Psychosexological correlates of 372 women with vulvodynia, overactive pelvic floor, postcoital cystitis, and interstitial cystitis.

BACKGROUND: Among the plethora of urogynecological conditions possibly affecting women, some of them, less explored, have significant impacts on sexological and psychological health, with a mutual influence. AIM: The aim of this study was to investigate the sexological and psychological correlates of four urogynecological pathologies in a sample of women of childbearing age: overactive pelvic floor, vulvodynia, postcoital cystitis, and interstitial cystitis. Women cured of these conditions were also included, to assess the same aspects after the remission of physical symptoms. METHODS: We recruited 372 women with an average age of 33.5 years through an online platform shared by a popular forum for women with urogynecological pathologies between March and May 2021. The participants filled out a socio-anamnestic questionnaire and a set of psychometric tests. OUTCOMES: Participant data were collected by use of the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Toronto Alexithymia Scale-20, Female Sexual Function Index, and Orgasmometer-F, and the SPSS (Statistical Package for Social Sciences) v.26 was used for data analysis. RESULTS: Overactive pelvic floor was reported by 66.4% of the women, vulvodynia by 55%, postcoital cystitis by 58.8%, and interstitial cystitis by 8.3%, and these conditions were often comorbid with each other, with 9.4% and 7% of women reporting having suffered psychological and sexual abuse, respectively. The presence of past abuse was correlated with overactive pelvic floor (P < .05), vulvodynia (P < .01), and major depression (P < .01). Significantly more depression occurred in women with vulvodynia than in the other subgroups (P < .05), except for women with only an overactive pelvic floor. There was no difference between the subgroups in the occurrence of alexithymia, sexual function, and orgasm (P < .05). Interestingly, the prevalence of sexual dysfunction increased in cured women. CLINICAL IMPLICATIONS: The lack of significant differences, except for depression, between the pathological subgroups suggests a similar clinical and psychological relevance of the four pathologies studied. The persistence of sexual dysfunctions in cured women may be related to a residual dysfunctional relational modality with the partner. STRENGTHS AND LIMITATIONS: The evaluation of both psychological and sexological variables in a group of less-explored urogynecological conditions represents a strength of this study, while a lack of a face-to-face assessment could represent a limitation. CONCLUSION: The results of the present study should promote psychosexological interventions in women with these diseases, both during the pathological state and after remission.

Psychometric properties of the pediatric ward nurses' caring self-efficacy scale: A Turkish validity and reliability study.

PURPOSE: To translate the 51-item Pediatric Ward Nurses' Caring Self-Efficacy Scale into Turkish and to test the validity and reliability of the Turkish version of the scale in the Turkish population. DESIGN AND METHODS: The study was conducted with 308 nurses working in the pediatric/pediatric wards of two hospitals in Turkey between September 2021 and January 2022. A Personal Information Form, the Pediatric Ward Nurses' Caring Self-Efficacy Scale, and the Nursing Profession Self-Efficacy Scale (NPSES) were used to determine the care self-efficacy levels of the research sample. RESULTS: The Cronbach alpha value of the scale, which was adapted to Turkish culture, was 0.982, and the test-retest reliability coefficient was 0.994. Factor loads varied between 0.40 and 0.89. The Kaiser-Meyer-Olkin sample fit coefficient of the scale was 0.963 and the Barlett sphericity test χ2 value was 15,259.02 (p < 0.001). It was determined to have a six-factor structure in Turkish culture and showed good fit indices for the Turkish scale (GFI = 0.93, CFI = 0.97, TLI = 0.96 and RMSEA = 0.09). CONCLUSIONS: The Pediatric Ward Nurses' Caring Self-Efficacy Scale was found to be valid and reliable for sensitively detecting changes in the care self-efficacy levels of nurses working in pediatric wards. PRACTICE IMPLICATIONS: The scale can be used by professionals interested in scientific knowledge about pediatric population.

Psychometric properties of the Norwegian version of the Strength and Difficulties Questionnaire in a preschool sample.

