Adaptación transcultural y características de la versión española de la escala COMFORT Behavior Scale en el paciente crítico pediátrico / Transcultural adaptation and characteristics of the Spanish version of the COMFORT Behavior Scale in pediatric critical care patients

OBJETIVOS: Determinar las propiedades métricas de la escala COMFORT Behavior Scale desarrollada por van Dijk et al. (2000) en el contexto del paciente crítico pediátrico. DISEÑO: Estudio observacional, psicométrico y prospectivo. LUGAR DE ESTUDIO: Unidad de Cuidados Intensivos de un hospital pediátrico y universitario de tercer nivel asistencial. PACIENTES: Un total de 311 niños con una mediana de edad de 5,07 años (0,9-11,7). INTERVENCIONES: Ninguna. PRINCIPALES VARIABLES Y RESULTADOS: La escala fue administrada de forma simultánea por 2enfermeros a 311 pacientes ingresados en una unidad de críticos de 18 camas de un hospital pediátrico de tercer nivel asistencial. La versión española de la COMFORT Behavior Scale obtuvo un alfa de Cronbach de 0,715 y está compuesta por 3factores, con 2ítems cada uno: 1) alerta y movimiento físico; 2) calma/agitación y respuesta respiratoria/llanto, y 3) tono muscular y tensión facial. CONCLUSIONES: La escala COMFORT B logró ser adaptada al idioma español y mostró ser válida para determinar y cuantificar el grado de confort en un grupo de niños ingresados en una unidad de cuidados pediátricos española

OBJECTIVES: To determine the measurement properties of the Spanish version of the COMFORT Behavior Scale developed by van Dijk et al. (2000) in pediatric critical care patients. DESIGN: Prospective observational and psychometric study. SETTING: Level III Intensive Care Area at a university's children hospital. PATIENTS: A total of 311 children with median age of 5.07 years (IQR = 0.9-11.7). INTERVENTIONS: None. PRINCIPAL VARIABLES AND RESULTS: To determine the measurement properties the Spanish version of the COMFORT Behavior Scale was simultaneous administered by 2nurses to 311 patients admitted to an eighteen-bed critical care unit of a third level pediatric hospital. The Spanish version of the COMFORT Behavior Scale obtained a Cronbach alpha coefficient of 0.715 and it is a tool made up of 3factors with 2items: 1) alertness and physical movement; 2) calmness/agitation and respiratory response/crying, and 3) muscle tone and facial tension. CONCLUSIONS: The COMFORT B was adapted to Spanish and it has shown to be a valid an reliable tool to assess comfort in a group of children admitted to an Spanish Intensive Care Unit

Expectations of nursing degree students: A longitudinal analysis.

BACKGROUND: The expectations of students regarding their studies have a strong influence on their academic performance and personal training, and they are closely related with their academic and professional future. OBJECTIVES: To analyze initial expectations and how they are fulfilled, in a cohort of nursing students during the four years of their degree program. DESIGN: Creation and validation of a questionnaire and longitudinal study. SETTING: University nursing school in Catalonia (Spain). PARTICIPANTS: 339 students of the nursing degree. METHODS: Two questionnaires were constructed with 10 items each, of a mixed nature: some items were previously validated in prior studies while other new items were made and included, following a review of the literature. The questionnaires were designed to assess the expectations of the students at the beginning of the academic year (CUDEX questionnaire) and the fulfillment of these at the end of the year (CUDEX-C questionnaire). RESULTS: Internal consistency (Cronbach's alpha) for the CUDEX questionnaire and the CUDEX-C was 0.70. Factorial analysis of the expectations questionnaires suggested a three-factor model, with an acceptable internal consistency for each of the factors. Statistically significant differences were found between the initial expectations and their fulfillment at the end of the academic year for all the factors and in all four years of the degree program. CONCLUSIONS: The three-factor model of the expectations (Academic adaptation, personal development, and academic performance) shows a good fit for the several samples and time points. The nursing students feel that not all of their expectations were fulfilled during their studies, and there were significant differences between their initial expectations and those fulfilled, in terms of all three factors.

