An item response theory approach to the measurement of working memory capacity.

Complex span tasks are perhaps the most widely used paradigm to measure working memory capacity (WMC). Researchers assume that all types of complex span tasks assess domain-general WM. However, most research supporting this claim comes from factor analysis approaches that do not examine task performance at the item level, thus not allowing comparison of the characteristics of verbal and spatial complex span tasks. Item response theory (IRT) can help determine the extent to which different complex span tasks assess domain-general WM. In the current study, spatial and verbal complex span tasks were examined using IRT. The results revealed differences between verbal and spatial tasks in terms of item difficulty and block difficulty, and showed that most subjects with below-average ability were able to answer most items correctly across all tasks. In line with previous research, the findings suggest that examining domain-general WM by using only one task might elicit skewed scores based on task domain. Further, visuospatial complex span tasks should be prioritized as a measure of WMC if resources are limited.

Treatment of COVID-19 during the Acute Phase in Hospitalized Patients Decreases Post-Acute Sequelae of COVID-19.

BACKGROUND: The post-acute sequelae of SARS-CoV-2 (PASC) infection have caused a significant impact on our health system, but there is limited evidence of approved drugs focused on its prevention. Our objective was to identify risk factors that can determine the presence of PASC, with special attention to the treatment received in the acute phase, and to describe the profile of persistent symptoms in a multidisciplinary Post-Coronavirus Disease-19 (COVID-19) Unit. METHODS: This one-year prospective observational study included patients following an acute COVID-19 infection, irrespective of whether they required hospital admission. A standardized symptom questionnaire and blood sampling were performed at the first follow-up visit, and demographic and clinical electronic data were collected. We compared subjects with PASC with those who had fully recovered. Multivariate logistic regression was performed to identify factors associated with PASC in hospitalized patients, and Kaplan-Meier curves were used to assess duration of symptoms according to disease severity and treatments received in the acute phase. RESULTS: 1966 patients were evaluated; 1081 had mild disease, 542 moderate and 343 severe; around one third of the subjects had PASC, and were more frequently female, with obesity, asthma, and eosinophilia during acute COVID-19 disease. Patients who received treatment with dexamethasone and remdesivir during the course of the acute illness showed a lower median duration of symptoms, compared with those who received none of these treatments. CONCLUSION: Treatment with dexamethasone and/or remdesivir may be useful to reduce the impact of PASC secondary to SARS-CoV-2 infection. In addition, we identified female gender, obesity, asthma, and disease severity as risk factors for having PASC.

Characterizing Relationships Among the Cognitive, Physical, Social-emotional, and Health-related Traits of Military Personnel.

INTRODUCTION: Personnel engaged in high-stakes occupations, such as military personnel, law enforcement, and emergency first responders, must sustain performance through a range of environmental stressors. To maximize the effectiveness of military personnel, an a priori understanding of traits can help predict their physical and cognitive performance under stress and adversity. This work developed and assessed a suite of measures that have the potential to predict performance during operational scenarios. These measures were designed to characterize four specific trait-based domains: cognitive, health, physical, and social-emotional. MATERIALS AND METHODS: One hundred and ninety-one active duty U.S. Army soldiers completed interleaved questionnaire-based, seated task-based, and physical task-based measures over a period of 3-5 days. Redundancy analysis, dimensionality reduction, and network analyses revealed several patterns of interest. RESULTS: First, unique variable analysis revealed a minimally redundant battery of instruments. Second, principal component analysis showed that metrics tended to cluster together in three to five components within each domain. Finally, analyses of cross-domain associations using network analysis illustrated that cognitive, health, physical, and social-emotional domains showed strong construct solidarity. CONCLUSIONS: The present battery of metrics presents a fieldable toolkit that may be used to predict operational performance that can be clustered into separate components or used independently. It will aid predictive algorithm development aimed to identify critical predictors of individual military personnel and small-unit performance outcomes.

What is theory of mind? A psychometric study of theory of mind and intelligence.

