Assessment of Frailty by the French Version of the Vulnerable Elders Survey-13 on Digital Tablet: Validation Study.

BACKGROUND: Frailty assessment is a major issue in geriatric medicine. The Vulnerable Elders Survey-13 (VES-13) is a simple and practical tool that identifies frailty through a 13-item questionnaire completed by older adults or their family caregivers by self-administration (pencil and paper) or by telephone interview. The VES-13 provides a 10-point score that is also a recognized mortality predictor. OBJECTIVE: This study aims to design an electronic version of the Echelle de Vulnérabilité des Ainés-13, the French version of the VES-13 (eEVA-13) for use on a digital tablet and validate it. METHODS: The scale was implemented as a web App in 3 different screens and used on an Android tablet (14.0× 25.6 cm). Participants were patients attending the outpatient clinic of a French geriatric hospital or hospitalized in a rehabilitation ward and family caregivers of geriatric patients. They completed the scale twice, once by a reference method (self-administered questionnaire or telephone interview) and once by eEVA-13 using the digital tablet. Agreement for diagnosis of frailty was assessed with the κ coefficient, and scores were compared by Bland and Altman plots and interclass correlation coefficients. User experience was assessed by a self-administered questionnaire. RESULTS: In total, 86 participants, including 40 patients and 46 family caregivers, participated in the study. All family caregivers had previously used digital devices, while 13 (32.5%) and 10 (25%) patients had no or infrequent use of them previously. We observed no failure to complete the eEVA-13, and 70% of patients (28/40) and no family caregivers needed support to complete the eEVA-13. The agreement between the eEVA-13 and the reference method for the diagnosis of frailty was excellent (κ=0.92) with agreement in 83 cases and disagreement in 3 cases. The mean difference between the scores provided by the 2 scales was 0.081 (95% CI-1.263 to 1.426). Bland and Altman plots showed a high level of agreement between the eEVA-13 and the reference methods and interclass correlation coefficient value was 0.997 (95% CI 0.994-0.998) for the paper and tablet group and 0.977 (95% CI 0.957-0.988) for the phone and tablet groups. The tablet assessment was found to be easy to use by 77.5% (31/40) of patients and by 96% (44/46) of caregivers. Finally, 85% (39/46) of family caregivers and 50% (20/40) of patients preferred the eEVA-13 to the original version. CONCLUSIONS: The eEVA-13 is an appropriate digital tool for diagnosing frailty and can be used by older adults and their family caregivers. The scores obtained with eEVA-13 are highly correlated with those obtained with the original version. The use of health questionnaires on digital tablets is feasible in frail and very old patients, although some patients may need help to use them.

Linguistic validation and cognitive assessment of the French version of the Acute Cystitis Symptom Score questionnaire.

INTRODUCTION: The Acute Cystitis Symptom Score (ACSS) questionnaire first developed in Russian and Uzbek languages and now available in many other languages can be used for clinical diagnostics and patient-reported outcome (PRO) in female patients with acute uncomplicated cystitis (AUC). The aim of the current study was the linguistic validation and cognitive assessment of the French version of the ACSS questionnaire according to internationally accepted guidelines. METHODS: After two forward translations from Russian into the French language and backward translation into Russian and Uzbek, the two original languages, the scientific committee (SC) performed a slightly adapted French version, which finally was cognitively assessed by female subjects with different ages and educational levels and medical professionals, such as nurses, physicians, and pharmacists. RESULTS: All comments of the female subjects and professionals were discussed within the SC and after slight, but necessary adaptations, the SC agreed on the final study version of the French ACSS. CONCLUSION: Now, the linguistically validated and cognitively assessed French version of the ACSS can be used for clinical studies and practice.

Validation of the French version of the Vulnerable Elders Survey-13 (VES-13).

