Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

A Psychometric Analysis of the Organizational Readiness for Implementing Change (ORIC) in a Child Welfare Setting.

PURPOSE: This study consisted of a psychometric analysis of the brief and expanded versions of the Organizational Readiness for Implementing Change (ORIC) to assess the scale's validity and reliability in a child welfare setting. METHOD: Based on responses from a sample of 313 child welfare professionals, factorial structure was assessed through exploratory and confirmatory factor analysis. Construct validity was assessed through correlations with theoretically linked concepts, and internal consistency was assessed through Cronbach's alpha. RESULTS: Factor analysis yielded a unidimensional structure for the brief version and a two-factor structure for the expanded version. However, the models did not meet the standards for sufficient fit, as evidenced by the fit indices. Both the brief and expanded versions were significantly and positively correlated with theoretically linked concepts. Internal consistency of the brief (α = .96) and expanded versions (α = .96) was excellent. DISCUSSION: Though the measure holds promise with respect to construct validity and internal consistency, further testing of the factorial structure in a variety of child welfare samples is warranted. CONCLUSION: This study supports the field of child welfare with information regarding one possible measure of organizational readiness, an important concept in implementation science.

The Grenada Learning and Memory Scale: Psychometric features and normative data in Caribbean preschool children.

OBJECTIVE: Neuropsychological assessment of preschool children is essential for early detection of delays and referral for intervention prior to school entry. This is especially pertinent in low- and middle-income countries (LMICs), which are disproportionately impacted by micronutrient deficiencies and teratogenic exposures. The Grenada Learning and Memory Scale (GLAMS) was created for use in limited resource settings and includes a shopping list and face-name association test. Here, we present psychometric and normative data for the GLAMS in a Grenadian preschool sample. METHODS: Typically developing children between 36 and 72 months of age, primarily English speaking, were recruited from public preschools in Grenada. Trained Early Childhood Assessors administered the GLAMS and NEPSY-II in schools, homes, and clinics. GLAMS score distributions, reliability, and convergent/divergent validity against NEPSY-II were evaluated. RESULTS: The sample consisted of 400 children (190 males, 210 females). GLAMS internal consistency, inter-rater agreement, and test-retest reliability were acceptable. Principal components analysis revealed two latent factors, aligned with expected verbal/visual memory constructs. A female advantage was observed in verbal memory. Moderate age effects were observed on list learning/recall and small age effects on face-name learning/recall. All GLAMS subtests were correlated with NEPSY-II Sentence Repetition, supporting convergent validity with a measure of verbal working memory. CONCLUSIONS: The GLAMS is a psychometrically sound measure of learning and memory in Grenadian preschool children. Further adaptation and scale-up to global LMICs are recommended.

Cultural adaptation and psychometric analysis of Communication Activities of Daily Living third edition in Spanish and Catalan for people with aphasia.

BACKGROUND: In the Spanish and Catalan context, there is currently a lack of standardized, linguistically adapted tools to assess people with communication disorders. This lack is especially evident when it comes to instruments designed to assess functional communication. AIMS: The main objective of this study is to adapt the instrument entitled Communication Activities of Daily Living 3rd edition (CADL-3) into European Spanish (CADL-3VE) and Catalan (CADL-3VC), thus providing a new tool to assess the functional communication of patients with aphasia in the Spanish and Catalan populations. METHODS & PROCEDURES: A total of 152 people, all residents of Catalonia, took part in the study. The CADL-3VE test was administered to 125 Spanish-speaking participants, who were divided into two groups, one consisting of patients with aphasia and the other a control group. The CADL-3VC test was administered to 27 Catalan-speaking patients with aphasia. Other tests and assessment scales were used for the external validation of the test. OUTCOMES & RESULTS: Reliability scores were recorded for both new versions of the test. There was a very strong correlation between the CADL-3VE test and external criteria. The scores for both of the new versions showed significant differences in terms of performance between the aphasia and control groups. Both versions displayed similarities with the original test with respect to most of the psychometric analyses carried out. CONCLUSION & IMPLICATIONS: The test makes it possible to assess everyday communicative functioning and participation in real-world contexts. As such, it helps inform the creation of personalized, interdisciplinary treatment plans aimed at functional objectives that consider the patient's context. WHAT THIS PAPER ADDS: What is already known on the subject In order to effectively assess aphasia based on a bio-psycho-social perspective, it is necessary to examine functional communication. In other words, there is a need to explore the kinds of communication difficulties that people face in their everyday lives. Communication Activities of Daily Living (CADL-3) is an English-language test that was developed to assess functional communication by simulating certain everyday activities. What this study adds This paper offers an analysis of the items, reliability and validity of the Spanish and Catalan versions of the CADL-3 test. What are the clinical implications of this work? This new instrument has the potential to play an essential role in assessing the everyday functional communication of people with aphasia in Spain.