Theory of mind (ToM) is an essential ability for social competence and communication, and it is necessary for understanding behaviors that differ from our own (Premack & Woodruff, 1978). Recent research suggests that tasks designed to measure ToM do not adequately capture a single ToM ability (Warnell & Redcay, 2019; Quesque & Rossetti, 2020) and, instead, might be related to tasks of general cognitive ability (Coyle, Elpers, Gonzalez, Freeman, & Baggio, 2018). This hinders the interpretation of experimental findings and puts into question the validity of the ToM construct. The current study is the first psychometric assessment of the structure of ToM to date. Comparing ToM to crystallized intelligence (Gc) and fluid intelligence (Gf), the study aims to (a) understand whether ToM should be considered a monolithic ability and (b) explore whether tasks of ToM adequately assess ToM, above and beyond general cognitive ability. For this, confirmatory factor analyses (CFAs), exploratory factor analysis (EFA), and exploratory network analysis (NMA) were conducted. The results of the models largely point to the same conclusion: while ToM tasks are not merely assessing cognitive ability, they are not purely assessing a single ToM construct either. Importantly, these findings align with recent theoretical accounts proposing that ToM should not be considered a monolithic construct (Quesque & Rossetti, 2020; Schaafsma, Pfaff, Spunt, & Adolphs, 2015, Devaine, Hollard, & Daunizeau, 2014), and should instead be explored and measured as multiple domains.

It Takes a Village: Using Network Science to Identify the Effect of Individual Differences in Bilingual Experience for Theory of Mind.

An increasing amount of research has examined the effects of bilingualism on performance in theory of mind (ToM) tasks. Bilinguals outperform monolinguals in ToM when comparing groups. However, it is unclear what aspects of the bilingual experience contribute to this effect in a dynamic construct like ToM. To date, bilingualism has been conceptualized as a dichotic skill that is distinct from monolingualism, obscuring nuances in the degree that different bilingual experience affects cognition. The current study used a combination of network science, cognitive, and linguistic behavioral measurements to explore the factors that influence perspective-taking ToM based on participants' current and previous experience with language, as well as their family networks' experience with language. The results suggest that some aspects of the bilingual experience predict task performance, but not others, and these predictors align with the two-system theory of ToM. Overall, the findings provide evidence for the extent to which individual differences in bilingualism are related to different cognitive outcomes.

Toward Predicting Human Performance Outcomes From Wearable Technologies: A Computational Modeling Approach.

Wearable technologies for measuring digital and chemical physiology are pervading the consumer market and hold potential to reliably classify states of relevance to human performance including stress, sleep deprivation, and physical exertion. The ability to efficiently and accurately classify physiological states based on wearable devices is improving. However, the inherent variability of human behavior within and across individuals makes it challenging to predict how identified states influence human performance outcomes of relevance to military operations and other high-stakes domains. We describe a computational modeling approach to address this challenge, seeking to translate user states obtained from a variety of sources including wearable devices into relevant and actionable insights across the cognitive and physical domains. Three status predictors were considered: stress level, sleep status, and extent of physical exertion; these independent variables were used to predict three human performance outcomes: reaction time, executive function, and perceptuo-motor control. The approach provides a complete, conditional probabilistic model of the performance variables given the status predictors. Construction of the model leverages diverse raw data sources to estimate marginal probability density functions for each of six independent and dependent variables of interest using parametric modeling and maximum likelihood estimation. The joint distributions among variables were optimized using an adaptive LASSO approach based on the strength and directionality of conditional relationships (effect sizes) derived from meta-analyses of extant research. The model optimization process converged on solutions that maintain the integrity of the original marginal distributions and the directionality and robustness of conditional relationships. The modeling framework described provides a flexible and extensible solution for human performance prediction, affording efficient expansion with additional independent and dependent variables of interest, ingestion of new raw data, and extension to two- and three-way interactions among independent variables. Continuing work includes model expansion to multiple independent and dependent variables, real-time model stimulation by wearable devices, individualized and small-group prediction, and laboratory and field validation.

Cultural Adaptation and Psychometric Properties of the Spanish Version of the Occupational Balance Questionnaire: An Instrument for Occupation-Based Research.