BACKGROUND: Identifying and assessing degree and type of frailty among older persons is a major challenge when targeting high risk populations to identify preventive interventions. The Vulnerable Elders Survey-(VES-13) is a simple instrument to identify frailty defined as risk for death, functional decline or institutionalization. OBJECTIVE: Translate VES-13 into French and validate it. METHODS: The French version of VES-13 was developed by forward-backward translation of the VES-13 survey instrument. The authors assessed its feasibility, construct validity, and ability to predict the combined outcomes of admission to institution or death at 18 months, in 135 persons over 70 years of age living in the community. Subjects were recruited from three settings: Group 1 - a health prevention center (n = 45); Group 2 - an ambulatory care geriatric clinic (n = 40); and Group 3 - an intermediate care hospital unit (n = 50). The combined outcomes data were recorded by telephone interview with participants or a proxy. RESULTS: Feasibility of the French version, named Echelle de Vulnérabilité des Ainés-13 or EVA-13, was excellent. The scale classified 5 (11%) persons as vulnerable (score of 3 or more) in Group 1, 23 (58%) in Group 2 and 45 (90%) in Group 3 (p < 0.001) with scores of 0.91 +/- 1.16, 4.27 +/- 3.17 and 6.90 +/- 3.17, respectively (p < 0.001). At follow-up, among the 60 non-vulnerable subjects, 58 (96%) were alive and living at home, whereas 46 (65%) of the 70 vulnerable subjects were alive and living at home (p < 0.001). CONCLUSIONS: EVA-13 was determined to be valid and reliable.

Metacognitive beliefs in depressed in-patients: adaptation and validation of the short version of the Metacognitions Questionnaire (MCQ-30) for French clinical and non-clinical samples.

BACKGROUND: The short form of the Metacognitions Questionnaire (MCQ-30) is a brief multi-dimensional measure which explores the metacognitive processes and beliefs about worry and cognition that are central to the vulnerability and maintenance of emotional disorders. AIMS: The first aim of the study was to create and validate a French version of the MCQ-30 in a non-clinical and a clinical sample of depressed in-patients. METHOD: A French adaptation of the MCQ-30 was administered to a sample of 467 individuals from the general population and 73 hospitalized patients with major depressive disorder. Internal consistency was measured by Cronbach's alpha reliability coefficients. Factor structure was assessed using a confirmatory factor analysis on the non-clinical group and a multi-trait-multi-method analysis on the psychiatric group. Criterion validity was explored by comparing the scores of the two samples. Measures of rumination, worry and depression were used to explore convergent validity. RESULTS: Confirmatory factor analysis in the non-clinical sample indicated that the French version of the MCQ-30 has the same factor structure as the MCQ-30's original five-factor solution. In the clinical sample, the multi-trait-multi-method analysis revealed discrepancies with the original factor structure, and the MCQ-30 and its subscales were less reliable. Our results provide evidence of a convergent validity. The MCQ-30 scores were also able to discriminate between psychiatric and non-clinical samples. CONCLUSIONS: Our results show that the French version of the MCQ-30 is a valid instrument for measuring metacognitive beliefs in non-clinical population. Further research is needed to support its use among depressed in-patients.

Assessing health-related quality of life with the SCOPA-PS in French individuals with Parkinson's disease having undergone DBS-STN: A validation study.

INTRODUCTION: The aims of this study were to validate the French version of the SCales for Outcomes in Parkinson's Disease-PsychoSocial (SCOPA-PS) in individuals with Parkinson's disease (PD) who underwent deep brain stimulation of the subthalamic nucleus (DBS-STN), to confirm the unifactorial structure of this questionnaire, and to establish its psychometric properties. METHODS: Routinely used psychological questionnaires (BDI-II, STAI-Y, PDQ-39, UPDRS III) and the SCOPA-PS were used for a cross-sectional observational study of 154 PD patients. SCOPA-PS acceptability, scaling assumption, reliability, ordinal confirmatory factor analysis and validity were assessed. RESULTS: The ICC for two-week test-retest reliability was 0.88. SEM was 8.42. In confirmatory factor analysis, the one-factor model showed an acceptable fit to the data (Chi(2)/df=2.130; CFI=0.976; RMSEA=0.086). No floor or ceiling effects were observed. Skewness was 0.33. Item-total correlation coefficients ranged from 0.47 to 0.71. Cronbach's alpha was 0.86. SCOPA-PS SI correlated with PDQ-39 SI (rs=0.83) and with state-anxiety and depression (rs=0.56 and 0.69 respectively). The SCOPA-PS SI was higher in more depressed patients and in those with the most severe PD motor symptoms. CONCLUSION AND DISCUSSION: SCOPA-PS French version is a one-factor scale with satisfactory psychometric properties consistent with other language versions. This short scale can be used to evaluate the psychosocial component of QoL in PD patients treated with DBS-STN.

