Cross-cultural adaptation and validation of a self-administered Urdu version of the child oral impacts on daily performances index among 11-12-year-old children in Lahore, Pakistan.

The Child Oral Impacts on Daily Performances (Child-OIDP) index was developed to assess children's oral health-related quality of life. This study aimed to culturally adapt the self-administered Child-OIDP index into Urdu, evaluate its psychometric properties, and provide an initial estimate of oral impacts among 11-12-year-old children in Lahore, Pakistan. The translation of the Child-OIDP index from English to Urdu was performed, and the content and face validity of the initial Urdu version were evaluated by experts and 11-12-year-old children, respectively. The psychometric properties of the Urdu Child-OIDP were assessed by administering the index to 264 children aged 11-12 from five schools in the Lahore district. Psychometric properties were evaluated using criterion and construct validity, internal consistency, test-retest reliability, and global self-rated oral items, followed by an oral examination. The standardized Cronbach's alpha was 0.77, and the weighted Kappa was 0.94 (intraclass correlation coefficient = 0.98). The index exhibited significant associations with subjective outcome measures, dental problem history, and dental caries status (p = 0.001). Children reporting poor oral health, lower satisfaction with oral health, and experiencing oral impacts demonstrated higher Child-OIDP scores. Additionally, children with dental caries and perceived treatment needs exhibited higher Child-OIDP scores, indicating poorer Oral Health-Related Quality of Life (OHRQoL). The prevalence of oral impacts was 88.3% (mean score = 17.8, standard deviation (SD) =14.7). Eating performance was the most affected while speaking was the performance least affected, while toothache and sensitive teeth were identified as the two most common causes of oral impacts. Toothache was the primary cause of condition-specific impacts, responsible for the majority of oral impacts. This study demonstrates that the self-administered Urdu Child-OIDP index is a valid and reliable tool for assessing OHRQoL among 11-12-year-old children in Lahore, Pakistan.

Where should I search next? Messages embedded in storybooks influence children's strategic exploration in Turkey and the United States.

Despite the vital role of curiosity-driven exploration in learning, our understanding of how to enhance children's curiosity remains limited. Here, we tested whether hearing a strategic curiosity story with curiosity-promoting themes (e.g., strategically approaching uncertainty, adapting flexibly to new information) versus a control story with traditional pedagogical themes (e.g., following rules, learning from others) would influence children's strategic exploration across two cultures. Three- to 6-year-olds from the United States (N = 138) and Turkey (N = 88) were randomly assigned to hear one of these stories over Zoom, before playing a game in which they searched for sea creatures across five fish tanks. All tanks had the same number of hiding spots but varied in the number of creatures they contained. Time was limited and children could not return to prior tanks, pushing them to allocate search effort strategically. Results indicated that across both countries, children in the strategic curiosity condition explored the virtual "aquarium" more broadly; they moved through tanks more rapidly than children in the control condition and were more likely to explore all five tanks before time ran out. Children in the strategic curiosity condition also showed relatively more strategic search, adapting their search based on the likelihood of finding creatures in each tank. While further research is needed to pinpoint which elements of our stories produced differences in search behavior and whether they did so by enhancing or inhibiting children's strategic exploration, storybooks appear to be a promising method for shaping children's exploration across multiple countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Current Status of Translational Science in Nursing Across Four Countries.

The raison d'être of nursing is caring for human beings. Mainly due to its close link to the nursing discipline's raison d'être, "caring," translational science is recently getting more attention from nursing scientists across the globe. This paper is to discuss the current status of translational science in nursing across four countries (the USA, Taiwan, South Korea, and Japan). The data used in this discussion paper included: (a) written notes on issues related translational research/science in individual countries; (b) written memos on exemplars/cases from their own experiences; and (c) summaries of literature reviews. The data analysis was conducted using a simple content analysis. Four themes reflecting the current status of translational science across the countries were identified: (a) "contextualized in unique culture and history of nursing"; (b) "connecting basic science to clinical practice"; (c) "an extension of evidence-based practice"; and (d) "highly promoted, but still minimal translation of nursing knowledge."

