Chronbach's Alpha Coefficient Research Articles

A Comprehensive Assessment of the Chinese Version of the Duke Activity Status Index in Patients with Cardiovascular Diseases.

Exercise capacity serves as a direct representation of cardiac function. The Duke Activity Status Index (DASI), a self-administered 12-item questionnaire, covers aspects of daily living, household tasks, sexual function, and physical activity. Although widely used to evaluate exercise capacity, its validation in Chinese cardiovascular disease (CVD) patients has not been thoroughly explored. Considering the significant cultural and lifestyle differences between China and Western countries, which may influence Chinese patients' comprehension and responses to DASI, our objective is to culturally adapt DASI for Chinese patients with CVD to ensure its precision in assessing exercise capacity. The cultural adaptation of the original DASI questionnaire into Chinese followed a rigorous process to ensure its validity, reliability, and sensitivity to Chinese CVD patients. The study included 107 outpatients diagnosed with CVD who completed the DASI and cardiopulmonary exercise testing (CPET). Cronbach's alpha, Spearman correlation, and factor analysis were utilized to test reliability and validity. Receiver operating characteristic (ROC) curve analysis was employed to assess the prognostic utility of the DASI. Participants had a mean DASI score of 39.40 10.75 and a peak oxygen uptake (Peak ) of 19.53 5.89 mL/min/kg. The Chinese version of the DASI exhibited satisfactory reliability and validity in CVD patients, with a Chronbach's alpha coefficient of 0.706. The DASI score demonstrated a moderate correlation with Peak measured by CPET (r = 0.67, p 0.001). Factor analysis yielded three factors, accounting for 56.76% of the total variance, with factor 1 contributing to 26.38% of the variance. ROC curve analysis demonstrated that the DASI exhibited discriminative utility in the identification of patients with improved long-term prognosis (p 0.001). The ROC curve had an area of 0.788 [95% confidence interval (CI) = 0.704-0.871]. The DASI score 36.85 served as the optimal threshold for enhanced long-term prognosis, exhibiting a sensitivity of 0.80 and a specificity of 0.69. The culturally adapted DASI questionnaire is a straightforward and efficient tool for reasonably evaluating exercise capacity in Chinese CVD patients.

Validation and reliability of the Persian version of the Zurich Claudication Questionnaire in patients with lumbar spinal stenosis

One of the applicable tools introduced as a specific tool for assessing claudication in patients with lumbar spinal stenosis is the Zurich Claudication Questionnaire (ZCQ). This questionnaire has been validated in different populations of patients. The present study aimed to determine the validation status of the Persian version of ZCQ. After professional translation of the ZCQ by native English translators, it was executed twice before surgery with 1 day interval on 45 Iranian patients with spinal stenosis. The reliability was assessed by determining the Chronbach's Alpha coefficient as well as intraclass correlation coefficient (ICC). To assess the concurrent validity, the correlation across the 3 domains of the questionnaire was calculated by the Pearson's correlation test and the content validity was determined using a panel of experts. To assess test-retest reliability, the ICC for ZCQ for symptom severity, functional disability, and satisfaction domains were 0.80, 0.82, and 0.78, indicating acceptable reliability. Regarding internal consistency, Cronbach's alpha coefficients for the Persian version of ZCQ for the 3 above domains were shown to be 0.96, 0.92, and 0.90 respectively. On the subject of content validity, the 3 questionnaire's domains were marked as relevant with the content validity indices of 0.88, 0.82, and 0.80 respectively. Concerning concurrent validity, all 3 domains of the Persian ZCQ correlated strongly with 1 another. The ZCQ questionnaire with the same original structure is completely functional and reliable in the Iranian patient community.

Psychometric Properties and Factor Analyses of the a New Social Adjustment Measure for Arabic Postgraduate Students in Malaysia (SAMA)

The purpose of this study was to create a theoretically driven instrument of Social adjustment entitled Social Adjustment measure for Arabic Postgraduate students in Malaysia )SAMA) and determine its validity and reliability. Exploratory factor analysis ( EFA) and confirmatory factor analysis (CFA) were used to assess the dimensionality, structural validity and internal consistency of the instrument. The Chronbach Alpha coefficient was also calculated using the test-retest and Split-half methods. The Participants included 206 Arab postgraduate students in Malaysia. It was found that this measure has theoretically been effectively supported to measure the social adjustment by assessing three dimensions ( Academic, Family, and local dimensions “friends & neighbors”(. Regarding its reliability, The Chronbach Alpha coefficient was 0.75. The test-retest method yielded a coefficient of 0.82 while the split-half method yielded 0.76, indicating that the scale enjoys high reliability .