Psychometric Properties of a Digital Goniometer in Upper and Lower Cervical Range of Motion Measurement.

OBJECTIVE: The purpose of this study was to examine the intrarater reliability and criterion validity of a digital goniometer for measuring cervical range of motion including an active sitting version of the cervical flexion rotation test, an important clinical measure for capturing upper cervical dysfunction. METHODS: A cross-sectional study (n = 18; 78% women) examined total cervical and upper cervical active ranges of motion (flexion, extension, side bending, rotation) measured concurrently using 3 measurement methods (a digital goniometer, the cervical range-of-motion instrument, and 3-dimensional motion analysis). Intraclass correlation coefficient (2,1), Pearson correlation coefficients (digital goniometer versus 3-dimensional motion analysis), and minimum detectable change were calculated. RESULTS: There was moderate to excellent intrarater reliability for the digital goniometer and good to excellent criterion validity of the digital goniometer for all cervical motions except left lateral flexion which was moderate (0.70). The sitting upper cervical flexion rotation test showed good to excellent reliability and validity. The minimal detectable change for the digital goniometer ranged from 3 to 8 degrees across cervical motions. CONCLUSION: In individuals without neck pain, a digital goniometer device was a reliable, valid, and an easy-to-administer clinical tool for measuring total cervical range of motion as well as for capturing upper cervical motion.

Usability Assessment Methods for Mobile Apps for Physical Rehabilitation: Umbrella Review.

BACKGROUND: Usability has been touted as one determiner of success of mobile health (mHealth) interventions. Multiple systematic reviews of usability assessment approaches for different mHealth solutions for physical rehabilitation are available. However, there is a lack of synthesis in this portion of the literature, which results in clinicians and developers devoting a significant amount of time and effort in analyzing and summarizing a large body of systematic reviews. OBJECTIVE: This study aims to summarize systematic reviews examining usability assessment instruments, or measurements tools, in mHealth interventions including physical rehabilitation. METHODS: An umbrella review was conducted according to a published registered protocol. A topic-based search of PubMed, Cochrane, IEEE Xplore, Epistemonikos, Web of Science, and CINAHL Complete was conducted from January 2015 to April 2023 for systematic reviews investigating usability assessment instruments in mHealth interventions including physical exercise rehabilitation. Eligibility screening included date, language, participant, and article type. Data extraction and assessment of the methodological quality (AMSTAR 2 [A Measurement Tool to Assess Systematic Reviews 2]) was completed and tabulated for synthesis. RESULTS: A total of 12 systematic reviews were included, of which 3 (25%) did not refer to any theoretical usability framework and the remaining (n=9, 75%) most commonly referenced the ISO framework. The sample referenced a total of 32 usability assessment instruments and 66 custom-made, as well as hybrid, instruments. Information on psychometric properties was included for 9 (28%) instruments with satisfactory internal consistency and structural validity. A lack of reliability, responsiveness, and cross-cultural validity data was found. The methodological quality of the systematic reviews was limited, with 8 (67%) studies displaying 2 or more critical weaknesses. CONCLUSIONS: There is significant diversity in the usability assessment of mHealth for rehabilitation, and a link to theoretical models is often lacking. There is widespread use of custom-made instruments, and preexisting instruments often do not display sufficient psychometric strength. As a result, existing mHealth usability evaluations are difficult to compare. It is proposed that multimethod usability assessment is used and that, in the selection of usability assessment instruments, there is a focus on explicit reference to their theoretical underpinning and acceptable psychometric properties. This could be facilitated by a closer collaboration between researchers, developers, and clinicians throughout the phases of mHealth tool development. TRIAL REGISTRATION: PROSPERO CRD42022338785; https://www.crd.york.ac.uk/prospero/#recordDetails.