Cross-cultural adaptation and validation of the short nutritional literacy scale for young adults (18-35years) and analysis of the influencing factors.

OBJECTIVES: This study translated the short nutrition literacy scale for young adults (18-35 years) into Chinese, examined its reliability and validity, and analyzed its influencing factors. METHODS: The scale was translated using a modified Brislin translation model. A convenience sample of 508 cases was selected for the survey. Content validity, structural validity, Cronbach's alpha coefficient, and test-retest reliability were used to evaluate the scale's reliability and validity. To screen the factors influencing nutrition literacy in young people. RESULTS: The Chinese version of the Item-Level Content Validity Index (I-CVI) was 0.833 ~ 1, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.908. The cumulative variance contribution of the scale was 51.029%, and the model was generally well-fitted. The Cronbach's alpha coefficient and retest reliability of the scale were 0.826 and 0.818. The results showed that the level of education, mother's education, nutrition-related courses, and frequency of attention to nutritional health information were the factors influencing the nutritional literacy of young people. CONCLUSION: The Chinese version of the S-NutLit Scale can effectively assess the nutrients of young Chinese people. Low levels of education, low levels of education of mothers, lack of exposure to nutrition-related courses, and low frequency of attention to nutritional health information can lead to lower levels of nutritional literacy among young people.

Dimensions of wisdom perception across twelve countries on five continents.

Wisdom is the hallmark of social judgment, but how people across cultures recognize wisdom remains unclear-distinct philosophical traditions suggest different views of wisdom's cardinal features. We explore perception of wise minds across 16 socio-economically and culturally diverse convenience samples from 12 countries. Participants assessed wisdom exemplars, non-exemplars, and themselves on 19 socio-cognitive characteristics, subsequently rating targets' wisdom, knowledge, and understanding. Analyses reveal two positively related dimensions-Reflective Orientation and Socio-Emotional Awareness. These dimensions are consistent across the studied cultural regions and interact when informing wisdom ratings: wisest targets-as perceived by participants-score high on both dimensions, whereas the least wise are not reflective but moderately socio-emotional. Additionally, individuals view themselves as less reflective but more socio-emotionally aware than most wisdom exemplars. Our findings expand folk psychology and social judgment research beyond the Global North, showing how individuals perceive desirable cognitive and socio-emotional qualities, and contribute to an understanding of mind perception.

Brazilian Version of the Vestibular Activities and Participation Measure: Cross-Cultural Adaptation, Validity, and Reliability.

BACKGROUND: Vestibular Activities and Participation Measure (VAP) subscales assess the effect of vestibular disorders on activity and participation. This study aimed to perform the cross-cultural adaptation and assess the validity, internal consistency, reliability, and measurement error of the Brazilian version of VAP subscales. METHODS: The cross-cultural adaptation followed the translation, synthesis, back-translation, review by a committee of experts, and pretesting phases. Structural validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), while Spearman's correlation between VAP subscales and the Dizziness Handicap Inventory (DHI) was used to assess construct validity. Cronbach's alpha measured internal consistency. Intraclass correlation coefficient (ICC) assessed intra- and inter-rater reliability, and measurement error was calculated by using the standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS: Additional information was included in the Brazilian version of the Vestibular Activities and Participation measure (VAP-BR) after approval by one of the developers of the instrument to improve the understanding among individuals. One factor was found in the EFA for each subscale with 50% explained variance. Regarding CFA, the subscales 1 (S1) and 2 (S2) presented, respectively, adequate model fit indices (ie, comparative fit index of 0.99 and 0.97, and standardized root mean square residual of 0.04 for both subscales), but a very low factor load in item 6 of S1 (0.08). Chronbach's alpha was 0.80 (S1) and 0.82 (S2). For intra-rater assessment, the S1 and S2 presented an ICC of 0.87 and 0.90, SEM of 0.01 and 1.16, and MDC of 0.39 and 0.46, respectively. When assessed by 2 different raters, SEM values were 1.03 and 1.53, and MDC values were 2.85 and 4.23 for S1 and S2, respectively; both subscales showed an ICC of 0.92. Correlations between DHI and VAP subscales presented coefficients above 0.57. CONCLUSION: The Brazilian version of VAP subscales presents good measurement properties and may assist health professionals in identifying activity limitations and participation restrictions in individuals with vestibular disorders.

