12-item Version Research Articles

Global and Dimensions of Mental Health in Arthritis Patients.

Arthritis is one of the main clusters of long-lasting musculoskeletal and joint disorders. Recently, there has been increasing interest in the impact of arthritis patients' mental health, which has mainly focused on depression and anxiety in clinical samples. However, much less is known about how domains of mental health based on the widely used 12-item version of the general health survey (GHQ-12) are affected by arthritis. The current research answered this question using confirmatory factor analysis, general linear models, and one-sample t-tests on a nationally representative sample from the United Kingdom with 5588 arthritis patients and 8794 participants indicating that they were not clinically diagnosed with arthritis. The current study found that (1) a total of three factors of GHQ-12 that are labeled GHQ-12A (social dysfunction and anhedonia; six items), GHQ-12B (depression and anxiety; four items), and GHQ-12C (loss of confidence; two items), and (2) both the global mental health and dimensions of mental health are negatively affected by arthritis. Clinicians could use the results from the present study to make better treatment decisions for patients with arthritis.

Anterior cervical discectomy and fusion to treat cervical instability with vertigo and dizziness: A single center, retrospective, observational study.

The current study attempts to investigate the role of anterior cervical discectomy and fusion (ACDF) in alleviating symptoms in patients with cervical vertigo associated with cervical instability. The patients of cervical instability with vertigo and dizziness who underwent ACDF between January 2011 and December 2019 were followed-up for more than two years. Demographic data (age, sex, follow up period and levels of instable cervical segments) were assessed; Symptoms of vertigo and dizziness before and after surgery were assessed by the 15-item version of the Vertigo Symptom Scale (VSS) and the 25-item Dizziness Handicap Inventory (DHI). The severity and frequency of other symptoms like neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache, diplopia and blurring of vision before and after surgery were also assessed. A total of 92 patients underwent ACDF for cervical instability with vertigo and dizziness between January 2011 and December 2019, of which 79 patients were included in the final analysis. The number of instable levels had no correlation with VSS and DHI scores before surgery (p > 0.05), while patients with C3/4 instability suffering a severer vertigo than other levels. Both DHI and VSS scores were significantly reduced after ACDF and this was sustained within two years after surgery (p < 0.001). Although there was no statistical difference in the ratio of patients with vertigo relief, patients with one-level cervical instability demonstrated a more rapid recovery than patients with multi-level cervical instability (p = 0.048). Also, there was improvement in other symptoms such as neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache and blurring of vision after surgery. Vertigo caused by C3/4 instability was severer than other levels such as C4/5 and C5/6. During 2 years' follow-up the significant relief of vertigo and dizziness was observed after anterior cervical surgery. Other accompanying symptoms except hypomnesia were also extenuated in follow-up period.

Investigating measurement invariance of the Emotion Regulation Questionnaire-8 (ERQ-8) across 29 countries

The widely used Emotion Regulation Questionnaire (ERQ) measures the habitual use of cognitive reappraisal and expressive suppression. Recently, a more economical 8-item version of the ERQ was proposed that showed good model fit. We assessed whether the latent constructs of the ERQ-8 are generalizable across different countries and cultures. To this end, we used data from the COVIDiSTRESS survey and investigated measurement invariance of the ERQ-8 in a large sample that included 11,288 individuals from 29 countries with diverse cultural backgrounds. Our analyses revealed configural and metric invariance of the ERQ-8 in 14 countries. The results suggest that emotion regulation strategies may not readily converge across all cultures. This underscores the importance of testing measurement invariance before interpreting observed differences and similarities between countries.