Transcultural adaptation and characteristics of the Spanish version of the COMFORT Behavior Scale in pediatric critical care patients. / Adaptación transcultural y características de la versión española de la escala COMFORT Behavior Scale en el paciente crítico pediátrico.

OBJECTIVES: To determine the measurement properties of the Spanish version of the COMFORT Behavior Scale developed by van Dijk et al. (2000) in pediatric critical care patients. DESIGN: Prospective observational and psychometric study. SETTING: Level III Intensive Care Area at a university's children hospital. PATIENTS: A total of 311 children with median age of 5.07 years (IQR = 0.9-11.7). INTERVENTIONS: None. PRINCIPAL VARIABLES AND RESULTS: To determine the measurement properties the Spanish version of the COMFORT Behavior Scale was simultaneous administered by 2nurses to 311 patients admitted to an eighteen-bed critical care unit of a third level pediatric hospital. The Spanish version of the COMFORT Behavior Scale obtained a Cronbach alpha coefficient of 0.715 and it is a tool made up of 3factors with 2items: 1) alertness and physical movement; 2) calmness/agitation and respiratory response/crying, and 3) muscle tone and facial tension. CONCLUSIONS: The COMFORT B was adapted to Spanish and it has shown to be a valid an reliable tool to assess comfort in a group of children admitted to an Spanish Intensive Care Unit.

Impact of the intellectual disability severity in the Spanish Personal Outcomes Scale.

BACKGROUND: The interest in measuring quality of life (QoL) in persons with intellectual disability (ID) has brought about a number of QoL measurements for this population. These measurements need to address two issues that have contributed to enhancing the current instruments. First, the necessity to develop measures with adequate psychometric properties, which has been discussed in recent studies, and second, the agreement between experts in analysing objective and subjective perspectives, as well as the use of self-report to include the participation of the person with ID. The question that we set out to investigate in this paper is whether the measurements function properly for the person with ID, independent of their level of severity. We used the Spanish version of the Personal Outcomes Scale, as it is a psychometrically sound instrument and includes three sources of information (the person with ID, a professional and a family member). METHOD: The sample was composed of 529 persons with ID (296 men, representing 55.95% of the total sample, and 233 women, with Mage  = 35.03, SD = 10.82) from several regions of Spain, along with their professional of reference and a family member. The severity variable was estimated for each item based on estimations of differential item functioning. RESULTS: The results showed that several items were undervalued by the assessments if the severity of the ID was greater. Mainly, this difference was observed in the assessments by professionals and in the dimensions of rights, personal development and self-determination. CONCLUSIONS: This paper focuses on the uses and interpretations of the results of the QoL measurements in the Personal Outcomes Scale. The results indicate that, in our sample, when people with high levels of ID are assessed, the functioning of some items are affected by the severity of this disability. For correct use, these items must be interpreted on the basis of the results obtained. Additionally, it is necessary to thoroughly review the QoL indicators for persons with severe or profound ID.

The Spanish version of the Self-Determination Inventory Student Report: application of item response theory to self-determination measurement.

BACKGROUND: A new measure of self-determination, the Self-Determination Inventory: Student Report (Spanish version), has recently been adapted and empirically validated in Spanish language. As it is the first instrument intended to measure self-determination in youth with and without disabilities, there is a need to further explore and strengthen its psychometric analysis based on item response patterns. METHOD: Through item response theory approach, this study examined item observed distributions across the essential characteristics of self-determination. RESULTS: The results demonstrated satisfactory to excellent item functioning patterns across characteristics, particularly within agentic action domains. Increased variability across items was also found within action-control beliefs dimensions, specifically within the self-realisation subdomain. CONCLUSIONS: These findings further support the instrument's psychometric properties and outline future research directions.

Item response theory analysis applied to the Spanish version of the Personal Outcomes Scale.