Posttraumatic anger: a confirmatory factor analysis of the Dimensions of Anger Reactions Scale-5 (DAR-5) - French adaptation.

Background: Research has shown that posttraumatic anger is common after a traumatic experience, represents a risk factor for post-trauma psychopathology, and can be screened for using the Dimensions of Anger Reactions Scale-5 (DAR-5), a concise five-item measure. However, a French version of the DAR-5 is not yet available. Objective: We aimed to provide a French adaptation (DAR-5-F) and to replicate, in a French community sample, the psychometric properties of the original DAR-5. Method: After translation using transcultural psychometric principles, the DAR-5-F was presented to 822 fluent French speakers alongside validated scales of anger (State-Trait Anger Expression Inventory-2), anxiety and depression (Hospital Anxiety and Depression Scale), alcohol misuse (Alcohol Use Disorders Identification Test-Consumption), and trauma exposure (Life Events Checklist-5). Results: Confirmatory factor analyses confirmed that DAR-5-F scores fit a single-factor model as described with the English version of the scale. The scale showed noteworthy internal consistency and robust convergent validity with trait anger. The screening DAR-5-F cut-off of ≥12 successfully differentiated high from low scores of STAXI-2, anxiety, depression, and traumatic exposure. Conclusions: The DAR-5 is a robust, psychometrically strong brief scale of anger useful for post-trauma screening, with the DAR-5-F now available for use in French-speaking populations. Future research that examines relationships between the DAR-5-F and variables such as trauma severity and posttraumatic stress symptoms will further improve our understanding of these phenomena.

Antecedentes: La investigación ha demostrado que la ira postraumática es común después de una experiencia traumática, representa un factor de riesgo para psicopatología post trauma, y puede ser tamizada usando las dimensiones de la Escala de Reacciones de Ira-5 (DAR-5 por sus siglas en inglés), una medida concisa de 5 items. Sin embargo, una versión francesa del DAR-5 no está aún disponible.Objetivo: Nuestro objetivo fue proveer una adaptación francesa (DAR-5-F) y replicar, en una muestra de la comunidad francesa, las propiedades psicométricas de la DAR-5 original.Método: Después de una traducción usando principios psicométricos transculturales, la DAR-5-F se presentó a 822 francoparlantes fluidos junto a escalas validadas de ira (Inventario de Expresión de Ira estado-rasgo, STAXI-2), ansiedad y depresión (Escala de Ansiedad y Depresión Hospitalaria, HAD), abuso de alcohol (Test de Identificación de Trastornos por consumo de alcohol, AUDIT- Consumo), y exposición a trauma (Lista de Chequeo de Eventos Vitales, LEC-5).Resultados: El análisis factorial confirmatorio confirmó que el puntaje de DAR-5 F calza con un modelo de factor único como se describió en la versión inglesa de la escala. La escala mostró una consistencia interna notable y una validez convergente robusta con la ira-rasgo. El punto de corte del tamizaje de DAR-5 F igual o mayor a 12 diferenció exitosamente los puntajes altos de los bajos de STAXI-2, ansiedad, depresión, y exposición traumática.Conclusiones: La DAR-5 es una escala de ira breve robusta, psicométricamente fuerte útil para el tamizaje post trauma, con la DAR-5 F ahora disponible para su uso en población francoparlante. Investigaciones futuras que examinen la relación entre la DAR-5 F y variables tales como severidad del trauma y síntomas de estrés postraumático mejorarán aún más nuestra comprensión de este fenómeno.

