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1.
Health Expect ; 24(6): 2065-2077, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34492734

RESUMO

BACKGROUND: The Living with Chronic Illness (LW-CI) Scale is a comprehensive patient-reported outcome measure that evaluates the complex process of living with long-term conditions. OBJECTIVE: This study aimed to analyse the psychometric properties of the LW-CI scale according to the classic test theory and the Rasch model among individuals living with different long-term conditions. DESIGN: This was an observational, international and cross-sectional study. METHODS: A total of 2753 people from six Spanish-speaking countries living with type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, Parkinson's disease, hypertension and osteoarthritis were included. The acceptability, internal consistency and validity of the LW-CI scale were analysed using the classical test theory, and fit to the model, unidimensionality, person separation index, item local independency and differential item functioning were analysed using the Rasch model. RESULTS: Cronbach's α for the LW-CI scale was .91, and correlation values for all domains of the LW-CI scale ranged from .62 to .68, except for Domain 1, which showed correlation coefficients less than .30. The LW-CI domains showed a good fit to the Rasch model, with unidimensionality, item local independency and moderate reliability providing scores in a true interval scale. Except for two items, the LW-CI scale was free from bias by long-term condition type. DISCUSSION: After some adjustments, the LW-CI scale is a reliable and valid measure showing a good fit to the Rasch model and is ready for use in research and clinical practice. Future implementation studies are suggested. PATIENT AND PUBLIC CONTRIBUTION: Patient and public involvement was conducted before this validation study - in the pilot study phase.

2.
Front Public Health ; 9: 678926, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34136459

RESUMO

Objective: To describe changes in knowledge, attitudes and preventive practices (KAP), risk perception, and psychological variables of Spanish population toward the COVID-19 pandemic from July to November 2020. Methods: Three samples, each of one composed by 1,000+ persons aged 18 years or older, were interviewed online in three rounds, every 2 months, from July to November 2020. Results: The level of knowledge on COVID-19 was high in the three rounds, with percentages above 95% of correct answers related to ways of contagion and correct use of face masks. The most accepted measure was the mandatory use of face masks (80-86% of agreement in the three rounds, p = 0.001), followed by the night curfew (63% of agreement). Most participants (>80%) consistently reported using face masks, ventilating spaces, and washing or disinfecting hands. However, risk perception and self-efficacy were low. Worry about losing a loved one, the health system overload and people who do not wear face masks was high (>85% of the samples). The percentage of respondents who felt depressed due to COVID-19 increased from round 1 to round 3 (p = 0.044). Conclusions: Spanish population has a high degree of KAP, but a relatively low risk perception and self-efficacy. These findings can help health authorities to guide containment measures and campaigns addressed to improve preventive practices.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , SARS-CoV-2 , Espanha/epidemiologia , Inquéritos e Questionários , Organização Mundial da Saúde
3.
Value Health ; 24(6): 874-883, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34119086

RESUMO

OBJECTIVES: The mapping technique can estimate generic preference-based measure scores through a specific measure that cannot be used in economic evaluations. This study compared 2 response mapping methods to estimate EQ-5D-5L scores using the Western Ontario McMaster Universities Osteoarthritis (WOMAC). METHODS: The sample consisted of 758 patients with the hip or knee osteoarthritis recruited in baseline. Bayesian networks (BN) and multinomial logistic regression (ML) were used as response mapping models. Predictions were obtained using the 6-month follow-up as a validation sample. The mean absolute error, mean squared error, deviation from the root mean squared error and intraclass correlation coefficient were calculated as precision measures. RESULTS: There was 5.5% of missing data, which was removed. The mean age was 69.6 years (standard deviation = 10.5), with 61.6% of women. The BN model presented lower mean absolute error, mean squared error, root mean squared error and higher intraclass correlation coefficient than the ML model. Only the WOMAC items pain and physical function items were related with the EQ-5D-5L dimensions. CONCLUSION: BN response mapping models are more robust methods, with better prediction results, than ML models. The BN model also provided a graphic representation of the dependency relationships between the EQ-5D-5L dimensions and the different WOMAC items that could be useful in the clinical investigation of patients with hip or knee osteoarthritis.