BACKGROUND: The study of measurements of quality of life (QoL) is one of the great challenges of modern psychology and psychometric approaches. This issue has greater importance when examining QoL in populations that were historically treated on the basis of their deficiency, and recently, the focus has shifted to what each person values and desires in their life, as in cases of people with intellectual disability (ID). Many studies of QoL scales applied in this area have attempted to improve the validity and reliability of their components by incorporating various sources of information to achieve consistency in the data obtained. The adaptation of the Personal Outcomes Scale (POS) in Spanish has shown excellent psychometric attributes, and its administration has three sources of information: self-assessment, practitioner and family. The study of possible congruence or incongruence of observed distributions of each item between sources is therefore essential to ensure a correct interpretation of the measure. The aim of this paper was to analyse the observed distribution of items and dimensions from the three Spanish POS information sources cited earlier, using the item response theory. METHOD: We studied a sample of 529 people with ID and their respective practitioners and family member, and in each case, we analysed items and factors using Samejima's model of polytomic ordinal scales. RESULTS: The results indicated an important number of items with differential effects regarding sources, and in some cases, they indicated significant differences in the distribution of items, factors and sources of information. CONCLUSIONS: As a result of this analysis, we must affirm that the administration of the POS, considering three sources of information, was adequate overall, but a correct interpretation of the results requires that it obtain much more information to consider, as well as some specific items in specific dimensions. The overall ratings, if these comments are considered, could result in bias.

Characterizing Magnitude and Selectivity of Attrition in a Study of Mild Cognitive Impairment.

OBJECTIVES: Attrition is one of the greatest difficulties in longitudinal studies on cognitive ageing because of the associated risk of underestimating declines. The aims of this paper were to characterize the magnitude and selectivity of attrition in a study of mild cognitive impairment. DESIGN: Forty two patients with multiple-domain amnestic MCI, 71 with single-domain amnestic MCI, 35 with non-amnestic MCI and 318 healthy controls were recruited from primary care centers and assessed at baseline. MEASUREMENTS: All participants underwent extensive neuropsychological evaluation, including the Mini-Mental State Examination, the Californian Verbal Learning Test, the CAMCOG-R battery, the Counting Span task and Listening Span task, and the Subjective Memory Complaints Questionnaire. RESULTS: 21.5% of the participants at baseline did not participate in the follow-up assessment. Comparison between respondents and non-returners did not reveal differences in cognitive performance in the MCI group. Data obtained at the initial assessment regarding comorbidity, social activities and attention given to memory training enabled prediction of the status of the participants in the follow-up assessment. CONCLUSION: Identification of potential non- returners is relevant, especially in MCI studies, in order to develop retention strategies to minimize attrition.

Family quality of life: adaptation to Spanish population of several family support questionnaires.

BACKGROUND: The concept of family quality of life has emerged as a decisive construct in the last decades to improve the capabilities of families and to assess the outcomes of the services and supports they get. The goal of this research is to adapt three instruments to the Spanish population: the 'Beach Center Family Quality of Life Scale', the 'Beach Center Family-Professional Partnership Scale' and the 'Service Inventory'. These tools were originally designed by researchers from the Beach Center on Disability, University of Kansas, in order to obtain some input from the families of people with intellectual disability (ID) with regard to the attention they get from the early childhood intervention services. METHOD: The sample included a total of 202 families of children with ID, between 0 and 6 years old, all of them cared for at 13 early childhood intervention centres. Based on a confirmatory factorial analysis, we have explored the psychometric properties of the three scales administered to respondents. Statistical analyses were conducted with the spss software version 17.0 and the EQS software version 6.1 for Structural Equation Models. RESULTS: The results confirm that the factor structure of the 'Beach Center Family Quality of Life Scale', the 'Beach Center Family-Professional Partnership Scale' and the 'Service Inventory' adapted for the Spanish population fit the factor models proposed by the authors of the surveys. Consequently, the scales are ready to be used. CONCLUSIONS: The developed measures may serve as a foundation for good decision-making from practices and policies.

