Cross-cultural adaptation and psychometric evaluation of the social frailty scale in Iranian older adults.

BACKGROUND: Social frailty is a holistic concept encompassing various social determinants of health. Considering its importance and impact on health-related outcomes in older adults, the present study was conducted to cross-culturally adapt and psychometrically evaluate the Social Frailty Scale in Iranian older adults in 2023. METHODS: This was a methodological study. The translation and cross-cultural adaptation of the Social Frailty Scale 8-item (SFS-8) was conducted according to Wild's guideline. Content and face validity were assessed using qualitative and quantitative methods. Then, 250 older adults covered by comprehensive health centers were selected using multistage random sampling. Participants completed the demographic questionnaire, the Abbreviated Mental Test score, the SFS-8, and the Lubben Social Network Scale. Construct validity was assessed by principal component analysis (PCA) and known-group comparisons. The Mann‒Whitney U test was used to compare social frailty scores between the isolated and non-isolated older adults. Internal consistency, equivalence, and stability were assessed using the Kuder-Richardson method, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the minimum detectable change (MDC). The ceiling and floor effects were also assessed. The data were analyzed using JASP 0.17.3. RESULTS: The ratio and index of content validity and the modified kappa coefficient of all the items were 1.00. The impact score of the items was greater than 4.6. PCA identified the scale as a single component by removing two questions that could explain 52.9% of the total variance in the scale score. The Persian version of the Social Frailty Scale could distinguish between isolated and non-isolated older adults (p < 0.001). The Kuder-Richardson coefficient, ICC, SEM, and MDC were 0.606, 0.904, 0.129, and 0.358, respectively. The relative frequencies of the minimum and maximum scores obtained from the scale were 34.8 and 1.2, respectively. CONCLUSIONS: The Persian version of the Social Frailty Scale (P-SFS) can be used as a valid and reliable scale to assess social frailty in Iranian older adults.

Translation and Validation of the Chinese Language Version of the Control of Allergic Rhinitis and Asthma Test in Patients with Allergic Rhinitis.

Objective: Due to the escalating global prevalence of allergic rhinitis (AR) and its status as an independent risk factor for asthma, timely and effective control of AR is crucial. Achieving this often involves the accurate assessment of AR. Currently, the Control of Allergic Rhinitis and Asthma Test (CARAT) is widely used as an assessment tool, but its measurement effectiveness in Chinese AR patients remains unclear. Therefore, this study aims to evaluate the reliability and validity of the Chinese version of the CARAT10 scale (CARAT10-C) and analyze its application value in the assessment of allergic rhinitis and asthma control trials. Methods: The study enrolled 130 patients with AR from the Ear, Nose, and Throat (ENT) outpatient department of a comprehensive teaching hospital from March to May 2022 as participants. The reliability and validity of the CARAT10-C scale were assessed using Cronbach's alpha coefficient (CAC), Kaiser-Meyer-Olkin (KMO), and Bartlett's sphericity test. Additionally, the study analyzed the effectiveness of the CARAT10-C scale in its application within the Control of Allergic Rhinitis and Asthma Test (CARAT). Results: The Cronbach's alpha coefficient ranges between 0 and 1, with higher values indicating better reliability. Significant differences in exploratory factor analysis suggest good validity. The Cronbach's alpha coefficient of the CARAT10-C scale was 0.806. Exploratory factor analysis revealed that the eigenvalues of Component 1 (3.851) and Component 2 (2.193) were both greater than 1, with a cumulative variance contribution rate (CVCR) of 60.436%. Items 6-10 were primarily loaded on Component 1 (Asthma), while items 1-4 were mainly influenced by Component 2 (AR), with loading ranges of 0.508-0.874, all significant at P < .001. The composite reliability (CAC) of the CARAT10-C scale was 0.806, exceeding 0.8, indicating high reliability. Component 1 had a CAC of 0.834, and Component 2 had a CACs of 0.807, both exceeding 0.8, indicating high reliability for both components. Conclusion: The CARAT10-C scale demonstrates good reliability and validity in the preliminary assessment of AR. It holds potential value in the evaluation and management of AR in China, although the specific application effects still require further investigation.