4.
BMJ Open ; 11(5): e048702, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016666

RESUMO

OBJECTIVE: Most patients with mild COVID-19 had to stay at home trying to implement an optimal quarantine. The aim of this study was to describe the COVID-19 cases during the first wave of the pandemic in Spain, how they managed the disease at home, focusing on differences by age, as well as differences in knowledge, attitudes and preventive practices, compared with the uninfected population. DESIGN: An online survey was used to conduct a cross-sectional study of individuals who were 14 years or older living in Spain during the COVID-19 lockdown. The main variable was a COVID-19 case. Logistic regression models for COVID-19 cases were obtained using a backward stepwise procedure to assess the association between social variables, disease knowledge, attitudes, prevention practices and emotional impact. RESULTS: 3398 people completed the survey. Participants' mean age was 49.6 (SD=14.3). COVID-19 was significantly more prevalent among married people (5.3%) and those currently doing an on-site work (8.7%). Most of the COVID-19 cases stayed at home (84.0%) during the episode. There were significant age-based differences with regard to self-isolation conditions at home during the disease. COVID-19 cases showed better attitudes, practices and knowledge about disease symptoms and transmission than the uninfected population. COVID-19 cases also felt more depressed (adjusted OR: 3.46, 95% CI 1.45 to 8.26) and had better preventive behaviour than the uninfected population, such as always wearing a mask outside the home (adjusted OR 1.58, 95% CI 1.06 to 2.30). CONCLUSION: COVID-19 cases found it difficult to comply with recommended home self-isolation conditions, with differences by age group. COVID-19 had an important impact on care dependency in non-hospitalised patients, who were mostly dependent on their families for care. It is necessary to reinforce social and health services and to be ready to meet the care needs of populations during the different waves or in future epidemics.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Espanha/epidemiologia , Inquéritos e Questionários
5.
Artigo em Inglês | MEDLINE | ID: mdl-33919964

RESUMO

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (-0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction (p = 0.039) was found. In Spain, a higher participation (ß = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (ß = 0.099, p < 0.001), functional ability (ß = 0.044, p = 0.023), and cognitive and sensory ability (ß = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.


Assuntos
Envelhecimento Saudável , Qualidade de Vida , Idoso , Europa (Continente) , Humanos , Pessoa de Meia-Idade , Portugal , Espanha , Suécia
6.
Aggress Behav ; 47(3): 354-363, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33611803

RESUMO

Despite the efforts of recent decades to reduce gender inequality, sexism is still prevalent among adolescents. The objective of this study was to identify the main socioeconomic characteristics, personal experiences, resources, and competencies associated with sexism in a sample of adolescents from different European countries. Baseline data from the Lights4Violence project included 1555 students ages 12-17 from secondary schools in six European countries (Spain, Italy, Romania, United Kingdom, Portugal, and Poland). Linear regression models were carried out, stratified by sex for benevolent (BS) and hostile (HS) dimensions of the Ambivalent Sexism Inventory. The average age of the sample was 14.3 years (SD = 1.5), 59.3% were girls. Boys scored higher on the measure of sexism (mean BS = 29.7; HS = 29.1) than girls (BS = 27.5, HS = 23.0; p < .001). Girls whose mothers had a university degree reported lower BS (ß = -0.113; p = .023) (reference: lower education). Girls who had experienced dating violence reported higher HS (ß = .080; p = .010) than those who had never been in an intimate relationship. For both sexes, high aggressiveness was associated with high levels of HS, and high aggressiveness was related to high levels of BS in boys. High assertiveness was associated with high levels of BS in both sexes and with high levels of HS in boys. A high level of problem-solving ability was associated with lower HS in both sexes. The study reinforces the need to invest in school programs aimed at preventing dating violence and promoting positive youth development.