Psychometric characteristics of the Spanish version of the HIV Symptom Index.

BACKGROUND: The aim of this study was to determine the psychometric properties of the Spanish-language version of the HIV-Symptom Index (HIV-SI) questionnaire in Spanish patients undergoing antiretroviral therapy. METHODS: Between 2014 and 2016, an observational, multicenter, prospective cohort study was conducted in seventeen Spanish hospitals to validate HIV-SI questionnaire in terms of: construct validity (confirmatory factor analysis), internal consistency (Cronbach's alpha), convergent validity (Pearson's correlation coefficient) and Known-group validity. In addition, a sensitivity to change analysis was also performed. RESULTS: A total of 232 patients were included in the study. They had a mean age of 46.17 (SD9.82) and were 75% male. The median overall score for the HIV-SI was 10 (IQR 4- 19.5) and the most common symptoms reported were feelings of nervousness or anxiety, fatigue or energy loss, feeling sad or depressed, stomach pain or bloating, and difficulty sleeping. In the current study, the Spanish HIV-SI questionnaire showed a high internal consistency (α = 0.89) and adequate construct validity (CFI and TLI > 0.90). When contrasted with the MOS-HIV questionnaire, an inverse correlation was found. It showed a good association with the mental (r=-0.61; P < 0.0001) and physical score (r=-0.60; P < 0.0001). In a multivariate analysis, the age of the patient, female condition, hepatitis C coinfection, concomitant treatment and non-adherence resulted in a higher HIV-SI score. CONCLUSIONS: Our study has shown that the Spanish HIV-SI is a valid and reliable self-administered PROM for routine measurement of patient- reported symptoms among Spanish patients on antiretroviral treatment.

An open-access database of video stimuli for action observation research in neuroimaging settings: psychometric evaluation and motion characterization.

Video presentation has become ubiquitous in paradigms investigating the neural and behavioral responses to observed actions. In spite of the great interest in uncovering the processing of observed bodily movements and actions in neuroscience and cognitive science, at present, no standardized set of video stimuli for action observation research in neuroimaging settings exists. To facilitate future action observation research, we developed an open-access database of 135 high-definition videos of a male actor performing object-oriented actions. Actions from 3 categories: kinematically natural and goal-intact (Normal), kinematically unnatural and goal-intact (How), or kinematically natural and goal-violating (What), directed toward 15 different objects were filmed from 3 angles. Psychometric evaluation of the database revealed high video recognition accuracy (Mean accuracy = 88.61 %) and substantial inter-rater agreement (Fleiss' Kappa = 0.702), establishing excellent validity and reliability. Videos' exact timing of motion onset was identified using a custom motion detection frame-differencing procedure. Based on its outcome, the videos were edited to assure that motion begins at the second frame of each video. The videos' timing of category recognition was also identified using a novel behavioral up-down staircase procedure. The identified timings can be incorporated in future experimental designs to counteract jittered stimulus onsets, thus vastly improving the sensitivity of neuroimaging experiments. All videos, their psychometric evaluations, and the timing of their frame of category recognition, as well as our custom programs for performing these evaluations on our, or on other similar video databases, are available at the Open Science Framework (https://osf.io/zexc4/).

Development and validation of the modified Yale Food Addiction Scale for Children 2.0.

