Validation of voice scales into Spanish: Systematic review of the psychometric properties / Validación de escalas de voz al español: revisión sistemática de las propiedades psicométricas

Introduction: To use a test in a language or culture other than the original it is necessary to carry out, in addition to its adaptation, a psychometric validation. This systematic review assesses the validation studies of the voice self-report scales in Spanish. Methods: A systematic review was performed searching ten databases. The assessment was carried out following the criteria proposed by Terwee et al. (2007) together with some specifically proposed for this study. Validation studies in Spanish of self-report voice scales published in indexed journals were included and the search was updated on February 2nd, 2023. Results: 15 studies that evaluated 12 scales were reviewed. It was verified that not all the validations were adjusted to the criteria used and that the properties to verify the metric strength of the validations were, in general, few. Conclusions: This systematic review shows that the included studies do not report much evidence of metric quality. It should be considered that different strategies have currently been developed to obtain more and better evidence of reliability and validity. Our contribution is to reflect on the usual practice of validation of self-report scales in Spanish language. The most important weakness is the possibility of using broader and more current evaluation protocols. We also propose to continue this work, completing it with a meta-analytic study.(AU)

Introducción: Para utilizar una prueba en una lengua o cultura distinta de la original es preciso realizar, además de su adaptación, una validación psicométrica. Esta revisión sistemática valora los estudios de validación de las escalas de autoinforme de voz en español. Método: Se realizó una revisión sistemática buscando en diez bases de datos. La valoración se llevó a cabo siguiendo los criterios propuestos por Terwee et al. (2007) junto con algunos específicamente propuestos para este trabajo. Se incluyeron estudios de validación en español de escalas de autoinforme publicados en revistas indexadas. La última búsqueda fue realizada el 2 de febrero de 2023. Resultados: Se revisaron 15 trabajos que evaluaron 12 escalas. Se comprobó que no todas las validaciones se ajustaron a los criterios utilizados y que las propiedades para comprobar la robustez métrica de estas fueron, por lo general, pocas.Conclusiones: Esta revisión sistemática muestra que los estudios incluidos no reportan demasiada evidencia de calidad métrica. Debería considerarse que en la actualidad se han desarrollado diferentes estrategias para obtener más y mejor evidencia de fiabilidad y validez. Nuestra contribución ha sido valorar la práctica de la validación de las escalas de autoinforme en lengua española. La más importante debilidad es la posibilidad de usar algún protocolo más amplio y actual. También proponemos continuar este trabajo con un estudio metaanalítico.(AU)

Normative Values for the Spanish Version of the Voice Symptom Scale (VoiSS)

Objective: The aim of this study was to establish normative values for the Voice Symptom Scale (VoiSS) in the Spanish community population (without voice problems), using a sample from a large area of southeastern Spain. Method: The sample consisted of 115 adults from ages 16 to 87, 60 of whom were women and 55 were men. Participants included the family members of patients who attended the Otorhinolaryngology (ENT) and Speech Therapy Clinic at a referral hospital in the region of Murcia, Spain, and some of the clinic's staff. All the participants reported never having suffered from any voice disorder before. Results: The normative values obtained in this study for the VoiSS were 14.61 (SD=8.18) for the total score, 7.57 (SD = 5.42) for the Impairment subscale, 1.04 (SD = 1.65) for the Emotional subscale, and 5.99 (SD = 3.61) for the Physical subscale. The percentile values were also obtained for the VoiSS scale and for its three subscales. Conclusions: This study presents normative values for the VoiSS scale that have not previously been obtained in Spain. These values can be used as a reference to detect possible voice disorders.