Assuntos
Sexismo , Adolescente , Criança , Europa (Continente) , Feminino , Humanos , Itália/epidemiologia , Masculino , Portugal/epidemiologia , Espanha , Reino Unido
7.
Artigo em Inglês | MEDLINE | ID: mdl-33546373

RESUMO

Dating violence (DV) among adolescents is a public health issue because of its negative health consequences. In this study, we aimed to analyse the prevalence and the psychosocial and socioeconomic risk and protective factors associated DV among male and female adolescents in Europe. It was performed a cross-sectional study based on a non-probabilistic sample of 1555 students aged 13-16 years (2018-2019). The global prevalence of DV victimization was significantly greater among girls than boys (girls: 34.1%, boys: 26.7%; p = 0.012). The prevalence of DV in both girls and boys was greater for those over age 15 (girls: 48.5% p < 0.001; boys: 35.9%; p = 0.019). There was an increased likelihood of DV victimization among girls whose fathers did not have paid employment (p = 0.024), who suffered abuse in childhood, and reported higher Benevolent Sexism [PR (CI 95%): 1.01 (1.00-1.03)] and machismo [1.02 (1.00-1.05)]. In the case of boys, the likelihood of DV increased with abuse in childhood (p = 0.018), lower parental support [0.97 (0.96-0.99)], high hostile sexism scores (p = 0.019), lower acceptance of violence (p = 0.009) and high machismo (p < 0.001). Abuse in childhood was shown to be the main factor associated with being a victim of DV in both population groups, as well as sexism and machismo attitudes. These results may contribute to future DV prevention school programs for both, teenagers and children of elementary school ages.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Masculino
8.
J Adolesc Health ; 68(5): 922-929, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33067152

RESUMO

PURPOSE: To analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries. METHODS: Cross-sectional design. We recruited 1,555 participants ages 13-16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence-dating violence, bullying, cyberbullying, abuse in childhood-and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex. RESULTS: Acceptance of violence was higher for those who had lower perceived social support from parents (ßgirls = -154, p < .001; ßboys = -.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (ßgirls = .067, p = .035; ßboys = .225, p < .001; (ßgirls = .118, p < .001; ßboys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys. CONCLUSIONS: Machismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Portugal , Apoio Social , Violência
9.
Artigo em Inglês | MEDLINE | ID: mdl-33271817

RESUMO

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience (n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Apoio Social , Adolescente , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Polônia , Portugal , Romênia , Instituições Acadêmicas , Espanha
10.
Artigo em Inglês | MEDLINE | ID: mdl-33233793

RESUMO

PURPOSE: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe. METHODS: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression. RESULTS: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: -1.55, -0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: -0.42, -0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: -1.11, -0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain. CONCLUSION: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.


Assuntos
Solidão , Qualidade de Vida , Isolamento Social , Idoso , Europa (Continente) , Feminino , Humanos , Masculino , Estudos Prospectivos , Espanha , Suécia
11.
Artigo em Inglês | MEDLINE | ID: mdl-32932768

RESUMO

The purpose of this study is to assess the psychometric properties of the Portuguese version of the Control, Autonomy, Self-realization, and Pleasure (CASP)-12 scale used in the Survey of Health, Aging and Retirement in Europe (SHARE) project. Data were obtained from a representative sample of 1666 people aged ≥50 years living in Portugal and participating in the SHARE wave 6. In addition to the CASP-12 scale, sociodemographic data and health status, activity limitation (GALI), depression (Euro-D) and satisfaction with life scores were collected. Data quality and acceptability, construct and structural validity and internal consistency of the CASP-12 scale were analyzed. A Rasch analysis was also performed. CASP-12 total score (mean: 33.3; standard deviation: 5.8, range: 12-48) correlated with Euro-D (-0.57) and with life satisfaction (0.52). Mean scores were significantly lower for women, people aged ≥75 years and those with activity limitations and worse health status (p < 0.001). The confirmatory factor analysis showed good fit to the 4-factor model (root mean squared error of approximation (RMSEA): 0.07; comparative fit index (CFI): 0.90, χ2 (48) = 444.59, p < 0.001), which was confirmed by Rasch analysis (χ2 (36) = 10.089, p = 0.745, person separation index (PSI) = 0.722 for the 4-factor model). For domains, person separation index ranged 0.31-0.79 and Cronbach's alpha, 0.37-0.73. In conclusion, the Portuguese version of the CASP-12 scale presents some inadequacies in acceptability, internal consistency and structural validity.