[Constructive praxis to the copy: extended standards of the Barcelona test]. / Praxis constructiva a la copia: normas ampliadas del test Barcelona.

BACKGROUND: Drawings tasks have achieved a very central position in neurology by virtue of their sensitivity to many different kinds of brain lesions. Variables of age and education may significantly affect test performance and therefore should taken into account when developing test norms. OBJECTIVES: To increase the sample of the original version of the Barcelona test (BT) and analyze the results of the drawing task. PATIENTS AND METHODS: 322 normal subjects (47.1% women and 52.9% males), stratified in 7 groups according to age and education were included in the large sample. Copying subtest of the BT were used. Descriptive statistics and multiple lineal regression were applied to the data. RESULTS: Due to the relevance of age and education on coping drawing tasks (Kruskal-Wallis: p < 0.001 for age and p < 0.001 for education). Both variables (age and education) were analyzed using multiple lineal regression in order to establish possible effects of age and/or education for each group (F = 18.073; p < 0.001). Subjects aged more than 70 had the best adjust to the regression model (R2 = 0.4245; F = 18.07; p < 0.001; delta R2 = 13.56). Furthermore age has an important role as modulator to the results. CONCLUSIONS: Age and education influenced copying drawing performance for raw scores as well as when considering timed performance, in a different way for each studied group. While the correlation of education and performance on copy drawing tasks is a direct one, for age this relation is inverse.

[Digit span, automatic speech and orientation: amplified norms of the Barcelona Test]. / Series de dígitos, series automáticas y orientación: normas ampliadas del Test Barcelona.

BACKGROUND: Digit span, automatic speech and orientation are screening tests of interest in neurology due to their high sensitivity in cerebral pathologies and easy applicability. These tasks assess attention, concentration, mental control, orientation and short-term memory. OBJECTIVES: To analyze the impact of age and education on the results of the following subtest included in the Barcelona Test: digit span, automatic speech and orientation. PATIENTS AND METHODS: 275 normal subjects were evaluated. Mean (SD) age: 52 (17.7), range (18-19). Mean education: 9 (5.5) years, range (0-25). Subjects were stratified into 7 groups by age and education. Nine items of Barcelona Test were used: digits span forward and backward, automatic speech, forward and backward, with and without time, and person, time and place orientation. RESULTS: Statistical description, parametric and non parametric test. The Kruskal Wallis test was used, showing that aged and education are significant difference in the automatic speech forward or backward, with or without time, while it did not showed a significant difference in the different groups in the orientation tests. Analysis of Variance for group of age and education showed significant differences in the digit span forward and backward (F = 19.92; p < 0.001; F = 18.44, p < 0.001), respectively. CONCLUSIONS: Both age (inversely) and education (directly) influenced on the scores of the analyzed items, except to person, place and time orientation that are not affected for them.

[Abstract abilities: amplified norms for the Barcelona Test]. / Capacidades abstractas: normas ampliadas del Test Barcelona.

INTRODUCTION: By abstract abilities is understood the ability of comprehend relations identifying the essential components and taking out from them a common feature. Its evaluation constitutes a great challenge for neuropsychology. Several studies have showed the influence of age and formal education in the performance of tests assessing these abilities. AIM: To analyse the WAIS-style abstract abilities included in the abbreviated version of the Barcelona Test determining the influence of and formal education and obtaining more normative data for a Spanish population. METHOD: A sample of 264 subjects was randomly selected. The subtests of the Barcelona Test were administered in a single session to every subject. We selected the scores obtained in Arithmetic Problems (raw and timed), Similarities, Digit Symbol and Block Design (raw and timed). RESULTS: The analysis of the variance showed statistically significant results of the selected items according to age and formal education. The formal education, as the lineal regression showed, resulted significant for all the items, being the Arithmetic Problems the only subtests not influenced significantly by the formal education. CONCLUSION: The results obtained in this study are in general concordant to the ones of the reviewed bibliography.