Assessing patient satisfaction with telephone-based consultations before, during and after the COVID-19 pandemic in Spain.

OBJECTIVE: To validate a questionnaire to analyze the perception of users of primary care (PC) with telephone consultation (TC), and to study the satisfaction with TC by users of PC services. DESIGN: A two-phase study was conducted. Firstly, a questionnaire on satisfaction with telemedicine services was validated. Secondly, a cross-sectional study on satisfaction with TC was conducted. SETTING: PC. PARTICIPANTS: 405 users of PC services in Zaragoza (Spain). MAIN OUTCOME MEASURE: Our main outcome was the satisfaction with telemedicine services PC services. Factor analysis was carried out using the exploratory factor analysis with Varimax rotation. The reliability of the dimensions obtained was analyzed using Cronbach's alpha. The inferential analysis was conducted using parametric tests. RESULTS: The questionnaire was a valid and reliable tool (α>0.9) to assess the satisfaction of PC service users with telemedicine services. Before COVID-19, the satisfaction of the users with PC was adequate (mean=6111/10). However, during the COVID-19 the attention in PC centers became mostly telephone-based and satisfaction lowered as disappointing (mean=3555/10). Regarding the future of telemedicine, users considered it as unsatisfactory (mean=2977/10). Being a woman, being unemployed and belonging to an area of low vulnerability led to a worse perception of telemedicine. CONCLUSION: This questionnaire was a valid and reliable tool to assess the satisfaction of PC service users with telemedicine services. Perceptions of patient satisfaction decreased during COVID-19. Thus, TC seems to be a good option when the patients consider it to be a complementary rather than a substitute tool to follow-up their conditions.

Cross-Cultural Validation of the RosaQoL Scale in Spanish Language. / Validación transcultural al idioma español de la escala RosaQoL.

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

Value of combining transect counts and telemetry data to determine short-term population trends in a globally threatened species.

To evaluate conservation interventions, it is necessary to obtain reliable population trends for short (<10 years) time scales. Telemetry can be used to estimate short-term survival rates and is a common tool for assessing population trends, but it has limitations and can be biased toward specific behavioral traits of tagged individuals. Encounter rates calculated from transects can be useful for assessing changes across multiple species, but they can have large confidence intervals and be affected by variations in survey conditions. The decline of African vultures has been well-documented, but understanding of recent trends is lacking. To examine population trends, we used survival estimates from telemetry data collected over 6 years (primarily for white-backed vultures [Gyps africanus]) and transect counts conducted over 8 years (for 7 scavenging raptors) in 3 large protected areas in Tanzania. Population trends were estimated using survival analysis combined with the Leslie Lefkovitch matrix model from the telemetry data and using Bayesian mixed effects generalized linear regression models from the transect data. Both methods showed significant declines for white-backed vultures in Ruaha and Nyerere National Parks. Only telemetry estimates suggested significant declines in Katavi National Park. Encounter rates calculated from transects also showed declines in Nyerere National Park for lappet-faced vultures (38% annual declines) and Bateleurs (18%) and in Ruaha National Park for white-headed vultures (Trigonoceps occipitalis) (19%). Mortality rates recorded and inferred from telemetry suggested that poisoning is prevalent. However, only 6 mortalities of the 26 presumed mortalities were confirmed to be caused by poisoning, highlighting the challenges of determining the cause of death when working across large landscapes. Despite declines, our data provide evidence that southern Tanzania has higher current encounter rates of African vultures than elsewhere in East Africa. Preventing further declines will depend greatly on mitigating poisoning. Based on our results, we suggest that the use of multiple techniques improves understanding of population trends over the short term.

Importancia de combinar los conteos de transectos y los datos de telemetría para determinar las tendencias poblacionales a corto plazo de especies amenazadas a nivel mundial Resumen Para evaluar las intervenciones de conservación es necesario obtener tendencias poblacionales confiables para escalas temporales cortas (<10 años). La telemetría puede usarse para estimar las tasas de supervivencia a corto plazo, además de que es una herramienta común para analizar las tendencias poblacionales, pero tiene limitantes y puede sesgarse con el comportamiento específico de los individuos marcados. Las tasas de encuentro calculadas a partir de transectos pueden ser útiles para analizar cambios en varias especies, aunque pueden tener intervalos grandes de confianza y verse afectadas por las variantes en las condiciones del censo. La declinación de los buitres africanos está bien documentada, pero hace falta el conocimiento sobre las tendencias recientes. Usamos las estimaciones de supervivencia tomadas de datos telemétricos recolectados durante seis años (principalmente del buitre Gyps africanus) y los conteos de transecto de siete especies carroñeras realizados durante ocho años en tres áreas protegidas en Tanzania. Estimamos las tendencias poblacionales con la combinación de análisis de supervivencia y el modelo de matriz Leslie Lefkovitch hecho con los datos telemétricos y usando modelos bayesianos de regresión lineal generalizada de efectos mixtos hechos con los datos de los transectos. Ambos métodos indicaron declinaciones significativas de Gyps africanus en los Parques Nacionales Ruaha y Nyerere. Sólo las estimaciones telemétricas sugirieron una declinación significativa en el Parque Nacional Katavi. Las tasas de encuentro calculadas a partir de los transectos también indicaron declinaciones de Torgos tracheliotos (38% de declinaciones anuales) y de Terathopius ecaudutus (18%) en el Parque Nacional Nyerere y de Trigonoceps occipitalis (19%) en el Parque Nacional Ruaha. Las muertes registradas e inferidas a partir de la telemetría sugieren que el envenenamiento es prevalente. Sin embargo, sólo se confirmaron seis muertes por envenenamiento de las 26 supuestas, lo que resalta los obstáculos para determinar la causa de muerte cuando se trabaja en paisajes amplios. A pesar de las declinaciones, nuestros datos proporcionan evidencia de que el sur de Tanzania tiene tasas actuales de encuentro con buitres africanos más altas que en cualquier otra parte del occidente de África. La prevención de declinaciones en el futuro dependerá principalmente de evitar el envenenamiento. Con base en nuestros resultados, sugerimos que el uso de técnicas múltiples incrementa el conocimiento sobre las tendencias poblacionales a corto plazo.