The Positive Aspects of Caregiving Scale can be shortened to six items: application of item response theory

Objective For nearly two decades, with one exception, researchers have used the Positive Aspects of Caregiving Scale (PACS) without a close examination of how the items behave. This study examined PACS’ measurement model and item response characteristics, including differential item functioning (DIF) by race. Methods Item response theory was used to analyze the baseline data of the Resources for Enhancing Alzheimer’s Caregiver Health (REACH) I trial (N = 1229). Bifactor confirmatory models were estimated to assess dimensionality, and whether the items behaved differently in African Americans and Hispanics, with Whites serving as the comparison, were examined using the multiple-indicators multiple-causes model. Results For both 9- and 11-item versions, 1-factor and bifactor solutions supported a unidimensional structure. However, the items performed generally poorly in differentiating levels of the latent construct, especially between moderate and high true scores. Additionally, five items were found to have DIF, which were unrelated to relationship differences among racial groups. While African Americans and Hispanics reported higher positive gains than Whites, their differences were accentuated by the DIF items as a whole. A 6-item version called PACS-II was created by removing the DIF items. Besides reducing estimated racial differences, PACS-II removed race-based heterogeneity of variance that was evidenced in the original, longer versions. Conclusions Being free of racial bias, PACS-II is preferred over the original versions, though the ceiling effect of measurement (prevalence of extreme scores on the high end) remains to be an issue for improvement.

Psychometric properties of Iowa Anesthesia Satisfaction Scale Turkish version.

The Iowa Satisfaction with Anesthesia Scale (ISAS) is a valid and reliable measurement tool developed to evaluate patient satisfaction with anesthesia care during different surgical interventions. It is adapted to various languages and used in many studies. Considering the satisfaction of the patient with anesthesia applied in surgical procedures, the presence of such a measurement tool is crucial. From this point of view, the study aimed to evaluate psychometric properties of the ISAS by adapting it to Turkish culture. In this study, a descriptive, methodological and cross-sectional design was used. A total of 210 patients who underwent surgery under general or regional anesthesia were in the study. ISAS Turkish version (ISAS-T) shows good reliability which is obvious with a Cronbach's alpha value of 0.80. The correlation levels of the items with the ISAS total score were calculated between .45 and .73. Test-retest reliability was calculated as 0.83. CFA analysis was applied to the one-dimensional 11-item final version of ISAS. The uni-dimensionality of the 11-item scale was confirmed on a Turkish patient sample. The fit indices for the model obtained were calculated as χ2/sd = 2.342, RMSEA = .80, SRMR = .04, CFI = .90, GFI = .92. The fit indices of the model have good and acceptable fit values. Based on the psychometric evaluation, ISAS-T is a valid and reliable measurement tool for measuring patient satisfaction with anesthesia applied during different surgical procedures.

Post-COVID-19 perceived stigma-discrimination scale: psychometric development and evaluation

The study aimed to adapt and evaluate a scale to measure COVID-19-CED in COVID-19 survivors. A sample of 330 COVID-19 survivors filled out the COVID-19 Perceived Discrimination Scale (C-19-PDS). C-19-PDS was adapted from the Tuberculosis Perceived Discrimination Scale (11 items). Confirmatory factor analysis showed poor goodness-of-fit indicators. However, the 5-item version of the C-19-PDS showed better goodness-of-fit indicators, high internal consistency, and non-gender DIF. This instrument is recommended to evaluate COVID-19-CED in Colombian and other Spanish-speaking populations.

Validity and Reliability of the CarGOQoL Questionnaire Among Informal Caregivers of Patients With Cancer.

The 29-item CareGiver Oncology Quality of Life (CarGOQoL) scale measures quality of life (QoL) based on the specific characteristics of informal caregivers of patients with cancer. The 29-item CarGOQoL has been translated to numerous other languages and validated, thus confirming its validation. This study aimed to evaluate the reliability and validity of the Korean version of the 29-item CarGOQoL. We recruited 316 informal caregivers of patients with cancer. Data were collected using structured questionnaires between January 23, 2019 and November 30, 2019, and analyzed using SPSS 27.0 and Amos 23.0. Internal consistency, construct validity, convergent and discriminant validity of the items, criterion validity, and known-group validity were tested. The 10-factor model was validated by a confirmatory factor analysis (χ2 = 687.633; P < .001; normed χ2 = 2.084; comparative fit index = .922; Tucker-Lewis index = .904; standardized root mean square residual = .050; root mean square error of approximation = .059). Criterion validity was demonstrated using the World Health Organization Quality of Life instrument-short version (r = .495-607), visual analog scale (VAS) for QoL (r = .509), and VAS for burden (r = -.457). The 29-item Korean version of the CarGOQoL had known-group validity according to the Eastern Cooperative Oncology Group performance status of the patients. Cronbach's alpha coefficient for the total scale was .90. The 29-item Korean version of the CarGOQoL demonstrated acceptable validity and reliability for measuring QoL among Korean informal caregivers of patients with cancer. The 29-item Korean version of the CarGOQoL scale can be useful in Korean oncology clinical practice and research when assessing the quality of life of informal caregivers of patients with cancer.