Objetivo: El objetivo de este estudio fue establecer valores normativos para la escala Voice Symptom Scale (VoiSS) en población comunitaria española (sin problemas de voz), utilizando una muestra de un área extensa del sureste de España. Metodología: La muestra estuvo compuesta por 115 personas (60 mujeres y 55 hombres) con edades comprendidas entre los 16 y 87 años. Los participantes eran familiares que acompañaron a los pacientes a las sesiones clínicas de ORL y de Logopedia de un hospital de referencia de la Región de Murcia, así como personal del hospital. Todos declararon no padecer ningún trastorno de la voz. Resultados: Los valores normativos obtenidos en este estudio para el VoiSS fueron 14.61 (SD=8.18) para la puntuación total, 7.57 (SD = 5.42) para la subescala Limitación, 1.04 (SD = 1.65) para la subescala Emocional y 5.99 (SD = 3.61) para la subescala Física. Los valores percentílicos se obtuvieron también para la escala VoiSS y para sus tres subescalas. Conclusiones: Este estudio presenta valores normativos para la escala VoiSS que no han sido todavía obtenidos en España. Estos valores pueden utilizarse como referencia para detectar posibles trastornos de voz.

Hypotonia: Is It a Clear Term and an Objective Diagnosis? An Exploratory Systematic Review.

BACKGROUND: Hypotonia is considered a determinant factor in multiple developmental disorders and is associated with various characteristics and morbidities. It is necessary to perform a systematic review to know which characteristics are described as associated with hypotonia in children and which methods are used for its diagnosis. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used to develop the systematic review protocol. A search of databases (Pubmed, Cochrane, Web of Knowledge, among others) was performed in May 2021 to identify relevant studies. Those describing characteristics or tests of hypotonia assessment were included, excluding those that exclusively addressed peripheral hypotonia. Two reviewers evaluated the articles and collected the data in a table, noting the authors, date of publication, type of study, and characteristics or tests described in relation to hypotonia. The quality of the studies was also assessed, and data were extracted. RESULTS: A total of 8778 studies were identified and analyzed, of which 45 met the inclusion criteria. Fifty-three characteristics associated with hypotonia and tests used for its evaluation were located, with pull to sit and vertical suspension being the most frequently referenced. CONCLUSIONS: The characteristics associated with hypotonia, more highly debated by authors are muscle strength, hypermobility, or the maintenance of antigravity postures. The most used test in the diagnosis of hypotonia is observation, followed by the pull-to-sit test, and adoption of frog posture. A unanimous understanding of the term hypotonia would favor further research.

Spanish translation, cross-cultural adaptation, and initial assessment of psychometric properties of the Life in Childhood Epilepsy Questionnaire (QOLCE-16).

OBJECTIVE: The aim of this study was the translation and cultural adaptation (TCA) of the Spanish version of the16-item Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-16) and an initial assessment of its psychometric properties. METHODS: The English version of the QOLCE-16 was cross-culturally adapted into Spanish using a back TCA procedure. Subsequently, for the process of validation of the Spanish version of QOLCE-16, the parents of 75 children with epilepsy (CWE) completed the QOLCE-16 questionnaire, the Pediatric Quality-of-Life Inventory (PedsQL™ 4.0), and the Pediatric Sleep Questionnaire (PSQ) twice in an interval of 7-10 days. The psychometric properties of the four domains of functioning (cognitive, emotional, social, and physical functioning subscales) were analyzed, together with the total QOLCE-16 score using Classical Test Theory. RESULTS: The scores of the Spanish version of the QOLCE-16 were obtained (alpha coefficient: 0.882, intraclass coefficient: 0.945). The standard error of measurement for the total score was 4.58, and the minimal detectable change was 13.44. Construct validity was tested using Confirmatory Factor Analysis. The estimates of the loadings for the four factors were higher than 0.35 and significant (α = 0.05). The four-factor model for QOLCE-16 [Chi- squared (p = 0.0540), comparative fit index = 0.985, Tucker-Lewis index = 0.982, root mean square error of approximation = 0.056 (0.000-0.0987), weighted root mean square residual = 0.707] showed good fit to these data. Convergent validity with PedsQL™ 4.0. was 0.791 and the discriminant validity of the QOLCE-16 with PSQ was -0.280. CONCLUSIONS: The Spanish version of the QOLCE-16 displays good psychometric properties of validity and reliability. All goodness-of-fit indices represent a good model fit, maintaining the multidimensional Health-related quality-of-life (HRQoL) model of the original English version. The Spanish version of this test can be used reliably to assess HRQoL in CWE in a Spanish-speaking population.