Validation of the Chinese version of the Walsh Family Resilience Questionnaire.

The Walsh Family Resilience Questionnaire (WFRQ) is one of the most widely used and strong theory-based measurement tools of family resilience. This study aimed to develop and psychometrically test the Chinese version of the WFRQ (WFRQ-C). The WFRQ was translated following Brislin's translation model. Psychometric testing, combining classical theory test and item response theory, was conducted with a sample of 800 community adult residents. The Connor-Davidson resilience scale-10 (CD-RISC-10), Self-reported Family Happiness Scale (SFHS-1), and Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale (Family APGAR-5) were applied for convergent validity. Six items were deleted at the item analysis level. The minimum average partial test and a parallel analysis supported a three-factor structure, which was validated by confirmatory factor analysis. The three factors were named "Family belief system," "Organization, communication and problem solving," and "Utilization of external resources." The WFRQ-C was significantly correlated with CD-RISC-10, SFHS-1, and Family APGAR-5, with r values ranged from 0.51 to 0.56. The Cronbach's α was 0.97 for the scale and 0.93, 0.95, and 0.72 for the three factors, respectively. The ICCs of 0.96 for the whole scale, and 0.95, 0.75, and 0.95 for the three factors, respectively. The mean score for the WFRQ-C was 97.00 ± 17.94, of which per capita monthly income and education level were predictors. The 26-item WFRQ-C is a stable, concise, and validated tool to measure family resilience. It is applicable for Chinese community adults in nonspecific stressful settings and has potential utility in the health care domain.

El Cuestionario de resiliencia familiar de Walsh (Walsh Family Resilience Questionnaire, WFRQ) es uno de los instrumentos teóricos de medición de la resiliencia familiar más utilizados y sólidos. Este estudio tuvo como finalidad desarrollar y evaluar psicométricamente la versión china del WFRQ (WFRQ-C). El WFRQ se tradujo siguiendo el modelo de traducción de Brislin. Se realizó una evaluación psicométrica combinando la teoría clásica de los tests y una teoría de respuesta al ítem con una muestra de 800 residentes adultos de la comunidad. Se aplicó la Escala de resiliencia de Connor y Davidson-10 (CD-RISC-10), la Escala de felicidad familiar autoinformada (SFHS-1) y la Escala del APGAR familiar (Family APGAR-5) -adaptación, asociación, crecimiento, afecto, determinación- para la validez convergente. Se borraron seis ítems a nivel del análisis de los ítems. La evaluación parcial de promedio mínimo y un análisis paralelo respaldaron una estructura de tres factores, que fue validada por el análisis factorial confirmatorio. Se denominó a los tres factores "sistema de creencias familiares", "organización, comunicación y resolución de problemas" y "utilización de recursos externos". El WFRQ-C estuvo correlacionado significativamente con la CD-RISC-10, la SFHS-1 y el APGAR-5 familiar, con valores r que oscilaron entre 0.51 y 0.56. El alfa de Cronbach fue de 0.97 para la escala, y de 0.93, 0.95 y 0.72 para los 3 factores, respectivamente. Los coeficientes de correlación intraclase fueron de 0.96 para la escala completa, y de 0.95, 0.75 y 0.95 para los 3 factores, respectivamente. El puntaje promedio para el WFRQ-C fue de 97.00±17.94, que fue pronosticado por los ingresos mensuales por persona y el nivel de educación. El WFRQ-C de 26 ítems es un instrumento estable, conciso y validado para medir la resiliencia familiar. Puede aplicarse en adultos de la comunidad china en entornos estresantes no específicos y posiblemente en el ámbito de la asistencia sanitaria.

Brazilian instrument for assessing of eating disorders in children and adolescents.

OBJECTIVE: This study aimed to develop the Brazilian instrument for assessing eating disorders in children and adolescents and test its psychometric quality using item response theory (IRT). DESIGN: Cross-sectional study. PARTICIPANTS: Participants aged between five and twelve years old of both sexes. MAIN MEASURES: IRT logistic model of two parameters was used to evaluate the item's severity and discrimination and test information curve of symptoms of eating disorders' latent trait symptoms. Content validity and reliability were also assessed. The IRT evaluation suggested that the instrument contained items that performed differently concerning severity, discrimination, and test information curve presented good accuracy. RESULTS: There was agreement on the clarity of language (83.3%) and theoretical relevance (91.7%), indicating good content validity. The value of the Cronbach's Alpha was 0.63 (95% confidence interval), and the result of the Spearman-Brown test was 0.65. CONCLUSION: These results indicate good performance of the screening tool in assessing the level of eating disorders in children and adolescents.

Validation of the health literacy scale in patients with hypertension in Mexico.

