InterRAI Quality of Life for Mental Health and Addictions: Psychometric Properties and Differences Across Age, Gender, and Service Settings in Brazil

Deinstitutionalization enables the removal of users from asylums with the support of the Psychosocial Care Network (PCN), which is based on the Psychosocial Care Centers (PCCs). One of the current impasses is the emergence of private/religious institutions that are updating the asylum model. In order to analyze what leads to neo-institutionalization in these locations, an ethnographical study was carried out on nine cases in four PCCs of the three PCNs in the city of Rio de Janeiro, through scrutiny of medical records, interviews with the patient, family members, PCC technicians and managers of the asylums per se. These locations were institutionalized despite the support of the PCCs and were selected for the research due to the diversity of characteristics, territories and institutional destinations that permitted investigation. The conclusion drawn is that neo-institutionalization is motivated by different factors: crisis, asylum concept, disarticulation and precariousness of intra- and intersectoral networks, reduced teams and insufficient number of territorial services, institutionalization of PCCs, low crisis reception capacity, family overload and family expectations, lack of regular support for family members and housing projects for users whose caregivers have died, are elderly or become ill.

The article was aimed at discussing the centrality of the concept of culture and its implications in the Global Mental Health (GMH) project, not only from a macro perspective, but also at the local level-more specifically in the Brazilian Unified Health System in the relationship between the devices of the Psychosocial Care Network (PCN) and primary health care (PCH). Therefore, the discussion was concentrated in two different blocks: in the first one, we reflected about the GMH project from the perspective of guaranteeing the right to health, considering sociocultural aspects of mental suffering. In the second block, we will discuss how this perspective can contribute to the increase of care practices at the interface between primary health care and mental health in the Unified Health System. We concluded that considering culture is fundamental to conduct good mental health practice, so that GMH is necessarily polyphonic, while guaranteeing and universalizing the right to health, being a powerful ally in the fight for the defense of SUS (Unified Health System).

Chronic kidney disease (CKD) represents a significant global public health challenge, characterized by its high prevalence and the complexity of its treatment, which collectively impose substantial burdens on patients' quality of life and healthcare systems. Hemodialysis remains a critical life-sustaining treatment for CKD patients, with arteriovenous fistulas (AVFs) being the most commonly used vascular access. The long-term functionality of AVFs relies heavily on patients' self-care abilities, encompassing their knowledge of maintenance practices, appropriate attitudes toward care, and the implementation of effective self-care behaviors. Consequently, accurately assessing the self-care capabilities of patients with AVFs is essential for optimizing treatment outcomes and enhancing their overall quality of life. This study aims to translate the scales of knowledge, attitude, and practice of self-care for patients with arteriovenous fistula (SKAPS-AVF) into Chinese and evaluate its psychometric properties among Chinese patients to ensure its validity and reliability in clinical and research settings. The study employed the Brislin translation model to translate and back-translate the original scale, followed by cultural adaptation to ensure its relevance to the Chinese context. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the structural validity of the scale. Reliability was evaluated by calculating Cronbach's alpha, split-half reliability, and McDonald's Omega (Ω) to determine the internal consistency and stability of the scale. Exploratory factor analysis (EFA) revealed that the translated scale has a three-factor structure, with eigenvalues greater than 1 for all factors and a total variance explanation rate of 63.099%. Confirmatory factor analysis (CFA) demonstrated good model fit, with fit indices such as the chi-square value, Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) meeting acceptable standards. Reliability analysis indicated that Cronbach's alpha, split-half reliability, and McDonald's Omega values all exceeded 0.7, suggesting good internal consistency and stability of the scale. The C-SKAPS-AVF demonstrated good psychometric properties, with high structural validity and reliability, making it a robust tool for assessing self-care capabilities in patients with arteriovenous fistulas. This scale provides a reliable measurement tool for related clinical interventions and research. However, future studies should consider expanding the sample size and evaluating the scale's longitudinal stability and applicability across different cultural contexts.

