Adaptación transcultural al español y validez de contenido de 3 escalas de riesgo nutricional / Cross-cultural adaptation to Spanish and content validity of three nutritional risk scales

Introducción: Existen diversas escalas diseñadas para determinar el riesgo de desnutrición al ingreso hospitalario en población infantil, sin embargo, la mayor parte de estos instrumentos se desarrollan y publican en lengua inglesa, siendo preceptiva su adaptación transcultural y validación para poder ser utilizados en nuestro país.Objetivos: Adaptar transculturalmente 3 escalas diseñadas para determinar el riesgo de desnutrición ligada a la enfermedad y determinar la validez de su contenido.Material y métodos: Adaptación transcultural mediante el método de traducción-retrotraducción de acuerdo con las recomendaciones de la International Test Commission Guidelines for Translating and Adapting Tests. Se midió la validez de contenido a través de un panel de expertos (bajo 7 criterios básicos de selección adaptados del modelo Fehring) que evaluaron cada ítem de las escalas midiendo 4 criterios: ambigüedad, sencillez, claridad y relevancia. Con la puntuación extraída se obtuvo el estadístico V de Aiken para cada ítem y para las escalas completas.Resultados: Partiendo de 3 traducciones independientes por escala se obtuvieron 3 versiones definitivas en castellano de las escalas PNRS, STRONGkids y STAMP semánticamente equivalentes a sus versiones originales. Las escalas PNRS y STRONGkids presentaron una V de Aiken superior a 0,75 en todos sus ítems, mientras que escala STAMP presentó un valor inferior a 0,75 para el ítem «peso y altura».Conclusión: Este estudio aporta las versiones en castellano adaptadas transculturalmente de las escalas PNRS, STRONGkids y STAMP. Las escalas PNRS y STRONGkids presentan un contenido válido para ser aplicadas en el contexto hospitalario estatal. STAMP requiere la adaptación de su ítem «peso y altura» para considerar adecuado su uso en población infantil española. (AU)

Introduction: There are various scales designed to determine the risk of malnutrition at hospital admission in children. However, most of these instruments are developed and published in English. Their cross-cultural adaptation and validation being mandatory in order to be used in our country.Objectives: Cross-culturally adapt three scales designed to determine the risk of malnutrition linked to the disease and determine the validity of their content.Material and methods: Cross-cultural adaptation using the translation-back-translation method in accordance with the recommendations of the International Test Commission Guidelines for Translating and Adapting Tests. Content validity was measured by a panel of experts (under seven basic selection criteria adapted from the Fehring model) who evaluated each item of the scales by measuring 4 criteria: ambiguity, simplicity, clarity and relevance. With the extracted score, Aiken's V statistic was obtained for each item and for the complete scales.Results: Starting from three independent translations per scale, 3 definitive versions in Spanish of the PNRS, STRONGkids and STAMP scales were obtained semantically equivalent to their original versions. The PNRS and STRONGkids scales presented an Aiken's V greater than 0.75 in all their items, while the STAMP scale presented a value less than 0.75 for the item “weight and height”.Conclusion: This study provides the transculturally adapted Spanish versions of the PNRS, STRONGkids and STAMP scales. The PNRS and STRONGkids scales present valid content to be applied in the state hospital context. STAMP requires the adaptation of its item “weight and height” to consider its use in a Spanish child population adequate. (AU)

Cross-cultural adaptation to Spanish and content validity of three nutritional risk scales.

INTRODUCTION: There are various scales designed to determine the risk of malnutrition at hospital admission in children. However, most of these instruments are developed and published in English. Their cross-cultural adaptation and validation being mandatory in order to be used in our country. OBJECTIVES: Cross-culturally adapt three scales designed to determine the risk of malnutrition linked to the disease and determine the validity of their content. MATERIAL AND METHODS: Cross-cultural adaptation using the translation-back-translation method in accordance with the recommendations of the International Test Commission Guidelines for Translating and Adapting Tests. Content validity was measured by a panel of experts (under seven basic selection criteria adapted from the Fehring model) who evaluated each item of the scales by measuring 4 criteria: ambiguity, simplicity, clarity and relevance. With the extracted score, Aiken's V statistic was obtained for each item and for the complete scales. RESULTS: Starting from three independent translations per scale, 3 definitive versions in Spanish of the PNRS, STRONGkids and STAMP scales were obtained semantically equivalent to their original versions. The PNRS and STRONGkids scales presented an Aiken's V greater than 0.75 in all their items, while the STAMP scale presented a value less than 0.75 for the item "weight and height". CONCLUSION: This study provides the transculturally adapted Spanish versions of the PNRS, STRONGkids and STAMP scales. The PNRS and STRONGkids scales present valid content to be applied in the state hospital context. STAMP requires the adaptation of its item "weight and height" to consider its use in a Spanish child population adequate.