PURPOSE: The Strength and Difficulties Questionnaire (SDQ) is widely used internationally, however less so in preschool populations and validations studies are thus needed. This study examined the psychometric properties of the Norwegian version parent report of the SDQ - preschool version (SDQ 2-4). MATERIALS AND METHODS: Parents of 289 Norwegian children in the age span 1-6 years old filled out the SDQ 2-4, the Child Behavior Checklist (CBCL), and background information. Internal consistency, factor structure, and convergent validity were assessed. RESULTS: The results showed satisfying internal consistency for the total difficulties score, but worse for some of the subscales. The five-factor structure showed a good fit. Good convergent and divergent validity was found in terms of correlations with CBCL. Sex differences were found on all scales, boys scoring higher on all problem scales. CONCLUSIONS: The SDQ 2-4 can be a promising instrument to screen for emotional and behavioral difficulties among Norwegian preschoolers, particularly in high-risk populations.

OpenWMB: An open-source and automated working memory task battery for OpenSesame.

Working memory capacity (WMC) has been measured with a plethora of cognitive tasks. Several preeminent automated batteries of working memory (WM) tasks have been developed recently. However, despite all their advantages, most batteries were programmed in paid platforms and/or only included a single WM paradigm. To address these issues, we developed the OpenWMB, an automated battery comprising seven tasks from three distinct paradigms (complex spans, updating tasks, and binding tasks) that tap into several functional aspects of WM (simultaneous storage and processing, updating, and binding). The battery runs on open-source software (OpenSesame) and is freely available online in a ready-to-download format. The OpenWMB possesses flexible features and includes a data processing script (that converts data into a format ready for statistical analysis). The instrument is available in Portuguese and English. However, we only assessed the psychometric properties of the former version. The Portuguese version presented good internal consistency and considerable internal and predictive validity: all tasks loaded into a single factor. Additionally, the WMC estimate was strongly correlated with a fluid intelligence factor. This study also tried to contribute to the ongoing debate regarding the best method to assess WMC. We computed a permutation analysis to compare the amount of variance shared between a fluid intelligence factor and (1) each WM task, (2) homogenous WMC factors (based on multiple tasks from the same paradigm), and (3) heterogeneous WMC factors (derived from triplets of tasks from different paradigms). Our results suggested that heterogeneous factors provided the best estimates of WMC.

New Psychometric Evidence of the Grief Impairment Scale (GIS) in People Who Have Experienced the Death of a Loved One From a Network Psychometric Approach in Two Latin American Countries.

This study aimed to evaluate the psychometric properties of the Grief Impairment Scale (GIS) using a network psychometric model. A total of 1048 individuals from Peru and El Salvador participated. A network psychometric model was used to determine internal structure, reliability, and cross-country invariance. The results indicate that the GIS items were grouped into a single network structure through Exploratory Graph Analysis. Reliability was estimated by structural consistency, and it was found that when replicating the network structure within an empirical dimension, a single network structure was consistently obtained, and all items remained stable. Furthermore, the network structure was invariant, thus functioning similarly across the different country groups. In conclusion, the GIS presented solid psychometric evidence of validity based on its internal structure, reliability, and cross-country invariance. Therefore, the GIS is a psychometrically sound measure of functional impairment symptoms due to grief for Peruvian and Salvadoran individuals.

Beyond biopsychosocial: The keystone mechanism theory of pain.

Pain is a deeply personal experience, with interindividual differences in its chronification and treatment presenting a formidable healthcare challenge. The biopsychosocial model (BPSm) has been hugely influential within nascent attempts at precision pain medicine, steering the field away from a reductionist biomechanical viewpoint and emphasising complex interactions of biological, psychological, and social factors which shape the individuality of pain. However, despite offering a strong theoretical foundation and holistic perspective, we contend that the BPSm remains limited in its capacity to deliver truly mechanistically informed treatment of pain. We therefore propose the keystone model of pain which offers a pragmatic balance between the dimensionality expansive BPSm and overly reductive approaches, providing both theoretical and practical advantages for the transition from treating populations to individual people.

Validation of the illustrated questionnaire on eating and sedentary behaviors (QUICAS) for seven to ten-year-old children.