OBJECTIVE: Scientific interest in the concept of food addiction is growing, but more studies are needed in youth samples. Brief, psychometrically valid, and developmentally appropriate measures are needed to support the assessment of food addiction in large-scale studies of youth that need to minimize participant burden. While a brief version of the Yale Food Addiction Scale 2.0 (YFAS 2.0) exists for adults, no comparable scale exists for youth. Thus, the current study aimed to develop a brief and valid measure of food addiction for use in youth populations (the modified YFAS for children 2.0). METHOD: Data stem from the Food Addiction Denmark (FADK) Project, where random samples of 559 adolescents from the general population and 413 adolescents from a population with mental disorder completed the 35-item original YFAS for children 2.0 (YFAS-C 2.0). An abbreviated 13-item version was developed, and the psychometric properties of the modified YFAS-C 2.0 (mYFAS-C 2.0) were then evaluated. RESULTS: The mYFAS-C 2.0 exhibited a one-factor structure and was found to have sound psychometric properties regarding internal consistency and convergent, discriminant, and incremental validity. This was evident in both the general adolescent population sample and the sample of adolescents with mental disorders. CONCLUSIONS: The mYFAS-C 2.0 provides a brief and psychometrically valid measure of food addiction for youth, which may be beneficial for study designs (e.g., epidemiological samples) that aim to minimize participant burden. Future research on the test-retest reliability of the mYFAS-C 2.0 and its psychometric properties in younger children are important next steps.

Appraisal and evaluation of the quality of life in pulmonary arterial hypertension instruments: A systematic review using COSMIN methodology.

AIM: The aim of this review was to identify specific instruments currently available for measuring quality of life in patients with pulmonary arterial hypertension (PAH) and to evaluate their psychometric properties in order to provide robust evidence for their application in clinical practice. BACKGROUND: Pulmonary arterial hypertension is a rare pulmonary vascular disorder predominantly affecting women aged 30-50 years. It leads to elevated pulmonary artery pressure, causing increased cardiac workload. Symptoms such as dyspnea and fatigue progressively deteriorate. Given the substantial impact on patient well-being, quality of life assessment is a critical concern. Generic quality of life measures often fail to capture the unique challenges associated with PAH. Therefore, identifying a PAH-specific quality of life instrument is essential for optimising patient management. DESIGN: A systematic literature review. METHODS: A systematic review was performed to assess the psychometric properties of quality of life instruments for PAH patients, following the 2018 Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The literature search was conducted across Pubmed, Scopus, CINAHL, EMBASE, and APA PsycINFO databases. RESULTS: This review included four quality of life instruments: CAMPHOR, LPHQ, emPHasis-10, and PAH-SYMPACT. CAMPHOR and PAH-SYMPACT received a GRADE A rating, while LPHQ and emPHasis-10 were rated GRADE B. Despite some sample size limitations, these instruments demonstrated varying degrees of internal reliability, validity, and content coverage for assessing quality of life in pulmonary arterial hypertension patients. CONCLUSIONS: This review provides an overview of available tools for assessing quality of life in patients with pulmonary arterial hypertension. Critical evaluation of these tools highlights incomplete psychometric assessments and methodological limitations in reference studies. Future research should prioritise more rigorous methodologies to ensure comprehensive psychometric evaluations.

Lowering the burden: Shorter versions of the Program Sustainability Assessment Tool (PSAT) and Clinical Sustainability Assessment Tool (CSAT).

BACKGROUND: Although significant advances have been made in the conceptualization of sustainability, having pragmatic, psychometrically valid tools remains a need within the field. Our previous work has developed frameworks and tools to assess both program sustainability and clinical sustainability capacity. This work presents new, psychometrically tested short versions of the Program Sustainability Assessment Tool (PSAT) and the Clinical Sustainability Assessment Tool (CSAT). METHODS: These methods were conducted in identical, parallel processes for the CSAT and PSAT. Previously collected data for these instruments was obtained across a variety of settings, contexts, and participants. We first conducted testing to determine cronbach's alpha of shortened domains (3 items each) and then conducted Confirmatory Factor Analysis to ensure that the domains were still appropriate for the tool. After, the team met to review the results and determine the final versions of the short PSAT and short CSAT. RESULTS: The short PSAT retained cronbach's alpha's of 0.82 - 0.91 for each domain of the tool, with which maintains excellent reliability for the tool. Confirmatory factor analysis highlights that the short PSAT retains conceptual distinction across the 8 domains, with CFI scores greater than 0.90, RMSEA scores below 0.6, and SRMR scores less than 0.08. The short CSAT had cronbach's alpha of 0.84 - 0.92 for each of the domains of the tool, also suggesting excellent reliability of the domains within the measure after dropping two items/domain. Confirmatory factor analysis of the short CSAT meets the same specifications as above, again highlighting conceptual distinction across the domains. CONCLUSION: Each tool was able to be shortened to three items per domain while maintaining strong psychometric properties. This results in a tool that takes less time to complete, meeting one of the key calls for pragmatic measures within implementation science. This advances our abilities to measure and test sustainability within implementation science.