French validation of the sleep disturbance scale for children (SDSC) in young children (aged 6 months to 4 years).

The sleep disturbance scale for children (SDSC) has been translated and adapted into several languages and its psychometric properties are good. Notably, a French version has been validated for 4- to 16-year olds. The objective of the current study was therefore to adapt and validate the SDSC for French young children (aged 6 months to 4 years). METHOD: 421 French-speaking mothers of children aged between 6 months and 4 years completed the SDSC and the Brief Infant Sleep Questionnaire (BISQ) which is specifically for young children. Of these, 105 children were diagnosed with sleep disorders (clinical group) during a sleep consultation, and 316 completed the SDSC and BISQ in a network of nurseries (control group). Several factor analyses were conducted to identify the most consistent factor structure for this sample. RESULTS: Three items from the previous version were deleted due to lack of clinical relevance for this age group. The best factor analysis revealed six factors, comparable to the Italian version of the SDSC for children: Disorders of Initiating Sleep, Disorders of Maintaining Sleep, Sleep Hyperhidrosis, Sleep Breathing Disorders, Parasomnias, and Non-Restorative Sleep and Excessive Somnolence. This psychometric structure is reliable and aligned with expert diagnoses. The convergent validity, and divergent and internal reliability were acceptable. CONCLUSION: This study validates a 22-item SDSC for French young children. Coupled with some questions from the BISQ, the SDSC could therefore be used to facilitate the detection of sleep disturbances in children aged between 6 months and 4 years old.

Translation, cross-cultural adaption and validation of the French version of the Forgotten Joint Score in total hip arthroplasty.

INTRODUCTION: The ability to "forget" a joint implant in everyday life is considered to be the ultimate objective in arthroplasty. Recently, a scoring system, the Forgotten Joint Score (FJS-12), was published based on a self-administered questionnaire comprising 12 questions assessing how far patients had been able to forget their hip or knee prosthesis. The main objective of the present study was to translate, adapt and assess a French-language version of the FJS-12 in total hip arthroplasty (THA) patients. PATIENTS AND METHODS: The questionnaire was translated by 2 orthopedic surgeons and a medical physician, all bilingual, then back-translated into English by two native English-speaking translators unacquainted with the original. A concertation meeting adopted a beta-version of this Score de Hanche Oubliée (SHO-12), which was then tested on 15 randomly selected THA patients and adapted according to their comments. The final version was validated following the international COSMIN methodology. Data collection was prospective, included all patients operated on by a single surgeon using a single technique. Reference questionnaires comprised Oxford Hip Score (OHS-12) and modified Harris Hip Score (HHS). The 3 assessments were conducted with a minimum 1 year's follow-up. The SHO-12 was administered twice, with a 1-week interval. Statistical tests assessed construct validity (Pearson correlation test), internal coherence (Cronbach alpha), reliability (intraclass correlation coefficient) and feasibility (percentage missing values, administration time and ceiling and floor effects). RESULTS: Translation/back-translation encountered no particular linguistic problems. Fifty-eight patients (63 THAs) responded to all questionnaires: 22 female, 36 male; mean age, 62.7±15.2 years. Mean follow-up was 1.6±0.4 years. SHO-12 correlated strongly with OHS-12 and HHS. Internal coherence was good (alpha=0.96) and reproducibility excellent. No floor or ceiling effects were found. CONCLUSION: SHO-12, the French-language version of the FJS-12 in THA, is a valid, reproducible self-administered questionnaire, comparable to the English-language version. LEVEL OF EVIDENCE: I, Testing of previously developed diagnostic criteria on consecutive patients - Diagnostic study.

Health-related quality of life in children with dysphonia and validation of the French Pediatric Voice Handicap Index.