Suicide resilience has garnered increasing attention from researchers due to its potential role in suicide prevention. In 2021, Sánchez-Teruel etal. developed a tool to assess the resilience levels of individuals with a history of suicide attempts. The Scale of Resilience to Suicide Attempts (SRSA) is composed of 18 items across three dimensions: internal protection, emotional stability, and external protection. While the scale has shown robust psychometric properties in Spanish-speaking populations, cultural differences call for a revalidation of its psychometric characteristics among suicide attempters in Mainland China. This study aims to translate and adapt the SRSA into Chinese, and to evaluate its psychometric properties in adolescents who have attempted suicide in Mainland China. Following Brislin's translation model, a survey was conducted using purposive sampling on 393 adolescents who had attempted suicide at the Hangzhou Normal University Affiliated Hospital and the Affiliated Mental Health Center of Zhejiang University School of Medicine. An expert panel evaluated the content validity. The scale's structural validity was assessed through exploratory factor analysis and confirmatory factor analysis, along with measurement invariance. Additionally, tests for convergent validity, discriminant validity, and criterion-related validity were conducted. Reliability was evaluated using Cronbach's alpha coefficient, McDonald's omega, test-retest reliability, and split-half reliability. The Chinese version of the SRSA comprises three dimensions and 16 items. The item-level content validity index for all items ranged from 0.88 to 1.00, while the Scale-Level Content Validity Index was 0.97. The three common factors explained a cumulative variance of 59.339%. Confirmatory factor analysis demonstrated a good model fit. The Cronbach's alpha coefficient for the entire scale was 0.908, and McDonald's omega was 0.910, with individual dimension Cronbach's alpha values ranging from 0.780 to 0.869 and McDonald's omega ranging from 0.859 to 0.910. The Chinese version of the SRSA is a valid and reliable tool for assessing the resilience levels of adolescents who have attempted suicide in Mainland China.

Abstract: Introduction: Services aimed at psychosocial care are essential for guaranteeing the rights of the assisted population, acquiring a long process, and still current, called Psychiatric Reform, with a public policy design of strategies and programs for the effectiveness of care aimed at the individual and their social context. Among these, embracement stands out as an interlocutor in the processes that involve the user of the Psychosocial Care Network and the services provided by the health units, with emphasis on the Psychosocial Care Center and in particular care related to alcohol and drug users (CAPSad). The present experience report aims to present the nuances of embracement present in the services and activities provided by a CAPSad in a municipality in the interior of Bahia and the importance of this experience for medical training. Experience report: the experiences were presented in four moments: first contacts and the experience of getting to know the CAPSad; Symposium on the care of users of alcohol and other drugs, monitoring medical consultations in mental health and carrying out activities in the waiting room and with therapeutic groups. Discussion: The experiences of comprehensive mental health care enabled the medical student to experience embracement and the singularities of psychosocial care; understand the vulnerabilities of people who use alcohol and illicit drugs; the importance of the family in the care process; participate in medical consultations based on the Person-Centered Clinical Method; as well as multiprofessional care for the integrality of health actions. Conclusion: Comprehensive mental health care constitutes a challenging and necessary topic for the training of the future physician. The inclusion of the student in the psychosocial care network favors the processes aimed at teaching-learning and strengthens the teaching-service-community integration.

Artificial intelligence (AI) has recently entered the medical field, but the level of readiness of medical students for it is not obvious. A tool with appropriate psychometric properties for use in different languages and for international comparison is required to measure this readiness. Medical Artificial Intelligence Readiness Scale for medical students (MAIRS-MS) is most complete scale for this purpose till now. The purpose was to evaluate the Psychometric properties of the Persian-translated version of the MAIRS-MS and verify the replication of the original factor structure in Persian. This study was conducted at Guilan University of Medical Sciences in 2023. Validation of the Persian translated scale (P-MAIRS-MS) was performed by determining the face, content, and construct validity and reliability, impact Score, CVI, CVR, Cronbach's alpha, McDonald's omega, and ICC, and performing confirmatory factor analysis (CFA). AMOS26 and SPSS26 software were used. The translated scale had good quantitative and qualitative face and content validity (all items had the Impact Score higher than 1.5, CVI >= 0.8 and CVR>= 0.8). CFA confirmed the appropriate fit of the four-factor model (χ2/df = 1.963, RMSEA-0.063, CFI = 0.939, GFI = 0.901). Convergent validity was suitable in the first- and second-order CFA (AVE > 0.5, CR > 0.7 CR > AVE for each factor except Ability). Cronbach's alpha (α=0.938) and McDonald's omega (ω= 0.938), and ICC (0.992) indicated acceptable reliability and reproducibility of the scale. The P-MAIRS-MS demonstrated good psychometric properties and can be used for measuring and international comparing the medical students' readiness for AI.