Turkish Adaptation of the ADORE: A Study of Validity and Reliability.

It is obvious that current tools in literature that are used to measure female's sexual quality of life focus only on the objective dimension of sexual function, failing to examine quality of life on a multidimensional level. The aim of this research is to examine the validity and reliability of the ADORE for Turkish society. In the methodological research, 500 females were included. The research data was collected with "Descriptive Information Form" "ADORE" and "Sexual Quality of Life-Female (SQOL-F)." ADORE is a five-Likert-type type and 36-item scale that was developed to assess female's sexual quality of life. It has six sub-dimensions. It is stated that ADORE can better evaluate female's sexual quality of life holistically and contextually. The validity of ADORE was analyzed as linguistic, content, and construct validities. In determining the reliability of the scale, item-total score correlation, Cronbach alpha (Cr α) coefficient, Pearson correlation, split-half analysis, test-retest, and parallel form were used. Content validity index was found to be 0.90. The confirmatory factor analysis was performed for construct validity. ADORE's Cr α reliability coefficient was determined to be .95. According to ADORE test-retest analyses, it was found that there is a positively strong and statistically high significant correlation among scores of the scale. It was determined that there is an acceptable correlation between ADORE and SQOL-F. In determining female's sexual quality of life in Turkish society, ADORE is a valid and reliable scale. It is a useful scale for health professionals working in the clinic to evaluate female's sexual quality of life.

Translating and Validating the Vietnamese Version of the Health Sciences Evidence-Based Practice Questionnaire.

No validated instrument is available for assessing the evidence-based practice capacity of Vietnamese health professionals. This study aimed to translate and validate the Health Sciences Evidence-Based Practice questionnaire (HS-EBP) from English to Vietnamese and ascertain its psychometric properties. Data were collected from two obstetric hospitals in Vietnam. Participants: A total of 343 midwives were randomly selected. The HS-EBP questionnaire was translated by a group of bilingual experts into Vietnamese (HS-EBP-V). Content validity was assessed by two experts. Internal consistency and test-retest reliabilities were assessed using Cronbach's α and intraclass correlation (ICC), respectively. Construct validity was assessed using the contrasted groups approach. As a result, the content validity index of the HS-EBP-V reached 1.0. For the individual subscales, Cronbach's α was 0.92-0.97 and ICC was between 0.45 and 0.66. The validity of the contrasted-groups approach showed discrimination by a significant difference in the subscale scores among diploma holders compared with bachelor's degree holders (p < 0.001). The validation of the HS-EBP questionnaire indicated satisfactory psychometric properties. The results indicate that the HS-EBP is a reliable and valid instrument which assesses the competencies of as well as facilitators of and barriers to the five steps of EBP among midwives. The HS-EBP-V was deemed a reliable and validated tool for assessing the competency and application of EBP among Vietnamese healthcare professionals.

Assessment of the climacteric syndrome: a narrative review.

PURPOSE: Many menopausal women suffer from a variety of estrogen deficiency-related symptoms and chronic medical conditions. Health care professionals should be able to identify and quantify symptoms to facilitate diagnosis, indicate and monitor treatment. Therefore, various questionnaires have been developed and are used as a simple, time-saving and cost-effective mean to assess and monitor menopausal complaints. The aim of this review is to provide an overview and comparison of the available tools for climacteric syndrome assessment. METHODS: Three electronic databases (Pubmed, EMBASE and Cochrane Database of Systematic Reviews/CDRS) were searched covering a time period of 10 years using a combination of relevant controlled vocabulary terms and free-text terms. Relevant references were evaluated for inclusion in a stepwise approach. RESULTS: The literature research revealed four questionnaires (Kupperman Index, Menopause Rating Scale, Menopause Specific Quality of Life Questionnaire and Greene Climacteric Scale) that are used to holistically assess the climacteric syndrome, varying in type of assessment, included symptoms, rating system of severity, weighing of symptoms, resulting total rating score and validation status. Further questionnaires are available to assess single symptoms or group of symptoms relating to specific aspects of menopause (e.g., vasomotor symptoms, insomnia, etc.). CONCLUSION: Four holistic questionnaires addressing menopausal symptoms have been developed [KI, MRS, MENQOL (-Intervention), Greene Climacteric Scale]. All but one (KI) have been validated and are available in different languages. However, there are still several shortcomings such as the lack of recognition of ethnic and cultural background and missing thresholds for treatment initiation and monitoring.