Building a new scale to measure worries about oral hygiene self-management in vulnerable older adults.

This paper describes a new scale to measure worries about self-management of oral hygiene in low-income older adults. Oral hygiene that prevents oral diseases and worsening of chronic conditions improves with instruction, but other cognitive/emotional factors impede oral hygiene practice especially among older adults. Many scales measure dental anxiety, but none measures oral hygiene self-management worries. Formative research with diverse older adults 55-95 in low-income housing identified scale items. A 23-item scale was tested in a pilot intervention study (n=84) and formalised with a new sample (N=331). In both studies, PCA/factor analysis produced two subscales: (a) worries about cleaning teeth and (b) consequences of cleaning. Chronbach's alpha coefficient evaluated internal consistency, and Pearson's r and Kendall tau/Spearman's rho evaluated scale predictability, convergent and divergent validity. The scale and subscales showed good internal consistency in both studies (over 0.90) and stability T0 0.90; T1: 0.90). In the larger sample, statistically significant correlations between the scale, subscales; plaque score, and similar scales (perceived risk of oral health problems, and fears of oral diseases) demonstrated convergent validity. For divergent validity, the worries scale, not the GOHAI, a similar scale measuring oral health life quality, was associated with Plaque Score. Each scale was associated with different mediators suggesting different constructs. The overall scale has good internal consistency, test-retest reliability, predictability and convergent and divergent validity. It captures a psycho-emotional construct useful in oral health research and hygiene education with older adults.

Adaptation and validation of receptive expressive emergent Language Test-3: Evidence from Hindi speaking children with cochlear implant

IntroductionSelection of an effective tool for assessment of language learning outcomes in post cochlear implantation is always an important but challenging task. Receptive expressive emergent language test-3rd Eds. (REELT-3) is one of the comprehensive language assessment tools used in India. In case of administration of REELT-3, which is standardized in English speaking typically developing western population, to another language speaking population with post-cochlear implant condition, the test outcome may get compromised owing to linguistics and population variability. The objective of the study is to test and validate REELT-3 in Hindi speaking children with cochlear implantation. MethodsNinety six typically developing children (22.3 ± 6.9 months, 48 boys and 48 girls) and 96 children with cochlear implantation (25.8 ± 9.2 months, 57 boys and 39 girls) participated in this study. As per the eligibility criteria of REELT-3, infants and toddlers with cochlear implant of age below 36 months participated in this study. Criterion, content and construct validity were tested using correlation based statistical analysis. ResultsHigh content validity was established by obtaining very low correlation coefficient r = 0.16 across two distinct population of typically developing children and children with cochlear implantation. Similarly, correlation coefficient of r = 0.84 revealed high criterion validity across REELT-3 in English and Hindi speaking conditions. Finally, correlation coefficient of r = 0.87was obtained between language raw score and chronological age to establish construct validity. Chronbach alpha coefficient (Chronbach α = 0.85) and interclass correlation coefficient 0.87was observed for REELT-3 which suggests good internal consistency and test-retest reliability, respectively. Receiver Operating Characteristics curve analysis of the REELT-3 suggested that area under curve 0.95 (95% CI = 0.89–0.99, p < 0.001) is excellent. The cut-off Language Ability Score (LAS) was determined as 74.5 with the sensitivity of 87.9% and specificity of 84.1% infer high sensitivity and specificity. ConclusionsThese results validate that REELT-3 can be used in assessment of language outcome in Hindi speaking children with post-cochlear implantation. Clinical assessment of receptive and expressive language will be beneficial in effective evaluation as well as in therapeutic planning.

Translation, Cross-cultural Adaptation and Validation of the Farsi Version of NIH Task Force's Recommended Multidimensional Minimal Dataset for Research on Chronic Low Back Pain