Confiabilidad y validez de un cuestionario de desarrollo infantil en encuestas nacionales / Reliability and validity of a questionnaire of child development for national surveys

Resumen: Introducción: El tamizaje del desarrollo infantil en encuestas nacionales es un insumo para la formulación de po líticas públicas que contribuyan a su diagnóstico e intervención precoz, dirigidos a favorecer un de sarrollo integral y desempeño escolar exitoso hasta la adolescencia, no obstante, pocos países en La tinoamérica cuentan con esta información. Objetivo: Evaluar la confiabilidad y validez convergente de una adaptación cultural del Cuestionario de Tamizaje de Desarrollo Infantil para Encuestas en Hogares (DIEH) y describir la prevalencia de alteraciones en el desarrollo en niños de 2 meses a 5 años en Bucaramanga-Colombia. Sujetos y Método: Se realizó una evaluación de pruebas diagnósti cas. Participaron 224 niños de dos meses hasta los cinco años y sus padres o cuidadores procedentes de Bucaramanga - Colombia, entre julio y diciembre de 2016. La Escala Abreviada del Desarrollo (EAD) fue aplicada por fisioterapeutas entrenados y el DIEH, fue respondido por los padres o cui dadores. A partir del alpha de Cronbach, el Coeficiente de Correlación Intraclase (CCI) y los límites de acuerdo Bland y Altman se estableció la confiabilidad del DIEH; con el Coeficiente de Correlación de Spearman la validez convergente. Resultados: A partir del DIEH las prevalencias de rezagos y retrasos fueron 38.8% y 11.2% respectivamente; la consistencia interna osciló entre 0.23 y 0.76. La reproducibilidad registró CCI entre 0.60 y 0.92; la validez convergente fue casi perfecta (p: 0.96). Conclusiones: La adaptación cultural del DIEH mostró propiedades psicométricas aceptables, que podrían complementarse con estudios adicionales para recomendar su uso en encuestas nacionales en Latinoamérica.

Abstract Introduction: The child development screening in national surveys supports the formulation of public policies that contribute to its diagnosis and early intervention, aimed at promoting comprehensive development and successful school performance until adolescence, however, few countries in Latin America have this information. Objective: To assess the reliability and convergent validity of a cultural adaptation of the Screening Questionnaire of Child Development for Household Surveys (DIEH) and to des cribe the prevalence of developmental alterations in children aged between 2 months and 5 years in Bucaramanga-Colombia. Subjects and Method: Between July and December 2016, an evaluation of diagnostic tests was carried out in which participated 224 children aged between two months and five years and their parents or caregivers from Bucaramanga, Colombia. The Abbreviated Developmental Scale was applied by trained physiotherapists and the DIEH was answered by the parents or caregi vers. The reliability of the DIEH was established using the Cronbach's alpha, the Intraclass Correla tion Coefficient (ICC) and the Bland and Altman limits of agreement, and the convergent validity was established through the Spearman Correlation Coefficient. Results: Based on the DIEH, the pre valence of lags and delays was 38.8% and 11.2% respectively, internal consistency ranged from 0.23 to 0.76; reproducibility showed an ICC between 0.60 and 0.92; and the convergent validity was almost perfect (p: 0.96). Conclusion: The cultural adaptation of the DIEH showed acceptable psychometric properties, which could be complemented with additional studies to recommend its use in national surveys in Latin America.

Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke.

Background: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke. Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance. Results: The raters showed a percentage agreement of ≥75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between -0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance. Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.

Consistencia interna y validez concurrente del cuestionario para evaluación de limitaciones y restricciones en niños con TDAH / Internal Consistency and Concurrent Validity of the Questionnaire for Limitations and Restrictions Assessment in Children with ADHD / Consistência interna e validez concorrente do questionário para avaliação de limitações e restrições em crianças com TDAH

