Design and Validation of a Questionnaire to Measure the Perception of Nursing Degree Students about the Learning Process in Primary Care.

The aim of this study was to develop a tool for the evaluation of the learning process of the clinical practicum in primary care. The study was carried out in two phases: (1) identification of the categories that determine the perception of the nursing degree students about the learning process in the clinical practicum in primary care and the items for each category; and (2) cross-sectional study in a sample of 475 nursing degree students. The psychometric properties in terms of reliability (internal consistency) and construct validity were analyzed through a confirmatory factor analysis. Cronbach's alpha coefficient of internal consistency for the entire questionnaire was 0.93, and that for each of the categories was above 0.70 in all cases. The chi-squared test was statistically significant (2.84; p < 0.001). The confirmatory factor analysis produced a model of 6 dimensions and 41 items. The parameters were estimated through the least squares method. All saturations were statistically significant (p < 0.05). In view of the results of this study, it can be asserted that the questionnaire to measure the perception of the nursing degree students about the learning process in the community clinical practicum (QPCLP) presents good properties in terms of internal consistency and validity.

Validity of the Functioning Assessment Short Tests (FAST), in patients with schizophrenia.

INTRODUCTION: Functional impairment in schizophrenia is one of the main features of the disorder and implies a great impact on the patient's quality of life. The Brief Functioning Assessment Scale (FAST), originally validated in bipolar disorder, has also been validated for its application in other mental disorders. However, we only found one study on the reliability and validity of the Brazilian version in schizophrenia. The purpose of this study was to analyze the psychometric properties of the Spanish version of the FAST in patients diagnosed with schizophrenia. MATERIAL AND METHODS: A total of 226 patients with a diagnosis of schizophrenia were evaluated by mean the FAST, the GAF and the self-care requirements scale (ERA). Scale properties were analyzed in terms of internal consistency, inter-observer agreement and test-retest reliability. Convergent validity with the GAF and ERA scales was also analyzed, as well as construct validity by means of a Confirmatory Factor Analysis (CFA). RESULTS: For the total scale, the results showed high internal consistency (Cronbach's Alpha of, 87), as well as good inter-observer (ICC=,86) and test-retest (ICC=,77) agreement. Concurrent validity with the GAF scale was discrete (r=-,32; P<,001) and with the ERA scale was moderate (r=,50; P<,001). CFA showed an internal structure that matched the six factors proposed by the original scale, with a good level of item saturation for each factor. CONCLUSIONS: The FAST scale showed good psychometric properties in terms of reliability and validity in its Spanish version for its application in patients with schizophrenia. It can be considered as a good tool to assess different areas of functional impairment in clinical practice and research.

Validación de la versión española de la Escala de funcionamiento breve (FAST) en pacientes diagnosticados de esquizofrenia / Validity of the Functioning Assessment Short Tests (FAST), in patients with schizophrenia

Introducción: El deterioro funcional es una de las principales características del curso de la esquizofrenia e implica un gran impacto en la calidad de vida del paciente. La Escala de funcionamiento breve (FAST), validada originalmente en trastorno bipolar, también ha sido validada para su aplicación en otros trastornos mentales, aunque solo encontramos un estudio sobre la fiabilidad y validez de la versión brasileña en esquizofrenia. El propósito de este estudio fue analizar las propiedades psicométricas de la versión española de la FAST en pacientes diagnosticados de esquizofrenia.Material y métodos: Un total de 226 pacientes con diagnóstico de esquizofrenia fueron evaluados, cumplimentando la FAST, la GAF y la Escala de requisitos de autocuidado (ERA). Se analizaron las propiedades de la escala en términos de consistencia interna, concordancia interobservador y fiabilidad test-retest. Se analizó también la validez convergente con las escalas GAF y ERA, y la validez de constructo mediante un análisis factorial confirmatorio.Resultados:Para el total del cuestionario los resultados mostraron una elevada consistencia interna (Cronbach's Alpha de 0,87), así como una buena concordancia interobservador (CCI=0,86) y test-retest (CCI=0,77). La validez concurrente con la escala GAF fue discreta (r=–0,32; p<0,001) y con la escala ERA moderada (r=0,50; p<0,001). El análisis factorial confirmatorio mostró una estructura interna que se ajustaba a los 6 factores de la escala original, con un buen nivel de saturación de los ítems para cada factor.Conclusiones: La escala FAST mostró buenas propiedades psicométricas en términos de fiabilidad y validez en su versión española para su aplicación en pacientes con esquizofrenia. Se puede considerar una buena herramienta para evaluar diferentes áreas del deterioro funcional en la práctica clínica y en investigación. (AU)