Translation and cultural adaptation of the National Institutes of Health (NIH) Task Force's minimal dataset. The purpose of this study was to evaluate validity and reliability of the Farsi version of NIH Task Force's recommended multidimensional minimal dataset for research on chronic low back pain (CLBP). Considering the high treatment cost of CLBP and its increasing prevalence, NIH Pain Consortium developed research standards (including recommendations for definitions, a minimum dataset, and outcomes' report) for studies regarding CLBP. Application of these recommendations could standardize research and improve comparability of different studies in CLBP. This study has three phases: translation of dataset into Farsi and its cultural adaptation, assessment of pre-final version of dataset's comprehensibility via a pilot study, and investigation of the reliability and validity of final version of translated dataset. Subjects were 250 patients with CLBP. Test-retest reliability, content validity, and convergent validity (correlations among different dimensions of dataset and Farsi versions of Oswestry Disability Index, Roland Morris Disability Questionnaire, Fear-Avoidance Belief Questionnaire, and Beck Depression Inventory-II) were assessed. The Farsi version demonstrated good/excellent convergent validity (the correlation coefficient between impact dimension and ODI was r = 0.75 [P < 0.001], between impact dimension and Roland-Morris Disability Questionnaire was r = 0.80 [P < 0.001], and between psychological dimension and BDI was r = 0.62 [P < 0.001]). The test-retest reliability was also strong (intraclass correlation coefficient value ranged between 0.70 and 0.95) and the internal consistency was good/excellent (Chronbach's alpha coefficients' value for two main dimensions including impact dimension and psychological dimension were 0.91 and 0.82 [P < 0.001], respectively). In addition, its face validity and content validity were acceptable. The Farsi version of minimal dataset for research on CLBP is a reliable and valid instrument for data gathering in patients with CLBP. This minimum dataset can be a step toward standardization of research regarding CLBP. 3.

Validation of the Persian Version of the American Orthopedic Foot and Ankle Society Score (AOFAS) Questionnaire.

American Orthopedic Foot and Ankle Society Score (AOFAS) is a reliable and reproducible measurement tool which is commonly used for the assessment of foot and ankle conditions. In this study we aimed to translate and assess the psychometric properties of the Persian version of AOFAS questionnaire. In this study, we enrolled 53 patients with ankle and hindfoot conditions. Our study was conducted according to five staged cross-cultural adaption steps including translation, synthesis, back translation, expert committee review, and pretesting. After that reliability of the subjective parts calculated by Cronbach's alpha and the intraclass correlation coefficient (ICC) and the reliability of the objective items estimated using Cohen's kappa test. Also, construct validity was assessed by testing the Persian AOFAS against the SF-36 questionnaire. Chronbach's alpha coefficient was 0.696, which was considered acceptable. Furthermore, the test-retest reliability measured by using the ICC for the subjective subscales was 0.853 (P<0.001). The reliability of testing the objective subscales was calculated by using Kappa, which indicated acceptable values. Pearson correlation coefficient between AOFAS and SF-36 was 0.415 (P=0.008). In addition, floor and ceiling effects were calculated 1.9% and 7.5% respectively. In our study, Persian translation of AOFAS demonstrated acceptable validity and reliability with no need to be culturally adapted.

Psychometric properties of the communication skills attitude scale (CSAS) measure in a sample of Iranian medical students.

Communication skill (CS) has been regarded as one of the fundamental competencies for medical and other health care professionals. Student's attitude toward learning CS is a key factor in designing educational interventions. The original CSAS, as positive and negative subscales, was developed in the UK; however, there is no scale to measure these attitudes in Iran. The aim of this study was to assess the psychometric characteristic of the Communication Skills Attitude Scale (CSAS), in an Iranian context and to understand if it is a valid tool to assess attitude toward learning communication skills among health care professionals. Psychometric characteristics of the CSAS were assessed by using a cross-sectional design. In the current study, 410 medical students were selected using stratified sampling framework. The face validity of the scale was estimated through students and experts' opinion. Content validity of CSAS was assessed qualitatively and quantitatively. Reliability was examined through two methods including Chronbach's alpha coefficient and Intraclass Correlation of Coefficient (ICC). Construct validity of CSAS was assessed using confirmatory factor analysis (CFA) and explanatory factor analysis (PCA) followed by varimax rotation. Convergent and discriminant validity of the scale was measured through Spearman correlation. Statistical analysis was performed using SPSS 19 and EQS, 6.1. The internal consistency and reproducibility of the total CSAS score were 0.84 (Cronbach's alpha) and 0.81, which demonstrates an acceptable reliability of the questionnaire. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI/Ave) demonstrated appropriate results: 0.97 and 0.94, respectively. An exploratory factor analysis (EFA) on the 25 items of the CSAS revealed 4-factor structure that all together explained %55 of the variance. Results of the confirmatory factor analysis indicated an acceptable goodness-of-fit between the model and the observed data. [χ2/df = 2.36, Comparative Fit Index (CFI) = 0.95, the GFI=0.96, Root Mean Square Error of Approximation (RMSEA) = 0.05]. The Persian version of CSAS is a multidimensional, valid and reliable tool for assessing attitudes towards communication skill among medical students.