Construct validity and reliability of the Brazilian version of the Maternal-Fetal Attachment Scale (MFAS): a proposal for a 12-item short version.

This study aimed to update the assessment of construct validity and reliability of the Brazilian version of the Maternal-Fetal Attachment Scale (MFAS). This is part of a cohort study, in which the scale was applied to 415 pregnant women. The factor structure was verified via structural equation models. Comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA) were used to verify the model fit. Additionally, to test the validity of the MFAS based on external variables, generalized linear model was performed to test the association between obstetric variables, social support, and symptoms of depression with the MFAS. The reliability was analyzed via the composite reliability coefficient (CR). The 12-item short version of the Brazilian MFAS showed adequate parameters of construct validity (CFI = 0.969, TLI = 0.960 and RMSEA = 0.032, 90%CI: 0.012-0.048) and is composed of three factors ("empathy and care", "role-taking", and "interaction with the fetus") containing 12 items. The total scores of the MFAS were positively correlated with social support (p-value < 0.001) and negatively correlated with depressive symptoms (p-value = 0.007). Moreover, women who live with a partner (p-value = 0.026) and had intended pregnancies (p-value < 0.001) presented a better bond with the fetus. Regarding reliability, factors 1 and 2 showed adequate values (CR = 0.72 and CR = 0.82, respectively) and factor 3 regular value (CR = 0.63). This 12-item short version of the Brazilian MFAS may be a reliable and valid instrument for scientific studies and clinical assistance in Brazil.

Concordance among the patient-, proxy-, and clinician-rated versions of World Health Organization Disability Assessment Schedule-2.0 36-item version in India

Concordance among the patient-, proxy-, and clinician-rated versions of World Health Organization Disability Assessment Schedule-2.0 36-item version in India

Relationship Between Mental Health Education Competency and Interpersonal Trust Among College Counselors: The Mediating Role of Neuroticism

Based on the motivated cognition account, this study aimed to explore the relationship between mental health education competency and interpersonal trust among college counselors, as well as the mediating effect of neuroticism. A total of 483 college counselors were selected, including 155 men and 328 women. Theyoungestcollege counselor was 22 years old and the oldest was 56 years old (M = 31.69, SD = 6.12). The college counselors were asked to fill out the Mental Health Education Competency Scale for College Counselors, a 10-item short version of the Big Five Inventory, and an Interpersonal Trust Scale. (1) This study found a significantly positive correlation between mental health education competency and interpersonal trust. (2) Mental health education competency and interpersonal trust were negatively correlated with neuroticism. (3) The mediating role of neuroticism in the association between mental health education competency and interpersonal trust was significant. Mental health education competency partly affected interpersonal trust via the mediating effect of neuroticism.

Development and Validation of a Multidimensional Short Version Zarit Burden Interview (ZBI-9) for Caregivers of Persons With Cognitive Impairment.

There is a lack of appreciation of the full dimensionality of the original 22-item Zarit Burden Interview (ZBI) in the development of short versions. Existing short versions are premised upon a 1-factor or 2-factor structure or statistical techniques for item selection. Thus, there is a need for ZBI short versions that considers the multidimensional constructs of role strain, personal strain, and worry about performance (WaP) during item selection to provide a more holistic and comprehensive evaluation. To develop and validate a short version of ZBI through a combined quantitative and qualitative approach that incorporates the validated 4-factor structure of role strain demands; role strain-control; personal strain, and WaP. We studied 202 caregivers of patients with dementia (84.2%) or mild cognitive impairment (15.8%) attending a memory clinic in Singapore. Confirmatory factor analysis and qualitative considerations from expert consensus were used for item selection. Confirmatory factor analysis fit statistics support the 4-factor structure. The 9-item ZBI-9 showed good internal consistency (Cronbach's α=0.87) and convergent validity with anxiety and depression (Pearson correlation: Hospital Anxiety and Depression sub-scales, r≥0.56, P <0.001; ZBI- 22, r=0.95, P <0.001). Using a cut-off score of ≥13, ZBI-9 displayed good discriminatory ability for depressive symptoms (area under curve=0.79, P <0.001; sensitivity=70%, specificity=75%). The ZBI-9 also displayed comparable performance to the 22-item full version and three 12-item short versions. The ZBI-9 is a multidimensional short-version assessment tool for caregivers of persons with dementia and mild cognitive impairment that is reliable, valid, and discriminates depressive symptoms.