Perceived ageism has been increasingly recognized as a critical determinant of the health and well-being of older adults. However, the cross-cultural validation of instruments measuring ageism remains limited. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Turkish version of the Perceived Ageism Questionnaire (PAQ-TR). Content validity was assessed by a multidisciplinary expert panel. Construct validity was examined using exploratory (EFA) and confirmatory factor analyses (CFA). Convergent validity was tested through correlations with the Brief Aging Perceptions Questionnaire (B-APQ). Reliability was evaluated using Cronbach's alpha, McDonald's omega, and test-retest intraclass correlation coefficients (ICC). Statistical analyses were performed using IBM SPSS Statistics v27 (IBM Corp., Armonk, NY, USA) and AMOS v22 (IBM Corp., Chicago, IL, USA). A total of 307 older adults (137 men and 170 women) participated in the study. The mean age was 71.19 (6.96) years, and 55.7% of the participants were female. An EFA confirmed the original two-factor structure, explaining 61.2% of the total variance, which was subsequently verified by a CFA, showing a good model fit. EFA confirmed the original two-factor structure, explaining 61.2% of the total variance (Kaiser-Meyer-Olkin = 0.82; Bartlett's χ2(28) = 412.5, p < 0.001). The structure was subsequently verified by CFA, which demonstrated an excellent model fit (Comparative Fit Index = 0.97; Tucker-Lewis Index = 0.96; Root Mean Square Error of Approximation = 0.052; Standardized Root Mean Square Residual = 0.041). The Negative subscale showed high internal consistency (Cronbach's alpha (α) = 0.84; McDonald's Omega (ω) = 0.85), whereas the Positive subscale indicated moderate reliability (α = 0.58; ω = 0.60). The test-retest reliability was excellent, reflecting strong temporal stability (Intraclass Correlation Coefficient = 0.91). Convergent validity showed that the positive subscale was related to positive aging perceptions and less to negative ones, while the negative subscale showed the opposite pattern. The PAQ-TR demonstrated adequate psychometric properties for assessing perceived ageism among older adults in Türkiye. While the Negative subscale showed robust reliability, the positive subscale required refinement. These findings highlight both the cross-cultural validity of the PAQ and the influence of cultural norms on positive aging perception. The PAQ-TR is a valuable tool for research and clinical practice.

Objective: to analyze the daily work of a Psychosocial Care Center and its articulation with the Psychosocial Care Network in the context of the COVID-19 pandemic. Methods: this is a qualitative study, produced by means of the researcher’s diary and semi-structured interviews with nine health professionals, submitted to thematic-categorical content analysis. Results: the pandemic revealed failures in the management of services, lack of public investment, and the unpreparedness of professionals, intensifying work fragmentation, network disarticulation, non-assistance, and pre-existing asylum practices. Conclusion: the reality of the daily work of psychosocial care services shows that multifaceted actions that consider the complex social process of the psychiatric reform are necessary, especially in the pandemic, seeking the effective institutionalization of the psychosocial care model and the formation of centers of resistance to the established asylum model.

In recent decades, public policies of the Unified Health System (SUS) in Brazil have structured a community mental health care network (RAPS) based on various community actions and services. This study carried out evaluative research on the implementation of the structure and process dimensions of this care network in Minas Gerais, the second most populous state of Brazil, generating indicators that can enhance the strategic management of the public health system in the strengthening the psychosocial care in the state. The application of a multidimensional instrument, previously validated (IMAI-RAPS), in 795 of the 853 municipalities in Minas Gerais was carried out between June and August 2020. Regarding the structural dimension, we noticed an adequate implementation of services like ‘Family Health Strategy,’ ‘Expanded Family Health Center,’ and ‘Psychosocial Care Centers’ but a lack of ‘Beds in General Hospitals’ destinated to mental health care, ‘Unified Electronic Medical Records’ and ‘Mental Health Training Activities for Professionals.’ In the process dimension, adequate implementation of actions such as ‘Multidisciplinary and Joint Care,’ ‘Assistance to Common Mental Disorders by Primary Health Care,’ ‘Management of Psychiatric Crises in Psychosocial Care Centers,’ ‘Offer of Health Promotion Actions,’ and ‘Discussion of Cases by Mental Health Teams’ point to a form of work consistent with the guidelines. However, we detected difficulties in the implementation of ‘Psychosocial Rehabilitation Actions,’ ‘Productive Inclusion,’ ‘User Protagonism,’ ‘Network Integration,’ and practical activities for the effectiveness of collaborative care. We found a better implementation of the mental health care network in more populous, demographically dense, and socioeconomically developed cities, which shows the importance of regional sharing of services that are not possible for small cities. The evaluation practices of mental health care networks are scarce throughout the Brazilian territory, a fact also found in Minas Gerais, highlighting the need for its expansion not only in the scientific sphere but also in the daily life of the various levels of management.