The Illustrated Questionnaire on Eating and Sedentary Behaviors (QUICAS) was developed and validated for schoolchildren seven to ten years old. It used previous day recall and was illustrated with ten eating behaviors (referring to the act of eating without distractions, with company, on a regular basis, the type of food eaten, and participation in tasks involved in meal preparation) and five sedentary behaviors (related to the use of television, computer, tablet, cell phone, and video game). The instrument was validated in four stages: (1) Its content was developed based on literature review and expert evaluation; (2) Items were validated by comparing the responses of children and their parents, through a questionnaire on Google Forms. At this stage, a convenience sample was adopted, consisting of 145 parent-child dyads. High sensitivity (average of 90.7%); high specificity (mean of 87.9%); low number of false positives (mean of 12.1%); low number of false negatives (mean of 9.3%); almost perfect agreement between the child's and the parent's reports (k = 0.81); and low disagreement (≤22%) were found. In addition, the child's gender and age did not significantly influence the child's report. (3) The illustrations were validated in a focus group with 18 children, who satisfactorily described all the eating and sedentary behaviors of the illustrations. (4) In the pretest of the questionnaire on Google Forms, with the participation of 15 children, the majority (86.7%) judged the questionnaire as excellent or good. Therefore, the QUICAS is valid to assess eating and sedentary behaviors in schoolchildren seven to ten years old.

Psychometric evaluation of the tinnitus impact questionnaire using patients seeking help for tinnitus or tinnitus with hyperacusis.

OBJECTIVE: To evaluate the psychometric properties of the Tinnitus Impact Questionnaire (TIQ), whose questions focus on assessing the impact of tinnitus on the patient's day to day activities, mood, and sleep, and not on hearing difficulties. DESIGN: This was a retrospective cross-sectional study. STUDY SAMPLE: Data were included for 172 adult patients who attended a tinnitus and hyperacusis clinic in the UK within a six-month period and who had completed the TIQ. RESULTS: Two items whose scores were very highly correlated with those for other items were removed, leaving seven items. Exploratory factor analysis suggested a single factor for the TIQ. A multiple causes multiple indicator model showed significant but very small direct effects of age on TIQ scores for two items, after adjustment for gender. The TIQ had excellent internal consistency, with Cronbach's alpha = 0.89. The total TIQ score was moderately to strongly correlated with scores for the Tinnitus Handicap Inventory, Screening for Anxiety and Depression-Tinnitus questionnaire, Hyperacusis Questionnaire, and Hyperacusis Impact Questionnaire, indicating convergent validity. The TIQ score was weakly correlated with the pure-tone average hearing threshold, indicating discriminant validity. CONCLUSIONS: The TIQ is a brief, valid and internally consistent questionnaire for assessing the impact of tinnitus.

Oral health-related quality of life in patients aged 8 to 19 years with cleft lip and palate: a systematic review and meta-analysis.

BACKGROUND: Cleft lip and palate (CLP) is the most common facial birth defect worldwide and causes morphological, aesthetic, and functional problems with psychosocial implications for an individual's life and well-being. The present systematic review and meta-analysis assessed whether the treatment of CLP impacts the oral health-related quality of life (OHRQoL) in children and adolescents in comparison to healthy controls. METHODS: We searched MEDLINE/PubMed, EMBASE, and PsycINFO databases using terms related to CLP, and included articles until August 2023. Observational comparison studies that assessed OHRQoL in non-syndromic CLP patients aged 8-19 years with validated scales designed to such aim or scales capable to identify aspects related to oral health compared to healthy controls were included. We used the ROBINS-I tool for risk of bias assessment. A meta-analysis of continuous variables was performed using inverse variance for pooling estimates, Standardized Mean Difference (SMD) as a summary measure, with random effects model. Heterogeneity was estimated by the I2 statistics. Sensitivity analyses included subgrouping based on the scale, risk of bias and scale domains. Meta-regression was performed under a mixed-effects model considering the variables type of scale, scale domains and risk of bias. RESULTS: Fourteen studies were included comprising 1,185 patients with CLP and 1,558 healthy controls. The direction of the effect of OHRQoL favoured the healthy group (-0.92; 95% CI:-1,55;-0,10) and I2 = 95%. After removing three studies, I2 dropped to 80%. Meta-regression showed no influence on risk of bias (p = 0.2240) but influence of scale type (p = 0.0375) and scale domains (p < 0.001). The subgroup analysis indicated that the CPQ and COHIP scales presented very discrepant SMD values, despite pointing to the same effect direction. In contrast, the OHIP scale showed a non-significant difference between cases and controls, with estimates much lower than the other two scales. Results also suggest that OHRQoL associated with oral functionality and social well-being is more influential on outcomes than emotional well-being. CONCLUSION: The global OHRQoL is slightly worst in the CLP patients than control group. The difference between OHRQoL was mainly detected through OHIP. The most affected domains are functional, emotional and social. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022336956.