Development and initial validation of the nonalcoholic fatty liver disease self-management questionnaire.

The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, and self-management is essential to improve health outcomes in this population. Despite the importance of self-management, there is no instrument to assess it in patients with NAFLD. The purpose of this study was to develop and validate an initial version of a self-management questionnaire for patients with NAFLD. This was a methodological and psychometric study conducted between April and November 2019. The NAFLD self-management questionnaire was developed after a theoretical and literature review and focus group interviews in three phases: (1) item generation, (2) item evaluation, and (3) psychometric evaluation. Participants (N = 155) were recruited from a hospital in Seoul, South Korea. Items were generated based on clinical NAFLD guidelines and the individual and family self-management theory. Construct validity was assessed using exploratory factor analysis. Six-factors were extracted from 22 items: lifestyle management, medical treatment compliance, management of medication and dietary supplements, alcohol consumption management, sleep management, and family support. These factors accounted for 67.4% of the total variance; each factor had an eigenvalue greater than 1, and Cronbach's alpha for the scale was 0.87. The NAFLD self-management questionnaire showed acceptable initial validity and reliability. The instrument can prove useful in the formulation of tailored interventions based on individual patients' care needs. Furthermore, it may be used as an indicator of health outcomes in this population.

Development and preliminary psychometric investigation of the German Satisfaction with Comprehensive Cancer Care (SCCC) Questionnaire.

PURPOSE: The assessment of patient satisfaction during treatment is essential to provide patient-centered high-quality cancer care. Nevertheless, no German instrument assesses patient satisfaction with comprehensive cancer care, which not only includes oncological treatment, but also interpersonal quality of care as well as psychosocial support services. Based on the French REPERES-60, we developed the German Patient Satisfaction with Comprehensive Cancer Care (SCCC) questionnaire. METHODS: The REPERES-60 was translated and the items were adapted to make it applicable to the German healthcare system and across different tumor entities. Scales of the resulting instrument were extracted via principal axis factoring (PAF). Subsequently, we investigated the reliability (Cronbach's Alpha, CA), discriminatory power (corrected item-scale correlations) and convergent validity (pre-specified correlations of the SCCC with different outcomes). RESULTS: The SCCC consisted of 32 items which were subsequently tested among a sample of 333 patients across different tumor entities (response rate: 47%). Average age was 59 years (standard deviation: 14), 63% were male. PAF revealed four multi-item scales named Competence, Information, Access and Support accounting for 71% of the variance. Two single-items scales assess global satisfaction with medical and psychosocial care, respectively. CA across the multi-item scales ranged from .84 to .96. Discriminatory power was sufficiently high, with all r ≥ .5. Convergent validity was largely verified by negative associations of the four multi-item scales with depressive/anxious symptomatology (r ≥ - .18, p < .01) and fatigue/overall symptom burden (r ≥ - .14, p < .01). CONCLUSION: We developed a tool to assess patient satisfaction with comprehensive cancer care in Germany. The SCCC showed satisfactory psychometric properties. Further studies are needed to verify these preliminary findings.

Psychometric properties of the Chinese version of the Trunk Impairment Scale in people with a stroke.