Adaptación cultural y estudio piloto de la versión española de la Voice Symptom Scale (VoiSS) / Cultural adaptation and pilot study of the Spanish version of the Voice Symptom Scale (VoiSS)

Objetivo: Realizar la adaptación cultural de la versión española de la Voice Symptom Scale (VoiSS) y su evaluación métrica inicial mediante un estudio piloto. Método: La escala fue traducida por 3expertos en Logopedia. Se llevó a cabo una retrotraducción por 2personas (una nativa inglesa y una traductora profesional) que no conocían el objetivo del estudio. Después de comparar las traducciones, se llegó a una versión previa del instrumento, que fue entonces aplicado en un estudio piloto con 45 pacientes con disfonía. Resultados: Durante el estudio piloto no se modificó ni eliminó ninguno de los ítems originales. A partir de estos resultados se elaboró la versión final de la escala. Discusión: La adaptación cultural al español de la VoiSS se ha realizado de acuerdo con criterios y pautas recomendados internacionalmente y los resultados del estudio piloto señalan su adecuación. La validación completa del instrumento está en marcha y concluirá próximamente

Aim: To carry out the cultural adaptation of the Spanish version of the Voice Symptom Scale (VoiSS) and its initial metric evaluation though a pilot study. Method: The scale was translated by 3bilingual experts in speech-therapy. A back translation procedure was performed by 2experts (an English native and a professional translator) who were not aware of the aim of the study. After the comparison of the translation, a previous version of the instrument was produced, and then applied in a pilot study with 45 patients with dysphonia. Results: During the process of translation and cultural adaptation, no original item was changed and/or eliminated. These findings were used to develop the final version of the scale. Discussion: The cultural adaptation into Spanish of the VoiSS is performed according to international criteria and guidelines, and the results from the pilot study indicate its suitability. The validation of the instrument is currently underway and is very close to completion

Actitudes hacia la violencia, impulsividad, estilos parentales y conducta externalizada en adolescentes: comparación entre una muestra de población general y una muestra clínica / Attitudes towards violence, impulsivity, parenting styles and externalized behavior in adolescents: comparison between a general and a clinical samples

Los Trastornos de Conducta Externalizantes (TCE) constituyen uno de los problemas de salud mental más comunes entre los adolescentes, y repercuten gravemente en el ámbito familiar, escolar y social. La finalidad de este estudio fue comparar adolescentes de población general sin diagnóstico de TCE con adolescentes de una muestra clínica en una serie de variables identificadas como predictoras de la de la conducta externalizada. El estudio incluyó a adolescentes con edades comprendidas entre 12-15 años de la Región de Murcia. Se empleó un diseño selectivo descriptivo y analítico, así como comparativo transversal en una muestra de 327 adolescentes, que se distribuyeron de la siguiente manera: (a) Grupo Clínico (GC), integrado por 59 participantes, y (b) Grupo General (GG), formado por 268 adolescentes. Los resultados de este estudio indican que la conducta externalizada está relacionada principalmente con la impulsividad, aunque modulada por factores relacionados con la socialización familiar y cultural del adolescente. Asimismo, los adolescentes de la muestra clínica describen los estilos parentales que reciben como más autoritarios y menos inductivos que los adolescentes de población general

Externalizing Behavior Disorders are one of the most common mental health problems among adolescents, and they have a severe impact on family, school, and social settings. The purpose of this study was to compare adolescents from the general population without an externalizing behavior diagnosis with adolescents from a clinical sample in a series of variables identified as predictors of externalizing behavior. The study included adolescents aged between 12-15 years from the Region of Murcia. A cross-sectional, descriptive, analytical design was used with a sample of 327 adolescents, who were distributed as follows: (a) Clinical Group, made up of 59 participants, and (b) General Group, made up of 268 adolescents. The results of this study indicate that externalizing behavior is mainly related to Impulsivity, although modulated by factors related to the adolescent's family and cultural socialization. The adolescents of the clinical sample described the parental styles they received as more authoritarian and less inductive than those of the adolescents from the general population

The Spanish version of the prenatal breast-feeding self-efficacy scale: reliability and validity assessment.