OBJECTIVE: voice disorders are common in the pediatric population and can negatively affect children's quality of life. The pediatric voice handicap Index (pVHI) is a valid instrument to assess parental perception of their children voice but it is not translated into French language. The aim of the present study was to adapt a French version of the pVHI and to evaluate its psychometric properties including construct validity, reliability, and some aspects of external validity. PATIENTS AND METHOD: we performed a cross sectional study including 32 dysphonic children and 60 children with no history of voice problems between 3 and 12 years of age. The original pVHI was translated into French language according to forward-backward rules and then administered to parents or caregivers. Construct validity and internal consistency were explored using confirmatory factor analysis and Cronbach's alpha. The questionnaire was filled twice to assess test-retest reliability using the intra-class correlation coefficient. The external validity was explored by comparing the French pVHI total and subscales scores between dysphonic and asymptomatic children. Correlations between the French pVHI and both the perceptual GRBAS scale and the health-related quality of life (HRQOL) survey "Vécu et Santé Perçu de l'Adolescent et de l'Enfant" (VSP-Ap) were also performed. RESULTS: the structure of the French pVHI showed a good fit with excellent reliability (α = 0.929) and high test-retest reliability. Significant differences were found between the group of dysphonic children and the control group (p < 0.001). The French pVHI scores were positively correlated to all parameters of the GRBAS scale (p < 0.05). Significant negative correlations were found between the Functional domain of the pVHI and various domains of the VSP-Ap as Leisure Activities, Schooling and Sentimental Relationship (p < 0.05). CONCLUSION: the French pVHI is considered to be a valid and reliable instrument to assess voice-related quality of life in children with voice disorder. We recommend its use in the multidimensional protocols for assessing voice disorder in the pediatric population.

Assessing technical competence in laparoscopic surgery in France: Ratification of the GOALS rating scale.

BACKGROUND: The question of assessing surgical competence is the focus of mainly Anglo-Saxon studies. The GOALS questionnaire (Global Operative Assessment of Laparoscopic Skills) specific to laparoscopic surgery assessment has been developed since 2005. The aim of the study was to assess the metrological qualities of the GOALS questionnaire after ratification in French language. METHODS: To produce a French version of the GOALS surgical competence assessing tool according to an established method (translation - backward translation - retranslation) and to check the metrological qualities (user satisfaction, acceptability, reliability and validity) of this questionnaire through observing residents while in training program on 22 residents in Gynaecology Obstetrics during the laparoscopy training, with the performance of a nephrectomy on a porcine model. RESULTS: The discrepancies in the initial translations were mainly due literal translations. Only synonymous differences were observed in the two backward translations. Comparison with original version led to 8 minor changes. No changes occurred between the 2 French versions. Satisfaction surveys when using the GOALS questionnaire by both examiners and students are similar. Face and content validity seemed good and there is no significant discrepancy between the examiners and the students (11.5 [9-15]; 12.4 [9-15]; P=0.40). Assessment by examiners showed an median value of 17.8 [9-26] with good correlation (α=0.80). By contrast, self-assessment, although there is no significant discrepancy, showed heterogeneity. GOALS French version was able to prove a significant progression both in self-assessment and external evaluation between the act performed on the first nephrectomy on the first day of the first session of the training and the fourth nephrectomy performed on the first day of the second session of the training. CONCLUSION: Our work allowed obtaining a GOALS French version with acceptable validity, good consistency between the assessments and ability to measure progress.

Validation of the French version of the MacNew heart disease health-related quality of life questionnaire.

BACKGROUND: Assessment of health-related quality of life is widely recommended by European health agencies in relevant research studies as well as in clinical care. AIMS: To validate the French version of the MacNew heart disease health-related quality of life questionnaire. METHODS: As part of the International HeartQoL Project, 323 French-speaking patients with ischaemic heart disease (angina, n=76; myocardial infarction [MI], n=155; heart failure, n=91; mean age 58.6±11.3 years) were recruited at seven cardiac rehabilitation centres. All patients completed the French versions of the MacNew questionnaire, the Short Form-36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale, to evaluate the psychometric properties of the French version of the MacNew instrument. RESULTS: The mean MacNew global scale scores were 4.6±0.8, 5.0±1.0 and 4.8±0.9 in patients with angina, MI and heart failure, respectively (P<0.05, MI versus angina). We observed minimal missing items and ceiling effects and no floor effects. Factor analysis confirmed a three factorial structure explaining 55.9% of the observed variance. Internal consistency reliability (Cronbach's α) ranged from 0.86 to 0.94 and test-retest reliability ranged from 0.68 to 0.73 Convergent validity was confirmed in the total group and each diagnosis, although the correlations between the MacNew physical subscale and the SF-36 mental component summary were higher than expected. Discriminative validity was partially confirmed with the SF-36 health transition item and fully confirmed with anxiety and depression as predictor variables. CONCLUSION: The French version of MacNew questionnaire is recommended for assessing health-related quality of life in French-speaking patients with ischaemic heart disease.