Assuntos
Envelhecimento , Qualidade de Vida , Aposentadoria , Idoso , Europa (Continente) , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Portugal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
BMC Neurol ; 20(1): 346, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32933508

RESUMO

BACKGROUND: Neurologists play an essential role in facilitating the patient's process of living with Parkinson's disease (PD). The Living with Chronic Illness Scale-PD (LW-CI-PD) is a unique available clinical tool that evaluates how the patient is living with PD. The objective of the study was to analyse the LW-CI-PD properties according to the Rasch model. METHODS: An open, international, cross-sectional study was carried out in 324 patients with Parkinson's disease from four Latin American countries and Spain. Psychometric properties of the LW-CI-PD were tested using Rasch analysis: fit to the Rasch model, item local independency, unidimensionality, reliability, and differential item functioning by age and gender. RESULTS: Original LW-CI-PD do not fit Rasch model. Modifications emerged included simplifying the response scale and deleting misfit items, the dimensions Acceptance, Coping and Integration showed a satisfactory fit to the Rasch model, with reliability indices greater than 0.70. The dimensions Self-management and Adjustment to the disease did not reach fit to the Rasch model. CONCLUSION: Suggestions for improving the LW-CI-PD include a multidimensional and shorter scale with 12 items grouped in three subscales with a simpler response scheme. The final LW-CI-PD Scale version is a reliable scale, with good internal construct validity, that provides Rasch transformed results on linear metric scale.


Assuntos
Doença de Parkinson , Psicometria , Estudos Transversais , Humanos , América Latina , Doença de Parkinson/classificação , Doença de Parkinson/diagnóstico , Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia , Psicometria/métodos , Psicometria/normas , Reprodutibilidade dos Testes , Espanha
13.
Int J Public Health ; 65(2): 165-174, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31705149

RESUMO

OBJECTIVES: As reported in other high-income countries, around the 2008 Great Recession the Spanish banking sector engaged abusive practices that satisfy the definition of fraud. Our objective is to examine the association between self-reported bank fraud and physical health, using a gender perspective. METHODS: With data from the 2017 Madrid Health Survey, we examined the association between the economic impact of fraud and poor self-rated health (SRH), comorbidity and pain (N = 4425). Interactions of time since fraud and sex with economic impact were tested by Poisson regression models with robust variance. RESULTS: In total, 11% of adults in Madrid reported bank fraud since 2006. Among men, those who experienced frauds with severe economic impact were more likely to report adverse health than those who did not experience fraud (PR comorbidity: 1.46; PR pain conditions: 2.17). Among men time elapsed since fraud strengthened the association between severe economic impact and poor SRH (p = 0.022; p = 0.006, respectively). Among women, associations did not reach statistical significance. CONCLUSIONS: Bank frauds are an emerging phenomenon which is likely to damage public health. Stricter regulation to protect people from fraudulent bank practices is needed.


Assuntos
Conta Bancária/legislação & jurisprudência , Comorbidade , Fraude/legislação & jurisprudência , Nível de Saúde , Dor , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Autorrelato , Espanha , Transtornos Relacionados ao Uso de Substâncias , Adulto Jovem
14.
J Parkinsons Dis ; 10(1): 275-282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31868685

