Barthel Index is a valid and reliable tool to measure the functional independence of cancer patients in palliative care.

BACKGROUND: Our objective was to verify the reliability, internal consistency and construct validity of the Barthel Index in Brazilian cancer patients in palliative care. METHODS: We included patients with cancer, both sexes, and age greater than or equal to 18 years. We used to evaluate patients the Barthel Index, Karnofsky Performance Scale (KPS), and European Organization for Research in the Treatment of Cancer Questionnaire-core 15 (EORTC-QLQ-C15-PAL). The measurement properties evaluated in this study were test-retest and inter-rater reliability and construct validity (tested by means of correlations with other instruments). RESULTS: We included 220 patients for construct validity and a subsample of 27 patients for reliability analyses. We observed adequate reliability (intraclass correlation coefficient ≥ 0.962) and internal consistency (Cronbach's alpha = 0.942). There were adequate correlations between the Barthel Index and the KPS (rho = 0.766), and the functional capacity domain of the EORTC-QLQ-C15-PAL (rho = -0.698). CONCLUSION: The Brazilian version of the Barthel Index presents adequate test-retest and inter-rater reliability, acceptable internal consistency, and valid construct for measuring functional independence in cancer patients.

Fear of Return to Sport Scale (FRESS): a new instrument for use in injured professional or recreational athletes in rehabilitation.

Objective: To create, develop, and validate the Fear of Return to Sport Scale (FRESS) for injured professional or recreational athletes in rehabilitation. Methods: This is a questionnaire validation study. To determine the structural and construct validity, 192 injured professional or recreational athletes of different sports modalities were included. We used a subsample with 32 participants to analyze test-retest reliability and internal consistency. Main outcome measures were the FRESS, Numerical Pain Scale (NPS), Pain-Related Catastrophizing Thoughts Scale (PCTS), Self-Estimated Functional Inability because of Pain Questionnaire for athletes (SEFIP-sport), and Hospital Anxiety and Depression Scale (HADS). Results: Initially, 25 questions were proposed by the specialists. Of these, 4 questions were excluded due to similarity with others. After applying the content validity coefficient, 8 questions were excluded for presenting a value lower than 0.80, leaving 13 items. The exploratory factor analysis identified the one-dimensional structure of the FRESS with 13 items. However, five items were excluded for presenting high covariance with the error of several other FRESS items in the confirmatory factor analysis. Thus, the final version of the FRESS was defined with one domain and eight items. Regarding the construct validity, we observed a magnitude of correlation varying between 0.257 and 0.470 between the FRESS and the instruments used here. We observed adequate test-retest reliability (intraclass correlation coefficient = 0.896) and internal consistency (Cronbach's alpha = 0.868). Ceiling and floor effects were not observed. Conclusion: The FRESS with one domain and eight items has acceptable measurement properties and its use in clinical and sports environments to measure the fear of returning to sport in injured professional or recreational athletes is supported. Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-022-00975-4.