To analyze the psychometric properties of the cross-culturally adapted version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) Compact Form Brazil. A methodological study was conducted with 281 adult Primary Health Care users. Data collection took place online. Confirmatory Factor Analysis (CFA) was used to evaluate the psychometric properties of the PREOS-PC after the process of cross-cultural adaptation to the Brazilian context. Internal consistency was evaluated through Cronbach's alpha coefficient (α) and McDonald's omega coefficient (ω). The sample consisted of 73.3% women. The mean age was 36.1 years (SD = 12.2). Of the 23 items of the PREOS-PC that were eligible for CFA, a model with four correlated domains and 16 items presented satisfactory fit indexes. The domains were Practice Activation (PrA) (four items), Patient Activation (PaA) (two items), Experiences of patient safety events (EPaS) (five items) and Outcomes of patient safety (OPaS) (six items). One domain (GPeS) presented one question with a 0 to 10 response scale and two open questions, which cannot be inserted in the CPA due to the nature of the items, but can be included in the application of the scale, being evaluated individually. In this factorial model, five items (EPaS2, EPaS3, EPaS4, EPaS5, EPaS6 and EPaS8) presented factor loadings ≤ 0.30. The α and ω values demonstrated good internal consistency for all domains of the PREOS-PC. The Brazilian version of the PREOS-PC Compact Form Brazil composed of four domains (PrA, PA, EPaS and OPaS) and 16 items presented evidence of validation of its psychometric properties and can be used to evaluate the experiences and results of patient safety in Primary Health Care in the Brazilian context.

Suggestibility is a personality trait that reflects a general tendency to accept messages. The Multidimensional Iowa Suggestibility Scale (MISS) is a self-report scale developed to measure the degree of individuals' perceptions of their suggestibility. This study aimed to adapt the MISS in an Italian sample. We conducted two studies. In the first study, 345 subjects (270 females (78%), mean age = 36.21 years ± 14.06 SD) completed the translated Italian version of the MISS, composed of five subscales (consumer suggestibility; persuadability; sensation contagion; physiological reactivity; peer conformity). We investigated the structural validity of the scale through confirmatory factor analysis (CFA) testing four measurement models (unidimensional, four-factor, hierarchical four factors, and bifactor) and explored reliability in terms of internal consistency through the McDonald's omega. In the second study, we cross-validated the MISS on a new independent sample. We enrolled 277 participants (196 females (71%), mean age 30.56, SD = 12.58) who underwent the new version of the scale. We performed factor analyses to test structural validity and compared four measurement models. Then, we investigated reliability and conducted a latent variable analysis to explore divergent validity. The CFA in the first study revealed a bifactor solution of the MISS. This structure was interpretable and provided an adequate fit for the data. The final version of the scale was reduced to forty-six items with globally good indices of adaptation. The scale also demonstrated acceptable reliability in terms of internal consistency through the McDonald's Hierarchical Omega. In the second study, we found that the bifactor structure was confirmed. Factor loadings inspection revealed that there was no justification to report only the separate scores for the subscales. We also found that the scale showed good internal consistency, but mixed evidence for divergent validity. In the end, the Italian version of the MISS demonstrated good psychometric properties which will be discussed in detail below.

Self-efficacy in clinical performance scale: A psychometric validity study with nursing students.