INTRODUCTION: Health literacy integrates skills around health care. The measurement of health literacy is relevant for proposing improvement interventions. The European HLS-EU-Q16 scale allows to comprehensively evaluate health literacy, but its psychometric properties have not been assessed in Mexico. OBJECTIVE: To validate the HLS-EU-Q16 scale in patients with hypertension in Mexico. METHODS: A validation study of a measuring instrument was carried out. The construct was evaluated by means of factor analysis; internal consistency, using Cronbach's alpha; and test-retest reliability, using intraclass correlation coefficient (ICC). The information was collected by interviewing 349 patients with hypertension in a family medicine unit of the Mexican Institute of Social Security, from April to June 2022. RESULTS: In 23.8% of the patients, health literacy was inadequate; in 44.4%, problematic; and in 31.8%, sufficient. The scale was found to retain 12 items and two factors (HLS-EU-Q12M). Cronbach's alpha was 0.83, and ICC was 0.94. CONCLUSION: The HLS-EU-Q12M scale in Mexican Spanish is a valid instrument for assessing health literacy in adults with hypertension.

ANTECEDENTES: La alfabetización en salud integra las habilidades en torno al cuidado de la salud. La medición de la alfabetización en salud es relevante para proponer intervenciones de mejora. La escala europea HLS-EU-Q16 permite evaluar la alfabetización en salud de forma integral, pero sus propiedades psicométricas no se han evaluado en México. OBJETIVO: Validar la escala HLS-EU-Q16 en pacientes con hipertensión en México. MATERIAL Y MÉTODOS: Se realizó estudio de validación de un instrumento de medición. El constructo se evaluó mediante análisis factorial, la consistencia interna mediante alfa de Cronbach y la confiabilidad prueba-reprueba mediante coeficiente de correlación intraclase (CCI). La información fue recolectada mediante entrevistas a 349 pacientes con hipertensión en una unidad de medicina familiar del Instituto Mexicano del Seguro Social, de abril a junio de 2022. RESULTADOS: El 23.8 % de los pacientes tuvo una alfabetización en salud inadecuada; 44.4 %, problemática; y 31.8 %, suficiente. Se encontró que la escala está conformada por 12 reactivos y dos factores (HLS-EU-Q12M). El alfa de Cronbach fue de 0.83 y el CCI, de 0.94. CONCLUSIÓN: La escala HLS-EU-Q12M es un instrumento válido en español de México para evaluar la alfabetización en salud en adultos con hipertensión arterial.

Spanish Version of the RECAP Questionnaire to Assess Control of Atopic Eczema: Translation, Cultural Adaptation, Validation, and Correlations with Other Patient-Reported Outcome Measures. / Traducción, adaptación transcultural, correlación con otros PRO y validación del cuestionario RECAP sobre el grado de control de la dermatitis atópica.

BACKGROUND: The 7-item RECAP (Recap of Atopic Eczema) questionnaire is used to assess the control of different degrees of eczema severity in patients of all ages. Long-term control of eczema is one of the 4 core outcome domains to be assessed in clinical trials of eczema therapies. After the RECAP was developed in the United Kingdom, it was translated into Chinese, German, Dutch, and French. OBJECTIVES: To produce a validated Spanish version of the RECAP questionnaire and, secondarily, to test its content validity in a group of Spanish patients with atopic eczema. MATERIAL AND METHODS: In a 7-step process we produced 2forward translations and 1back translation of the RECAP questionnaire. Experts then held two meetings to reach consensus and draft a Spanish version of the questionnaire. Fifteen adult patients with atopic eczema were interviewed to evaluate the comprehensibility, comprehensiveness, and relevance of the drafted items. These patients also completed the Atopic Dermatitis Control Tool (ADCT), the Dermatology Life Quality Index (DLQI), and the Patient-Oriented Eczema Measure (POEM). Stata software (version 16) was then used to explore the correlations between the patients' scores on these tools and the RECAP. RESULTS: The patients found the Spanish version of the RECAP to be comprehensible and easy to answer. We observed a strong correlation between results on the Spanish RECAP and the ADCT, and highly significant correlations between the RECAP and the DLQI and POEM tools. CONCLUSIONS: The culturally adapted Spanish version of the RECAP is linguistically equivalent to the original version of the questionnaire. RECAP scores correlate highly with other patient-reported outcome measures.

Parental worry about children: Scale development and validation among Chinese parents of preschool children.

Chinese parents tend to exhibit a high level of worry about their children during the preschool years, which may adversely influence children's mental health. Few studies have investigated the content and intensity of parental worry about children among Chinese parents of preschool children. This study developed and validated the Parental Worry About Children Scale (PWCS) for Chinese parents of preschool children. A pool of 70 items was created after an open-ended questionnaire survey of 1069 Chinese parents of preschool children and an Internet-content analysis, followed by an assessment for content validity by eight experts. Exploratory factor analysis was then conducted with 680 Chinese parents of preschool children, resulting in the formal PWCS consisting of 40 items in four dimensions: physical well-being, psychological well-being, learning/living abilities, and future/uncertain risks. With a sample of 1548 Chinese parents of preschool children, the PWCS demonstrated good structural validity, internal consistency reliability, measure invariance across mothers and fathers, and criterion-related validity. The PWCS may help elucidate the characteristics and antecedents of parental worry about children and the mechanisms underlying its influence on children's mental health in the Chinese context. In clinical practice, this new instrument may facilitate the emergence of effective intervention strategies for alleviating parental worry about children and its negative impact on children's mental health.