Occupational balance (OB) may be a major determinant of health outcomes due to its role in bringing a sense of purpose in the occupations that are personally experienced as a process of getting health and wellness. The Occupational Balance Questionnaire (OBQ) is a reliable instrument for measuring OB, although it has not been adapted and validated in Spain so far; therefore, this study had a double aim: (1) to translate and cross-culturally adapt the original OBQ version into Spanish (OBQ-E); (2) to analyze the psychometric properties for its use in the Spanish population. Standard procedures were used for the cross-adaptation process and pilot testing was carried out using three different samples to extend the applicability of the OBQ-E. Validation measures of the final version of the OBQ-E were conducted in a sample of 219 participants. The OBQ-E showed that items and instructions were culturally appropriate and written clearly. Psychometric testing showed excellent internal consistency (Cronbach's alpha = 0.87; Guttman split-half coefficient = 0.85), good test-retest reliability (rs (Spearman rho) = 0.73), and acceptable convergent validity (overall status, rs = 0.37; Related Quality of Life, rs = 0.42; Satisfaction with Life Scale, rs = 0.54). The findings suggest that the OBQ-E may be a suitable instrument for assessing OB in the Spanish population; hence, it is a promising tool for epidemiological research that will significantly contribute to the understanding of OB as a health-related factor. Nevertheless, further investigation is also warranted to explore the potentiality of this instrument for clinical purposes.

Adult bilinguals outperform monolinguals in theory of mind.

Theory of mind (ToM) is an essential ability for social competence and communication, and it is necessary for understanding behaviours that differ from our own. Research on bilingual children has reported that 3- and 4-year-old bilinguals outperform monolinguals in ToM tasks. Research suggests that adult bilinguals also might outperform monolinguals; nevertheless, this effect has yet to be established. Here, we tested bilingual and monolingual adults on the director task. Results showed that bilingual adults outperformed monolinguals in response to perspective-dependent trials of the director task, but not in response to control trials. This suggests that bilingualism is associated with individuals' ability to take into account the perspective of another person. In addition, the number of cultures that participants were exposed to, regardless of whether the participant was bilingual or not, was also associated with ToM performance. Overall, the findings suggest that linguistic and cultural experience have an impact on ToM.

The Relationship between Theory of Mind and Intelligence: A Formative g Approach.

Theory of Mind (ToM) is the ability understand that other people's mental states may be different from one's own. Psychometric models have shown that individual differences in ToM can largely be attributed to general intelligence (g) (Coyle et al. 2018). Most psychometric models specify g as a reflective latent variable, which is interpreted as a general ability that plays a causal role in a broad range of cognitive tasks, including ToM tasks. However, an alternative approach is to specify g as a formative latent variable, that is, an overall index of cognitive ability that does not represent a psychological attribute (Kovacs and Conway 2016). Here we consider a formative g approach to the relationship between ToM and intelligence. First, we conducted an SEM with reflective g to test the hypothesis that ToM is largely accounted for by a general ability. Next, we conducted a model with formative g to determine whether the relationship between ToM and intelligence is influenced by domain-specific tasks. Finally, we conducted a redundancy analysis to examine the contribution of each g variable. Results suggest that the relationship between ToM and intelligence in this study was influenced by language-based tasks, rather than solely a general ability.

Development and validation of the QUECOMIICAT questionnaire: a tool to assess disease-related knowledge in patients with inflammatory bowel disease