BACKGROUND: The Trunk Impairment Scale (TIS) has been translated into Chinese, but the psychometric properties of the Chinese version of the TIS (TIS-C) have not yet been established. We aimed to examine the reliability and validity of the TIS-C for assessing sitting balance among Chinese people with a stroke. METHODS: A descriptive, cross-sectional design was used. We recruited a convenience sample of 170 subacute stroke patients aged 18 years or over from the neurology departments of four traditional Chinese medicine hospitals in China. Patients completed the TIS-C, the Berg Balance Scale and the Modified Barthel Index. The psychometric properties of the TIS-C were examined to establish test-retest reliability, internal consistency, equivalence, and content, criterion, and construct validity. RESULTS: Intraclass correlation coefficients for inter-rater and intra-rater reliability ranged from 0.75 to 0.89 and from 0.90 to 0.97, respectively. The TIS-C Cronbach α was 0.86. The strong correlation between the total score of the TIS-C and the Berg Balance Scale (rs = 0.81, p < 0.001) or Modified Barthel Index (rs = 0.84, p < 0.001) suggested good concurrent and convergent validity, respectively. Known-group validity was supported by the significant difference (p < 0.001) in TIS-C scores between participants with mild and moderate stroke. CONCLUSIONS: The TIS-C is a valid and reliable tool for assessing static and dynamic sitting balance as well as coordination of trunk movement among stroke survivors with mild and moderate stroke.

Reliability and validity of Midwifery - Obstetrics Collaboration (MOC) scale: A tool to improve collaborative practice.

OBJECTIVE: In recent decades, there has been a call to foster effective collaborative models of practice between midwives and obstetricians/gynecologists (OB/GYNs) in the United States in order to improve clinician satisfaction and outcomes for childbearing women. Currently, there is no existing validated scale that measures the collaboration between obstetricians and midwives on labor and birth units. We sought to develop and validate a Midwifery- Obstetrics Collaboration (MOC) Scale that measures obstetricians' attitudes towards collaboration between obstetricians and midwives on labor and birth units. DESIGN: Validation study. The items in the questionnaire to be validated were developed de novo by the authors, based on their experiences and expertise in collaborative practice as well as by incorporating key principles of effective collaborative practice documented in the literature. The questionnaire was then piloted among 13 content experts. SETTING: Anonymous online survey conducted in the United States. PARTICIPANTS: We validated the questionnaire among 471 obstetricians in the United States from Sept 2019 to March 2020. The respondents included general obstetrician and gynecologists (OB/GYN) attendings, OB/GYN hospitalists, maternal fetal medicine (MFM) fellows and MFM attendings who practice on a labor and birth unit in the United States. MEASUREMENTS AND FINDINGS: We performed reliability analysis of the a priori items. We measured concurrent validity with an existing scale that measures inter-professional collaboration between nurses and physicians. We also correlated our scale with concerns for liability when working in a collaborative practice with midwives. Lastly, we measured discriminant validity with a single item burn out scale. The novel MOC Scale demonstrated construct and concurrent validity, and high inter-item reliability (a=0.93). The MOC Scale correlated with concerns about liability (r=0.63, p <0.001) but was not associated with burnout indicating the uniqueness of the new construct. KEY CONCLUSIONS: The MOC Scale is validated to assess collaboration between obstetricians and midwives on labor and birth units from an obstetrician's perspective IMPLICATIONS FOR PRACTICE: The MOC Scale can be used as a tool in clinical practice, to assess and foster effective collaboration between obstetricians and midwives from an obstetricians' perspective especially when used in conjunction with other tools that take into the account the perspectives of midwives and childbearing women.

Psychometric properties of the Chinese version of Five Facet Mindfulness Questionnaire-short form in cancer patients: a Bayesian structural equation modeling approach.

BACKGROUND: Mindfulness has emerged as an important correlate of well-being in various clinical populations. The present study evaluated the psychometric properties of the 20-item short form of the Five Facet Mindfulness Questionnaire (FFMQ-SF) in the Chinese context. METHODS: The study sample was 127 Chinese colorectal cancer patients who completed the FFMQ-SF and validated physical and mental health measures. Factorial validity of the FFMQ-SF was assessed using Bayesian structural equation modeling (BSEM) via informative priors on cross-loadings and residual covariances. Linear regression analysis examined its convergent validity with the health measures on imputed datasets. RESULTS: The five-factor BSEM model with approximate zero cross-loadings and one residual covariance provided an adequate model fit (PPP = 0.07, RMSEA = 0.06, CFI = 0.95). Satisfactory reliability (ω = 0.77-0.85) was found in four of the five facets (except nonjudging). Acting with awareness predicted lower levels of perceived stress, negative affect, anxiety, depression, and illness symptoms (ß = - 0.37 to - 0.42) and better quality of life (ß = 0.29-0.32). Observing, nonjudging, and nonreacting did not show any significant associations (p > .05) with health measures. Acting with awareness was not significantly correlated (r < 0.15) with the other four facets. CONCLUSION: The present findings provide partial support for the psychometric properties of the FFMQ-SF in colorectal cancer patients. The nonjudging facet showed questionable validity and reliability in the present sample. Further studies with larger sample sizes are needed to elucidate the viability of FFMQ-SF as a measure of mindfulness facets in cancer patients.