Los padres chinos tienden a demostrar un alto nivel de preocupación por sus hijos durante los años de preescolar, lo cual puede influir negativamente en la salud de mental de los niños. En pocos estudios se ha investigado el contenido y la intensidad de la preocupación de los padres por los niños entre los padres chinos de niños en edad preescolar. En este estudio se desarrolló y se validó la Escala de preocupación de los padres por los hijos (Parental Worry About Children Scale, PWCS) para padres chinos de niños en edad preescolar. Se creó un grupo de 70 ítems después de una encuesta abierta de 1069 padres chinos de niños en edad preescolar y un análisis de contenido de internet, seguido de una evaluación de validez del contenido realizada por ocho especialistas. Luego se llevó a cabo un análisis factorial exploratorio con 680 padres chinos de niños en edad preescolar, cuyo resultado fue la PWCS formal que consta de 40 ítems en cuatro dimensiones: bienestar físico, bienestar psicológico, habilidades de aprendizaje/para la vida y riesgos futuros/inciertos. Con una muestra de 1548 padres chinos de niños en edad preescolar, la PWCS demostró una buena validez estructural, fiabilidad de la coherencia interna, invariancia de las medidas entre las madres y los padres, y validez relacionada con el criterio. La PWCS puede contribuir a dilucidar las características y los antecedentes de la preocupación de los padres por los niños y los mecanismos que subyacen a su influencia en la salud mental de los niños en el contexto chino. En la práctica clínica, este nuevo instrumento puede facilitar el surgimiento de estrategias eficaces de intervención para aliviar la preocupación de los padres por los niños y su efecto negativo en la salud mental de los niños.

Rawl's questionnaire spanish validation for colorectal cancer screening with faecal occult blood testing. / Validación al castellano del cuestionario Rawl de cribado de cáncer colorrectal con sangre oculta en heces.

INTRODUCTION: Colorectal cancer 5-years-survival is 57%, partway due to a low rate of participation in screening programmes. Instruments analyzing causes of low adherence are needed. OBJECTIVE: To evaluate the validity and internal consistency of the Spanish version of Rawl's Questionnaire for the screening of colorectal cancer by faecal occult blood testing. TYPE OF STUDY: Questionnaire validation methodology. LOCATION: Three Primary Care Centres in Valencia. VARIABLES: Age, sex, civil status, educational level, social class, smoking, alcohol consumption, body mass index, personal and family history of cancer. RESULTS: We analyzed 408 individuals (237 cases and 171 controls). Mean age was 59.45 years (SD 5.17). Internal consistency of all variables reached a Cronbach's alfa of 0.796. The Cronbach's alfa benefit dimension of the screening was 0.871 and for the barrier dimension of the screening it was 0.817. Intraclass correlation coefficients of the test-retest for the benefit dimension of the screening was 0.809 (CI 95% 0.606-0.913) and 0.499 (CI 95% 0.126-0.750) for the barrier dimension. CONCLUSION: The Spanish version of Rawl's Questionnaire is valid, reliable and reproducible, so we have this validated instrument with which to identify barriers and benefits in a colorectal screening programme in Spain.

Translation into Spanish and validation of a short questionnaire to measure the control of inflammatory bowel disease from the patient's perspective: IBD-Control, EII-Control. / Traducción al español y validación de un cuestionario breve de medida del control de la enfermedad inflamatoria intestinal desde la perspectiva del paciente: IBD-Control, EII-Control.

OBJECTIVE: Measurement of patient-perceived outcomes in inflammatory bowel disease (IBD) care is becoming increasingly important. A simple and validated tool exists in English for this purpose, the "IBD-Control". Our aim is to translate it into Spanish, adapt and validate it. PATIENTS AND METHODS: The IBD-Control was translated into the Spanish instrument "EII-Control" and prospectively validated. Patients completed the EII-Control and other questionnaires that served as baseline comparators. The gastroenterologist performed a global assessment of the disease, calculated activity indices and recorded treatment. A subgroup of patients repeated the entire assessment at a second visit. The usefulness of IBD-Control summary scales (IBD-Control-8 and IBD-Control-VAS) was also analysed. RESULTS: A total of 249 IBD patients were included (101 repeated the second visit). Psychometric standards of the test: internal consistency: Cronbach's α for EII-Control 0.83 with strong correlation between EII-Control-8 and EII-Control-EVA (r=0.5); reproducibility: intra-class correlation 0.70 for EII-Control; construct validity: moderate to strong correlations between IBD-Control, IBD-Control-8 and IBD-Control-VAS versus comparators; discriminant validity: P<.001; sensitivity to change: same response as quality of life index. Sensitivity and specificity at cut-off point 14 of 0.696 and 0.903, respectively, to determine quiescent status. CONCLUSIONS: The IBD-Control is a valid instrument to measure IBD-Control from the patient's perspective in our environment and culture. Its simplicity makes it a useful tool to support care.

Validation of parental stress scale in a Greek sample of mothers with infants from 0 to 12 months.