Validation of a French questionnaire assessing knowledge of suicide.

OBJECTIVES: The objective of this study was to develop and validate the Knowledge of Suicide Scale (KSS), elaborated to assess adherence to myths about suicide. METHODS: The KSS is a self-questionnaire including 22 statements relating to myths about suicide for which the respondent is asked to rate his degree of adherence on a scale ranging from 0 ("strongly disagree") to 10 ("completely agree"). Using the script concordance test scoring method, the respondents' scores were compared with those of experts to obtain, for each item, a score between 0 (maximum deviation with the experts) and 1 (minimum deviation with the experts). One thousand and thirty-five individuals (222 psychiatric interns, 332 medical interns in the first semester excluding psychiatry and 481 journalism students) were included. RESULTS: According to the exploratory factor analysis, the KSS is a two-dimensional scale: the first subscale includes 15 items and the second seven items. The tool showed excellent face validity, correct convergent and divergent validities (multi-method multi-feature analyzes), and good internal consistency (Cronbach's alpha coefficient between 0.66 and 0.83 for scales and subscales). The KSS is moderately and negatively correlated with the Stigma of Suicide Scale (r=-0.3). It significantly discriminates groups with different expected levels of knowledge regarding suicide (P<0.001). CONCLUSIONS: The KSS demonstrated good psychometric properties to measure adherence to myths about suicide. This tool could be useful in assessing the effectiveness of suicide prevention literacy improvement programs.

Concordance and validity between versions of the ADHD Conners scale for Parents.

INTRODUCTION: The Conners Scale for Parents (CRS-P) is one of the reference tools for the diagnostic assessment of Attention Deficit and Hyperactivity Disorders (ADHD). It is commonly used in both research and clinical practice. The latest edition of the Conners Parents Scale Long Version (CRS-P3L) has undergone extensive modifications but has never been compared with the 2nd edition (CRS-P2L). We aim to study the concordance between the last two editions of the CRS-P, their internal consistency, and their validity against the criteria of the ADHD-RS. METHODS: The study population was a cohort of 30 children diagnosed with ADHD participating in a clinical trial. The parents of these children completed both editions of the CRS (P2L and P3L), as well as a DSM-IV ADHD Diagnostic Criteria Rating Scale (ADHD-RS). A linear regression model with the calculation of Lin's concordance coefficient (LCC) was used to study the concordance between the scales. Internal validity was estimated with Cronbach's alpha and inter-criteria validity with Spearman's correlation coefficient. RESULTS: The internal consistency found was "correct" to "good" for both editions (Cronbach alpha 0.85 and 0.77), their correlation with the ADHD-RS was medium to low (Spearman's coefficient 0.25 and 0.09). Concordance between the overall score and the sub-scores of the two editions of the same Conners scale (CRS-P2L and CRS-P3L) was fair to medium (LCC 0.29 to 0.69). CONCLUSIONS: The third edition of the long version of the CRS-P showed very poor concordance with the previous edition. The diagnostic profile of the children seems to have evolved with the new edition, which appears to affect the interpretation of the tests.

Validation of the Post-Traumatic Growth Inventory in Adolescents Who Lost a Family Member in the Past 4 years: Effects of Time After the Death Event and Gender.