Adaptação e validação da Utrecht Work Engagement Scale (UWES) aplicada a assistentes sociais em Portugal

Objetivo: O presente estudo visa avaliar os itens e as respetivas dimensões da Utrecht Work Engagement Scale (UWES-17) de Schaufeli e Bakker (2009), aplicada a assistentes sociais a exercer funções em Portugal. Método: Foi aplicada a versão portuguesa da UWES a uma amostra constituída por 1369 assistentes sociais portugueses, 94% do sexo feminino e 6% do sexo masculino, com uma média de idades de 39 anos (desvio-padrão = 8,99). A habilitação académica mais frequente é a licenciatura (63,8%) e no que respeita à atividade profissional possuíam, em termos médios, 12,99 anos de experiência (desvio-padrão = 8,28). A fidedignidade da escala foi avaliada através do coeficiente de alfa de Chronbach e a validade através da análise fatorial exploratória. Foi utilizada a pesquisa metodológica de natureza quantitativa. Resultados: Os resultados alcançados vão ao encontro dos valores presentes em estudos anteriores quanto à sua consistência interna, tanto dos 17 itens que compõe a escala como das suas três dimensões (“vigor”, “dedicação” e “absorção”). A UWES-17 neste estudo apresenta uma estrutura fatorial de três fatores, tal como o estudo original, mas a constituição dos itens de cada dimensão é diferente. Conclusões: A escala UWES-17 apresenta-se com boas características psicométricas e uma boa consistência interna.

Validity and reliability of a novel patient reported outcome tool to evaluate post-operative dysphagia, odynophagia, and voice (DOV) disability after anterior cervical procedures.

Existing evaluative instruments for dysphagia, odynophagia, and voice disturbance are cumbersome, focus pre-dominately on dysphagia, and often require administration by a certified Speech Pathologist. This study was conducted to utilize widely accepted instruments such as the American Speech and Hearing Association's National Outcomes Measurement System (NOMS) and VAS pain scales to validate a novel, patient-reported instrument that quantifies the severity of post-operative dysphagia, odynophagia, and voice disabilities (DOV). The DOV was developed and subjected to multiple rounds of face and content validation by representative patient cohorts and a panel of clinical experts. An established, prospective clinical registry was utilized to collect pre and post-operative VAS-swallow related pain and DOV measurements for subjects with recent anterior cervical procedures (n=25 content validation, n=20 criterion validation), or recent lumbar decompressions (n=33). NOMS evaluations were performed by a certified Speech Language Pathologist on the first post-operative day after minimally invasive anterior approaches to cervical reconstruction were performed in the criterion validation cohort. Content validity: Subjects with a recent anterior cervical procedure reported a significant increase in post-operative dysphagia (pre-op: 0.13±0.35, post-op: 1.08±1.41, p=0.01), odynophagia (pre-op: 0.24±0.69, post-op: 0.84±0.90, p=0.001), and voice (pre-op: 0.10±0.41, post-op: 0.88±0.92, p=0.0004) disturbance. In contrast, subjects with a recent lumbar procedure did not demonstrate a significant increase in post-operative dysphagia, odynophagia, or voice disturbance (p>0.05).Criterion validity: Chi-squared contingency testing for independence between converted NOMS and DOV instrument scores accepted linkage between the two instruments for dysphagia X2(DF: 12, n=20, Expected: 21.03, Observed: 24.4, p: 0.02) and voice X2(DF: 6, n=20, Expected: 12.60, Observed: 21.28, p: 0.002) dimensions. Similarly, converted swallow related VAS and DOV odynophagia instruments demonstrated linkage X2(DF: 9, n=20, Expected: 16.92, Observed: 24.21, p: 0.004).Internal Reliability: Chronbach's alpha coefficient of reliability was 0.74 between all DOV survey dimensions. The DOV survey is a valid patient-reported instrument to rapidly and reliably detect post-operative swallow and voice dysfunction.

Mental Illness Related Internalized Stigma: Psychometric Properties of the Brief ISMI Scale in Greece.