Parenting an offspring is a rewarding, albeit challenging task, often accompanied by high levels of stress. It is important to accurately assess the stress associated with parenting, as severe forms of stress may affect the parent-child dyad and lead to poor child outcomes. The aim of this study was to translate and validate the Parental Stress Scale (PSS) in the Greek population. We implemented forward and back translation and conducted a pilot test. A total of 735 mothers (Mage  = 34.6) with infants aged 0-12 months completed the PSS, the Edinburgh Postnatal Depression Scale, and the Hospital Anxiety and Depression Scale. The Greek PSS-18 showed good internal consistency (Cronbach's α = .83) and adequate convergent validity. Results of exploratory and confirmatory factor analysis revealed two underlying factors: positive aspects of parenting and negative aspects of parenting. Our data confirm the validity of the Greek version of the PSS-18 in mothers with infants aged 0-12 months. The Greek version of the PSS-18 could be a useful tool for professionals and researchers who are interested in perinatal period and the aspects of parenthood.

Criar a un hijo es una tarea gratificante, aunque desafiante, a menudo acompañada por altos niveles de estrés. Es importante evaluar con certeza el estrés asociado con la crianza, ya que formas severas de estrés pudieran afectar la díada progenitor-niño y llevar a pobres resultados en el niño. El propósito de este estudio fue traducir y validar la Escala de Estrés del Progenitor (PSS) en la población griega. Implementamos la traducción hacia adelante y hacia atrás y llevamos a cabo una examinación experimental. Un total de 735 madres (Edad promedio = 34.6) con infantes de edad 0-12 meses completaron la PSS, la Escala de Edimburgo de Depresión Posnatal y la Escala de Ansiedad de Hospital y Depresión. La PSS griega-18 mostró una buena consistencia interna (de Cronbach α = .83) y una validez de convergencia adecuada. Los resultados de los análisis de factores exploratorios y confirmatorios revelaron dos factores subyacentes: aspectos positivos de crianza y aspectos negativos de crianza. Nuestros datos confirman la validez de la versión griega de PSS-18 en madres con infantes de edad 0-12 meses. La versión griega de PSS-18 pudiera ser una herramienta útil para profesionales e investigadores que están interesados en el período perinatal y los aspectos de la maternidad/paternidad.

Le parentage d'un enfant est une tâche gratifiante mais également un défi, souvent accompagnée de niveaux de stress élevés. Il est important d'évaluer avec précision le stress lié au parentage puisque les formes sévères de stress affectent la dyade parent-enfant et mènent à de piètres résultats pour l'enfant. Le but de cette étude était de traduire et de valider l'Echelle de Stress Parental (abrégé en anglais et ici par PSS) chez la population grecque. Nous avons procédé à la traduction et fait un test pilote. Un total de 735 mères (Mâge = 34,6) avec des bébés âgés de 0 à 12 mois ont rempli la PSS, l'Echelle de Dépression Postnatale d'Edinbourg, et l'Echelle d'Anxiété de l'Hôpital et de Dépression. La PSS-18 grecque a fait preuve de bonne cohérence interne (Cronbach's α = .83) et d'une validité convergente adéquate. Les résultats de l'analyse de facteur exploratoire et confirmative ont révélé deux facteurs sous-jacents: les aspects positifs du parentage et les aspects négatifs du parentage. Nos données confirment la validité de la version grecque de la PSS-19 chez des mères avec des bébés âgés de 0 à 12 mois. La version grecque de la PSS-18 pourrait être un outil utile pour les professionnels et les chercheurs qui s'intéressent à la période périnatale et aux aspects du parentage.

Measuring the depth of reflection in reflective supervision/consultation sessions: Initial validation of the Reflective Interaction Observation Scale (RIOS).

Research on reflective supervision and reflective consultation (RS/C) is limited, and has primarily relied on self-report measures and qualitative interviews. To our knowledge, no measures currently exist which provide a way to observationally measure what occurs during an RS/C session. Thus, the Reflective Interaction Observation Scale (RIOS) was created as a way to more objectively measure the quality of RS/C. This study sought to provide initial evidence around the reliability and validity of the RIOS through a sample of child welfare workers (N = 40) who participated in six online group reflective consultation sessions and completed self-report surveys after their first and last session. The RIOS was used to code the first and last session each participant attended. Results showed that in this sample the RIOS Essential Elements had good variability and strong reliability. The data suggested that the five Elements could be condensed into three subscales, two of which showed significant change over time. The Self Openness subscale showed concurrent validity with existing self-report measures of RS/C. Results suggest that the RIOS shows promise as a measure that could contribute to a more rigorous evidence base for the practice of RS/C.

La investigación acerca de la supervisión con reflexión y la consulta con reflexión (RSC) es limitada y primariamente ha confiado en medidas de auto reporte y entrevistas cualitativas. Hasta donde alcanza nuestro conocimiento, no existen actualmente medidas que ofrezcan una manera de medir desde la perspectiva observacional lo que ocurre durante la sesión de RSC. Por tanto, la Escala de Observación de la Interacción con Reflexión (RIOS) se creó como una manera de medir más objetivamente la calidad de RSC. Este estudio se propuso proveer evidencia inicial acerca de la confiabilidad y validez de RIOS por medio de un grupo muestra de trabajadores den el campo del bienestar infantil (N = 40) que participaron en seis sesiones de grupo en línea sobre la consulta con reflexión y completaron encuestas de auto reporte después de su primera y última sesiones. RIOS se usó para codificar la primera y la última sesión a la que cada participante asistió. Los resultados muestran que en este grupo muestra los Elementos Esenciales de RIOS tuvieron buena variabilidad y una fuerte confiabilidad. La información sugiere que los cinco Elementos Esenciales pueden ser agrupados en tres subescalas, dos de las cuales muestras un cambio significativo con el pasar del tiempo. La escala de Auto Apertura mostró una validez concurrente con medidas existentes de auto reporte de RSC. Los resultados sugieren que RIOS es una medida prometedora que puede contribuir a una más rigurosa base de evidencia para la práctica de RSC.

