International psychometric validation of the Living with Chronic Illness Scale in Spanish-speaking patients with chronic obstructive pulmonary disease.

OBJECTIVES: To validate the Living with Chronic Illness (LW-CI) Scale in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Observational, cross-sectional validation study with retest. Acceptability, reliability, precision and construct validity were tested. SETTING: The study took place in primary and secondary specialised units of public and private hospitals of Spain and Colombia. PARTICIPANTS: The study included 612 patients with COPD assessed from May 2018 to May 2019. A consecutive cases sampling was done. Inclusion criteria included: (A) patients with a diagnosis of COPD; (B) native Spanish speaking; (C) able to read and understand questionnaires; and (D) able to provide informed consent. Exclusion criteria included: (A) cognitive deterioration and (B) pharmacological effect or disorder that could disrupt the assessment. RESULTS: The LW-CI-COPD presented satisfactory data quality, with no missing data or floor/ceiling effects, showing high internal consistency for all the domains (Cronbach's alpha for the total score 0.92). Test-retest reliability was satisfactory (intraclass correlation coefficient=0.92). The LW-CI-COPD correlated 0.52-0.64 with quality of life and social support measures. The scale demonstrated satisfactory known-groups validity, yielding significantly different scores in patients grouped according to COPD severity levels. CONCLUSIONS: This has been the first validation study of the LW-CI-COPD. It is a feasible, reliable, valid and precise self-reported scale to measure living with COPD in the Spanish-speaking population. Therefore, it could be recommended for research and clinical practice to measure this concept and evaluate the impact of centred-care interdisciplinary interventions based on the patients' perspective, focused on providing holistic and comprehensive care to patients with COPD.

Validation of living with chronic illness scale in a type 2 diabetes mellitus population.

BACKGROUND: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients' day-to-day quality of life. Our study aim is to validate the "Living with Chronic Illness Scale" for a Spanish-speaking T2DM population. METHODS: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument. RESULTS: The scale had an adequate internal consistency and test retest reliability (Cronbach's alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values < ½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL-BREF) (rs = 0.51-0.30) and ssatisfaction with life (SLS-6) (rs = 0.50-0.38). The original 26-items version of the scale did not support totally the confirmatory factor analysis. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity. CONCLUSIONS: The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person's life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.

Validation of the De Jong Gierveld Loneliness Scale, 6-item version, in a multiethnic population of Chilean older adults.

OBJECTIVE: To analyse the psychometric properties of the De Jong Gierveld Loneliness Scale, 6-item version (DJGLS-6), in a multiethnic sample of older Chilean adults. METHODS: A cross-sectional study was designed using a sample of 800 older people, and 71% were self-declared indigenous. Data quality and acceptability, internal consistency, and construct and structural validity of DJGLS-6 were analysed. The scale was also analysed according to the Rasch model. RESULTS: The DJGLS-6 scored higher for the non-indigenous group than for Aymara and Mapuche (P < .001). KR-20 coefficients (internal consistency) for emotional loneliness subscale reached 0.44 for Aymara and Mapuche and 0.62 for non-indigenous, and from 0.73 (non-indigenous) to 0.86 (Aymara) for social loneliness subscale. The confirmatory factor analysis identified one dimension. None of the two subscales fit the Rasch model. CONCLUSION: The results indicate that DJGLS-6 is a reliable and adequate scale for non-indigenous Chilean older people. However, it should be culturally adapted to indigenous ethnic minorities.

Psychometric Validation of the Living with Chronic Illness Scale in Patients with Chronic Heart Failure.

It is necessary to develop self-reported instruments that evaluate the process of living with chronic heart failure (HF) holistically. The Living with Chronic Illness Scale-HF (LW-CI-HF) is the only available tool to evaluate how patients are living with HF. The aim is to analyse the psychometric properties of the LW-CI scale in the HF population. An international, cross-sectional validation study was carried out in 603 patients living with HF from Spain and Colombia. The variables measured were living with HF, perceived social support, satisfaction with life, quality of life and global impression of severity. The LW-CI-HF scale presented good data quality and acceptability. All domains showed high internal consistency with Cronbach's alpha coefficient ≥ 0.7. The intraclass correlation coefficient for the total score was satisfactory (0.9) in test-retest reliability. The LW-CI-HF correlated 0.7 with social support and quality of life measures. Standard error of measurement was 6.5 for total scale. The LW-CI-HF scale is feasible, reliable and valid. However, results should be taken with caution in order to be used in clinical practice to evaluate the complex process of living with HF. Further research is proposed.

Assessment of Ataxia Rating Scales and Cerebellar Functional Tests: Critique and Recommendations.