Chromosome 8p Syndromes Clinical Presentation and Management Guidelines.

Rearrangements of the p-arm of Chromosome 8 can result in a spectrum of neurodevelopmental challenges, along with increased risk of epilepsy, structural brain and cardiac malformations, persisting developmental delays, and other health challenges. The majority of patients reported on in this sample are characterized by an inverted-duplication deletion rearrangement, but deletions, duplications, and mosaic ring changes in 8p result in similar phenotype. In this report, we add to the phenotypic and functional description of these patients according to their specific chromosomal rearrangement, share neuro-psychometric values, and propose surveillance care guidelines for caregivers and medical providers of patients with Chromosome 8p Syndromes. Observations from clinical experience with 24 patients seen at our 8p-dedicated Multi-Disciplinary Neurogenetics program are shared.

Dating Violence in University Students: Validation of the DVQ-VP Scale In Bolivia.

Background: Dating violence is an increasingly studied subject as it is related to the initial stages of what could later become intimate partner violence and even intrafamily violence. It is believed that love can cause behavioral patterns that will eventually become habits. The objective: of this study is to have valid and reliable instruments, adapted to different contexts, to accurately and promptly evaluate victims and aggressors and guide an appropriate intervention. Method: we worked with 2216 volunteer university students from Bolivia who had at least one relationship in the past twelve months. Exploratory and confirmatory factor analysis were conducted to adapt the Dating Violence Questionnaire for Victimization and Perpetration (DVQ-VP) for the Bolivian context. Results: the appropriate psychometric characteristics were confirmed for evaluating violence in dating relationships using a reduced version of 18 items in a five-factor model for victims and a single-factor scale for the evaluation of aggressors, which were found to be invariant for sex. Conclusions: a significant variability was found among the studies, making them less comparable. The implications and limitations of the study are noted.

Antecedentes: La violencia en el noviazgo es un tema que se estudia cada vez más, ya que se relaciona con las etapas iniciales de lo que más tarde podría convertirse en violencia de pareja e incluso violencia intrafamiliar. Se cree que el amor puede causar patrones de comportamiento que eventual mente se convertirán en hábitos. El objetivo: de este estudio es contar con instrumentos válidos y fiables, adaptados a diferentes contextos, para evaluar con precisión y prontitud a las víctimas y agresores, además de orientar una intervención adecuada. Método: Trabajamos con 2216 estudiantes universitarios voluntarios de Bolivia que tuvieron al menos una relación de pareja en los últimos doce meses. Se realizó análisis factorial exploratorio y confirmatorio para adaptar el DVQ-VP al contexto boliviano. Resultados: Se confirmaron las características psicométricas adecuadas para evaluar la violencia en las relaciones de noviazgo utilizando una versión reducida de 18 ítems en un modelo de cinco factores para las víctimas y una escala de un solo factor para la evaluación de los agresores, que se encontraron invariantes para el sexo. Conclusiones: Se señalan las implicaciones y limitaciones del estudio.

On the Dimensional Approach to Adolescent Psychopathology: a Systematic Review.