Aims:Since evaluation regarding the impact of mental illness related internalized stigma is scarce, there is a great need for psychometric instruments which could contribute to understanding its adverse effects among Greek patients with severe mental illness. The Brief Internalized Stigma of Mental Illness (ISMI) scale is one of the most widely used measures designed to assess the subjective experience of stigma related to mental illness. The present study aimed to investigate the psychometric properties of the Greek version of the Brief ISMI scale. In addition to presenting psychometric findings, we explored the relationship of the Greek version of the Brief ISMI subscales with indicators of self-esteem and quality of life.Methods:272 outpatients (108 males, 164 females) meeting the DSM-IV TR criteria for severe mental disorder (schizophrenia, bipolar disorder, major depression) completed the Brief ISMI, the RSES and the WHOQOL-BREF scales. Patients reported age and educational level. A retest was conducted with 124 patients.Results:The Chronbach’s alpha coefficient was 0 0.83. The test-retest reliability coefficients varied from 0.81 to 0.91, indicating substantial agreement. The ICC was for the total score 0.83 and for the two factors, 0.69 and 0.77 respectively. Factor analysis provided strong evidence for a two factor model. Factors 1 and 2 were named respectively “how others view me” and “how I view myself”. They were negatively correlated with both RSES and WHOQOL-BREF scales, as well as with educational level. Factor 2 was significantly associated with the type of diagnosis.Conclusions:The Greek version of the Brief ISMI scale can be used as a reliable and valid tool for assessing mental illness related internalized stigma among Greek patients with severe mental illness.

Investigating the relationship of mental health with job stress and burnout in workers of metal industries

Introduction: Since job stress and burnout are considered as basic factors in reducing efficacy and engendering physical and mental side effects, the present study was conducted with the aim of determining the mental health state and its relationship with job stress and burnout. Methods: The present study is a descriptive-analytical one which uses a cross-sectional design. In line with the research objectives, 125 workers of the metal industry were randomly selected. To collect data, the Demographic Characteristics Questionnaire, the Goldberg General Health Questionnaire, the US Institute of Mental Health Job Stress Questionnaire, and Maslach Job Burnout Inventory (with Chronbach's alpha coefficients of 0.89, 0.92, and 0.86, respectively) were used. Data analysis was conducted using SPSS-20. Results: The mean scores of mental health, job stress, and burnout are 47.97 ± 10.8, 147.54 ± 17.8, and 54.69 ± 13.94, respectively. According to Pearson correlation coefficient, mental health has a direct correlation with job stress and burnout. It means that by increasing the degree of job stress and burnout, the mental health state was unfavorable. Conclusions: Regarding the results of the present study in which there is a direct correlation between mental stress on job stress and burnout. If job stress and burnout in workplaces are not identified and controlled, they have negative effects on general health. Therefore, by identifying the resources and reasons of occurring job stress and burnout, and presenting practical and applied strategies for coping with and preventing the occurrence of job stress and burnout can supply and retain general health of the workers in workplaces.

Validation of the Chinese Version of the Short TEMPS-A and its application in patients with mood disorders

BackgroundThe short version of Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A) is a useful instrument to measure affective temperaments. Aims of the present study are to validate the Chinese Version of the Short TEMPS-A, and to explore whether it could be useful to distinguish patients with mood disorders from healthy controls or differentiate patients with bipolar disorder (BPD) from those with major depressive disorder (MDD) in Chinese population. MethodsA sample of 715 participants, including 387 patients with MDD, 143 with BPD and 185 healthy controls, was recruited. All participants completed The Chinese Version of the Short TEMPS-A. Standard psychometric tests of reliability and validation were performed. ANOVA, non-parameter test and Multiple Logistic Regression were used to test the association between TEMPS-A scores and mood disorders. ResultsThe originally proposed five factors of the Chinese Version of the Short TEMPS-A were upheld. The Chronbach-Alpha coefficients of it varied from 0.70 to 0.89 and test–retest Spearman׳s Correlation Coefficients varied from 0.52 to 0.85. Significant differences were found across the three groups on all five TEMPS-A subscales (P<0.001). Multiple Logistic Regression showed that hyperthymic temperament distinguished patients with BPD from those with MDD (OR 1.28, 95% CI 1.14–1.45, P<0.001) after controlling for age, gender and the severity of depression. LimitationsThe cross-sectional self-report design, unbalanced demographic characteristics and undifferentiated subtypes of bipolar disorders might limit the generalizability of the results. ConclusionThe Chinese Version of the Short TEMPS-A shows good reliability and validity. It might be used as a screening tool in the general population to identify the vulnerability for developing a mood disorder and the potential risk for bipolar disorder among those who only have depressive symptoms.

