.

OBJECTIVE: the present article evaluates the evidence relating to the conceptual adaptation, applicability and psychometric properties of activities of daily living measures in Spanish elderly people. MATERIAL AND METHODS: to obtain original documents, electronic searches were carried out in Spanish (IME and ISOC) and international databases (MEDLINE, PsycInfo, CINAHL and EMBASE). Manual searches and reference searches were also conducted. RESULTS: 34 articles relating to 4 instruments met the inclusion criteria: the Barthel Index, the Katz Index, the Red Cross Scale of Physical Disability and the Subscale of Personal Care Activities from the OARS. Overall, the results show a large number of versions for each instrument with weak transcultural adaptation processes and without standards for their administration or interpretation. The most frequently evaluated reliability measure was interrater reproducibility. The evidence on predictive validity is extensive, but the evidence on concurrent validity and responsiveness is almost nil. CONCLUSIONS: one version of the Barthel index and another one of the Katz index are the two versions about which the largest quantity of information has been obtained.

Cross-cultural validation of the "DISABKIDS" questionnaire for quality of life among Colombian children with chronic diseases.

OBJECTIVE: to describe the cross-cultural validation process of the "DISABKIDS" questionnaire in Colombia, for both the children and adolescents' version and the parents' version, an instrument intended to measure the health-related quality of life of Colombian children and adolescents with chronic diseases. METHOD: the cross-cultural validation process was conducted according to an international consensual systematic methodology, called standardized linguistic validation, to ensure linguistic equivalence with the original questionnaire. RESULTS: the pretest's cognitive interviews revealed a need to adjust the questionnaire, which consisted of asking for "health condition" rather than only asking for "condition". Due to the cultural context, the word "condition" used in the original version, when translated to Spanish, refers to socioeconomic conditions rather than health conditions. For this reason, 11 items in the children's version and eight items in the parents' version were adjusted. CONCLUSIONS: the Colombian version of DISABKIDS-37 to measure health-related quality of life among children and adolescents with chronic diseases in both the children's and parents' versions is equivalent to the original version and is appropriate for use in Colombia. Future studies can assess the questionnaire's psychometric properties.