Comparison of the Effect of the Person-Centered and Family-Centered Training via Telenursing on the Quality of Life in COVID-19 Patients.

Education of the patients with Coronavirus Disease 2019 (COVID-19) and their families is necessary to improve the quality of life. This study investigated the effect of person and family-centered training via telenursing on the quality of life in patients with COVID-19. This interventional study was performed on 88 patients with COVID-19 18--65 years and 44 family members referred to the Bank Melli Hospital, Tehran, Iran. The samples were randomly assigned into two groups person-centered and family centered. A cyberspace group including patients and their families was created. Four educational sessions planned (15--30-min-every day) and three sessions planned for completing the questionnaires via phone. The data were collected using demographic characteristics form and the 12-item Short-Form Health Survey version 2 before and 6 weeks after the intervention and were analyzed in SPSS 22 using Chi-square test, paired t-test, and independent t-test. The mean scores of quality-of-life increased significantly in the person-centered group from 26.81 ± 5.15 to 34.4 ± 4.39 before and six weeks after intervention, respectively (p < 0.001). The means scores of quality-of-life increased significantly in the family-centered group from 28.11 ± 4.79 to 35.86 ± 3.85 before and 6 weeks after the intervention, respectively. (p < 0.001). The person and family centered methods increase the mean scores of quality-of-life of patients with COVID-19. The family centered method can be more effective to improve the quality of life of these patients.

Characteristics of Gut Microbiota in Patients with Erectile Dysfunction: A Chinese Pilot Study.

Little is known about the role of gut microbiota in the pathogenesis of erectile dysfunction (ED). We performed a study to compare taxonomic profiles of gut microbiota of ED and healthy males. A total of 43 ED patients and 16 healthy controls were enrolled in the study. The 5-item version of the International Index of Erectile Function (IIEF-5) with a cutoff value of 21 was used to evaluate erectile function. All participants underwent nocturnal penile tumescence and rigidity test. Samples of stool were sequenced to determine the gut microbiota. We identified a distinct beta diversity of gut microbiome in ED patients by unweighted UniFrac analysis (R²=0.026, p=0.036). Linear discriminant analysis effect size (LEfse) analysis showed Actinomyces was significantly enriched, whereas Coprococcus_1, Lachnospiraceae_FCS020_group, Lactococcus, Ruminiclostridium_5, and Ruminococcaceae_UCG_002 were depleted in ED patients. Actinomyces showed a significant negative correlation with the duration of qualified erection, average maximum rigidity of tip, average maximum rigidity of base, tip tumescence activated unit (TAU), and base TAU. Coprococcus_1, Lachnospiraceae_FCS020_group, Ruminiclostridium_5, and Ruminococcaceae_UCG_002 were significantly correlated with the IIEF-5 score. Ruminiclostridium_5 and Ruminococcaceae_UCG_002 were positively related with average maximum rigidity of tip, average maximum rigidity of base, ΔTumescence of tip, and Tip TAU. Further, a random forest classifier based on the relative abundance of taxa showed good diagnostic efficacy with an area under curve of 0.72. This pilot study identified evident alterations in the gut microbiome composition of ED patients and found Actinomyces was negatively correlated with erectile function, which may be a key pathogenic bacteria.

Association between knee function and kinesiophobia 6 months after anterior cruciate ligament reconstruction.