RESUMO

BACKGROUND: Several scales are available for rating the severity of tremor at present. However, the sensitivity to change of these instruments has remained to be clarified. OBJECTIVE: To compare the sensitivity of the Fahn-Tolosa-Marin Tremor Rating Scale, the Part III of the Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the MDS-UPDRS Tremor Scale to the effects of various antitremor treatments. METHODS: Enrolling subjects with parkinsonism associated with tremor, we analyzed two scenarios: (1) tremor changes associated with acute levodopa challenge (n = 287) and (2) a 12-month outcome of different treatment options (n = 512) including deep brain stimulation (n = 146), levodopa/carbidopa intestinal gel infusion (n = 30), and initiating (n = 63) or adjusting oral antiparkinsonian medication (n = 273). Changes in tremor scales were assessed by effect size values (Cohen's d and eta-square). RESULTS: Part B of the Fahn-Tolosa-Marin Tremor Rating Scale was the most sensitive to acute levodopa challenge (Cohen's d = -1.04, η2 = 0.12). However, Part A of the Fahn-Tolosa-Marin Tremor Rating Scale showed the highest effect size, which was a small one (Cohen's d = -0.33, η2 = 0.03), for detecting a treatment-related change in the severity of tremor during long-term follow-up. CONCLUSIONS: The Fahn-Tolosa-Marin Tremor Rating Scale has a better ability to capture changes due to levodopa challenge or antiparkinsonian treatment than MDS-UPDRS Part III or MDS-UPDRS Tremor Scale.


Assuntos
Antiparkinsonianos/farmacologia , Estimulação Encefálica Profunda , Levodopa/farmacologia , Avaliação de Resultados em Cuidados de Saúde/normas , Transtornos Parkinsonianos/tratamento farmacológico , Índice de Gravidade de Doença , Tremor/tratamento farmacológico , Adulto , Idoso , Carbidopa/farmacologia , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Parkinsonianos/complicações , Sensibilidade e Especificidade , Tremor/etiologia
15.
Gac. sanit. (Barc., Ed. impr.) ; 33(6): 511-516, nov.-dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189844

RESUMO

Objetivo: Comparar las propiedades psicométricas de escalas de medición de las actividades de la vida diaria según distintos métodos y comprobar si los más complejos tienen más capacidad discriminatoria. Método: Muestra de personas mayores de la Encuesta sobre discapacidad, autonomía personal y situaciones de dependencia. Se utilizaron 14 ítems que medían actividades de la vida diaria. Cinco métodos de escalamiento: Suma y Rasch (los dos con ítems en forma dicotómica o politómica) y Guttman (forma dicotómica). Se evaluaron su capacidad discriminatoria (precisión relativa [PR]) y el área bajo la curva (AUC). Resultados: Todos los métodos mostraron altas correlaciones de Pearson entre ellos (0,765-0,993). Tenían similar poder discriminatorio al comparar categorías extremas de individuos no limitados respecto a gravemente limitados (PR: 0,93-1,00). El procedimiento Suma politómico mostró la mayor AUC (0,934; intervalo de confianza del 95% [IC95%]: 0,928-0,939) y el Guttman la menor (0,853; IC95%: 0,845-0,861). Conclusiones: Se observa una mayor fiabilidad en ítems politómicos que dicotómicos. Los métodos sencillos (Suma) y los complejos (Rasch) son opciones igualmente válidas. El método Guttman presentó peor capacidad discriminatoria


Objective: To compare the psychometric properties of scales top measure activities of daily living, constructed with different scaling methods, and to check whether the most complex scales have higher discriminatory capacity. Method: Sample of elderly people from the Spanish Survey on Disability, Personal Autonomy and Dependency We used 14 items that measured activities of daily living. Five scaling methods were applied: Sum and Rasch (both for dichotomous and polytomous items) and Guttman (dichotomous). We evaluated the discriminatory capacity (relative precision [RP]) and area under the curve (AUC). Results: All methods showed high Pearson correlations among them (0.765-0.993). They had similar discriminatory power when comparing extreme categories of individuals with no disability with severely limited (RP: 0.93-1.00). The polytomous Sum procedure showed the highest AUC (0.934; 95% confidence interval [95%CI]: 0.928-0.939) and Guttman the lowest (0.853; 95%CI: 0.845-0.861). Conclusions: Polytomous items have greater reliability than the dichotomous ones. Simplest methods (Sum) and most complex (Rasch) are equally valid. Guttman method presented worse discriminatory capacity