Introduction: adequate knowledge of inflammatory bowel disease (IBD) is essential for a successful patient-centered management of IBD. Objective: due to the scarcity of up-to-date tools for measuring IBD literacy, this single-center, prospective study aimed to develop and validate a new questionnaire to assess IBD-related knowledge. Material and methods: the study included patients followed up at the Crohn-Colitis Care Unit (UACC) at the Hospital Vall d'Hebron (Barcelona, Spain). Patients admitted to the UACC for the first time were subsequently enrolled into a standard IBD educational program. A pilot questionnaire was developed and validated in 92 IBD patients by determining the internal consistency reliability (Cronbach's α test), feasibility, construct validity (correlation with the Crohn's and Colitis Knowledge [CCKNOW] questionnaire and a knowledge visual analog scale [VAS]) and sensitivity (score change before and after a standard IBD educational program). The questionnaire, named "Qüestionari Coneixements Malaltia Inflamatòria Intestinal Catalunya" (IBD-knowledge questionnaire Catalonia) (QUECOMIICAT) was written in Spanish and had 25 items addressing six dimensions: general concepts, clinic, treatment, surgery, habits and social context. Results: the median (interquartile range) completion time was 15 (10-20) minutes and the floor and ceiling effects were 1.1% and 2.1%, respectively. The Cronbach's α coefficient was α = 0.75. QUECOMIICAT significantly correlated with the VAS (rho = 0.34, p < 0.01) and CCKNOW questionnaires (rho = 0.74, p < 0.01). Patient knowledge significantly increased 24 hours after attending a standard IBD educational program and remained statistically significant one month later (Pearson's test-retest correlation coefficient r = 0.81, p < 0.001). Conclusion: in conclusion, the QUECOMIICAT questionnaire is a new up-to-date tool to assess IBD-related knowledge with good feasibility and validation results for use in the routine clinical practice

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Development and validation of the QUECOMIICAT questionnaire: a tool to assess disease-related knowledge in patients with inflammatory bowel disease.

INTRODUCTION: adequate knowledge of inflammatory bowel disease (IBD) is essential for a successful patient-centered management of IBD. OBJECTIVE: due to the scarcity of up-to-date tools for measuring IBD literacy, this single-center, prospective study aimed to develop and validate a new questionnaire to assess IBD-related knowledge. MATERIAL AND METHODS: the study included patients followed up at the Crohn-Colitis Care Unit (UACC) at the Hospital Vall d'Hebron (Barcelona, Spain). Patients admitted to the UACC for the first time were subsequently enrolled into a standard IBD educational program. A pilot questionnaire was developed and validated in 92 IBD patients by determining the internal consistency reliability (Cronbach's α test), feasibility, construct validity (correlation with the Crohn's and Colitis Knowledge [CCKNOW] questionnaire and a knowledge visual analog scale [VAS]) and sensitivity (score change before and after a standard IBD educational program). The questionnaire, named "Qüestionari Coneixements Malaltia Inflamatòria Intestinal Catalunya" (IBD-knowledge questionnaire Catalonia) (QUECOMIICAT) was written in Spanish and had 25 items addressing six dimensions: general concepts, clinic, treatment, surgery, habits and social context. RESULTS: the median (interquartile range) completion time was 15 (10-20) minutes and the floor and ceiling effects were 1.1% and 2.1%, respectively. The Cronbach's α coefficient was α = 0.75. QUECOMIICAT significantly correlated with the VAS (rho = 0.34, p < 0.01) and CCKNOW questionnaires (rho = 0.74, p < 0.01). Patient knowledge significantly increased 24 hours after attending a standard IBD educational program and remained statistically significant one month later (Pearson's test-retest correlation coefficient r = 0.81, p < 0.001). CONCLUSION: in conclusion, the QUECOMIICAT questionnaire is a new up-to-date tool to assess IBD-related knowledge with good feasibility and validation results for use in the routine clinical practice.

Patient preferences for inflammatory bowel disease treatment objectives.

BACKGROUND: There is currently little evidence about what treatment objectives most interest patients with inflammatory bowel disease (IBD). AIMS: To determine patient preferences regarding IBD treatment objectives, specially the attributes they value most and the symptoms to be controlled as a priority. METHODS: Prospective, observational, anonymous study conducted in 117 outpatients with Crohn's disease or ulcerative colitis. RESULTS: The most important treatment objectives from the patients' perspective were: improving quality of life (40.2% of patients), and completely resolving symptoms (33.3%). Only 12.8% of patients indicated having a completely normal colonoscopy as a preferred objective. The symptoms the patients considered to be most important when prioritizing their control were: abdominal pain (23.1% of patients), and bowel movement urgency (17.1%). The preferred treatment objectives were similar for Crohn's disease and ulcerative colitis patients. CONCLUSIONS: Improving quality of life and completely controlling symptoms are the priority treatment objectives for IBD patients, with abdominal pain being the most important symptom. Conversely, therapeutic objective target goals proposed by physicians, such as healing the mucosal lesions, are not a priority for most patients. This indicates that there are discrepancies between patient and physician expectations, which should be taken into account if a patient-centered care model is to be implemented.