Midwives' self-reported knowledge and skills to assess and promote maternal health literacy: A national cross-sectional survey.

BACKGROUND: Little is known about midwives' knowledge and skills to assess and promote maternal health literacy. AIMS: To test the reliability and validity of a new tool to assess midwives' health literacy knowledge, skills and attitudes. METHODS: Using a cross-sectional design, midwives were recruited through professional and social media networks. The online survey included demographic and professional questions and a new measure on midwives' health literacy knowledge, skills and attitudes. Convergent validity was assessed using ten items from the Caring Assessment Scale. Perceived barriers to promoting maternal health literacy were sought. FINDINGS: Three hundred and seven participants completed the survey. A two-factor solution accounted for 41% of variance and resulted in 14 items, including all attitude items, being removed. Cronbach's alpha reliability was acceptable (Skills=.76; Knowledge=.66). Convergent validity was established. Most midwives (77.1%, n=221) reported giving limited attention to formally assessing women's health literacy. Between 30 to 60% of midwives never or only sometimes used specific techniques to promote maternal health literacy. Most (75%, n=201) had not received education about health literacy. DISCUSSION AND CONCLUSIONS: The new Transforming Maternity Care Collaborative Health Literacy tool was valid and reliable. Few midwives formally assessed or promoted women's health literacy. Midwives require education about maternal health literacy assessment and promotion to ensure women understand information being conveyed. A large national survey of midwives using the new tool is recommended.

Development of a survey instrument to evaluate women's experiences of their maternity care.

BACKGROUND: The process of developing a survey instrument to evaluate women's experiences of their maternity care is complex given that maternity care encapsulates various contexts, services, professions and professionals across the antenatal, intranatal and postnatal periods. AIM: To identify and prioritise items for inclusion in the National Maternity Experience Survey, a survey instrument to evaluate women's experiences of their maternity care in the Republic of Ireland. METHODS: This study used an adapted two-phase exploratory sequential mixed methods design. Phase one identified items for possible inclusion and developed an exhaustive item pool through a systematic review, focus groups and one to one interviews, and a gap analysis. Phase two prioritised the items for inclusion in the final item bank through a Delphi study and consensus review. FINDINGS: Following iterative consultation with key stakeholder groups, a bank of 95 items have been prioritised and grouped within eight distinct care sections; care during your pregnancy, care during your labour and birth, care in hospital after the birth of your baby, specialised care for your baby, feeding your baby, care at home after the birth of your baby, overall care and you and your household. CONCLUSION: Robust and rigorous methods have been used to develop a bank of 95 suitable items for inclusion in the National Maternity Experience Survey.

Validation of the MidACE tool - Students' perceptions of the Midwifery Academic role in clinical environments.

BACKGROUND: Situating Midwifery Academics in clinical environments can have an important impact on students' clinical learning. Students' perceptions of this support role in the clinical environment using standardised measures has been under-investigated. AIMS: To develop and test a tool that measures midwifery students' perceptions of the Midwifery Academic role on clinical learning and development of professional knowledge, skills and clinical capability. METHODS: A staged process for tool development included draft item generation, review by expert panel for face and content validity and pilot testing with a convenience sample of undergraduate midwifery students. Dimensionality, internal consistency and test-retest reliability were evaluated. RESULTS: Two hundred and seventy-nine midwifery students completed an online survey (74% response rate). Responses on the ten-item tool loaded strongly on one factor, explaining 69.6% of variance. Cronbach's alpha (0.94) and test-retest reliability (intraclass coefficient=.92; 95%CI .89-.95) were good. Most students agreed that the Midwifery Academic role supported the integration of midwifery theory and practice and critical self-reflection. Areas for improvement included working in partnership with preceptors; assessing students' development; and increased presence in the clinical environment. CONCLUSIONS: This study established reliability and validity of the Midwifery Academic in Clinical Environments (MidACE) tool. Students perceived Midwifery Academics could contribute further to their professional knowledge, skills and clinical capability through a strong collaborative presence in the clinical environment.

