Clasificación Internacional como plataforma esencial para la clarificación de conceptos relacionados con la salud / International Classification as an essential platform for clarifying concepts related to health

La Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF) constituye elmarco conceptual de la Organización Mundial de la Salud para una nueva comprensión del funcionamiento,la discapacidad y la salud. Como herramienta del nuevo paradigma en salud del siglo XXI, laCIF, por su validez de contenido, constituye la base para la clarificación de conceptos relacionados con la salud de amplia utilización en la literatura médica, y metodológicamente se ha demostrado útil para definir qué debemos medir al evaluar integralmente el funcionamiento de las personas a lo largo del tiempo y comprender cómo sus componentes interactúan entre sí.

The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. As a con-tent-valid, comprehensive and universally applicable health classification for the 21st century, it serves as a platform to clarify and specify health-related concepts that are frequently used in the medical lite-rature, and to describe the process of addressing the question of what to measure in studies in which the main focus is a comprehensive understanding of functioning over time, and how its components interact or affect each other.

Development and validation of a new instrument to measure health-related quality of life in patients with psoriatic arthritis: the VITACORA-19.

OBJECTIVE: To develop/validate an instrument to measure health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA), for use in clinical studies. METHODS: An item pool of 35 items was generated following standardized procedures. Item reduction was performed using clinimetric and psychometric approaches after administration to 66 patients with PsA. The resulting instrument, the VITACORA-19, consists of 19 items. Its validity content, internal consistency, test-retest reliability, known groups/convergent validity, and sensitivity to change were tested in a longitudinal and multicenter study conducted in 10 hospitals in Spain, with 323 patients who also completed the EuroQol 5-dimensional questionnaire (EQ-5D) and a health status transition item. There were 3 study groups: group A (n = 209, patients with PsA), group B (n = 71, patients with arthritis without psoriatic aspect, patients with arthrosis, and patients with dermatitis), and group C (n = 43, healthy controls). RESULTS: The questionnaire was considered easy/very easy to answer by 94.7% of the patients with PsA. The factorial analysis clearly identified only 1 factor. Cronbach's alpha coefficient and interclass correlation coefficients exceeded 0.90. Statistically significant differences (p < 0.001) were observed between groups: subjects from group C had better HRQoL, followed by group B, and finally group A had the worst HRQoL. The VITACORA-19 scores showed significant correlations (p < 0.001) to PsA disease activity, EQ-5D, and perceived health state, scoring the patients with better health state higher. The minimum important difference was established as an 8-point change in the global score. CONCLUSION: The Spanish-developed VITACORA-19, designed to measure HRQoL in patients with PsA, has good validity, reliability, and sensitivity to change.

[Quality of life, health and well-being conceptualizations from the perspective of the International Classification of Functioning, disability and health (ICF)]. / Los conceptos de calidad de vida, salud y bienestar analizados desde la perspectiva de la Clasificación Internacional del Funcionamiento (CIF).

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. As a content-valid, comprehensive and universally applicable health classification, it serves as a platform to clarify and specify health-related concepts that are frequently used in the medical literature as well-being, health state, health status, quality of life (QoL) and health-related quality of life (HRQoL). The ICF entities health and health-related domains and functioning will be used as starting point to reach the objective of the paper. Health domains refer to domains intrinsic to the person as a physiological and psychological entity. Health-related domains are not part of a person's health but are so closely related that a description of a person's lived experience of health would be incomplete without them. Functioning refers to all health and health-related domains within the ICF. Well-being is made up of health, health-related, and non-health-related domains, such as autonomy and integrity. QoL is the individual's perceptions of how the life is going in health, health-related, and non-health domains. HRQoL is the individual's perceptions of how the life is going in health and health-related domains. "HRQoL is to QoL as functioning is to well-being". The ICF represents a standardized and international basis for the operationalization of health based on its health domains, and is also the basis for the operationalization of functioning based on all health and health-related domains contained therein. The authors argue that functioning is an operationalization of health from a broader perspective that consider the individual person not only as a biological but also as a social entity.

Global psychology: a bibliometric analysis of Web of Science publications / Psicología a nivel mundial: un análisis bibliométrico de las publicaciones en la Web of Science

En el siguiente trabajo se realizó una clasificación por países, atendiendo al análisis de la producción científica de las revistas de psicología. Se analizaron un total de 108.741 documentos, publicados en la Web of Science. Los indicadores empleados fueron el Factor de Impacto Ponderado, el Factor de Impacto Relativo, la Tasa de Citas por artículo y artículos publicados en las cinco primeras revistas de Journal Citación Report (JCR). Los resultados indican que España posee el mayor porcentaje de artículos en las primeras cinco revistas del JCR, y Colombia es el segundo país latinoamericano de lengua castellana que tiene más citas por artículo. Países como Hungría, Italia y EE.UU, poseían un mayor Factor de Impacto y Tasa de Citas.

In this study, we carried a classification by country based on the analysis of the scientific production of psychology journals. We analyzed a total of 108,741 documents, published in the Web of Science. The indicators used were the Weighted Impact Factor, the Relative Impact Factor, the Citation Rate per article and the articles published in the top five journals of the Journal Citation Report (JCR). The results indicate that Spain has the highest percentage of articles in the top five journals in the JCR and Colombia is the second latin american, Spanish - speaking country that has more citations per article. Countries like Hungary, Italy and USA, had a higher Impact Factor and Citation Rate.

Application of item response theory to achieve cross-cultural comparability of occupational stress measurement.