Psychometric Properties of the Persian Translation of Pittsburgh Sleep Quality Index

Background: Pittsburgh sleep quality index (PSQI) is one of the most important instruments frequently used to assess sleep quality. This questionnaire is used to assess sleep styles and quality in adults through seven dimensions. Objectives: The study aims to investigate the reliability, validity and factor structure of the Persian version of PSQI. Materials and Methods: A Survey method with quantitative analytic approach was used in this research. A sample of 415 employees of Kerman hospitals participated in this study and filled the questionnaire. Forward-backward method was applied to translate the questionnaire from English to Persian. The following aspects of the Persian version of PSQI were evaluated: internal consistency (using Chronbach's alpha), concurrent validity (correlation with GHQ-28), and factor structure of the questionnaire. Results: Mean age of the participants was 35.18 years, and participants' average year of education was 15.3. The Chronbach's alpha coefficient was 0.55. According to the factor analysis, three factors were extracted accounting for 63.485% of the total variance. There was a significant correlation among different dimensions of the Persian version of PSQI. Concurrent validity analysis showed that PSQI and GHQ-28 were correlated significantly. Conclusions: The Persian version of PSQI exerted a satisfactory validity and reliability in our sample.

Validation of the Persian version of the fear avoidance belief questionnaire in patients with low back pain

Fear of pain or re-injury and avoidance attitudes have a great impact on maintenance of chronic low back pain (CLBP) and disability. Fear-Avoidance Beliefs Questionnaire (FABQ) is developed to assess these psychosocial factors. The aim of this study was to provide a translated and validated version of the FABQ for Persian speaking population. Forward and backward translation techniques were carried out for translation and cultural adaptation of the questionnaire into Persian. Internal consistency and test-retest reliability were used to assess the reliability of the Persian questionnaire. Construct validity of the scale was assessed by divergent validity (using Spearman correlation coefficient) and exploratory factor analysis. Principle component analysis with varimax rotation method was applied for assessment of factor analysis. The test-retest reliability was excellent with the Intra-class Correlation (ICC) value of 0.802 and 0.808 for the physical activity and work subscales of the questionnaire, respectively. The Chronbach's alpha coefficient value of 0.89, demonstrated adequate internal consistency of the questionnaire. Factor analysis revealed two factors which could explain 57.9% of the total variance. Items 7, 10 and 11 of the questionnaire were used in both major factors of the final Persian version. Regarding the divergent validity of the questionnaire, data demonstrated no correlation (r< 0.3) between factor 2 (which is about physical activity) and measured clinical variables (pain intensity and level of dysfunction), while factor 1 (which is about work) was fairly correlated with both pain intensity and disability level of the subjects. The provided Persian version of FABQ is a reliable and valid measurement and further research into its use as a diagnostic and prognostic tool is warranted. Development of this questionnaire will be useful for comparability between Persian and English language studies and facilitates an international collaboration in this field.

The Validity and Reliability Study of The Social Support Structure (Stress Buffering Model) In Iran

A sample of 877 individuals (57% women and 43% men) was selected randomly to study the validity and reliability structure of the social support that answered the researcher’s-made questionnaire of the social support. The result of validity study of the final questionnaire showed that the calculated Chronbach alpha coefficient was 0.736. The opinion of the authorities in the field of psychology concerning content validity of the questionnaire was positive. The result of exploratory/confirmatory factor analysis showed that all fitness indexes were in a very desirable limit (RMSEA = 0.056), and the model had a good fit with data. This was suggestive of the questions being in line with the theoretical structure.

Psychometric properties of The Hospital Anxiety and Depression Scale and The General Health Questionnaire‐20 in COPD inpatients

To compare the psychometric properties between the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire-version 20 (GHQ-20) in detecting psychological distress in COPD patients referred to pulmonary rehabilitation, and to examine the factor structure of GHQ-20. The study comprised 161 consecutive patients with mild to very severe COPD. For comparison of mean scores between the HADS and GHQ-20, one sample t-test was used. Potential differences in the detection of possible and normal cases were analysed using Pearson Chi square test. We report Pearson's correlations within and between the questionnaires, and internal consistency was assessed through Chronbach's alpha. The factor structure of the GHQ-20 was examined through principal axis factoring (PAF) with oblique rotation and eigenvalue >1. There were no differences in mean scores of psychological distress between HADS and GHQ-20 (12.03 vs. 24.73, p = 0.000), as well as no differences in the prevalence of possible cases of psychological distress (34.6 vs. 36.9, p = 0.000) and normal cases (65.4 vs. 63.1, p = 0.000). The observed difference between HADS and GHQ-20 regarding internal consistency was marginal, with Chronbach's alpha coefficients of 0.91 and 0.94, respectively. The PAF analysis resulted in a three-factor solution for GHQ-20, notably with only two items loading on the third factor, giving an internal consistency <0.70. A two-factor solution, comprising anxiety/depression and coping, may therefore be more appropriate. This study demonstrates no significant differences between the HADS and GHQ-20 in their ability to detect possible cases of psychological distress in a rehabilitation setting for COPD patients. Although the HADS and GHQ-20 are measuring different concepts of psychological distress, both questionnaires can be recommended as screening tools for detection of psychological distress in COPD inpatients. The GHQ-20 appears to be two-dimensional, comprising anxiety/depression as one dimension, and coping as the other dimension.