[Purpose] Kinesiophobia after anterior cruciate ligament reconstruction has been identified as an inhibitor of return to sports. This study aimed to clarify the relationship between kinesiophobia and knee function 6 months after anterior cruciate ligament reconstruction when the patient intends to return to sports. [Participants and Methods] A total of 66 patients who underwent primary anterior cruciate ligament reconstruction (mean age 17.3 ± 2.6 years, 17 males and 49 females, Tegner activity score ≥7) were included in the study. The 11-item version of Tampa scale of kinesiophobia was used to evaluate kinesiophobia 6 months postoperatively. Knee function was evaluated with knee extension muscle strength, tibial anterior displacement, heel buttock distance, heel height difference, anterior knee pain score, and single-leg hop test. The relationship between Tampa scale of kinesiophobia, patient characteristics, and knee function was investigated. [Results] A low Anterior knee pain score and low single-leg hop test, male gender, and age were significant factors associated with kinesiophobia. [Conclusion] Kinesiophobia was associated with a low anterior knee pain score and low single-leg hop test 6 months after anterior cruciate ligament reconstruction. Patients with a low single-leg hop test score or severe pain may need rehabilitation to reduce kinesiophobia.

Supplemental Material for 15-Item Version of the Boston Naming Test: Normative Data for the Latin American Spanish-Speaking Adult Population

Supplemental Material for 15-Item Version of the Boston Naming Test: Normative Data for the Latin American Spanish-Speaking Adult Population

Anxiety, Depression and Stress Among Female Medical Students During the Second Wave of the COVID-19 Pandemic and their Association with Family Functioning, Coping and Personality

Background and Aims: This research examined anxiety, depression, and stress levels in female medical students during the second wave of coronavirus disease 2019 (COVID-19) and the association between these variables and family functioning, coping, and personality factors. Materials and Methods: The cross-sectional online observational study was conducted using Google Forms. Anxiety, depression, and stress were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), family functioning using Family Adaptability, Partnership, Growth, Affection, and Resolve, coping using Brief COPE, and personality using the Big Five Inventory 10-item version. Results: Out of 750 students, 500 thoroughly responded to the online survey. Based on the DASS-21 scores, 57.6% of participants had some stress, 63.4% had some anxiety, and 54.8% had some degree of depression. Anxiety, depression, and stress were highly correlated with each other. Stress, anxiety, and depression were weakly linked with problem-focused coping, moderately correlated with emotion-focused coping, and strongly correlated with avoidant coping. Better family functioning was associated with lesser self-reported stress, anxiety, and depression. Neuroticism was associated with higher anxiety, depression, and stress, while agreeableness and conscientiousness were with lower psychological distress. Conclusion: High level of psychological suffering was prevalent among medical students during the COVID-19 pandemic. Their anxiety, depression, and stress must be adequately managed.

Negative association between loneliness and healthy state among rural residents in Japan: a cross-sectional single region population-based survey.

Objective: Loneliness is an important health problem in rural areas of Japan because of its ageing and declining population. Therefore, we investigated the association between loneliness and health. Materials and Methods: Self-administered questionnaires were distributed to rural adult residents. The Japanese 3-item versions of the UCLA Loneliness Scale, self-rated health (SRH), and objective health status (whether the respondents had a physical and/or mental illness) were used. We defined a UCLA score of four points or more as loneliness, an SRH of four points or more as a subjective healthy state, and no physical or mental illness as an objective healthy state. The association was adjusted for sociodemographic data, lifestyle habits, and isolation risk using logistic regression analysis. Results: The five-year population decline rate in the target areas was 10.2 to 12.3%. Of the 2,700 participants, there were 1,211 male and 1,489 female respondents, with an average age of 65.4 years. Moreover, 358 (13.6%) were living alone, and 829 (31.5%) were living in couple-only households. Among the participants, 1,395 (53.2%) experienced loneliness, 1,751 (65.7%) had good self-rated health, and 1,587 (60.8%) had objective health status. Loneliness was negatively associated with good SRH (OR=0.56, CI=0.45-0.70) and objective health status (OR=0.57, CI=0.46-0.71) after adjusting for sociodemographic data, lifestyle habits, and the risk of isolation. Statistically significant confounding factors for subjective and/or objective health status were employment, not smoking, obesity, exercise, having a family doctor, having an above-average number of teeth, and the ability to leave home. Conclusion: In an ageing and declining population, loneliness is an independent factor affecting the health status of rural residents and is not limited to older adults. Therefore, measures to reduce it are needed.