Anxiety disorder is one of the most common mental disorders. This cross-sectional research aimed to determine anxiety literacy (A-Lit) psychometric properties among the Iranian population in 2022. This research was conducted on 690 people in Iran in 2022. In this study, people were selected by proportional stratified sampling, and the validity and reliability of the A-Lit designed by Griffiths were assessed. Validity of A-Lit was assessed by face validity, content validity, and confirmatory factor analysis. Reliability of A-Lit was evaluated by the McDonald's omega coefficient, Cronbach's alpha coefficient, and test- retest. In analytical sections, the tests of One-way ANOVA, Chi-squared test, and independent samples t-test were used. The rates of S-CVI/Ave and CVR for A-Lit were 0.922 and 0.774, respectively. In confirmatory factor analysis, three items were deleted because the factor loading was less than 0.4, and goodness-of-fit indexes (Some of goodness-of-fit indexes: χ2/df = 4.175, GFI: 0.909, RMSEA = 0.068, PCFI = 0.745, AGFI = 0.883) were confirmed as the final model with 19 items. For all items, the Cronbach's alpha coefficient was 0.832, the McDonald's omega coefficient was 0.835, and the intraclass correlation coefficient was 0.874. According to the results of this study, 1.3% (n = 9) did not answer any questions correctly and 8.4% (n = 58) were able to answer 1-6 questions correctly. Approximately 72% (n = 495) were able to answer 7-12 questions, and eventually only 18.6% (n = 128) were able to answer 13 questions and more. There was a significant relationship between sex, age group, occupation status, marital status, and get information related to mental illness with A-Lit level (p < 0.05). The Persian version of A-Lit was confirmed with 19 items, and this scale is a reliable tool for measuring A-Lit in the general population. The results also showed that a few people have a higher level of anxiety literacy and that educational and intervention programs need to be designed and implemented for the public population.

Depression and anxiety are the most common mental health problems among adolescents. The Depression Anxiety Stress Scales for Youth (DASS-Y) is a newly developed instrument designed to assess these problems in adolescents. The present study aims to evaluate the psychometric properties of the DASS-Y among Chinese adolescents. A total of 326 secondary school students aged 14-18 years participated in the study. A convenience sampling method was adopted to conduct a test-retest of the DASS-Y among Chinese secondary school students. McDonald's omega, Cronbach's alpha, and intraclass correlation coefficient (ICC) along with their 95% CI were used to assess the internal consistency and test-retest reliability of the DASS-Y. Confirmatory Factor Analysis (CFA) evaluated the structural validity and convergent validity of the DASS-Y through the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), as well as Average Variance Extracted (AVE) and Composite Reliability (CR). Pearson correlation coefficients with the General Health Questionnaire-12 (GHQ-12), and the Pittsburgh Sleep Quality Index (PSQI) assessed criterion validity. The CFA confirmed the validity the DASS-Y three-factor model consisting of depression, anxiety, and stress. The internal consistency reliability of the DASS-Y was found to be robust, with McDonald's omega and Cronbach's alpha values exceeding 0.8 for all dimensions across two measurements. The test-retest reliability was stable. The structural validity was reasonable and effective. Additionally, convergent validity is satisfactory, while criterion validity is also satisfactory. The three-factor model consisting of depression, anxiety and stress was confirmed through CFA. The DASS-Y exhibits satisfactory psychometric properties among Chinese secondary school adolescents, reliably and appropriately screening for mental health issues such as depression and anxiety within this population. Consequently, it can be employed as a standard tool for routine mental health surveillance in secondary schools.

Scientific assessment is a crucial first step in establishing effective communication between healthcare teams and caregivers. Given the lack of reliable and effective tools to comprehensively assess the quality of communication between healthcare teams and caregivers of cancer patients in China. This study aimed to translated and culturally adapted the Caregiver-Centered Communication Questionnaire (CCCQ) and assessed its psychometric properties in caregivers of cancer patients in China. CCCQ was translated into Chinese following Brislin's model and culturally adapted according to a Delphi expert panel. Then pretested and refined the Chinese versions of the CCCQ (CCCQ-C) among 10 caregivers. A cross-sectional survey was conducted among 600 caregivers of cancer patients from October to December 2024. Psychometric properties of CCCQ-C were evaluated exploratory factor analysis (EFA), confirmatory factor analysis (CFA), McDonald's omega coefficient, and test-retest reliability. The CCCQ-C demonstrated strong content validity (I-CVI = 0.800 ~ 1.000, S-CVI = 0.980) and internal consistency (McDonald's omega = 0.965). EFA identified five factors explaining 71.014% cumulative variance, while CFA confirmed good model fit. Test-retest reliability was excellent (r = 0.820, ICC = 0.806). The overall questionnaire remained unchanged in terms of 5 dimensions and 30 items during the process of translation and validation. In China's medical environment for cancer patients, CCCQ-C demonstrates acceptable psychometric properties, making it a reliable and effective assessment tool for evaluating communication between healthcare teams and caregivers. This provides valuable guidance for future practice, research and policy making.