Validez y fiabilidad de la versión argentina del PCAT-AE para evaluar la atención primaria de salud

To determine the validity and reliability of the version of the Primary Care Assessment Tool for adult users, adapted for Argentina (known as AR-PCAT-AE). Two cross-sectional pilot studies were conducted among people over age 17, largely through self-administered questionnaires. Items that were equivalent to the original version of the PCAT and 13 others proposed for the instruments were analyzed. The factorial validity and reliability of the scores for each dimension were studied. The validity indicators were: factors that had three or more items with a factorial load of > 0.35, item-total correlation > 0.30, and interpretation of the solution according to the theoretical model. The factorial analysis yielded nine factors that explained 57.4% of the variability. Considering the pre-established criteria for validity, two items were excluded from the dimensions of continuity and comprehensiveness and six were added to comprehensiveness and cultural competency. In the dimensions, the percentage of questions with an item-total correlation of greater than 0.30 ranged from 67% to 100% and the Chronbach's (alpha) coefficient of internal consistency ranged from 0.44 to 0.90. The validity and reliability of the AR-PCAT-AE questionnaire are adequate, maintaining high equivalence with the original version. The process presented could be adopted in other contexts to advance the evaluation of primary health care functions with quality tools.

The effect of reflexotherapy on chemotherapy-induced vomiting of

AbstractBackground and aimVomiting as a side effect of chemotherapy causes to refuse or delay in treatment by most cases. Nowadays,for controlling these side effects researchers attempt to use noninvasive-, safe- and low cost methods, insteadof expensive drugs with various side effects. This study aimed to assess effect of reflexotherapy on vomitingreduction among patients under chemotherapy, in oncology-hematology ward of Zahedan's Ali Ebn AbitalebHospital in 2010.Materials and MethodsThis study was a before and after clinical trial (pre-test and post-test) with a group of 37 patients. Theparticipants were selected using purposeful sampling method and based on the results of a pilot study. Theywere also considered once in the control group (receiving anti-vomiting drug Granisetron) and after 15 to 20days in the interventional group (receiving reflexotherapy in a period of 10 minutes for each leg). TheSummary of Morrow Questionnaire and CTCv2.0 Y/WX FindingsThe mean age of samples was 44.73 ±13.38 (years). Majority of participants were married and women.Patients were in their second to 15th cycle of chemotherapy; receiving Cisplatin–Gemzar or Adriamycincyclophosphamideand were from breast cancer cases. Assessment of severity of vomiting during first 24hours showed more sever vomiting in the first 4 hours among control group than interventional group(p . [3 Dec 2009].-Hodgson H (2000) Does reflexology impact on cancer patient's quality of life? Nursing Standard. 14 (31) 33-38-Helms R Quan JD (2006). Textbook of Therapeutics: Drugs and Disease Management. 8thedition.Baltimore, LippincottWilliams and Wilkins.-Kohara H et al (2004). Combined modality treatment of aromatherapy, footsoak and reflexology relieves fatigue inpatients with cancer. Journal of Palliative Medicine. 7 (6) 791-796.-Kris MG (2003). Why do we need another antiemetic? Journal of Clinical Oncology. 21 (22) 4077-4080.-Lett A (2000). Reflex Zone Therapy for Health Professionals. 1th edition. London, Churehill Livingstone publishing.-Moosavizadeh K Ansari H (2008). [Alternative/complementary medicine and medical education]. Payesh, Journal ofthe Iranian Institute for Health Sciences Research. 7 (4) 329-336. 2009.-National Cancer Institute (A) 2009. [On line] http: // www. cancer.gov/cancertopics/treatment/druginfo. htm [7 Feb2009].-National Cancer Institute (B) 2009 .[on line] http: // www.cancer.gov/ProtocolDevelopment/electronic_applications/ctc.htm [7 Feb 2009].-Patient-Reported Outcome and Quality of Life Instruments Database 2009.