Les recherches sur la supervision réflective et la consultation réflective (RSC) sont limitées et ont avant tout reposé sur des mesures d'auto-évaluation et des entretiens qualitatifs. A notre connaissance il n'existe actuellement aucune mesure qui offre une manière de mesurer par observation ce qui se passe durant une session de RSC. Par conséquent l'Echelle d'Observation de l'Interaction Réflective (abrégé RIOS en anglais) a été créée en tant que moyen de mesurer par observation la qualité de la RSC. Cette étude s'est donné pour but d'offrir des résultats préliminaires sur la fiabilité et la validité de RIOS au travers d'un échantillon d'employés de la protection de l'enfance (N = 40) ayant participé à des sessions de consultation réflective de groupe en ligne et rempli des questionnaires d'auto-évaluation après la première et la dernière session. RIOS a été utilisée pour coder la première et la dernière session à laquelle chaque participant a participé. Les résultats montrent que dans cet échantillon les éléments essentiels de RIOS avaient une bonne variabilité et une fiabilité forte. Les données suggèrent que les cinq éléments essentiels pourraient être condensés en trois sous-échelles, deux d'entre elles ayant fait preuve d'un changement important au fil du temps. Les sous-échelles d'Ouverture de Soi ont fait preuve d'une validité simultanée avec des mesures auto-rapportées de la RSC qui existaient déjà. Les résultats suggèrent que RIOS est prometteuse en tant que mesure qui pourrait contribuer à une base factuelle plus rigoureuse pour la pratique de la RSC.

Exploring the feasibility of validating early developmental screening tools for American Indian and Alaska Native children.

Screening children from birth through age 5 is critical to early identification of challenges and referral to intervention to support optimal development. Screening of American Indian and Alaska Native (AIAN) children lags behind that of other children, partly due to the lack of screening tools validated for this population. This study tested the feasibility of an online data collection strategy for use in a future study of the validity of existing screening instruments for AIAN children. Parents of AIAN children in four communities were recruited to complete screeners, provide demographic information, and provide feedback on experiences with online data collection. Participants were given the option of receiving screening results from the local early childhood program through which they were recruited. 240 participants began the process, 183 were enrolled in a partner program and reported a birthdate for at least one AIAN child, 157 had an age-eligible child, 81 began the consent process, 62 consented, and 39 fully completed data collection. Most participants were female and AIAN, the majority reported that online data collection was easy. Collecting screener validation data on a large sample of AIAN children may be able to utilize online data collection tools, with in-person support to facilitate participation.

Un examen de detección en los niños a partir del nacimiento hasta la edad de 5 años es esencial para la temprana identificación de retos y la referencia a intervenciones como apoyo a un desarrollo óptimo. El examen de detección en el caso de niños del grupo Indio Americano y Nativo de Alaska (AIAN) está muy por debajo del de otros niños, en parte debido a la falta de herramientas de detección validadas para esta población. Este estudio puso a prueba la posibilidad de una estrategia electrónica de recolección de datos para uso en un estudio futuro acerca de la validez de los existentes instrumentos de detección para niños AIAN. Se reclutaron progenitores de niños AIAN en cuatro comunidades para completar los exámenes de detección, proveer información demográfica, así como proveer información sobre las experiencias con la recolección electrónica de datos. A los participantes se les dio la opción de recibir los resultados de la detección de parte del programa local para la temprana niñez a través del cual habían sido reclutados. 240 participantes comenzaron el proceso; 183 estaban matriculados en un programa paralelo y reportaron la fecha de nacimiento de por lo menos un niño AIAN; 157 tenían un niño elegible según la edad; 81 comenzaron el proceso de consentimiento; 62 consintieron; 39 completaron en su totalidad la recolección de datos. La mayoría de los participantes eran mujeres y AIAN; la mayoría reportó que la recolección electrónica de datos fue fácil. La recolección de información de validación de la detección en un grupo muestra grande de niños AIAN pudiera ser capaz de utilizar herramientas electrónicas de recolección de datos, con un apoyo presencial para facilitar la participación.

Le dépistage des enfants de la naissance à l'âge de 5 ans est critique pour l'identification précoce des défis et problèmes et l'orientation vers l'intervention afin de soutenir le développement optimal. Le dépistage des enfants d'amérindiens des Etats-Unis et des autochtones d'Alaska est en retard par rapport à celui des autres enfants, en partie du fait du manque d'outils de dépistage validés pour cette population. Cette étude a testé la fiabilité de la stratégie de collecte de données en ligne pour son utilisation pour une étude à venir sur la validité d'instruments de dépistage existants pour les enfants AIAN. Les parents d'enfants AIAN de quatre communautés ont été recrutés afin de remplir des dépistages, d'offrir des renseignements démographiques, et d'offrir des commentaires sur les expériences de collecte de données en ligne. Les participants ont reçu l'option de recevoir les résultats de dépistage d'un programme de petite enfance local au travers duquel ils avaient été recrutés. 240 participants ont commencé le processus. 183 ont été inscrits dans un programme partenaire et ont fait état de la date de naissance d'au moins un enfant AIAN. 157 avait un enfant admissible par l'âge. 81 ont commencé le processus de consentement. 62 ont consenti. 39 ont fini la collecte de données en ligne. La collecte de données de validation du filtre de recherche sur un grand échantillon d'enfants AIAN pourrait utiliser des outils de collecte de données en ligne avec un soutien en personne afin de faciliter la participation.

[Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©]. / Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©.

OBJECTIVE: Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DESIGN: Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SETTING: Primary Health Care. PARTICIPANTS: One hundred fifty-five general practitioners and nurses working at Primary Health Care. INTERVENTIONS: Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. MAIN MEASURES: Competence in brief tobacco intervention measured by the BTI-Prof©. RESULTS: Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676-0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76-0.928), p<0.0001. CONCLUSIONS: The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.

[Development of a formative evaluation instrument for the community health worker health agent]. / Desarrollo de un instrumento de evaluación formativa del agente comunitario de salud.

To validate a formative evaluation instrument of the community health agent. DESIGN: Methodological study with a quantitative approach. LOCATION: Carried out in two municipalities in the South of Brazil. PARTICIPANTS: 40 nurses for 350 community health agents. PARTICIPANTS: The instrument was developed based on a competency framework of the Ministry of Health. The principal component analysis method was used for factor analysis. Internal validity and reliability were measured by Cronbach's alpha. The intraclass correlation coefficient, the Student's t test for paired samples and the ANOVA analysis of variance were used. RESULTS: The factor analysis produced a factor structure with six factors and the 52 competencies of the original instrument were maintained. The final version of the instrument was structured into six domains: "Micro-area monitoring" (12 competencies), "Health promotion" (nine competencies), "Prevention and monitoring of specific groups and morbidities" (10 competencies), "Prevention and monitoring of environmental and social risk" (nine competences), "Planning and evaluation" (seven competences), "Teamwork" (five competences). Cronbach's alpha coefficient was 0.981, the test and the new test was p=0.851 by the Student's t-test, and the ICC was 1.0. CONCLUSIONS: The validated instrument constitutes an important reference in the discussion of the work of the Community Health Agent in the current context of public health policies. In addition to supporting the role of nurses in the supervision/in-service training of these professionals.

Development and validation of the Attachment Relationship Inventory-Caregiver Perception 2-5 years (ARI-CP 2-5): Psychometric structure, external validity, and norms.

There is a lack of instruments assessing child-caregiver attachment relationships in early childhood to be used in attachment-based practice, in particular from a caregiver's perception, which is an important factor of clinical importance to take into account in parenting interventions targeting young children. Therefore, the 48-item Attachment Relationship Inventory-Caregiver Perception 2-5 years (ARI-CP 2-5) was developed. Survey data of 446 caregivers of 2- to 5-year-old children were collected, and a subsample of 83 caregivers participated in an observation study. Confirmatory factor analysis confirmed a four-factor structure of secure, avoidant, ambivalent, and disorganized attachment relationship. Indications of configural, metric, and scalar invariance were found for caregivers' and children's sex, children's age, and population (clinical vs. general population). The four scales showed sufficient internal consistency and significant associations with children's psychopathology, caregivers' general attachment representations, caregivers' mind-mindedness, and population type. Moreover, preliminary evidence for convergent validity with observational attachment measures was found. It is concluded that the ARI-CP 2-5 is a valid instrument that can be used as part of the screening and assessment of insecure attachment relationships.

Hacen falta instrumentos que evalúen las relaciones de afectividad niño-cuidador en la temprana niñez para ser usados en la práctica que se basa en la afectividad, en particular desde la perspectiva del cuidador, lo cual es un factor clave de importancia clínica para tomar en cuenta en las intervenciones de crianza que se enfocan en niños pequeños. Por tanto, se desarrolló el Inventario de la Relación Afectiva - Percepción del Cuidador 2-5 años, que consta de 48 aspectos (ARI-CP 2-5). Se recogió información de encuesta de 446 cuidadores de niños de 2 a 5 años de edad, y un subgrupo muestra de 83 cuidadores participó en un estudio de observación. Los análisis de factores confirmatorios corroboraron una estructura de cuatro factores de la relación de afectividad que es segura, la que evita, la ambivalente y la desorganizada. Se encontraron indicaciones de invariabilidad en el aspecto configuracional, métrico y de escala en cuanto al género sexual de los cuidadores y del niño, la edad del niño, y la población (clínica y general). Las cuatro escalas mostraron una suficiente consistencia interna y asociaciones significativas con la sicopatología de los niños, las representaciones generales de afectividad del cuidador, la conciencia mental de los cuidadores, así como el tipo de población. Es más, se encontró una evidencia preliminar para la validez convergente con las medidas de afectividad de observación. Se concluye con que el ARI-CP 2-5 es un instrumento válido que puede usarse como parte de la detección y evaluación de las relaciones de afectividad inseguras.