In child and adolescent psychiatry, the clinical presentation of disorders in adolescents is complex, and categorical approaches have limitations by focusing on individual disorders. The intricate system of psychopathology during adolescence can be effectively modeled using network science, which integrates statistical and computational techniques through artificial intelligence tools. Network analysis of psychometric data from psychiatric disorder assessment tests has been extensively studied in both general psychiatry and child psychiatry. However, a comprehensive evaluation of existing network approaches that model multiple psychiatric or neurodevelopmental disorders encountered in adolescents remains necessary. We conducted a systematic literature review across two different databases - PubMed and Scopus - using the keywords "network analysis", "adolescent" and "psychiatry" to address this question. The selection of articles was based on age criteria and the number of pathological entities studied. Out of 406 articles, 69 were selected and analyzed. The results from some of these studies are described in this article. Notably, we observe significant heterogeneity in the findings, highlighting both the richness and complexity of adolescent psychopathology. Further research is needed to validate the already proposed results and standardize the models studied.

Development and Psychometric Properties of the Therapeutic Relationship Assessment Scale-Patient (TRAS-Patient).

The therapeutic relationship plays a crucial role in nursing care for people with mental illness. Adopting a systemic and person-centred approach that considers the individual experiences and needs of the person is paramount. However, no instruments were found in the literature designed to evaluate the nurse-patient therapeutic relationship from the perspective of a person with mental illness. This study aimed to develop and evaluate the psychometric properties of an instrument for assessing the quality of the nurse-patient therapeutic relationship from the patient's perspective. An e-Delphi study was conducted to develop the assessment tool, and a psychometric study was carried out to examine its psychometric properties. The sample comprised 240 adults with mental illness. Internal consistency was assessed using Cronbach's alpha and the Omega coefficient. The final structure of the assessment instrument included 24 items distributed across two factors, explaining 64.2% of the variance. Cronbach's alpha was 0.94, and the Omega coefficient was 0.96. The intraclass correlation coefficient was 0.84 (95% CI: 0.66-0.92). The therapeutic relationship assessment scale (TRAS-Patient) shows good psychometric properties. This is a relevant tool for assessing the quality of the nurse-patient therapeutic relationship from the patient's perspective, thus promoting a patient-centred approach and responding to the patient's needs. Mental health nurses can access a tool for evaluating the nurse-patient therapeutic relationship centred on disciplinary knowledge. This enables patient involvement in care, enhanced care and person-centred practice.

Development and validation of the Thai Halitosis Associated Life-Quality Test (T-HALT): an evaluation of psychometric properties.

BACKGROUND: Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. MATERIALS AND METHODS: This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. RESULTS: T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. CONCLUSION: T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.

Measuring internalized health-related stigma across health conditions: development and validation of the I-HEARTS Scale.

BACKGROUND: Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. METHODS: An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. RESULTS: Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1-7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. CONCLUSIONS: The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. STUDY PRE-REGISTRATION: https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f .

Workplace dignity scale in Iranian nurses: translation and psychometric evaluation.

BACKGROUND: Workplace dignity is defined as a person's perception of respect and trust, equal and fair treatment, valuing the person, independence, freedom of expression, and decision-making enjoyed by the employee in the workplace. Therefore, this study aimed to develop the Workplace Dignity Scale (WDS) and evaluate its psychometric properties. METHODS: In this methodological study, WDS was translated based on Beaton et al. Guideline. After assessing face and content validity (using CVI, CVR, modified kappa, and item impact), 250 nurses were selected by random sampling from Kashan hospitals in 2023. Then, WDS was assessed through expletory factor analysis (EFA), known-groups comparison, internal consistency, and stability. The ceiling and floor effects were also examined. Data were analyzed using SPSS v16 by Kruskal-Wallis test, Cronbach's alpha, McDonald's Omega, interclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable changes (MDC). RESULTS: The scale's CVI, CVR, and modified kappa were above 0.79. Item impact was higher than 1.5. EFA extracted three factors, including "general dignity, respect, and indignity", that could explain 70.6% of the total variance in scale. WDS could differentiate between the three groups in terms of occupation satisfaction status. Cronbach's alpha, McDonald's Omega, ICC, SEM, and STC of scale were 0.949, 0.950, 0.970, 2.793, and 7.742, respectively. CONCLUSION: The Persian version of the WDS has shown validity and reliability for measuring workplace dignity among nurses in the Iranian context.

