Validation of the Chinese version of the Walsh Family Resilience Questionnaire.

The Walsh Family Resilience Questionnaire (WFRQ) is one of the most widely used and strong theory-based measurement tools of family resilience. This study aimed to develop and psychometrically test the Chinese version of the WFRQ (WFRQ-C). The WFRQ was translated following Brislin's translation model. Psychometric testing, combining classical theory test and item response theory, was conducted with a sample of 800 community adult residents. The Connor-Davidson resilience scale-10 (CD-RISC-10), Self-reported Family Happiness Scale (SFHS-1), and Family APGAR (Adaption, Partnership, Growth, Affection, Resolve) Scale (Family APGAR-5) were applied for convergent validity. Six items were deleted at the item analysis level. The minimum average partial test and a parallel analysis supported a three-factor structure, which was validated by confirmatory factor analysis. The three factors were named "Family belief system," "Organization, communication and problem solving," and "Utilization of external resources." The WFRQ-C was significantly correlated with CD-RISC-10, SFHS-1, and Family APGAR-5, with r values ranged from 0.51 to 0.56. The Cronbach's α was 0.97 for the scale and 0.93, 0.95, and 0.72 for the three factors, respectively. The ICCs of 0.96 for the whole scale, and 0.95, 0.75, and 0.95 for the three factors, respectively. The mean score for the WFRQ-C was 97.00 ± 17.94, of which per capita monthly income and education level were predictors. The 26-item WFRQ-C is a stable, concise, and validated tool to measure family resilience. It is applicable for Chinese community adults in nonspecific stressful settings and has potential utility in the health care domain.

El Cuestionario de resiliencia familiar de Walsh (Walsh Family Resilience Questionnaire, WFRQ) es uno de los instrumentos teóricos de medición de la resiliencia familiar más utilizados y sólidos. Este estudio tuvo como finalidad desarrollar y evaluar psicométricamente la versión china del WFRQ (WFRQ-C). El WFRQ se tradujo siguiendo el modelo de traducción de Brislin. Se realizó una evaluación psicométrica combinando la teoría clásica de los tests y una teoría de respuesta al ítem con una muestra de 800 residentes adultos de la comunidad. Se aplicó la Escala de resiliencia de Connor y Davidson-10 (CD-RISC-10), la Escala de felicidad familiar autoinformada (SFHS-1) y la Escala del APGAR familiar (Family APGAR-5) -adaptación, asociación, crecimiento, afecto, determinación- para la validez convergente. Se borraron seis ítems a nivel del análisis de los ítems. La evaluación parcial de promedio mínimo y un análisis paralelo respaldaron una estructura de tres factores, que fue validada por el análisis factorial confirmatorio. Se denominó a los tres factores "sistema de creencias familiares", "organización, comunicación y resolución de problemas" y "utilización de recursos externos". El WFRQ-C estuvo correlacionado significativamente con la CD-RISC-10, la SFHS-1 y el APGAR-5 familiar, con valores r que oscilaron entre 0.51 y 0.56. El alfa de Cronbach fue de 0.97 para la escala, y de 0.93, 0.95 y 0.72 para los 3 factores, respectivamente. Los coeficientes de correlación intraclase fueron de 0.96 para la escala completa, y de 0.95, 0.75 y 0.95 para los 3 factores, respectivamente. El puntaje promedio para el WFRQ-C fue de 97.00±17.94, que fue pronosticado por los ingresos mensuales por persona y el nivel de educación. El WFRQ-C de 26 ítems es un instrumento estable, conciso y validado para medir la resiliencia familiar. Puede aplicarse en adultos de la comunidad china en entornos estresantes no específicos y posiblemente en el ámbito de la asistencia sanitaria.

A Rasch analysis of the Conley Scale in patients admitted to a general hospital.

Purpose: The Conley Scale (CS) is a widely used tool for assessing the risk of falling for inpatients. The purpose of this study was to assess its unidimensionality, internal construct validity, targeting and reliability using Confirmatory Factor Analysis (CFA) and Rasch analysis (RA).Methods: The CS was administrated to a sample of 58,370 subjects admitted to a general hospital.Results: The CFA supported the unidimensionality of the CS (Root Mean Square Error of Approximation (RMSEA) = 0.040) only after adjusting for local dependency between two items. The scale did not fit the Rasch model (χ218 = 4688.5; p = 0.0000) and this was confirmed notwithstanding adjusting for type-I error (by creating 10-subsample of 250 subjects) and extensive post-hoc modifications. The analysis of targeting showed a marked floor effect (47.1%), whereas the reliability appeared adequate for group measurement (0.800) only after adjusting for the skewed distribution of the calibrating sample.Conclusion: The results of this study suggested that the CS, although unidimensional, could not provide interval-scale measurement of the risk of falling, had a measurement range that mismatched the ability range of the population being measured, and had a reliability inadequate for individual person measurements. Given these findings, the use of the CS to identify inpatients at risk of falling is not recommended.Implications for rehabilitationThe Conley Scale is a unidimensional tool according to Confirmatory Factor Analysis.However, Rasch analysis demonstrated that the tool could not provide interval-scale measurement of the risk of falling, had a measurement range that did not fit the ability range of the population being measured, and had a level of reliability which was inadequate for its intended purpose, that is individual person measurement.The diagnostic utility of the known published cutoff is severely hampered by the severe mistargeting and reduced reliability of the tool.Given these shortcomings, the Conley Scale cannot be recommended to identify inpatients at risk of falling.

The cross-cultural adaptation and psychometric validation of the MSSS-88 for use in Italian patients with multiple sclerosis.

PURPOSE: To cross-culturally translate the Multiple Sclerosis Spasticity Scale into Italian and to evaluate its psychometric properties in patients with multiple sclerosis. METHODS: The Italian version of Multiple Sclerosis Spasticity Scale was developed in accordance with international standards and subsequently administered to 232 Italian adults with multiple sclerosis. The following psychometric properties were analyzed: internal consistency through Cronbach's α and item-to-total correlation, dimensionality with factor analysis, and convergent and criterion validity through hypotheses-testing, comparing the Multiple Sclerosis Spasticity Scale with other outcome measures (Fatigue Severity Scale, Multiple Sclerosis Quality of Life, Modified Ashworth Scale, Barthel Index, and Expanded Disability Status Scale) and analyzing related constructs. Finally, we correlated the MSSS-88 subscales with each other. RESULTS: The final Multiple Sclerosis Spasticity Scale version was well-understood by all subjects. The internal consistency was good (Cronbach's α ≥0.90). Factor analysis revealed that each subscale was unidimensional. Convergent and criterion validity were supported by acceptable correlations with other disease-specific questionnaires, according to the a priori expectations. CONCLUSIONS: The final Italian Multiple Sclerosis Spasticity Scale version showed robust psychometric properties. Therefore, it can be recommended as an assessment tool for clinical and research use to evaluate spasticity in Italian patients with multiple sclerosis. Implications for rehabilitation The Multiple Sclerosis Spasticity Scale was developed to measure patients' perception of the impact of spasticity on life of subjects with multiple sclerosis. In a sample of Italian subjects with multiple sclerosis, the Multiple Sclerosis Spasticity Scale revealed good internal consistency and convergent and criterion validity. Factor analysis demonstrated that each subscale was unidimensional. Each subscale can be used to assess the impact of spasticity in Italian patients with multiple sclerosis.