BACKGROUND: Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breast-feeding self-efficacy is a mother's confidence in her ability to breastfeed and is predictive of breastfeeding behaviors. The Prenatal Breast-feeding Self-efficacy Scale (PBSES) was developed among English-speaking mothers to measure breastfeeding self-efficacy before delivery. OBJECTIVES: To translate the PBSES into Spanish and assess its psychometric properties. DESIGN: Reliability and validity assessment. SETTING: A public hospital in Yecla, Spain. PARTICIPANTS: A convenience sample of 234 pregnant women in their third trimester of pregnancy. METHODS: The PBSES was translated into Spanish using forward and back translation. A battery of self-administered questionnaires was completed by participants, including a questionnaire on sociodemographic variables, breastfeeding experience and intention, as well as the Spanish version of the PBSES. Also, data on exclusive breastfeeding at discharge were collected from hospital database. Dimensional structure, internal consistency and construct validity of the Spanish version of PBSES were assessed. RESULTS: Confirmatory factor analysis suggested the presence of one construct, self-efficacy, with four dimensions or latent variables. Cronbach's alpha coefficient for internal consistency was 0.91. Response patterns based on decision to breastfeed during pregnancy provided evidence of construct validity. In addition, the scores of the Spanish version of the PBSES significantly predicted exclusive breastfeeding at discharge. CONCLUSIONS: The Spanish version of PBSES shows evidences of reliability, and contrasting group and predictive validity. Confirmatory factor analysis indicated marginal fit and further studies are needed to provide new evidence on the structure of the scale. The Spanish version of the PBSES can be considered a reliable measure and shows validity evidences.

Propiedades psicométricas de la versión abreviada de la Escala de Ira al Conducir (DAS) en población española: diferencias por edad, sexo e infracciones de tráfico / Psychometric properties of the brief version of the Driving Anger Scale (DAS) in Spanish language: Differences by age, gender and traffic violations

Uno de los grupos de factores asociados a los accidentes de tráfico son los factores de personalidad. En concreto, la ira en la conducción resulta uno de los potencialmente más relevantes, ya que puede motivar y elicitar conductas agresivas. Para medir este factor de personalidad, Deffenbacher, Oetting & Lynch (1994) desarrollaron la Driving Anger Scale (DAS) y una versión reducida de la misma (de tan sólo 14 ítems). Dada la amplia difusión de esta última, debido a su validez y rapidez, también ha comenzado a ser adaptada al español (Herrero-Fernández, 2011). Esta adaptación inicial no se ha realizado en población general y presenta una estructura factorial de tres dimensiones. Nuestro estudio ha llevado a cabo una ampliación de trabajos anteriores realizando una adaptación en población general, incluyendo datos sobre infracciones cometidas por los participantes y obteniendo propiedades psicométricas adecuadas de la escala, así como una nueva propuesta en cuanto a la composición del constructo «ira en la conducción». La estructura de la versión breve ha sido explicada por tres factores: «ira ante el avance impedido por otro», «ira ante infracción de otro conductor» e «ira ante ofensa directa»; nuestra propuesta añade un nuevo factor que hemos denominado «ira ante posible sanción». Su inclusión viene apoyada por razones teóricas y prácticas (AU)