Confirmatory Factor Analysis, Reliability, and Validity of the Persian Version of the Coping Strategies Questionnaire for Iranian People With Nonspecific Chronic Neck Pain.

OBJECTIVE: The purpose of this study was to assess the reliability and construct validity of, and perform confirmatory factor analysis of, the Persian version of the Coping Strategies Questionnaire (CSQ) for Iranian people with nonspecific chronic neck pain. METHODS: We performed psychometric testing of the Persian version of the Coping Strategies Questionnaire. Participants were 123 native Persian speakers with chronic neck pain lasting at least 3 months. They were between 18 and 55 years old. The CSQ was administered by self-report. After 5 to 7 days, 94 participants completed the questionnaire in the retest session. Confirmatory factor analysis was done to assess the model fit (χ2 test, comparative fit index, and root-mean-square error of approximation) of the 7-factor solution of the Persian version of the CSQ. The Cronbach α was used for internal consistency; intraclass correlation coefficient, standard error of measurement, and minimal detectable change for reliability; and nonparametric tests of group differences and correlations for construct validity. To assess the construct validity, we examined the ability of the CSQ to discriminate people based on sex, level of education, and physical activity. Correlations with the Short Form Health Survey (SF-12), Tampa Scale for Kinesiophobia, visual analog scale, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, and Neck Disability Index were also determined to test the validity. RESULTS: Confirmatory factor analysis measures-χ2 test, comparative fit index, and root-mean-square error of approximation-were 1.72, 0.76, and 0.07, respectively. Internal consistency was excellent (0.85). All intraclass correlation coefficients were above the acceptable level of 0.70, with the highest reliability obtained for the Praying subscale in both test and retest sessions. The standard error of measurement for the CSQ total score was 2.26, and the minimal detectable change was 6.25. The Cronbach α for the total score and for the subscales ranged from 0.75 to 0.93. Scores of the subscales of the CSQ and other questionnaires showed low correlation except for the physical component of the SF-12. The Catastrophizing subscale had a positive correlation with the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, and Neck Disability Index, and a negative correlation with the SF-12. CONCLUSION: The CSQ has acceptable and good measurement properties to assess coping strategies in Iranian people with nonspecific chronic neck pain. It is a reliable measure, though, for validity only The Catastrophizing subscale showed significant correlation with other scales, but the findings should be interpreted with caution because of the limitations of the study.

Attitudes toward Complementary and Alternative Medicine, Beliefs in Afterlife and Religiosity among Psychiatrists, Psychologists and Theologists.

BACKGROUND: The aim of our study was to investigate the differences in beliefs, attitudes toward CAM, beliefs in afterlife and religiosity among the sample of psychiatrists, psychologists, and theologists. Relationship among these constructs could have impact on the concept of mental health. SUBJECTS AND METHODS: Research was conducted in the Split urban area, Croatia, during 2017 on a sample of psychiatrists (n=51), psychologists (n=55), and theologists (n=25). Participants were presented a figure of the human body, which contained numbers identifying eight different regions of the body. Participants were asked to select which region best represents the location of the self, soul, and mind in the body. We used CAIMAQ (The Complementary, Alternative and Integrative Medicine Attitudes Questionnaire) which contains five subscales. The Afterdeath Beliefs Scale was used to measure the varieties of afterlife beliefs. Analyses showed that applied questionnaires have appropriate reliability and expected factor structure. RESULTS: The most frequent locations of the Soul were 9 (37%, Not located in any centralized region in the body) and 5 (31% chest), whereas Self and Mind were mostly located in the head (43% and 73%). Psychiatrists and psychologists have average scores on positive pole of CAIMAQ but did not differ significantly (p>0.05). There were statistical differences between theologists and psychologists/psychiatrists on two subscales: "nutritional counseling and dietary/food supplements can be effective in the treatment of pathology" and "attitudes toward a holistic understanding of the disease" (p<0.05). There were significant correlations between religion and three CAIMAQ subscales. Although they were mostly religious, psychiatrists and psychologists had a higher average score on Annihilation than theologists. They also did not believe in body resurrection and connection between behavior during life and after death. CONCLUSION: The results of our study could have impact on the concept of mental health and in the future must be deeper evaluated within qualitative research methodology.