Cross-cultural adaptation and reliability of the European Portuguese version of the Musculoskeletal Health Questionnaire: A methodological study.

PURPOSE: To culturally adapt the Musculoskeletal Health Questionnaire (MSK-HQ) to European Portuguese and evaluate its reliability in individuals with musculoskeletal conditions. MATERIALS AND METHODS: The study was carried out in two phases. In the first phase, the MSK-HQ was translated and culturally adapted. In the second phase, a longitudinal observational study was carried out with a convenience sample of participants with musculoskeletal conditions. Data collection began at the start of physiotherapy treatments by filling in the MSK-HQ and Numeric Pain Rating Scale (NPRS). After 4-7 days, the participants were asked to fill out the MSK-HQ once again, as well as the Patient Global Improvement Change (PGIC) scale. The data collected was used to study internal consistency, test-retest reliability, and measurement error. Floor and ceiling effects were also analysed. RESULTS: The MSK-HQ was successfully translated and adapted into European Portuguese. The second phase of the study had a sample of 191 participants. This study demonstrated high internal consistency (Cronbach's α = 0.885) and excellent test-retest reliability (ICC(2,1) = 0.908). The analysis of measurement error resulted in an SEM of 2.818 and an SDC at 7.811. No floor or ceiling effect was observed. CONCLUSIONS: The MSK-HQ-PT is a reliable instrument for measuring musculoskeletal health. Further studies on its validity and responsiveness are needed.

Attitudes towards depression and its treatment among white, hispanic, and multiracial adults.

BACKGROUND: Depression is present in all societies and affects members of all racial and ethnic groups. However, attitudes about depression differ across groups and have been shown to impact help-seeking behaviors, preferences for treatments, and compliance with treatments. METHODS: Taking a cross-cultural approach, this project used a case vignette of depression to examine race/ethnic group differences in attitudes about depression and its treatment among young adults in the U.S. RESULTS: Data analyses revealed significant racial/ethnic group differences in attitudes as well as the treatments/strategies participants reported they would use. Gender x race/ethnicity interactions revealed that White and Multiracial/ethnic men were more likely to believe the vignette character should find a partner to help with symptoms, while White and Multiracial/ethnic women did not endorse those strategies. Hispanic men and women did not show a gender difference in that strategy, but gender differences were observed in other strategies. In a rare comparison, majority-minority Multiracial/ethnic participants (i.e., White selected as one of their races/ethnicities) rated identified helpers and treatments similarly to White participants and significantly higher than multiple-minority Multiracial participants (i.e., White not selected as one of their races/ethnicities). CONCLUSIONS: Findings supported previous research that indicates different U.S. racial/ethnic group ideas of depression and its treatment are potentially linked with cultural values, and we suggest that investigating these more fine-grained group differences can help to inform treating professionals as well as public health messages.

Cross-cultural adaptation and validation of Carolinas Comfort Scale to Brazilian Portuguese for inguinal hernia.