Introducción: El TDAH es uno de los diagnósticos más frecuentes en psiquiatría infantil, su diagnóstico temprano reviste una gran importancia para su intervención familiar, escolar y social. Basándose en la clasificación internacional del funcionamiento, la discapacidad y la salud CIF, se diseñó un cuestionario para la evaluación de limitaciones en la actividad y restricciones en la participación en niños con TDAH, el cuestionario CLARP-TDAH versión padres y profesores. Objetivo: Determinar el grado de consistencia interna de los CLARP-TDAH y su validez concurrente con el cuestionario de capacidades y dificultades SDQ versión padres y maestros. Materiales y métodos: Muestra de 203 niños de 6 a 12 años con TDAH, escolarizados, en cinco ciudades de Colombia. Se aplicaron estos cuestionarios a padres y profesores. El análisis de consistencia interna se realizó por coeficiente de Cronbach, y la validez concurrente mediante coeficiente de correlación de Spearman y con predictores múltiples y únicos a través de modelos de regresión lineal múltiple y simple. Resultados: La consistencia interna fue elevada para los cuestionarios globales y para cada uno de sus dominios. El CLARP-TDAH padres obtuvo consistencia interna de 0,83 y el CLARP-TDAH profesores de 0,93. Se halló validez concurrente entre los CLARPTDAH y el SDQ padres y maestros, existe concurrencia entre el CLARP-TDAH profesores y SDQ maestros, y entre el CLARP-TDAH padres y profesores, esto dado por valores p < 0,001.

Introduction: ADHD is one of the most common diagnoses in child psychiatry, its early diagnosis is of great importance for intervention at family, school and social environment. Based on the International Classification of Functioning, Disability and Health (ICF), a questionnaire was designed to assess activity limitations and participation restrictions in children with ADHD. The questionnaire was called "CLARP-ADHD Parent and Teacher Version". Objective: To determine the degree of internal consistency of the CLARP-ADHD questionnaire, and its concurrent validity with the "Strengths and Difficulties Questionnaire SDQ parent and teacher version". Material and Methods: A sample of 203 children aged 6 to 12 with ADHD, currently attending school in five Colombian cities. The questionnaires were applied to parents and teachers. The internal consistency analysis was performed through Cronbach coefficient and concurrent validity using the Spearman correlation coefficient utilizing multiple and unique predictors through multiple linear regression as well as simple regression models. Results: A high internal consistency was found for global questionnaires for each of its domains. The CLARP-ADHD for parents gave as result an internal consistency of 0.83, and the CLARP-ADHD for teachers one of 0.93. Concurrent validity was found between the CLARP-ADHD and the SDQ Parent and Teacher version; also, concurrence between the CLARPADHD for Teachers and the SDQTeachers was found, as well as between CLARPADHD for Parents and CLARP ADHD Teachers, given by p values of p < 0.001.

Introdução: O TDAH é um dos diagnósticos mais frequentes em psiquiatria infantil, seu diagnóstico precoce reviste uma grande importância para sua intervenção no nível familiar, escola e social. Baseando-se na classificação internacional do funcionamento, a deficiência e a saúde CIF, criou-se um questionário para a avaliação de limitações na atividade e restrições na participação em crianças com TDAH, o questionário CLARP-TDAH Versão Pais e Professores. Objetivo: Determinar o grau de consistência interna dos CLARP TDAH e sua validez concorrente com o questionário de capacidades e dificuldades SDQ versão pais e professores. Materiais e Métodos: Amostra de 203 crianças de 6 e 12 anos com TDAH, escolarizados, em cinco cidades da Colômbia. Aplicaram-se estes questionários a pais e professores. A análise de consistência interna realizou-se por coeficiente de Cronbach, e a validez concorrente mediante coeficiente de correlação de Spearman e com preditores múltiplos e únicos através de modelos de regressão lineal múltipla e simples. Resultados: A consistência interna foi elevada para os questionários globais e para cada um de seus domínios. O questionário CLARP-TDAH dos pais obteve consistência interna de 0,83, e o CLARP-TDAH dos professores de 0,93. Achou-se validez concorrente entre os CLARP TDAH e o SDQ Pais e Professores, existe concorrência entre o CLARP TDAH Professores e SDQ Professores, e entre o CLARP TDAH Pais e CLARP TDAH Professores, isto dado por valores p < 0,001.

Reproducibilidad en la ubicación de puntos cefalométricos de tejidos blandos en radiografías convencionales y digitales directas / Reproducibility of soft tissue cephalometric landmark identification by conventional and digital direct radiography