Psychometric Properties of the Hikikomori Questionnaire (HQ-25) in Türkiye

Hikikomori, which means 'social withdrawal' in Japanese, has been seen in a variety of cultures, particularly in developed countries and in the Far East region. The 25-item Hikikomori Questionnaire (HQ-25) is a scale designed to assist in the evaluation of hikikomori, but few studies have examined its psychometric properties in populations outside Japan. The aim of this study was to examine the psychometric properties of a shortened version of the HQ-25. The sample consisted of 501 Turkish participants between 12 and 65 years of age. Data analyses included examination of descriptive statistics, outliers, and normal distribution (skewness-kurtosis), as well as exploratory and confirmatory factor analysis (EFA and CFA respectively), Cronbach alpha and “split-half” for internal consistency and reliability, and Average Variance Extracted (AVE) and Composite Reliability (CR) for convergent and discriminant validity. A single factor model with 8 items from the HQ-25 was formed. Results demonstrated adequate psychometric properties for a single factor structure of an 8-item version of the Hikikomori Questionnaire (HQ-8). This study provides preliminary evidence of the reliability and validity of a brief version of the Hikikomori Questionnaire (HQ-8) in a sample of adults in Türkiye.

Measuring Impairments of Mentalization with the 15-Item Mentalization Questionnaire (MZQ) and Introducing the MZQ-6 Short Scale: Reliability, Validity and Norm Values Based on a Representative Sample of the German Population.

Deficits in mentalization are indicated by impaired emotional awareness and self-reflectiveness, and are associated with various mental disorders. However, there is a lack of validated research instruments. In this study, the psychometric properties of the Mentalization Questionnaire (MZQ) were evaluated in a representative German population sample with n = 2487 participants. Analyses included evaluation of the MZQs acceptance, reliability, and validity. Factorial validity was established with exploratory (EFA) and confirmatory factor analyses (CFA) after the dataset was randomly split. Dimensionality was evaluated with a bi-factor model. For convergent validity, correlations with the OPD SQS, PHQ-4, and POMS were calculated. While acceptance was good, internal consistencies (ω = 0.65-0.79) and factor structure of the original four subscales were not acceptable (TLI = 0.87, CFI = 0.91, RMSEA = 0.071). EFA indicated a 3-factor solution, which was not confirmed by CFA (TLI = 0.89, CFI = 0.91, RMSEA = 0.073). Correlations between subscales and bi-factor analyses indicated an underlying general factor (TLI = 0.94, CFI = 0.96, RMSEA = 0.053). A shortened 6-item version was comparable to the original scale. Age and sex-specific representative norm-values are presented. The MZQ is a feasible, reliable and valid self-report instrument to measure representations of inner mental states. However, when applied to non-clinical samples, the total score of the MZQ should be used.

A formula for calculating 30-item Geriatric Depression Scale (GDS-30) scores from the 15-item version (GDS-15)

The Geriatric Depression Scale with 30 items (GDS-30) and with 15 items (GDS-15) are both valid tools for assessing depression in older adults, but their absolute values are not directly comparable. Here, we used a dataset (n = 431) with GDS-30 scores from a project concerning fall-risk assessment in older adults (FARAO) to develop and validate a formula which can be used to convert GDS-15 scores into GDS-30 scores. We found that the GDS-15 score cannot simply be multiplied by 2 to obtain the GDS-30 scores and that estimations of GDS-30 from GDS-15 are not affected by age, sex and MMSE. Therefore, the optimal formula to estimate the GDS-30 score from the GDS-15 score was: GDS-30_estimated = 1.57 + 1.95 × GDS-15. This formula yielded an estimate of GDS-30 with an explained variance of 79 %, compared to 63 % when GDS-15 was simply multiplied by 2. Researchers that have used the GDS-15 and want to compare their outcomes to other studies that reported only the GDS-30 are advised to use this formula.