[Evaluation of patient satisfaction after stroke rehabilitation program. Validation study for the Spanish version of the Satisfaction Pound Scale]. / Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale.

BACKGROUND AND OBJECTIVE: The Satisfaction Pound Scale is a specific questionnaire to evaluate satisfaction with the rehabilitation program after a stroke. The aim of this study was to adapt this scale to Spanish and to evaluate its metric characteristics. METHOD: The adaptation included translation and back-translation methods. Metric characteristics were evaluated in 74 patients, all of whom were administered the Satisfaction Pound Scale and the Short Form 36 (SF-36). The statistical model was tested by confirmatory factor analysis (CFA). Reliability was determined through Cronbach alpha coefficient and a test-retest procedure. Construct validity was assessed by means of correlations between the satisfaction scale and the SF-36. RESULTS: Adjustment indicators in the CFA were very good. Reproducibility test showed correlations higher than 0.85, and all correlations between SF-36 dimensions and the satisfaction scale were lower than 0.2, in accordance with the hypotheses raised. CONCLUSIONS: The Spanish version of the Satisfaction Pounds Scale is reliable and valid, therefore it is a useful tool to assess satisfaction with the post-stroke rehabilitation program in our area.

Iron Deficiency in the Absence of Anemia Impairs the Perception of Health-Related Quality of Life of Patients with Inflammatory Bowel Disease.

BACKGROUND: Anemia is a common complication of inflammatory bowel disease (IBD) and contributes to the deterioration of health-related quality of life (HRQOL). Iron deficiency (ID) is a prevalent underlying factor, present in up to 90% of patients. In the absence of anemia, it is unclear as to what extent ID can affect HRQOL in patients with IBD. Our aim was to determine whether ID without anemia negatively affects normal perception of HRQOL in patients with IBD in remission. METHODS: We conducted a prospective, cross-sectional study in patients with IBD in remission without anemia. Blood samples were obtained to determine iron status, and patients completed the Inflammatory Bowel Disease Questionnaire-36. ID was defined on serum ferritin <30 ng/mL and transferrin saturation <16%. Restoration of HRQOL was defined as ≥209 on the Inflammatory Bowel Disease Questionnaire-36. RESULTS: One hundred-four patients with IBD in clinical remission were included; 45 patients were iron deficient and 59 had normal iron status. All patients were in clinical remission, with a median Harvey-Bradshaw Index ≤0 and Simple Clinical Colitis Activity Index ≤0. Median hemoglobin was 12.8 g/dL in the ID group and 13.9 g/dL in the normal iron status group (P < 0.05). Prevalence of female patients was higher in the ID group (odds ratio, 4.45; 95% CI, 1.7-11.7; P < 0.01). The median global value of Inflammatory Bowel Disease Questionnaire-36 was not different between the groups (219 in the ID group versus 230 in the normal iron status group, P = not significant), but restoration of health was significantly less frequent in patients with ID (odds ratio, 2.83; 95% CI, 1.22-6.6; P < 0.05). CONCLUSIONS: ID in absence of anemia negatively impacts normal perception of HRQOL in patients with IBD in remission. Correction of ID may be a new target in the treatment of these patients.

Evaluación de la satisfacción con el programa de rehabilitación tras el ictus: validación de la versión española de la Pound Satisfaction Scale / Evaluation of patient satisfaction after stroke rehabilitation program. Validation study for the Spanish version of the Satisfaction Pound Scale