Introducción: es escasa la información sobre la reproducibilidad de puntos cefalométricos de tejidos blandos, el propósito de este estudio fue evaluar la reproducibilidad y precisión de la ubicación de los puntos cefalométricos de tejidos blandos en una radiografía digital directa y una radiografía convencional. Método: se utilizaron 11 pares de radiografías convencionales y radiografías digitales directas las cuales se introdujeron en el programa Cephapoint. Se ubicaron 10 puntos cefalométricos en un plano cartesiano (X y Y) en las imágenes convencional y digital. Las medidas fueron hechas dos veces por 3 operadores con intervalo de 1 semana. Se halló el promedio de error interobservador para medir la reproducibilidad de cada punto y el error intraobservador para determinar la precisión. Resultados: el error interobservador en la ubicación de puntos cefalométricos en tejidos blandos fue menor a 1 mm para la mayoría de los puntos en ambas imágenes, excepto para mentón y pogonion, sin diferencias estadísticamente significativas. Se encontraron diferencias estadísticamente significativas entre las varianzas en el eje X, con menor variabilidad para la radiografía digital en los puntos labrale superior (p = 0,043), subnasal (p = 0, 013), columnella (p = 0,038), stomion superior (p = 0,029) y stomion inferior (p = 0,015). En el eje y no se presentaron diferencias estadísticamente significativas entre los dos métodos. La evaluación de la reproducibilidad intraobservador mostró coeficiente de correlación intraclase (CCI) excelente (0,935) en ambos métodos. Conclusión: de acuerdo con los hallazgos de este estudio las radiografías y los métodos evaluados brindan igual validez diagnóstica.

Introduction: there is little information on the reproducibility of soft tissue cephalometric points; the purpose of this study was then to evaluate the reproducibility and accuracy of soft tissue cephalometric landmark identification in direct digital radiography and conventional radiography. Methods: 11 pairs of conventional and direct digital radiographs were introduced in the Cephapoint program. 10 cephalometric points were located on a Cartesian plane (X and Y) in conventional and digital images. The measurements were taken twice by 3 operators with 1 week interval. Interobserver average error was calculated in order to assess reproducibility in each point, and intraobserver error was used to determine accuracy. Results: interobserver error in soft tissue cephalometric points was less than 1 mm for most points in both images, except in chin and pogonion, with no statistically significant differences. Statistically significant differences were found between the variances in the X axis, with less variability in the case of digital radiography in these points: labrale superius (p = 0.043), subnasale (p = 0, 013), columella (p = 0.038), stomion superius (p = 0.029), and stomion inferius (p = 0.015). The Y axis did not show statistically significant differences between the two methods. The assessment of intraobserver reproducibility showed an excellent Intraclass Correlation Coefficient (ICC) (0.935) in both methods. Conclusion: according to the findings of this study, the evaluated radiographs and methods offer similar diagnostic accuracy.

Fiabilidad y validez del instrumento "Fantástico" para medir el estilo de vida en adultos colombianos / The Fantastic instrument's validity and reliability for measuring Colombian adults' life-style

Objetivo El cuestionario «Fantástico¼ fue creado para ayudar a los profesionales de la salud a medir los estilos de vida de sus pacientes. El objetivo fue evaluar la fiabilidad y validez del cuestionario Fantástico, traducido al español en la versión de 3 opciones de respuesta, en un grupo de adultos colombianos. Materiales y Métodos Se aplicó por entrevista auto diligenciada en 550 personas. Se usaron medidas de tendencia central y dispersión para los dominios y grupos; cálculo de consistencia interna y correlación interescalar. Resultados Se encontró que los 25 ítems- y los agrupados en los 10 dominios superaron el estándar propuesto de fiabilidad (∞ de Cronbach) mayor a 0,50 y 0,73, respectivamente. Se encontró correlación interescalar como buenas y aceptables, en las diferentes categorías del cuestionario Fantástico (total vs. dominios), (r= 0,19-0,79 p<0,01). Conclusiones La versión 3 del cuestionario Fantástico reúne algunos de los criterios de consistencia interna y validez de constructo. Se recomienda utilizar el cuestionario en la atención primaria en salud y en estudios epidemiológicos.

Objective The Fantastic lifestyle assessment questionnaire was designed to help healthcare physicians measure their patients' life-styles. This work was thus aimed at assessing the reliability and validity of the Fantastic questionnaire (version 3 translated into Spanish) on a group of Colombian adults. Materials and Methods The questionnaire was administered to 550 people to fill out themselves. Measures of central tendency and dispersion were used for the domains and groups; internal consistency and inter-scalar correlation were calculated. Results It was found that the 25 items, and those grouped into 10 domains exceeded the proposed reliability standard (Cronbach ∞), being greater than 0.50 and 0.73, respectively. Inter-scalar correlation was good and acceptable in various categories of the Fantastic questionnaire (total cf domains), (r=0.19 to 0.79; p <0.01). >Conclusions Fantastic questionnaire version 3 brings together some of the internal consistency and construct validity criteria. It is recommended that the questionnaire be used in primary healthcare and epidemiological studies.