The personality factors are an important group of factors associated to traffic accidents. Specifically, driving anger can be one of the more remarkable variables because it can motivate and elicit aggressive behavior. To measure this personality factor Deffenbacher, Oetting & Lynch (1994) developed the Driving Anger Scale (DAS) and its abbreviated version (with only 14 items). Because of the widely dissemination of this short version, owing to its validity and time-saving properties, it have been accomplished its adaptation into Spanish too (Herrero-Fernández, 2011). This first Spanish adaptation did not use general population and found a three-factorial structure. In the present study we have carried out an extension to general population, including data on traffic violations. Appropriate psychometric properties and a new four-factorial structure of «driving anger» have been achieved. The three factors on previous short versions of the DAS have been called «traffic obstructions», «illegal driving», and «hostile gestures», but we have find a fourth factor we have named «possibility of being fined». Its rationale is both empirically and theoretically discussed (AU)

Letter to the Editor: Attitudes among Spanish general dentists in relationto burning mouth syndrome: Results of a national survey

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[Work satisfaction among Spanish nurses working in English hospitals]. / Satisfacción laboral de los profesionales de enfermería españoles que trabajan en hospitales ingleses.

OBJECTIVES: To evaluate work satisfaction among Spanish nurses employed by English hospitals, as well as the influence of several social and work-related variables associated with satisfaction. METHODS: We performed a cross-sectional study. All Spanish nurses (n=360) with a contract with any English hospital in April 2003 were included in the study. The self-administered and validated Font Roja work satisfaction questionnaire was used. RESULTS: The response rate was 78.6%. Overall work satisfaction among Spanish nurses was medium. The dimensions with higher work satisfaction were relationships with colleagues and superiors. The dimensions showing lowest work satisfaction were job satisfaction and professional competence. Statistically significant and positive associations were obtained between level of English, professional grade, shift pattern, working in the intensive care unit or accident and emergency department, time worked in English hospitals and degree of work satisfaction. CONCLUSIONS: Employers of Spanish nurses should try to increase job satisfaction and professional competence among these workers. Incentivation and professional promotion systems might help achieve this aim. Employers could also try to improve Spanish nurses' English level before contracts are signed and pay special attention to their needs during the first working year. Spanish nurses job satisfaction would also increase if they were allowed to choose their working shift and the unit or ward where they are going to work.

Satisfacción laboral de los profesionales de enfermería españoles que trabajan en hospitales ingleses / Work satisfaction among Spanish nurses working in English hospitals

Objetivos: Evaluar la satisfacción laboral de los profesionalesde enfermería españoles que trabajan en hospitales inglesesy la influencia de diversas variables sociolaborales.Métodos: Estudio transversal. Se incluyó a todo el personalde enfermería español que en abril de 2003 tenía contrato laboralen algún hospital inglés (n = 360). Se aplicó el cuestionarioautoadministrado y validado de Font Roja.Resultados: La tasa de respuesta fue del 78,6%. Las enfermerasque trabajan en hospitales ingleses tienen un nivel mediode satisfacción global. Las dimensiones asociadas a una satisfacciónlaboral más alta fueron las relaciones con los compañerosy las relaciones con los jefes; las dimensiones con unasatisfacción laboral más baja fueron la satisfacción por el trabajoy la competencia profesional. Se ha observado una asociaciónpositiva y estadísticamente significativa entre el nivelde satisfacción laboral y las variables nivel de inglés, grado profesionaly tiempo trabajado en Inglaterra; la jornada laboral,®otros» y trabajar en unidades de cuidados intensivos y urgenciastambién se asocian positivamente con la satisfacción laboral.Conclusiones: Los responsables de los hospitales inglesesque contratan profesionales de enfermería españoles deberíanincidir en mejorar su satisfacción por el trabajo y su competenciaprofesional. Para ello, se podrían incluir sistemas deincentivación y promoción profesional, tomar medidas previasa la contratación para mejorar el nivel de inglés, prestar especialatención a las necesidades del personal, sobre tododurante el primer año de trabajo, y facilitar la elección del servicioy la jornada laboral(AU)