Fundamento y objetivo. La Escala de Satisfacción de Pound es un cuestionario específico para evaluar la satisfacción con la rehabilitación seguida tras el ictus. Nuestro objetivo fue adaptar esta escala al español y evaluar sus características métricas. Método. La adaptación se realizó por traducción-retrotraducción. Las características métricas se evaluaron en 74 pacientes con la Escala de Satisfacción de Pound y el cuestionario de salud percibida Short Form 36 (SF-36). El modelo de medida se evaluó mediante análisis factorial confirmatorio (AFC); la fiabilidad, a partir de la consistencia interna y la reproducibilidad (test-retest); la validez de constructo se estudió mediante las correlaciones entre la escala de Pound y el SF-36. Resultados. Los indicadores de bondad de ajuste del AFC fueron muy buenos. En el estudio test-retest los coeficientes de correlación intraclase fueron>0,85. Todas las correlaciones entre las dimensiones del SF-36 y el cuestionario de satisfacción fueron<0,2. Conclusiones. La versión en español de la Escala de Satisfacción de Pound administrada telefónicamente es fiable y válida, resultando útil para evaluar la satisfacción con la rehabilitación seguida tras el ictus (AU)

Background and objective. The Satisfaction Pound Scale is a specific questionnaire to evaluate satisfaction with the rehabilitation program after a stroke. The aim of this study was to adapt this scale to Spanish and to evaluate its metric characteristics. Method. The adaptation included translation and back-translation methods. Metric characteristics were evaluated in 74 patients, all of whom were administered the Satisfaction Pound Scale and the Short Form 36 (SF-36). The statistical model was tested by confirmatory factor analysis (CFA). Reliability was determined through Cronbach alpha coefficient and a test-retest procedure. Construct validity was assessed by means of correlations between the satisfaction scale and the SF-36. Results. Adjustment indicators in the CFA were very good. Reproducibility test showed correlations higher than 0.85, and all correlations between SF-36 dimensions and the satisfaction scale were lower than 0.2, in accordance with the hypotheses raised. Conclusions. The Spanish version of the Satisfaction Pounds Scale is reliable and valid, therefore it is a useful tool to assess satisfaction with the post-stroke rehabilitation program in our area (AU)

Predictive value of early restoration of quality of life in Crohn's disease patients receiving antitumor necrosis factor agents.

BACKGROUND AND AIM: Crohn's disease (CD) impairs patients' health-related quality of life (HRQoL), therefore a goal of treatment is to improve their health. Recently, a more ambitious therapeutic target has been proposed, to reestablish patients' HRQoL to normal standards. There is no information on long-term prognostic value of restoring the health of patients with CD. Our aim was to determine if early restoration of HRQoL with antitumor necrosis factor (anti-TNF) agents is associated with long-term clinical remission. METHODS: Retrospective longitudinal study in patients with active CD treated with anti-TNF agents. Patients completed the Inflammatory Bowel Disease Questionnaire (IBDQ)-36 at baseline and weeks 2, 6, 14, 28, and 52. Early restoration of health was defined as an IBDQ-36 score > 209 at week 14, and long-term clinical remission as a Cohn's disease activity index (CDAI) score < 150 maintained through week 52. RESULTS: Ninety-four patients were included. Sixty-three patients maintained long-term remission, with 47 (75%) of them achieving early restoration of HRQoL. Of the 31 patients who did not maintain long-term remission, only 4 (13%) restored their HRQoL early (P < 0.01). There was a strong negative correlation between the IBDQ-36 at week 14 and CDAI values at week 52 (rs = - 0.64, P < 0.01). Ninety-two percent of patients with early restoration of HRQoL maintained long-term remission versus 37% who did not restore their HRQoL (P < 0.01). To predict long-term remission, the cutoff point of 209 of the early IBDQ-36 had an area under the receiver operating characteristic (AUROC) curve of 0.87. CONCLUSION: Achieving early restoration of HRQoL with anti-TNF agents is associated with sustained long-term remission. This could be a therapeutic goal of treatment in clinical trials and daily practice.

Questionnaries for measuring fatigue and its impact on health perception in inflammatory bowel disease.