French version of the Family Attitude Scale: psychometric properties and relation of attitudes to the respondent's psychiatric status.

The Family Attitude Scale (FAS) is a self-report measure of critical or hostile attitudes and behaviors towards another family member, and demonstrates an ability to predict relapse in psychoses. Data are not currently available on a French version of the scale. The present study developed a French version of the FAS, using a large general population sample to test its internal structure, criterion validity and relationships with the respondents' symptoms and psychiatric diagnoses, and examined the reciprocity of FAS ratings by respondents and their partners. A total of 2072 adults from an urban population undertook a diagnostic interview and completed self-report measures, including an FAS about their partner. A subset of participants had partners who also completed the FAS. Confirmatory factor analyses revealed an excellent fit by a single-factor model, and the FAS demonstrated a strong association with dyadic adjustment. FAS scores of respondents were affected by their anxiety levels and mood, alcohol and anxiety diagnoses, and moderate reciprocity of attitudes and behaviors between the partners was seen. The French version of the FAS has similarly strong psychometric properties to the original English version. Future research should assess the ability of the French FAS to predict relapse of psychiatric disorders.

Is the screening test of the French version of the dementia quality of life questionnaire indispensable?

The aim of this study was to evaluate the usefulness of the screening questions in the French version of the Dementia Quality of Life (DQoL) questionnaire. To assess the psychometric properties of the French DQoL, 155 patients with mild-to-moderate dementia were recruited. Here, we compared the psychometric properties of the instrument between patients who passed the screening test (n = 109) and the whole study population (n = 155). The French DQoL version showed a good test-retest reliability at a 2-week interval (0.95 ≤ intraclass correlation coefficients ≤ 1.0), and an average internal consistency (0.58 ≤ Cronbach's α ≤ 0.87) for the 2 study groups. Significant differences were observed in the 2 groups for 4 dimensions of the DQoL regarding dementia severity (Cornell scale), and for 3 dimensions evaluating depression (MMSE). Convergent validity with the Duke Health Profile revealed many significant correlations between dimensions not only in the 109 patients, but also in the whole study population. Our study demonstrated that patients who failed the screening procedure nonetheless seemed to be able to answer the DQoL questionnaire, the whole study group showing acceptable psychometric properties.

Validation of the French version of the Bournemouth Questionnaire.

Self questionnaires are an important aspect of the management of neck pain patients. The Bournemouth Questionnaire (BQ), based on the biopsychosocial model, is designed to evaluate patients with neck pain. The validated English version of this questionnaire (BQc-English) has psychometric properties that range from moderate to excellent. The goal of this study is to translate and validate a French version of the Bournemouth Questionnaire for neck pain patients (BQc-f). Its translation and adaptation are performed using the translation back-translation method, generating a consensus among the translators. This validation study was performed on 68 subjects (mean age 41 years old) who participated in a randomized controlled trial regarding the efficiency of manual therapy for neck pain patients. This experimental protocol was designed to generate data in order to evaluate the construct validity, longitudinal validity, test-retest reliability and responsiveness. The BQc-f psychometric properties of construct validity (r = 0.67, 0.61, 0.42) for pre treatment, post treatment and longitudinal validity, respectively), test-retest reliability (r = 0.97) and responsiveness (effect size = 0.56 and mean standardized response = 0.61) are sufficient to suggest it could be used in the management of patients with neck pain.