Objectives: To evaluate work satisfaction among Spanish nursesemployed by English hospitals, as well as the influenceof several social and work-related variables associated withsatisfaction.Methods: We performed a cross-sectional study. All Spanishnurses (n = 360) with a contract with any English hospital inApril 2003 were included in the study. The self-administeredand validated Font Roja work satisfaction questionnaire wasused.Results: The response rate was 78.6%. Overall work satisfactionamong Spanish nurses was medium. The dimensionswith higher work satisfaction were relationships with colleaguesand superiors. The dimensions showing lowest work satisfactionwere job satisfaction and professional competence.Statistically significant and positive associations were obtainedbetween level of English, professional grade, shift pattern,working in the intensive care unit or accident and emergencydepartment, time worked in English hospitals and degree ofwork satisfaction.Conclusions: Employers of Spanish nurses should try to increasejob satisfaction and professional competence amongthese workers. Incentivation and professional promotion systemsmight help achieve this aim. Employers could also try toimprove Spanish nurses’ English level before contracts are signedand pay special attention to their needs during the firstworking year. Spanish nurses´ job satisfaction would also increaseif they were allowed to choose their working shift andthe unit or ward where they are going to work(AU)

Actitud hacia biopsia oral entre dentistas en Murcia / Attitude towards oral biopsy among general dentists in Murcia

Objetivo: El objetivo de este trabajo fue investigar la actitud de los dentistas generales hacia el procedimiento de la biopsia oral como método de diagnostico en las lesiones orales.Material y Métodos: Se envió por correo postal a 520 dentistas generales de la comunidad murciana un cuestionario el que se incluían distintos ítems: sociodemográficos, años de experiencia profesional, el diagnostico de lesiones mucosas, realización de biopsias orales, estudio histopatológico de las mismas.Resultados: La tasa de respuesta fue del 32,7%, porcentaje que correspondía en un 55,9% a varones y en un 43,5% a mujeres, con una edad media, en conjunto de 35,9 años. Encontramos, como aspecto a destacar, que el grupo de menor experiencia profesional es el que no incluye como procedimiento de diagnostico la biopsia oral, con diferencias estadísticamentesignificativas( p=0,048)Conclusión: Existe un nivel de entrenamiento hacia la biopsia oral con el aumento de los años de experiencia profesional

Objective: The present study explores the attitude of general dentists towards oral biopsy as a diagnostic method in application to oral lesions.Material and methods: A questionnaire was administered by mail to 520 general dentists in the Autonomous Community of Murcia (Spain), addressing a number of items: sociodemographic parameters, years of professional experience, the diagnosis of mucosal lesions, the performance of oral biopsies, and their histopathological evaluation.Results: The global response rate was 32.7% (55.9% for males and 43.5% for females), with a global mean age of 35.9 years. Of note is the fact that the group with least professional experience did not include oral biopsy as diagnostic procedure, with statistically significant differences versus the other groups of experience (p=0.048)Conclusion: The assimilation of oral biopsy as a diagnostic procedure is seen to increase with the number of years of professional experience

Attitude towards oral biopsy among general dentists in Murcia.

OBJECTIVE: The present study explores the attitude of general dentists towards oral biopsy as a diagnostic method in application to oral lesions. MATERIAL AND METHODS: A questionnaire was administered by mail to 520 general dentists in the Autonomous Community of Murcia (Spain), addressing a number of items: sociodemographic parameters, years of professional experience, the diagnosis of mucosal lesions, the performance of oral biopsies, and their histopathological evaluation. RESULTS: The global response rate was 32.7% (55.9% for males and 43.5% for females), with a global mean age of 35.9 years. Of note is the fact that the group with least professional experience did not include oral biopsy as diagnostic procedure, with statistically significant differences versus the other groups of experience (p=0.048) CONCLUSION: The assimilation of oral biopsy as a diagnostic procedure is seen to increase with the number of years of professional experience.