Health related QoL in celiac disease patients in Slovenia.

BACKGROUND: Measurements of health-related quality of life (HRQoL) among celiac disease patients using a validated questionnaire have been lacking in Slovenia. This study aims to measure HRQoL in celiac disease (CD) patients using EQ-5D internationally validated questionnaire and comparing it to the HRQoL of the general population. METHODS: In this cross sectional analysis all of the approximately 2000 members of the Slovenian Celiac Society were invited to take part. We used a 3 step approach for recruitment and data collection. HRQoL was evaluated through the EuroQoL EQ-5D-5L instrument (Slovenian version) and analysed using the ordinal logistic regression. RESULTS: Out of 321 patients who gave their consent, 247 celiac patients were included in the study (77%). 68% of the participants were female and 53% of them lived in an urban setting. Most patients originated from North-East Slovenia, whereas approximately 30% of patients came from other Slovenian regions. The EQ-5D respondents' self-reported health status at the time of the study show that most patients have slight or no problems when living with CD. The duration of the gluten-free diet, academic education and rare (< 1 × year) doctor visits affect EQ-5D in a positive way. On the other hand, higher age and chronic rheumatic disease were negatively associated with EQ-5D also when compared to the general population. CONCLUSION: This is the first Slovenian study to measure the HRQoL of Slovenian CD patients, using an internationally validated questionnaire. The results of our study show that HRQoL is slightly impaired among Slovenian patients with CD. Clinical characteristics are better determinants of their HRQoL than socio-demographic factors. Greater awareness of the impact of CD on patients' HRQoL would improve the holistic management of CD patients.

Questionnaires assessing the use of complementary health approaches in pediatrics and their measurement properties: A systematic review.

OBJECTIVES: To identify questionnaires assessing the use of complementary health approaches (CHA) in pediatrics, describe their content, and appraise the methodological quality of the studies and the measurement properties of the questionnaires. METHOD: Major electronic databases were searched from 2011 to 2020. Studies which aimed to assess the use of CHA and studies which reported developing and validating CHA questionnaires in pediatrics were included. Two reviewers independently screened the studies, extracted the data, and rated the methodological quality of the studies and measurement properties of the questionnaires using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. When consensus was not reached, a third reviewer was consulted. RESULTS: Thirty-eight studies were included. From these studies, 35 CHA questionnaires with a variety of different items were identified. Only two studies aimed to evaluate the measurement properties of two questionnaires. One questionnaire, available as a self- and proxy-report, was initially validated in children with juvenile idiopathic arthritis, and the other, available as an interviewer-administered questionnaire, was validated in children with cancer. According to the COSMIN, the methodological quality of both studies was inadequate or doubtful, and both questionnaires was not thoroughly validated. CONCLUSION: This systematic review showed a lack of a thoroughly validated CHA questionnaire in pediatrics. However, two questionnaires were found to hold promise. To address this gap, one of the existing questionnaires should be adapted and further validated.

The Bournemouth Questionnaire for Neck Pain: Cross-cultural Adaptation, Reliability, and Validity of the Turkish Version.