PURPOSE: Inguinal hernias are highly prevalent worldwide and its surgical repair is one of the most common procedures in general surgery. The broad use of mesh has decreased the recurrence rates of inguinal hernia to acceptable levels, thus centering the attention on Quality of Life as a pivotal postoperative outcome. Carolinas Comfort Scale is a well-studied questionnaire designed to identify Quality of Life changes following hernia repair with mesh techniques. The aim of this study is to validate the CCS in Brazilian Portuguese for inguinal hernias. METHODS: The original CCS was translated into Brazilian Portuguese according to cross-cultural adaptation guidelines. We conducted a cross-sectional study in individuals aged 18 and above who had undergone inguinal laparo-endoscopic hernia repair for at least 6 months prior, between January 2019 and August 2022, at a Brazilian tertiary hospital. Participants answered an online survey containing the Brazilian CCS and the generic Patient-Reported Outcome Measure (PROM) Short-Form Health 36 (SF-36). Participants answered the same questionnaires in the follow-up after at least three weeks, with an additional question about satisfaction with surgery results. RESULTS: The survey was completed by 115 patients, of whom 78 (67%) responded to the follow-up questionnaire after 3 to 10 weeks. CCS showed excellent internal consistency, with Cronbach's α of 0.94. Intraclass correlation coefficient ranged from 0.60 to 0.82 in the test-retest analysis. Compared to SF-36, a strong correlation was observed in the physical functioning dimension, and a moderate correlation was found in role-physical and bodily pain (Pearson's Coefficient Correlation = 0.502, 0.338 and 0.332 respectively), for construct analysis. The mean CCS score was significantly lower (p < 0.001) among satisfied patients compared to the unsatisfied ones. CONCLUSION: The Brazilian version of CCS is a valid and reliable method to assess long-term quality of life after inguinal laparo-endoscopic hernia repair.

Cross-cultural adaptation and psychometric properties of the Malay version of parenting and child tooth brushing assessment (M-PACTA).

BACKGROUND: Malaysian preschool children continue to exhibit a high prevalence of dental caries and poor oral hygiene. There is a need to gain an in-depth understanding of oral hygiene habits and design suitable interventions to improve oral hygiene in early childhood. OBJECTIVE: To cross-culturally adapt and determine the psychometric properties of the Malay-translated Parenting and Child Tooth Brushing Assessment questionnaire (M-PACTA). METHODOLOGY: This cross-sectional study involved face and content validation, and forward and back-translation of PACTA. The M-PACTA was then tested for reliability and construct validity on 150 Malaysian parents of children aged 5 to 6 years old. RESULTS: Face validity indicated that the M-PACTA items were clear and easy to understand. For content validity, some words had to be modified in accordance with the recommendations of the expert committees to make it more coherent to Malaysians. Some statements in the parental knowledge scales were modified according to the guidelines applicable in Malaysia. The content comparison of the back translation with the adapted PACTA revealed that all items were semantic and linguistically equivalent. Exploratory factor analyses of M-PACTA suggested a two-factor structure for three scales including child behaviour scale ('non-compliance' and 'avoidance behaviour'), parental attitudes ('lack of concern' and 'attitude of care'), and parental knowledge ('general tooth brushing knowledge' and 'awareness of tooth brushing care') while for the parental strategy scale, three-factor structure was extracted including 'routine positive methods', 'uncommon positive methods', and 'negative methods'. Internal consistencies for all scales were good (α > 0.9). CONCLUSION: M-PACTA did not replicate the construct of the original PACTA. Nonetheless, M-PACTA demonstrated good construct validity, internal consistency reliability, and test-retest reliability within Malaysian context.

German translation and cross-cultural adaptation of the Vestibular Schwannoma Quality of Life Index (VSQOL).

BACKGROUND: Vestibular schwannomas (VSs) are benign tumors of the vestibulocochlear nerve that often cause significant neurological and functional impairment. Patient-reported outcomes, including quality of life (QoL), are essential for understanding the overall impact of VS and its treatment. This study aimed to translate and culturally adapt the Vestibular Schwannoma Quality of Life (VSQOL) Index into German to expand its relevance to German-speaking populations. METHODS: We used a qualitative approach including translation and cognitive interviews with 10 patients who underwent VS surgery. The translation process followed the TRAPD protocol to ensure linguistic and conceptual accuracy. Cognitive interviews assessed the comprehensibility and relevance of the translated questionnaire. RESULTS: The translation showed remarkable consistency between translators, with minor discrepancies resolved by consensus. Cognitive interviews provided valuable insights that led to refinements in item wording. Participants emphasized the importance of an additional item on physician referrals, reflecting differences in health care systems between the United States and Germany. CONCLUSIONS: The German VSQOL provides a comprehensive tool for assessing QoL in patients with VS that integrates patient-centered dimensions. A Validation study is underway to establish its reliability and validity.