Il y a un manque d'instruments évaluant les relations d'attachement enfant-aidant naturel dans la petite enfance pouvant être utilisés dans une pratique basée sur l'attachement, en particulier sur la perception de l'aidant naturel, qui est un facteur important de l'importance clinique à prendre en compte dans les interventions de parentages ciblant les jeunes enfants. Par conséquent l'Inventaire de 48 articles de la Relation d'Attachement - Perception de l'Aidant Naturel 2-5 ans (abrégé en anglais ARI-CP 2-5) a été développé. Les données de sondage de 446 aidants naturels d'enfants de 2 à 5 ans ont été recueillies et un sous-échantillon de 83 aidants naturels ont participé à une étude d'observation. Une analyse factorielle confirmatoire a confirmé une structure à quatre facteurs de la relation d'attachement sécure, évitant, ambivalent et désorganisé. Des indications d'invariance configurale, métrique et scalaire ont été trouvées pour le sexe des aidants naturels et des enfants, l'âge des enfants, et la population (clinique par rapport à population générale). Les quatre échelles ont démontré une cohérence interne suffisante et des associations importantes avec la psychopathologie des enfants, les représentations de l'attachement générale des aidants naturels, l'esprit-qualité mentale et le type de population. De plus une preuve préliminaire de validité convergente ave les mesures observationnelles d'attachement a été trouvée. Nous concluons que l'ARI-CP 205 est un instrument valide qui peut être utilisé pour le dépistage et l'évaluation de relations d'attachement insécures.

[Validation of the living with osteoarthritis in Spanish population]. / Validación de la escala de convivencia con artrosis en la población española.

OBJECTIVE: Present the psychometric results of the Living with Osteoarthritis (LW-OA) in Spanish population. DESIGN: Observational, cross-sectional and multicenter study, with retest on a fraction of the sample. LOCATION: Public and private centres of primary and secondary healthcare, as well as patient associations from Navarra, La Rioja, Madrid, Valencia and Malaga. PARTICIPANTS: The sample was composed by 291 patients with OA with a medical diagnosis in every stage of the disease from primary or secondary healthcare, Spanish nationality and not hospitalized. INTERVENTIONS: In addition to LW-OA, a sociodemographic questionnaire was included, as well as scales to evaluate social support perceived from the patient (DUFSS), quality of life (WHOQOL-BREF) and satisfaction with life. MAIN MEASUREMENTS: Psychometric properties of the LW-OA were measured, as viability and acceptability, reliability (internal consistency and reproducibility), precision and construct validity (convergent, internal and known-groups). RESULTS: 100% of the data were computable. Excellent data quality was obtained. Cronbach's alpha for the scale total was 0.87 and the homogeneity index 0.22. ICC for the scale total was 0.88. As for precision, the SEM was 5.18 (<½DE=7.47). CONCLUSIONS: The LW-OA is a valid and feasible measure to evaluate the process of living with OA in Spain.

Validation and psychometric properties of the 8-item Morisky Medication Adherence Scale (MMAS-8) in type 2 diabetes patients in Spain.

AIMS: To validate a translated and culturally adapted version of the Morisky Medication Adherence Scale for use in Spanish population, and to examine the psychometric properties of this scale in patients with type 2 diabetes mellitus in Spain. DESIGN: This cross-sectional study was conducted in a single university hospital in Spain. Patients diagnosed with type 2 diabetes mellitus at least 1 year before inclusion, being treated with anti-diabetic medication were included. INTERVENTION: We used the Spanish version of the scale to measure treatment adherence. PRINCIPAL MEASUREMENTS: three level categorical scale is broken down into low adherence (score of <6), medium adherence (score of 6 to <8) and high adherence (score of 8). To validate the questionnaire, we measured internal consistency through Cronbach's α, confirmed construct validity through an exploratory principal component analysis and assessed test-retest reliability. RESULTS: 232 patients met the inclusion criteria. The Cronbach's α coefficient was 0.40 (95% CI 0.28-0.52). The exploratory principal component analysis showed three components. The intraclass correlation coefficient was 0.718 (95% CI 0.564-0.823). CONCLUSIONS: the Spanish version of the Morisky Medication Adherence scale showed low internal consistency, the exploratory factor analysis identified three dimensions, and the test-retest reliability was acceptable, therefore, psychometric properties of MMAS-8 are not suitable for measuring medication adherence in type 2 diabetes mellitus patients from Spain.

[Clinical validation of 2 morbidity groups in the primary care setting]. / Validación clínica de 2 agrupadores de morbilidad en el ámbito de atención primaria.

INTRODUCTION: Adjusted Morbidity Groups (GMAs) and the Clinical Risk Groups (CRGs) are population morbidity based stratification tools which classify patients into mutually exclusive categories. OBJETIVE: To compare the stratification provided by the GMAs, CRGs and that carried out by the evaluators according to the levels of complexity. DESIGN: Random sample stratified by morbidity risk. LOCATION: Catalonia. PARTICIPANTS: Forty paired general practitioners in the primary care, matched pairs. INTERVENTIONS: Each pair of evaluators had to review 25 clinical records. MAIN OUTPUTS: The concordance by evaluators, and between the evaluators and the results obtained by the 2 morbidity tools were evaluated according to the kappa index, sensitivity, specificity, and positive and negative predicted values. RESULTS: The concordance between general practitioners pairs was around the kappa value 0.75 (mean value=0.67), between the GMA and the evaluators was similar (mean value=0.63), and higher than for the CRG (mean value=0.35). The general practitioners gave a score of 7.5 over 10 to both tools, although for the most complex strata, according to the professionals' assignment, the GMA obtained better scores than the CRGs. The professionals preferred the GMAs over the CRGs. These differences increased with the complexity level of the patients according to clinical criteria. Overall, less than 2% of serious classification errors were found by both groupers. CONCLUSION: The evaluators considered that both grouping systems classified the studied population satisfactorily, although the GMAs showed a better performance for more complex strata. In addition, the clinical raters preferred the GMAs in most cases.