Post-traumatic growth is the psychological capacity to perceive positive changes facing high-stress or potentially traumatic events and may be especially useful in lessening their effects in adolescents' lives. Present study aimed to evaluate the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in 662 Peruvian adolescents who suffered the death of an immediate family member over the last 4 years. Firstly, an exploratory graphical analysis (EGA) was conducted to determine the best parsimonious structure of the instrument and confirmed with its respective factor models. The results report adequate fit indices in the EGA Bifactor model. Furthermore, another structural model is included, which reports significant latent effects of the time elapsed since the relative's death and gender (male) on PTGI general factor. Likewise, gender measure was significantly related to items 3, 7, and 11, which is linked to personal growth.

Comparison of generic and specific instruments to assess the quality of life in patients with melasma.

OBJECTIVE: To compare the psychometric performance of a generic and specific instruments in assessing melasma-related quality of life. METHODS: A cross-sectional study was conducted with 150 patients with melasma attending an outpatient dermatology clinic of a public hospital in São Paulo state, Brazil. Data were collected using a questionnaire containing sociodemographic and clinical data as well as the generic WHOQOL-BREF, and the dermatological-specific Skindex-16 and HRQ-Melasma. RESULTS: The overall internal consistency of the domains of the three instruments was ≥ 0.7. A strong positive correlation was identified between the Skindex-16 and HRQ-Melasma domains (0.68-0.78). Item-response theory showed that most Skindex-16 and HRQ-Melasma domains were more informative than WHOQOL-BREF. CONCLUSION: The three instruments for assessing QOL tested presented good psychometric performance, with satisfactory internal consistency values. Only the two dermatological instruments, however, demonstrated a strong correlation between the domains that assess social, emotional, and functional aspects of QOL, indicating that both were able to identify impairments in other QOL dimensions in addition to the physical domain.

Validation of the severe respiratory insufficiency questionnaire for Chile.

BACKGROUND: Long-term home non-invasive ventilation (LTH-NIV) has an impact on the health-related quality of life of patients with chronic hypercapnic respiratory failure (CRF) of different causes. There are generic and specific questionnaires for respiratory diseases. In 2003 a specific questionnaire was developed for patients with CRF in LTH-NIV, called the Severe Respiratory Insufficiency (SRI) questionnaire, which has been shown to be reproducible and reliable and has been validated in several languages. The aim of the study was to translate and culturally adapt the SRI questionnaire for adult Chilean patients under LTH-NIV, and to assess its psychometric properties. METHODS: The Chilean version of the SRI was obtained using the translation-back translation method, which was then applied by cross-sectional study to a non-probabilistic convenience sample of stable patients from five regions of Chile. The validated Chilean version of the SRI questionnaire and SF-36 (gold standard) questionnaire were applied, demographic and ventilatory data were collected. Reliability was analysed using Cronbach's alpha and intraclass correlation (test-retest). Construct validity was tested using exploratory factor analysis (principal component extraction and equimax orthogonal rotation) and hypothesis testing (Mann-Whitney test). Convergent criterion validity was tested using Spearman's rho. RESULTS: The sample comprised 248 patients, 132 women (53.2%), median age (IQR) was 62 years (51-75), 146 patients (58.9%) were 60 years or older, 40% had a low education level. The mean ± SD completion time of the questionnaire was 18.8 ± 9.1 min, and 100% of the items were answered. The questionnaire was self-applied by 46.8% of the sample. The validated Chilean version of the SRI questionnaire showed very good overall reliability (0.95) and by scales (> 0.7). It showed a good correlation with the SF-36, with equivalent scales, a rotated matrix with 8 factors and hypotheses that explain the underlying constructs. CONCLUSIONS: The validated Chilean version of the SRI questionnaire has good psychometric properties. It is feasible, valid, and reliable for application to evaluate patients with CRF in LTH-NIV. It was found to be sensitive to assess the characteristics of the local population.

Translation, cross-cultural adaptation and validation of the revised-Skin Management Needs Assessment Checklist questionnaire in Malay language.