Introduction: Functional impairment in schizophrenia is one of the main features of the disorder and implies a great impact on the patient's quality of life. The brief functioning assessment scale (FAST), originally validated in bipolar disorder, has also been validated for its application in other mental disorders. However, we only found one study on the reliability and validity of the Brazilian version in schizophrenia. The purpose of this study was to analyze the psychometric properties of the Spanish version of the FAST in patients diagnosed with schizophrenia.Material and methods: A total of 226 patients with a diagnosis of schizophrenia were evaluated by mean the FAST, the GAF and the self-care requirements scale (ERA). Scale properties were analyzed in terms of internal consistency, inter-observer agreement and test–retest reliability. Convergent validity with the GAF and ERA scales was also analyzed, as well as construct validity by means of a Confirmatory Factor Analysis (CFA).Results: For the total scale, the results showed high internal consistency (Cronbach's Alpha of .87), as well as good inter-observer (ICC=.86) and test–retest (ICC=.77) agreement. Concurrent validity with the GAF scale was discrete (r=−.32; P<.001) and with the ERA scale was moderate (r=.50; P<.001). CFA showed an internal structure that matched the six factors proposed by the original scale, with a good level of item saturation for each factor.Conclusions: The FAST scale showed good psychometric properties in terms of reliability and validity in its Spanish version for its application in patients with schizophrenia. It can be considered as a good tool to assess different areas of functional impairment in clinical practice and research. (AU)

A Mobile App-Based Intervention Program for Nonprofessional Caregivers to Promote Positive Mental Health: Randomized Controlled Trial.

BACKGROUND: While nonprofessional caregivers often experience a sense of fulfillment when they provide care, there is also a significant risk of emotional and physical burnout. Consequently, this can negatively affect both the caregiver and the person being cared for. Intervention programs can help empower nonprofessional caregivers of people with chronic diseases and develop solutions to decrease the physical and psychological consequences resulting from caregiving. However, most clinically tested intervention programs for nonprofessional caregivers require face-to-face training, and many caregivers encounter obstacles that hinder their participation in such programs. Consequently, it is necessary to design internet-based intervention programs for nonprofessional caregivers that address their needs and test the efficacy of the programs. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a smartphone app-based intervention program to increase positive mental health for nonprofessional caregivers. METHODS: This study was a randomized controlled trial of 3 months' duration. A total of 152 caregivers over 18 years of age with a minimum of 4 months' experience as nonprofessional caregivers were recruited from primary health care institutions. Nonprofessional caregivers were randomized into two groups. In the intervention group, each caregiver installed a smartphone app and used it for 28 days. This app offered them daily activities that were based on 10 recommendations to promote positive mental health. The level of positive mental health, measured using the Positive Mental Health Questionnaire (PMHQ), and caregiver burden, measured using the 7-item short-form version of the Zarit Caregiver Burden Interview (ZBI-7), were the primary outcomes. Users' satisfaction was also measured. RESULTS: In all, 113 caregivers completed the study. After the first month of the intervention, only one factor of the PMHQ, F1-Personal satisfaction, showed a significant difference between the groups, but it was not clinically relevant (0.96; P=.03). However, the intervention group obtained a higher mean change for the overall PMHQ score (mean change between groups: 1.40; P=.24). The results after the third month of the intervention showed an increment of PMHQ scores. The mean difference of change in the PMHQ score showed a significant difference between the groups (11.43; P<.001; d=0.82). Significant changes were reported in 5 of the 6 factors, especially F5-Problem solving and self-actualization (5.69; P<.001; d=0.71), F2-Prosocial attitude (2.47; P<.001; d=1.18), and F3-Self-control (0.76; P=.03; d=0.50). The results of the ZBI-7 showed a decrease in caregiver burden in the intervention group, although the results were inconclusive. Approximately 93.9% (46/49) of the app users indicated that they would recommend the app to other caregivers and 56.3% (27/49) agreed that an extension of the program's duration would be beneficial. CONCLUSIONS: The app-based intervention program analyzed in this study was effective in promoting positive mental health and decreasing the burden of caregivers and achieved a high range of user satisfaction. This study provides evidence that mobile phone app-based intervention programs may be useful tools for increasing nonprofessional caregivers' well-being. The assessment of the effectiveness of intervention programs through clinical trials should be a focus to promote internet-based programs in health policies. TRIAL REGISTRATION: ISRCTN Registry ISRCTN14818443; http://www.isrctn.com/ISRCTN14818443. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-019-7264-5.