Measuring clinical outcomes in adult ADHD clinics: psychometrics of a new scale, the adult ADHD Clinical Outcome Scale.

BACKGROUND: Adult attention-deficit hyperactivity disorder (ADHD) clinics are in their infancy in Ireland and internationally. There is an urgent need for clinical evaluation of these services. Until now, clinical outcomes have relied mainly on functional scales and/or quality of life. However, adult ADHD is a longstanding disorder with many comorbidities. Although medication for ADHD symptoms can have immediate effects, co-occurring problems may take considerably longer to remediate. AIMS: To present the psychometrics of a short outcome measure of key clinical areas including symptoms. METHOD: The ADHD Clinical Outcome Scale (ACOS), developed by the authors, is a clinician-rated scale and was administered in consecutive adults attending an ADHD clinic. A modified version was completed by the participant. A second clinician independently administered the scale in a subsample. ACOS consists of 15 items rated on a Likert scale. Two self-report scales, the Adult ADHD Quality of Life Questionnaire (AAQoL) and Weiss Functional Impairment Rating Scale (WFIRS), were also administered. RESULTS: The mean age of 148 participants was 30.1 years (s.d. = 9.71), and 81 were female (54.7%). The correlation for interrater reliability was r = 0.868, and that between the participant and clinician versions was r = 0.663. The intraclass correlation coefficient for the internal consistency was 0.829, and the correlations for concurrent validity with total AAQoL and WFIRS scores were r = -0.573 and r = 0.477, respectively. Factor analysis revealed four factors: (a) attentional/organisational problems; (b) hyperactivity/impulsivity; (c) comorbidities; and (d) alcohol/drug use, self-harm and tension in relationships. CONCLUSIONS: The psychometrics of the ACOS are promising, and the inclusion of typically co-occurring clinical domains makes it suitable for use as a clinician-rated outcome measure in every contact with patients attending adult ADHD clinics.

Psychological problems and their impact on oral mucosal disease patients' quality of life: A cross-sectional study in the Chinese population.

Objectives: We aimed to investigate the presence of common psychological factors (i.e., stress, depression, anxiety) and their impact on the Oral health-related quality of life (OHRQoL) in patients diagnosed with four oral mucosal diseases (OMDs): recurrent aphthous ulcers (RAU), oral lichen planus (OLP), oral leukoplakia (OLK), and oral submucous fibrosis (OSF). Methods: A total of 229 patients with clinically diagnosed OMDs were enrolled in this study, consisting of 55 RAU, 68 OLK, 50 OLP, and 56 OSF patients. The patients were statistically analyzed for psychological problems and OHRQoL using the Visual Analog Scale (VAS)､ the 5-item Oral Health Impact Profile (OHIP-5) and the Depression Anxiety Stress Scale-21 (DASS-21) scales. Results: There were 229 valid questionnaires collected, consisting of 83 females and 146 males with a mean age of 45.24 (SD = 11.88) years. Multiple regressions between DASS-21 scores and OHIP-5 scores revealed generally negative impacts of psychological problems on OHRQoL, with depression on OLP (ß = 0.47), OLK (ß = 0.65) and OSF (ß = 0.38), stress on RAU (ß = 0.29), OLP (ß = 0.72), OLK (ß = 0.38) and OSF (ß = 0.60), and anxiety on OLP (ß = 0.33), OLK (ß = 0.49) and OSF (ß = 0.51). Conclusions: Psychological problems like depression, stress, and anxiety were found to be prevalent in OMDs patients and adversely affected their OHRQoL. The results support the biopsychosocial medical model in the treatment of OMDs patients. Clinical significance: The present study reinforced the crucial roles of psychological factors in impacting OMDs patients' OHRQoL. Therefore, it is necessary to monitor patients' psychological status and OHRQoL using questionnaires like DASS-21 and OHIP-5. Followed by psychological interventions, the treatment is expected to be enhanced.