Assuntos
Humanos , Masculino , Feminino , Idoso , Atividades Cotidianas/classificação , Envelhecimento/fisiologia , Avaliação Geriátrica/métodos , Desempenho Físico Funcional , Psicometria/instrumentação , Perfil de Impacto da Doença , Idoso Fragilizado/estatística & dados numéricos , Reprodutibilidade dos Testes , Avaliação da Deficiência
16.
Artigo em Inglês | MEDLINE | ID: mdl-31489951

RESUMO

Over the past few decades, the financial system has engaged in abusive practices that meet the definition of fraud. Our objective is to compare the prevalence of psychological distress and levels of health-related quality of life according to having been exposed to financial fraud and its economic impact on family finances. The City of Madrid Health Survey 2017 included specific questions on exposure to financial fraud-this section was administered to half of the participants (n = 4425). Mental health need or caseness was defined by a score greater than two on the 12-item version of the Goldberg health questionnaire. Health-related quality of life was assessed by the Darmouth Coop Functional Health Assessment Charts/WONCA (COOP/WONCA). The prevalence of financial fraud was 10.8%. The prevalence rate ratio for caseness of those who experienced severe economic impact due to fraud was 1.62 (95%, CI 1.17-2.25; reference: no fraud), after adjustment by age, sex, social class, and immigrant status. Women experienced a decreased quality of life, even with a moderate impact of fraud, while men experienced a decreased quality of life related to fraud with severe economic impact. The current study contributes to a growing body of literature showing the effects of economic shocks on health as a result of financial fraud.


Assuntos
Fraude , Saúde Mental , Qualidade de Vida , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde da População , Espanha , Transtornos Relacionados ao Uso de Substâncias , Inquéritos e Questionários , Adulto Jovem
17.
Health Qual Life Outcomes ; 17(1): 111, 2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31255183

RESUMO

BACKGROUND: Self-rated health (SRH) is a health measure used in studies of older adults. The objective of this study is to analyze SRH as a predictor of mortality in the institutionalized older population and the characteristics of those who do not provide information about their SRH on health questionnaires. METHODS: This is a 15-year follow-up study of older adult residents in nursing or care homes in of Madrid, Spain. SRH was measured on a 5-point Likert type scale. The association between answering the SRH question and socio-demographic and health characteristics was evaluated through prevalence ratio (PR), estimated by Poisson regression models. Survival rates associated with SRH were studied through a multivariate Cox regression. RESULTS: The sample has a mean age of 83.4 (standard deviation, SD = 7.3), with 75.7% women. Twelve percent did not answer the SRH item. Those who did not answer showed a higher probability of disability (Barthel index, PR = 0.76, 95% confidence interval = 0.67-0.86) and/or dementia (PR = 8.03, 3.38-19.03). A trend for higher mortality was observed in those persons who did not respond (adjusted hazard ratio HR = 1.26, 0.75-2.11). The mortality rate was 32% higher for those who declared poor SRH in comparison with those who reported good SRH (adjusted HR = 1.32, 1.08-1.6). CONCLUSIONS: There is an elevated number of people who do not respond to the SRH item, mainly those with disabilities and cognitive deterioration. Lack of response to SRH is a good indicator of 15-year mortality for persons institutionalized in care or nursing homes.