Brazilian version of the "Primary Sjögren's Syndrome - Quality of Life questionnaire (PSS-QoL)": translation, cross-cultural adaptation and validation.

BACKGROUND: The Primary Sjögren's Syndrome Quality of Life questionnaire (PSS-QoL) is the first specific instrument to assess health-related quality of life (HRQoL) in Sjögren's disease (SjD). The aim is to translate and cross-culturally adapt the PSS-QoL into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: The original English version was translated into Brazilian Portuguese by two native Brazilians who were proficient in the English language. The retranslation was conducted by two native Americans proficient in Brazilian Portuguese. A committee undertook an analysis of the translated and retranslated versions, resulting in the generation of the first Brazilian version, which was submitted to the cross-cultural adaptation phase. In this phase, 50 participants with SjD responded to the instrument in Stages I and II, resulting in the generation of the second and final Brazilian version. To assess the psychometric properties, demographic and clinical data were collected from 75 patients. The HRQoL questionnaires (final Brazilian version of the PSS-QoL, Short Form-36 Health Survey (SF-36) and EuroQoL-5 dimension (EQ-5D)) were completed. Construct validity was analyzed using the Pearson or Spearman correlation coefficient. Reliability was analyzed using Cronbach's alpha and the intraclass correlation coefficient (ICC). RESULTS: Eight questions and one response item were revised due to an incomprehension rate of greater than 15% among the participants in the cross-cultural adaptation phase. The final Brazilian version of the PSS-QoL was validated, revealing a high correlation between the total score and functional capacity (r= -0.713, p < 0.001), and vitality (r= -0.770, p < 0. 001) and mental health (r= -0.742, p < 0.001) domains of the SF-36 and a moderate correlation with the other domains of the SF-36 and a moderate correlation with the EQ-5D-tto (r= -0.573, p < 0.001), and EQ-5D-VAS (r= -0.559, p < 0.001). The intraobserver (ICC = 0.939; Cronbach's alpha = 0.964) and interobserver (ICC = 0.965; Cronbach's alpha = 0.964) reliability of the total score showed very high consistency. CONCLUSION: The Brazilian version of the PSS-QoL has been demonstrated to be a valid and reproducible instrument for the assessment of HRQoL in patients with SjD.

How teachers make connections among ideas in mathematics instruction.

Conceptual understanding involves understanding connections among ideas within a domain. In this chapter, we consider how teachers support students in learning about connections among ideas in mathematics. We review research focusing on teachers' connection making in mathematics classrooms, and we consider several dimensions of variability in that connection making. Across three corpora of lessons that varied in students' grade levels (first grade to college), cultural settings (United States and China), and mathematics content, we found that all teachers produced linking episodes, but the frequency with which they did so varied substantially, raising new questions about the sources and consequences of that variability. Teachers of first-grade students in China routinely engaged their students in co-constructing links; teachers of middle schoolers and college students in the United States typically explained links to students. Linking episodes targeted many different types of connections, including connections between representations, connections between principles and exemplars, connections between procedures and concepts, and connections between concepts and real-world instantiations. Across all three corpora, teachers expressed linked ideas multimodally in a majority of linking episodes. Based on the findings, we present several hypotheses about how teacher behaviors may support students' understanding of connections among ideas, and we suggest directions for future work.

Pain Sensitivity Questionnaire: Cross-cultural adaptation and validation of the Greek version.