INTRODUCTION: Pressure injury (PI) related knowledge can be used as an outcome indicator of a PI education program. In Malaysia, no scale has been translated and validated for measuring PI-related knowledge among patients with a PI. AIM: The purpose of this study was to cross-culturally adapt, translate and determine the validity and reliability of the Malay version of the revised-Skin Management Need Assessment Checklist (revised-SMnac). METHOD: The instrument was initially written in English and translated into the Malay language. The internal consistency, construct validity, and test-retest reliability were examined after the item and scale's cross-cultural equivalence and content validity were evaluated. Construct validity was determined through the administration of the instrument amongst 170 hospitalised patients with a PI. Content validity index (CVI) was further determined through validation by a panel of five wound care experts. The instrument's stability was determined by the test-retest model with a two-week interval. RESULTS: The content validity of the item-CVI (I-CVI) was >79%, indicating that all 17-items were appropriate, while the scale-CVI (S-CVI) of >0.83 indicated an acceptable scale. The Cronbach's Alpha was .994 indicated good internal consistency. Test-retest showed a good intra-class correlation coefficient, ICC = 0.955 with 95% CI [0.992-0.996]. CONCLUSIONS: The Malay version of the revised-SMnac demonstrated to be a valid and reliable tool to measure PI-related knowledge among the Malay-speaking patient population in Malaysia. The tool is recommended for use to measure the effectiveness of education programs related to PI care in future studies.

Psychometric Properties of a Persian Version of the SpREUK-P Questionnaire: An Instrument for Measuring the Importance and Frequency of Spiritual/Religious Practices in Iranian Patients with Chronic Gastrointestinal Diseases.

Attention to spiritual and religious issues is considered an important therapeutic method for patients with chronic disorders. This study aimed to assess the psychometric properties of a Persian version of the SpREUK-P questionnaire for evaluating spiritual and religious opinions among Iranian patients with chronic gastrointestinal diseases. This cross-sectional study was performed on 233 adult patients referring to the gastrointestinal clinic affiliated to Shiraz University of Medical Sciences, Shiraz, Iran, in 2017. The Persian version of the SpREUK-P questionnaire was prepared through the forward-backward translation method. The internal consistency of the questionnaire was evaluated by Cronbach's alpha coefficient. Furthermore, the construct validity of the instrument was assessed via exploratory factor analysis, while convergent and discriminant validity were investigated using Spearman correlation. Cultural adaptation, linguistic equivalency, and content validity of the Persian version of the SpREUK-P questionnaire were approved by a ten-member team of Shiraz University of Medical Sciences. Content validity indices were more than 0.8% across all items. Cronbach's alpha coefficients in terms of importance and practices were 0.81 and 0.71, respectively. Furthermore, the Persian version of the SpREUK-P showed excellent convergent validity and moderate to excellent discriminant validity. The results of exploratory factor analysis showed that all items were loaded properly on their own subscales, except for two items in the practice aspect and one item in the importance aspect. In conclusion, this study showed that the developed Persian SpREUK-P questionnaire is appropriate for assessing spiritual/religious opinions in Iranian patients with chronic diseases.

Rapid screener for the assessment of fear of progression in cancer survivors: The Fear of progression-Questionnaire Rapid Screener.

OBJECTIVES: Fear of progression (FoP) among cancer survivors can adversely affect all areas of life. Existing instruments are too long for implementation in routine care. Therefore, we developed and tested a rapid screener for FoP (FoP-Q-RS). METHODS: Data were derived from a register-based study among cancer survivors. The 12-item short form of the Fear-of-Progression Questionnaire (FoP-Q-SF) served as item-pool. Confirmatory factor analysis (CFA) was applied to determine (a) fit indices including comparative fit index (CFI) and standardised root mean square residual (SRMR) and (b) measures of reliability including composite reliability (CR). Fit indices were compared to the FoP-Q-SF. Sensitivity and specificity were calculated to recommend a cut-off (criterion: GAD-7 score ≥10). RESULTS: One thousand two cancer survivors participated (response rate: 53%). We selected five items for the FoP-Q-RS. CFA indicated acceptable fit (CFI = 0.936; SRMR = 0.048) and reliability (CR = 0.793). Fit indices were better than for the FoP-Q-SF. The cut-off ≥12 showed optimal balance between sensitivity (72%) and specificity (70%), the cut-off ≥10 revealed higher sensitivity (86%) with still tolerable specificity (52%). CONCLUSION: The FoP-Q-RS shows good psychometric properties and may be applied in routine care. Further studies on preferable cut-offs and other populations are needed.