Assuntos
Nível de Saúde , Qualidade de Vida , Autorrelato/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Seguimentos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , Modelos de Riscos Proporcionais , Espanha , Análise de Sobrevida
18.
Eur J Ageing ; 16(2): 193-203, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31139033

RESUMO

The objective of this study was to assess how disease burden caused by chronic conditions is related to mortality (predictive validity) and other health outcomes (convergent validity). This was studied in 625 community-dwelling adults living in Spain aged 65 years and older. Disease burden was measured with the Disease Burden Morbidity Assessment (DBMA). The association with 5-year mortality was assessed using a Cox model and Kaplan-Meier curves. For convergent validity, mean age, sex ratio, patient-centered outcomes and healthcare utilization were compared for high and low DBMA scores (< 10 vs. ≥ 10). Also, a multivariable linear regression model was used to evaluate the DBMA as a function of these variables. Mean DBMA score in our sample was 7.5. After 5 years, 35 participants had died (5.5%). The Cox model displayed a hazard ratio of 1.07, and the Kaplan-Meier curves showed lower survival for high DBMA scores. Among participants with high DBMA scores, low self-perceived health, disability and female sex were more frequent, and this group showed lower mean scores for quality of life (Personal Wellbeing Index), affect balance (Scale of Positive and Negative Experience) and physical activity (Yale Physical Activity Survey), higher mean age and higher healthcare utilization than persons with low DBMA scores. In the multivariable regression, all variables but age were significantly associated with the DBMA. In conclusion, the DBMA showed satisfactory predictive and convergent validity. In our aging society, it can be applied to better understand and improve care for older persons with multiple chronic conditions.

19.
Gac Sanit ; 33(6): 511-516, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30392648

RESUMO

OBJECTIVE: To compare the psychometric properties of scales top measure activities of daily living, constructed with different scaling methods, and to check whether the most complex scales have higher discriminatory capacity. METHOD: Sample of elderly people from the Spanish Survey on Disability, Personal Autonomy and Dependency We used 14 items that measured activities of daily living. Five scaling methods were applied: Sum and Rasch (both for dichotomous and polytomous items) and Guttman (dichotomous). We evaluated the discriminatory capacity (relative precision [RP]) and area under the curve (AUC). RESULTS: All methods showed high Pearson correlations among them (0.765-0.993). They had similar discriminatory power when comparing extreme categories of individuals with no disability with severely limited (RP: 0.93-1.00). The polytomous Sum procedure showed the highest AUC (0.934; 95% confidence interval [95%CI]: 0.928-0.939) and Guttman the lowest (0.853; 95%CI: 0.845-0.861). CONCLUSIONS: Polytomous items have greater reliability than the dichotomous ones. Simplest methods (Sum) and most complex (Rasch) are equally valid. Guttman method presented worse discriminatory capacity.


Assuntos
Atividades Cotidianas , Avaliação Geriátrica/métodos , Idoso , Área Sob a Curva , Intervalos de Confiança , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes
20.
Gerontologist ; 58(5): e302-e310, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-30219906

RESUMO

Purpose of the Study: The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire in which participants rate the disease burden caused by a number of medical conditions. This paper studies the measurement properties of the DBMA, using Rasch analysis. Design and Methods: We used data of 1,400 community-dwelling adults aged 50 years and older participating in the Ageing in Spain Longitudinal Study, Pilot Survey (ELES-PS). Test of fit to the Rasch model, reliability, unidimensionality, response dependency, category structure, scale targeting, and differential item functioning (DIF) were studied in an iterative way. Construct validity of the linear measure provided by the Rasch analysis was subsequently assessed. Results: To achieve an adequate fit to the Rasch model, all items were rescored by collapsing response categories. Reliability (Person Separation Index) was low. The scale was unidimensional and neither response dependency nor relevant DIF were found. The linear measure had a correlation of -0.48 with physical functioning, -0.47 with perceived health, 0.32 with depression, and -0.24 with quality of life (QoL) and displayed satisfactory known-groups validity by sex and age groups. Relative precision analysis showed that the linear measure discriminated better between age groups than the original raw score, but for sex no difference was found. Implications: Despite some limitations, support was found for the validity of the DBMA in older adults. Its linear scores may be useful to assess strategies aimed at improving the QoL of patients with multimorbidity. More research is needed in a hospital-based sample.


Assuntos
Efeitos Psicossociais da Doença , Autorrelato/normas , Idoso , Doença Crônica , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Espanha
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