INTRODUCTION: The Pain Sensitivity Questionnaire (PSQ) was developed to assess general pain sensitivity. OBJECTIVE: This study aimed to validate the Greek version of PSQ. METHODS: The questionnaire was translated into Greek (PSQ-GR) and piloted in a small sample of patients with chronic pain (n = 35). A total of 146 chronic pain patients and healthy volunteers completed the PSQ-GR, the Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS) and Central Sensitization Inventory (CSI). To evaluate the test-retest reliability, 36 volunteers completed the PSQ-GR twice over 7 ± 2 days. RESULTS: Internal consistency was excellent (Cronbach's alpha 0.90-0.96) for PSQ-total, PSQ-minor, and PSQ-moderate. The Intraclass Correlation Coefficient was estimated at 0.90-0.96 for PSQ-total, PSQ-minor and PSQ-moderate and the SEM was 0.59-0.90 for PSQ-total, PSQ-minor and PSQ-moderate approximately. The smallest detectable change was 0.48 for PSQ-total, 0.47 for PSQ-minor and 0.44 for PSQ-moderate. Positive and significant correlations were observed between PSQ-GR and HADS (r = 0.38, p < 0.01), PCS (r = 0.41, p < 0.01) and CSI (r = 0.30, p < 0.01). Statistically significant differences in PSQ-GR scores were identified between the healthy volunteers and the chronic pain patients. CONCLUSION: The PSQ-GR is a reliable and valid tool that can assess pain sensitivity in healthy individuals and chronic musculoskeletal pain patients.

Cross-cultural adaptation of the CALCULATE instrument into Brazilian Portuguese: pressure injury in intensive care.

OBJECTIVE: To perform the cross-cultural adaptation of CALCULATE for Brazilian Portuguese. METHOD: A methodological study conducted from January to December 2021, divided into six stages: translation, synthesis, back-translation, expert committee with the application of the content validity index, pre-testing in 40 adult patients, and submission to the authors. The study took place in the intensive care units of a public tertiary teaching hospital in the interior of the state of São Paulo, Brazil. The original CALCULATE has eight risk assessment items and is stratified with a score of 0-3 (high risk) and 4-8 (very high risk). RESULTS: After expert evaluation, the final content validity was 0.9. They suggested words and phrases that should undergo changes regarding textual equivalences, as well as definitions of acronyms and terminologies. In the pre-test, the items were assessed as suitable for understanding; only one item required additional explanation for adequacy. CONCLUSION: The cross-cultural adaptation of CALCULATE for Brazilian Portuguese was successfully performed, revealing a good content validity index, confirming the relevance and appropriateness of its items. CALCULATE is suitable for use in intensive care units and research and teaching centers.

Reinforcement learning of altruistic punishment differs between cultures and across the lifespan.

Altruistic punishment is key to establishing cooperation and maintaining social order, yet its developmental trends across cultures remain unclear. Using computational reinforcement learning models, we provided the first evidence of how social feedback dynamically influences group-biased altruistic punishment across cultures and the lifespan. Study 1 (n = 371) found that Chinese participants exhibited higher learning rates than Americans when socially incentivized to punish unfair allocations. Additionally, Chinese adults showed slower learning and less exploration when punishing ingroups than outgroups, a pattern absent in American counterparts, potentially reflecting a tendency towards ingroup favoritism that may contribute to reinforcing collectivist values. Study 2 (n = 430, aged 12-52) further showed that such ingroup favoritism develops with age. Chinese participants' learning rates for ingroup punishment decreased from adolescence into adulthood, while outgroup rates stayed constant, implying a process of cultural learning. Our findings highlight cultural and age-related variations in altruistic punishment learning, with implications for social reinforcement learning and culturally sensitive educational practices promoting fairness and altruism.

Conducting cross-cultural, multi-lingual or multi-country scale development and validation in health care research: A 10-step framework based on a scoping review.

Background: Valid, reliable and cross-cultural equivalent scales and measurement instruments that enable comparisons across diverse populations in different countries are important for global health research and practice. We developed a 10-step framework through a scoping review of the common strategies and techniques used for scale development and validation in a cross-cultural, multi-lingual, or multi-country setting, especially in health care research. Methods: We searched MEDLINE, Embase, and PsycINFO for peer-reviewed studies that collected data from two or more countries or in two or more languages at any stages of scale development or validation and published between 2010-22. We categorised the techniques into three commonly used scale development and validation stages (item generation, scale development, and scale evaluation) as well as during the translation stage. We described the most commonly used techniques at each stage. Results: We identified 141 studies that were included in the analysis. We summarised 14 common techniques and strategies, including focus groups or interviews with diverse target populations, and involvement of measurement experts and linguists for item content validity expert panel at the item generation stage; back-and-forth translation, collaborative team approach for the translation stage; cognitive interviews and different recruitment strategies and incentives in different settings for scale development stage; and three approaches for measurement invariance (multigroup confirmatory factor analysis, differential item functioning and multiple indicator multiple causes) for scale evaluation stage. Conclusions: We provided a 10-step framework for cross-cultural, multi-lingual or multi-country scale development and validation based on these techniques and strategies. More research and synthesis are needed to make scale development more culturally competent and enable scale application to better meet local health and development needs.