[online]http://www.proqolid.org/instruments/morrow_assessment_of_nausea_and_emesis_mane [9 Feb 2009].-Rick S (2007). [The Reflexology Work out]. 2ndedition. Translated by: Yousefi.B .Tehran, Elm and Harekat Publishing.(Persian).-Rivaz M et al (2005). [Efficacy of transcutaneous electrical nerve stimulation in the control of nausea and vomiting inpatients undergoing chemotherapy]. Journal of Medical Research of Shiraz University of Medical Sciences. 3 (2) 47-55.(Persian).-Ross CS et al (2002). A pilot study to evaluate the effect of reflexology on mood and symptom rating of advancedcancer patients. Palliative Medicine. 16 (6) 544-545.-Sajadian A et al (2005). [The use of complementary medicine in cancer patients]. Payesh, Journal of the IranianInstitute for Health Sciences Research. 4 (3) 197-205. (Persian).-Smeltzer SC Brunner L Suddarth D (2008). Textbook of Medical-Surgical Nursing (cancer).R1st edition. Translated by:Hosseinzadeh.M . Tehran, Boshra Publishing. (Persian).-Sok SR Erlen JA Kim KB (2004). Complementary and alternative therapies in nursing curricula : A new directionfor nurse educators. Journal of Nursing Education. 43 (9) 401-405.-Weiss R (2006). [Massage Therapy]. 1stedition. Translated by: Golchin.M. Tehran, Shahrab and Ayandehsazanpublishing. (Persian).-Wesa K Gubili J Cassileth B (2008). Integrative oncology: complementary therapies for cancer survivors.Hematology/Oncology Clinics of North America. 22 (2) 343-353.-Won JS Jeong IS Kim JS (2002). Effect of foot reflexology on vital signs, fatigue and mood in cancer patientsreceiving chemotherapy. Journal of Korean Academy of Fundamentals of Nursing. 9 (1) 16-26.-World Health Organization (2009). [On line] http: // www. Who.int/features/qa/15/en/index.htm [5 Feb 2009].-Xavier R (2007) Facts on refexology (Foot Massage). Nursing Journal of India. 98 (1) 11-12.-Yahyavi SH Nazari L (2006). [Role of haloperidol in managing gynecologic-related postoperative nausea andvomiting]. Medical Science Journal of Islamic Azad University Tehran medical branch. 15 (1) 9-13. (Persian).-Yang JH (2009). The effects of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoingchemotherapy". [Abstract]. Available at : http : // www.ncbi.nlm.nih.gov/pubmed/15778569.htm. Accessed: 7 Feb.-Zeighami Mohammadi Sh et al (2008). [Quality of life in cancer patients undergoing chemotherapy]. Scientific Journalof Hamadan Nursing and Midwifery Faculty. 16 (1) 5-10. (Persian).) was confirmed beforehand. Data was analyzed using central and dispersion indexes as well as Wilcoxon and Mann-Whitney tests and Marginalmodeling (generalized estimating equations GEE).(Common Toxicity Criteria Version 2) of National Cancer Institute of America were used for making a questionnaire to data collection. Face and content validity ofquestionnaire and its reliability (Chronbach alpha Coefficient =

Translating and testing the Liver Disease Symptom Index 2.0 for administration to people with liver cirrhosis in Egypt

The Liver Disease Symptom Index (LDSI) 2.0 is a simple, short and specific liver disease questionnaire in English, but an Arabic version does not exist, therefore we translated the LDSI-2.0 into Arabic and tested its psychometric properties in a pilot cross-sectional study. A convenience sample of 38 patients with liver cirrhosis from one hospital in Cairo, Egypt, were interviewed for approximately 45 min. Patients completed a background data sheet, the translated LDSI-2.0 and the Short Form (SF)-36v(2). Construct convergent validity was examined by correlating LDSI-2.0 items with the SF-36v(2) eight domains. Reliability was estimated using measures of internal consistency, test-retest reliability and internal consistency reliability. Median completion time was 10 min. The correlation between the translated LDSI-2.0 items and the SF-36 domains confirmed that there was moderate to high overlapping between the two measures, suggesting convergent validity of the LDSI-2.0. The LDSI-2.0 showed good to very good retest reliability (kappa value 0.62-0.94). Chronbach's alpha coefficient for the multi-item scales ranged from 0.73 to 0.96. The Arabic LDSI-2.0 therefore has satisfactory validity, retest reliability and internal consistency.