INTRODUCTION: fatigue impacts perceived health, but its importance in inflammatory bowel disease is not known. OBJECTIVES: to define the applicability of the fatigue measurement questionnaires and analyze it in patients with Crohn´s disease and ulcerative colitis. MATERIAL AND METHODS: in a first phase, the psychometric properties of 3 fatigue measurement questionnaires were determined in 99 patients: Daily Fatigue Impact Scale, Fatigue Severity Scale, and Modified Fatigue Impact Scale. In a second phase, fatigue status and its relationship to disease and quality of life was determined in 127 patients and 69 healthy controls. RESULTS: the first part of the study showed the applicability of the questionnaires listed in inflammatory bowel disease, the Daily Fatigue Impact Scale (DFIS) having the best correlation with the quality of life and clinical activity. In the second phase, significantly higher levels of fatigue were observed in active disease than in disease in remission and healthy controls (p < 0,05). The severity of fatigue was significantly correlated with quality of life (r = -0.66 and -0.72 between IBDQ-9 and DFIS and in Crohn´s disease and ulcerative colitis, respectively) and with disease activity (r = 0.25 and Crohn´s disease and ulcerative colitis, respectively, p < 0.05). CONCLUSIONS: in inflammatory bowel disease, fatigue measurement questionnaires have good properties and show that fatigue is an important manifestation of the disease, which has a significant impact on quality of life of patients.

Cuestionarios de medida e impacto de la fatiga en la percepción de salud en la enfermedad inflamatoria intestinal / Questionnaires for measuring fatigue and its impact on health perception in inflammatory bowel disease

Introducción: la fatiga repercute en la salud percibida, pero se desconoce su relevancia en la enfermedad inflamatoria intestinal. Objetivos: definir la aplicabilidad de cuestionarios de medida de fatiga y analizarla en pacientes con enfermedad de Crohn y colitis ulcerosa. Material y métodos: en una primera fase, en 99 pacientes se determinaron las propiedades psicométricas de 3 cuestionarios de medida de fatiga: Escala del Impacto Diario de Fatiga, Escala de Gravedad de la Fatiga y Escala Modificada del Impacto de Fatiga. En una segunda fase, se determinó el estado de fatiga y su relación con la enfermedad y la calidad de vida en 127 pacientes y 69 controles sanos. Resultados: la primera parte del estudio, demostró la aplicabilidad de los cuestionarios citados en la enfermedad inflamatoria intestinal, siendo la Escala del Impacto Diario de Fatiga (EIDF) el de mejor correlación con la calidad de vida y la actividad clínica. En la segunda fase, se objetivaron unos niveles significativamente superiores de fatiga en la enfermedad activa que en la enfermedad en remisión y los controles sanos (p < 0,05). La intensidad de la fatiga se correlacionó de forma significativa con la calidad de vida (r = -0,66 y -0,72 entre el IBDQ- 9 y EIDF en enfermedad de Crohn y colitis ulcerosa respectivamente) y con la actividad de la enfermedad (r = 0,25 y 0,33 en la enfermedad de Crohn y colitis ulcerosa respectivamente, p < 0,05). Conclusiones: en la enfermedad inflamatoria intestinal los cuestionarios de medida de fatiga tienen propiedades adecuadas y demuestran que la fatiga es una manifestación importante de la enfermedad, que repercute de forma significativa en la calidad de vida de los pacientes(AU)

Introduction: fatigue impacts perceived health, but its importance in inflammatory bowel disease is not known. Objectives: to define the applicability of the fatigue measurement questionnaires and analyze it in patients with Crohn’s disease and ulcerative colitis. Material and methods: in a first phase, the psychometric properties of 3 fatigue measurement questionnaires were determined in 99 patients: Daily Fatigue Impact Scale, Fatigue Severity Scale, and Modified Fatigue Impact Scale. In a second phase, fatigue status and its relationship to disease and quality of life was determined in 127 patients and 69 healthy controls. Results: the first part of the study showed the applicability of the questionnaires listed in inflammatory bowel disease, the Daily Fatigue Impact Scale (DFIS) having the best correlation with the quality of life and clinical activity. In the second phase, significantly higher levels of fatigue were observed in active disease than in disease in remission and healthy controls (p < 0,05). The severity of fatigue was significantly correlated with quality of life (r = -0.66 and -0.72 between IBDQ-9 and DFIS and in Crohn’s disease and ulcerative colitis, respectively) and with disease activity (r = 0.25 and Crohn’s disease and ulcerative colitis, respectively, p < 0.05). Conclusions: in inflammatory bowel disease, fatigue measurement questionnaires have good properties and show that fatigue is an important manifestation of the disease, which has a significant impact on quality of life of patients(AU)