Our objective was to examine cross-cultural comparability of standard scales of the Effort-Reward Imbalance occupational stress scales by item response theory (IRT) analyses. Data were from 20,256 Japanese employees, 1464 Dutch nurses and nurses' aides, 2128 representative employees from post-communist countries, 963 Swedish representative employees, 421 Chinese female employees, 10,175 employees of the French national gas and electric company and 734 Spanish railroad employees, sanitary personnel and telephone operators. The IRT likelihood ratio model was used for differential item functioning (DIF) and differential test functioning (DTF) analyses. Despite the existence of DIF, most comparisons did not show discernible differences in the relations between Effort-Reward total score and level of the underlying trait across cultural groups. In the case that DTF was suspected, excluding an item with significant DIF improved the comparability. The full cross-cultural comparability of Effort-Reward Imbalance scores can be achieved with the help of IRT analysis.

[Functioning and disability: the International Classification of Functioning, Disability and Health (ICF)]. / Funcionamiento y discapacidad: la clasificación internacional del funcionamiento (CIF).

The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. It covers most of the health and health-related domains that make up the human experience, and the most environmental factors that influence that experience of functioning and disability. With the exhaustive ICF, patients' functioning -including its components body functions and structures and activities and participation-, becomes a central perspective in medicine. To implement the ICF in medicine and other fields, practical tools (= ICF Core Sets) have been developed. They are selected sets of categories out of the whole classification which serve as minimal standards for the assessment and reporting of functioning and health for clinical studies and clinical encounters (Brief ICF Core Set) or as standards for multiprofessional comprehensive assessment (Comprehensive ICF Core Set). Different from generic and condition-specific health-status measures, the ICF Core Sets include important body functions and structures and contextual factors. The use of the ICF Core Sets provides an important step towards improved communications between healthcare providers and professionals, and will enable patients and their families to understand and communicate with health professionals about their functioning and treatment goals. Specific applications include multi- and interdisciplinary assessment in clinical settings and in legal expert evaluations and use in disease or functioning-management programs. The ICF has also a potential as a conceptual framework to clarify an interrelated universe of health-related concepts which can be elucidated based on the ICF and therefore will be an ideal tool for teaching students in all medical fields and may open doors to multi-professional learning.

[Job stress and quality of life of primary care health-workers: evidence of validity of the PECVEC questionnaire]. / Estrés laboral y calidad de vida en sanitarios de atención primaria: una prueba de la validez del cuestionario PECVEC.

OBJECTIVES: To evaluate the relationship between Health-Related Quality of Life (HRQL) and stress at work among Primary Care workers, as evidence of the construct validity of the Spanish version (PECVEC) of the profile of quality of life in the chronically ill (PLC) questionnaire. In addition, to check its other psychometric properties. DESIGN: Cross-sectional study. SETTING: Eighteen primary care centres in Health Area IV, Asturias (Oviedo), Spain, sharing similar socio-demographic conditions. PARTICIPANTS: Two hundred and thirty-three primary care nurses and physicians. MAIN MEASUREMENTS: HRQL was evaluated by the 6 general dimensions of the Spanish version of the PLC. Stress at work was evaluated by the three scales of the Effort-Reward Imbalance (ERI) questionnaire. RESULTS: The construct validity of the PECVEC was assessed by testing the inverse associations of QoL dimensions and job stress ones, when the most important confuser variables were monitored. The non-response rate was low (<3%), and no floor effects and only small ceiling effects were observed. Internal consistency analysis and exploratory and confirmatory factor analysis demonstrated high reliability, factorial validity and convergent/divergent validity of the PECVEC. CONCLUSIONS: The PECVEC demonstrates adequate psychometric properties for evaluating HRQL in healthy subjects.

[Measuring psychosocial stress at work in Spanish hospital's personnel. Psychometric properties of the Spanish version of Effort-Reward Imbalance model]. / Evaluación del estrés laboral en trabajadores de un hospital público español. Estudio de las propiedades psicométricas de la versión española del modelo Desequilibrio Esfuerzo-Recompensa.

BACKGROUND AND OBJECTIVE: Two main models are currently used to evaluate the psychosocial factors at work: the Demand-Control (or job strain) model developed by Karasek and the Effort-Reward Imbalance model, developed by Siegrist. A Spanish version of the first model has been validated, yet so far no validated Spanish version of the second model is available. The objective of this study was to explore the psychometric properties of the Spanish version of the Effort-Reward Imbalance model in terms of internal consistency, factorial validity, and discriminate validity. SUBJECTS AND METHODS: A cross-sectional study on a representative sample of 298 workers of the Spanish public hospital San Agustin in Asturias was performed. The Spanish version of Effort-Reward Imbalance Questionnaire (23 items) was obtained by a standard forward/backward translation procedure, and the information was gathered by a self-administered application. Exploratory factor analysis were performed to test the dimensional structure of the theoretical model. Cronbach's alpha coefficient was calculated to estimate the internal consistency reliability. Information on discriminate validity is given for sex, age and education. Differences were calculated with the t-test for two independent samples or ANOVA, respectively. RESULTS: Internal consistency was satisfactory for the two scales (reward and intrinsic effort) and Cronbach's Alpha coefficients higher than 0.80 were observed. The internal consistency for the scale of extrinsic effort was lower (alpha = 0.63). A three-factor solution was retained for the factor analysis of reward as expected, and these dimensions were interpreted as a) esteem, b) job promotion and salary and c) job instability. A one-factor solution was retained for the factor analysis of intrinsic effort. The factor analysis of the scale of extrinsic effort did not support the expected one-dimension structure. The analysis of discriminate validity displayed significant associations between measures of Effort-Reward Imbalance and the variables of sex, age and education level. CONCLUSIONS: This study is the first one supporting satisfactory psychometric properties of the Spanish version of the Effort-Reward Imbalance model. However, the factorial validity of the extrinsic effort could be questioned.