OBJECTIVE: The aim of this study was first to translate and culturally adapt the BQN, and then to investigate the validity and reliability of the Turkish version of the BQN in Turkish individuals with chronic neck pain. METHODS: The English version of the BQN was translated into Turkish with permission from its authors. That translation was assessed using 85 participants with a mean age of 46.75 years who had chronic neck pain. At the same time, the participants were assessed sociodemographically and with the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). A test-retest procedure was performed with 62 participants who underwent a second assessment with the BQN within 24 hours of the first assessment, to test its reliability. RESULTS: Internal consistency was strong and all Cronbach alpha values were between 0.97 and 0.99. The BQN showed high test-retest reliability (intraclass correlation coefficient ˃ 0.92) for all domains. The total mean (± standard deviation) scores for the 3 questionnaires were as follows: BQN, 30.9 (± 11.18); NPAD, 48.16 (± 12.93); NDI, 17.85 (± 6.29). The results of the Turkish version of the BQN illustrated adequate external construct validity and sensitivity. A Turkish translation of the test has not previously been available for chronic pain. CONCLUSION: The BQN was successfully translated and culturally adapted into Turkish. The reliability and validity were tested against the NPAD and the NDI. The Turkish version of the BQN is multidimensional, short, practical, and suitable for use with individuals with neck pain.

A Screening Tool for Patients With Lumbar Instability: A Content Validity and Rater Reliability of Thai Version.

OBJECTIVE: Lumbar instability is a condition that has been extensively reported in its prevalence and its effect on patients. To date, however, a clinical screening tool for this condition has not been developed for use in Thailand. The objectives of this study were to translate and test the content validity and rater reliability of a screening tool for evaluating Thai patients with lumbar instability. METHODS: The investigators selected the lumbar instability questionnaire from an original English version. Elements of the tool comprised the dominant subjective findings reported by this clinical population. The screening tool was translated into the Thai language following a process of cross-cultural adaptation. The index of item-objective congruence (IOC) was checked for content validity by 5 independent experts. Seventy-five Thai patients with chronic nonspecific low back pain were asked to report their symptoms. The interview procedure using the tool was conducted by expert and novice physical therapists, which informed the intraclass correlation coefficient (ICC) for inter- and intrarater reliability. RESULTS: The IOC was 0.95. The interrater ICC between expert and novice physical therapists was 0.92 (95% CI = 0.88-0.95). The intrarater ICC of novice physical therapist was 0.91 (95% CI = 0.86-0.94). CONCLUSION: The Thai version of the screening tool for patients with lumbar instability achieved excellent content validity and interrater and intrarater reliability. This screening tool is recommended for use with Thai patients with low back pain to identify the subpopulation with lumbar instability.

Cross-Cultural Adaptation and Validation of the Nepali Version of the Pelvic Girdle Questionnaire.

OBJECTIVE: The purpose of this study was to translate, cross-culturally adapt, and assess the reliability and validity of the Pelvic Girdle Questionnaire (PGQ) in pregnant Nepalese women. METHODS: The cross-cultural adaptation process was conducted according to the Guillemin guidelines. Reliability and validity were assessed using cross-sectional design. The participants responded to questionnaires of sociodemographics, the Nepali version of the PGQ, the Oswestry Disability Index, the Patient-Specific Functional Scale, the 5-item version of the Edinburgh Depression Scale, and the Numerical Pain Rating Scale. The internal consistency was assessed with Cronbach's alpha. The test-retest reliability was calculated using the intraclass correlation coefficient and smallest detectable change. Construct validity was assessed by testing 9 a priori hypotheses that examine correlations between the PGQ activity and symptom subscales, and also among the PGQ subscales and Oswestry Disability Index, Numerical Pain Rating Scale, Patient-Specific Functional Scale, and 5-item version of the Edinburgh Depression Scale. Spearman and Pearson's correlation were used to assess the correlations. RESULTS: A sample of 111 pregnant women were included in the study. The Cronbach's alpha for the Nepali version of the total PGQ was good (α = 0.83), and the test-retest reliability was acceptable (ICC2.1, 0.72) with a measurement error of SDC95% 18.6 points. Seven of the 9 hypotheses found support, which confirms acceptable construct validity of the Nepali PGQ. CONCLUSION: The Nepali version of the PGQ is a reliable and valid tool for assessing pelvic girdle pain in pregnant Nepalese women.