Cross-cultural adaptation of the Thoracic Outlet Syndrome Index for Turkish-speaking patients with thoracic outlet syndrome.

Background/aim: Considering that there is no specifically designed scale to measure quality of life (QoL) and level of functioning among Turkish-speaking patients with thoracic outlet syndrome (TOS), the aim of this study was to adapt the Thoracic Outlet Syndrome Index (TOSI) to the Turkish language (TOSI-TR) and analyze its psychometric properties in patients with TOS. Materials and methods: Thirty-nine patients with symptomatic TOS were included in the study. The participants were assessed using the following measures: the QuickDASH, the Western Ontario Rotator Cuff Index (WORC), and a visual analog scale (VAS). The psychometric properties of the TOSI-TR were examined in terms of test-retest reliability, construct validity, convergent validity, and feasibility. Results: The ICC2,1 of the TOSI-TR was 0.949 (95% CI: 0.903-0.973). The Kaiser-Meyer-Olkin value was found to be 0.716 with a significant result for Bartlett's sphericity test (p < 0.001). The TOSI-TR had a one-factor solution explaining 74.05% of the total variance. There was a significant correlation between TOSI-TR scores and QuickDASH (r = 0.762, p < 0.001), WORC (r =0.794, p < 0.001), and VAS (r = 0.663, p < 0.001) scores. The WORC and VAS scores were significant determinants of the TOSI-TR score, explaining 65.3% of the variance. There were no floor or ceiling effects. Conclusion: The TOSI-TR is a reliable, valid, and feasible questionnaire for the QoL and functional status in Turkish-speaking patients with TOS. We recommend this 15-item scale for optimal assessment in patients with TOS.

Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Assessment of Quality of Life-6 Dimensions (Malay-AQoL-6D) instrument among Malaysians living with chronic heart failure.

BACKGROUND: This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument's acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF). METHODS: The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity. RESULTS: The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83-1.00, average CVI: 0.98), internal consistency (Cronbach's alpha: 0.72-0.89; MacDonald's omega: 0.82-0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79-0.95). Confirmatory factor analysis confirmed the instrument's two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D's concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D's psychometric properties remained consistent across different missing data techniques. CONCLUSION: The findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument's test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.

Translation and cross-cultural adaptation of the Chinese version of the HLS-EU-Q47.

The development of health literacy in China is relatively slow, and there are fewer health literacy scales, which is difficult to measure. Therefore, this study aims to promote the development of health literacy in China through the translation and application of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). The scale was translated into Chinese, back-translated, culturally adapted and finally subjected to psychometric evaluation. A multi-stage stratified sampling method was used to select 2504 residents to test the reliability and validity of a questionnaire on health literacy. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the validity of the results, and the back consistency was calculated by Cronbach's alpha coefficient. The EFA revealed that health care, disease prevention and health promotion explained 78.68% of the total variance in health literacy. The scale and its subscales demonstrated strong internal consistency, with high Cronbach's alpha coefficients ranging from 0.947 to 0.983. CFA confirmed the three-factor model's goodness-of-fit for the Chinese population. The dimensions of healthcare, disease prevention and health promotion showed high convergent validity with an average variance extracted values ranging from 0.52 to 0.60 and composite reliability values ranging from 0.94 to 0.96. The reliable and valid Chinese version of the HLS-EU-Q47 (HLS19-Q47-CN) developed and evaluated in this study is an important tool for assessing health literacy levels in the Chinese population. Furthermore, as this tool has global applicability, it has the potential to assess health literacy levels across different countries, enabling practical international comparisons.