Inter-rater reliability among psychiatrists when assessing depression according to the Montgomery-Åsberg Depression Rating Scale.

INTRODUCTION: Montgomery-Åsberg Depression Rating Scale (MADRS) is a validated tool for rating the depth of depression. The structured interview guide for the MADRS (SIGMA) is an interview guide that has been developed in order to increase the inter-rater reliability. Patients often meet more than one psychiatrists during their hospitalization for depression. A divergent rating of depression between psychiatrists could affect both the treatment and the outcome. This makes knowledge of the inter-rater reliability among psychiatrists important. AIM: The primary aim of this study was to measure the inter-rater reliability between psychiatrists when rating depression using the MADRS. METHODS: Ten in-patients, who were diagnosed with depression, were filmed while being interviewed using the SIGMA. The patients were after that instructed to rate themselves using the self-rating version of the MADRS. Ten psychiatrists rated the pre-recorded interviews according to the MADRS. The inter-rater reliability was measured using intra-class correlation (ICC). RESULTS: The mean ICC for the total MADRS score was 0.952 (95% CI 0.891-0.986; p<.001) and Cronbach's alpha 0.961. ICC values for each item ranged between 0.866 and 0.978 (p<.001). Cronbach's alpha ranged between 0.905 and 0.984. The ICC values, when comparing the psychiatrists rating to the patients rating, ranged between 0.307 and 0.809 (p<.001). CONCLUSION: All of the ICC values in the study, except when comparing the psychiatrists rating to the patients self-rating, were considered to be excellent. This study confirms the findings of reliability found in similar studies which involved fewer raters and not exclusively psychiatrists.

Recovery-oriented care: mental health workers' attitudes towards recovery from mental illness.

BACKGROUND: The Recovery Knowledge Inventory (RKI) was developed to operationalise the recovery construct and in turn contribute to moving mental health services towards recovery-oriented practice. This study validated the RKI in a sample of Norwegian mental health care practitioners and examined mental health workers' knowledge of and attitudes towards patient recovery. METHODS: The RKI was translated into Norwegian and tested on 317 mental health workers from 7 primary and 22 specialised mental health care units within a defined geographical area of Norway. RESULTS: Psychometric challenges to the RKI were observed and called into question the previously proposed four-factor structure. The findings of the scale revealed that the study sample scored significantly lower than a comparable sample in a previous study, suggesting that the Norwegian mental health workers have relatively low orientation towards recovery. This finding was especially applicable to the reduction of symptoms and treatment, which the respondents perceived as essential for recovering from mental illnesses and substance abuse disorders. CONCLUSIONS: To operationalise the recovery construct, the development of a measure such as the RKI needs further attention. For psychiatric practice to be moved in a more recovery-oriented direction, consensus on what constitutes well-functioning recovery must be reached by patients, practitioners and researchers alike.

Examination of the psychometric properties of the Persian version of the attitude towards pressure ulcer prevention instrument in nurses.

INTRODUCTION: Pressure ulcer development is a known indicator of the quality of care. Negative attitudes towards the prevention of pressure ulcers can lead to preventive care with suboptimal quality. There is no valid and reliable instrument in Iran to assess clinicians' attitudes towards pressure ulcer prevention; therefore, this study aimed to examine the psychometric properties of the Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) in Nurses. METHODS: In this cross-sectional study, 250 nurses were selected using a convenience sampling method. Face, content, and construct validity were examined using exploratory factor analysis (EFA). Internal consistency was assessed using the McDonald's omega (ω), and reliability was assessed using the test-retest method. RESULTS: In the EFA, five factors of Competence, Responsibility, Perceived Consequences of Pressure Ulcers on Patients, Priority, and Confidence in the Effectiveness of Prevention were extracted that together explained 50.26% of the total variance. A McDonald's ω of 0.891 demonstrated the internal consistency of the total scale, and internal consistencies ranging from 0.70 to 0.86 were found for different dimensions of the instrument. In addition, an intraclass correlation coefficient (ICC) of 0.876 was found that indicated the reliability (stability) of the total scale (95% Confidence Interval [CI]: 0.736-0.963). CONCLUSION: The Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) has good validity and reliability in Iranian nurses and can be used in future clinical studies.