BACKGROUND: We assessed the clinimetric properties of ataxia rating scales and functional tests, and made recommendations regarding their use. METHODS: A systematic literature search was conducted to identify the instruments used to rate ataxia symptoms. The identified rating scales and functional ability tests were reviewed and ranked by the panel as "recommended," "suggested," or "listed" for the assessment of patients with discrete cerebellar disorders, using previously established criteria. RESULTS: We reviewed 14 instruments (9 rating scales and 5 functional tests). "Recommended" rating scales for the assessment of symptoms severity were: for Friedreich's ataxia, the Friedreich's Ataxia Rating Scale, the International Cooperative Ataxia Rating Scale (ICARS), and the Scale for the Assessment and Rating of Ataxia (SARA); for spinocerebellar ataxias, ICARS and SARA; for ataxia telangiectasia: ICARS and SARA; for brain tumors, SARA; for congenital disorder of glycosylation-phosphomannomutase-2 deficiency, ICARS; for cerebellar symptoms in multiple sclerosis, ICARS; for cerebellar symptoms in multiple system atrophy: Unified Multiple System Atrophy Rating Scale and ICARS; and for fragile X-associated tremor ataxia syndrome, ICARS. "Recommended" functional tests were: for Friedreich's ataxia, Ataxia Functional Composite Score and Composite Cerebellar Functional Severity Score; and for spinocerebellar ataxias, Ataxia Functional Composite Score, Composite Cerebellar Functional Severity Score, and SCA Functional Index. CONCLUSIONS: We identified some "recommended" scales and functional tests for the assessment of patients with major hereditary ataxias and other cerebellar disorders. The main limitations of these instruments include the limited assessment of patients in the more severe end of the spectrum and children. Further research in these populations is warranted. © 2020 International Parkinson and Movement Disorder Society.

Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile.

BACKGROUND: There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. OBJECTIVE: The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults. METHODS: Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche). RESULTS: The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p < 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche. DISCUSSION: The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. CONCLUSIONS: There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.

Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile

Abstract Background: There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. Objective: The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults.Methods: Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche).Results: The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p< 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche.Discussion: The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. Conclusions:There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.

Evaluación de los trastornos del sueño en la enfermedad de parkinson / Sleep disorders in patients with parkinson's disease

En la actualidad existen dos cuestionarios específicos para evaluar los trastornos del sueño de los pacientes con enfermedad de Parkinson: la Escala de Sueño para Enfermedad de Parkinson (Parkinson’s Disease Sleep Scal [PDSS]) y la SCOPA-Sueño (Scales for Outcomes in Parkinson’s Disease-Sleep). Estas dos escalas tienen, en conjunto, propiedades psicométricas satisfactorias y son de fácil aplicación e interpretación. Debido a su estructura y contenido pueden considerarse complementarias, dado que la PDSS informa más sobre la calidad del sueño nocturno y las causas de su alteración y la SCOPA-Sueño evalúa sueño nocturno y somnolencia diurna, pero no explora los síntomas que influyen en la calidad del sueño nocturno. Otros dos instrumentos específicos para la enfermedad de Parkinson, el Cuestionario y la Escala de Síntomas no Motores, se desarrollaron para identificar y cuantificar (respectivamente) dichas manifestaciones. Ambos contienen dominios específicos para trastornos del sueño que, aunque menos extensos y detallados que la PDSS y la SCOPA-Sueño, permiten cuantificarlos simultáneamente (y por tanto, establecer relaciones) con una variedad de alteraciones de enorme interés. Debido a la complejidad de las manifestaciones de la enfermedad de Parkinson, la evaluación del paciente es necesariamente compleja y ha de facilitarse mediante la disponibilidad de instrumentos útiles y válidos.

Intellectual disability: an approach from the health sciences perspective.

Intellectual disability (ID) is a complex condition that has not aroused very much interest in the health sciences and medical fields. As a result, a large part of the responsibility for caring for individuals with ID has fallen in the areas of education, social services and volunteering. Nevertheless, intellectual disability is a very significant health problem, whether because of its prevalence, the costs to the public health system, the families and society in general or due to related health complications. ID should be a priority area of study and action in the health field. This article reviews the conceptual, diagnostic and etiological problems that affect intellectual disability, as well as factors related with the health of the persons who are affected. In addition, some recommendations are outlined for improving health care for this population group.

Intellectual disability: an approach from the health sciences perspective: [review]

Intellectual disability (ID) is a complex condition that has not aroused very much interest in the health sciences and medical fields. As a result, a large part of the responsibility for caring for individuals with ID has fallen in the areas of education, social services and volunteering. Nevertheless, intellectual disability is a very significant health problem, whether because of its prevalence, the costs to the public health system, the families and society in general or due to related health complications. ID should be a priority area of study and action in the health field. This article reviews the conceptual, diagnostic and etiological problems that affect intellectual disability, as well as factors related with the health of the persons who are affected. In addition, some recommendations are outlined for improving health care for this population group.

La discapacidad intelectual (DI) es una condición compleja que no ha despertado gran interés en el campo médico y en el de las ciencias de la salud. Como consecuencia, gran parte de la responsabilidad del cuidado de los individuos con DI ha recaído en las áreas de la educación, el servicio social y el voluntariado. Sin embargo, la discapacidad intelectual es un problema de salud muy significativo, ya sea por su prevalencia, por los costos para el sistema de salud pública, para las familias y para la sociedad en general o debido a las complicaciones de salud relacionadas con ella. La DI debería ser un área de estudio y de acción prioritaria en el campo de la salud. Este artículo revisa los problemas conceptuales, diagnósticos y etiológicos que afectan a la discapacidad intelectual, así como los factores relacionados con la salud de las personas afectadas. Además se delinean algunas recomendaciones para mejorar el cuidado de la salud en este grupo de población.