External Construct Validity Research Articles

Cross-cultural adaptation and primary approbation of the Russian version of Posttraumatic Growth and Depreciation Inventory — Expanded version

Numerous studies suggest that caring for someone with a chronic disease is often associated with the various negative consequences for the patient’s informal caregivers. At the same time, positive changes caused by the stress influence of patient’s disease can be also noted. For example, the so-called posttraumatic growth. Currently, there is a lack of assessment tools in domestic psychology, that allow to investigate the relation between constructive (developmental) and destructive aspects of the relative’s mental response in a situation of chronic illness of a loved one.The aim of this work was to carry out cross-cultural adaptation and primary approbation of the Posttraumatic Growth and Depreciation Inventory — Expanded version (PTGDI-X). Primary approbation was performed on a focus group of relatives of patients with cerebral pathology (n = 61, mean age 51,2 [SD = 15,3] years). Convergent and discriminant validity of the PTGDI-X assessed using World Assumption Scale (WAS), Symptom Checklist-90-Revised (SCL-90-R), Level of Relatives’ Emotional Burnout Questionnaire (LREB). In addition, a specially adapted for the research Burden questionnaire was used.The analysis revealed good psychometric characteristics of the PTGDI-X Russian version in terms of: internal subscales consistency (Cronbach’s α coefficients varied from 0,73 to 0,86), internal and external construct validity

A new neuropsychological tool for simultaneous reading and executive functions assessment: initial psychometric properties.

The development of reading and complex executive functions is fundamental for achieving social, academic, and professional success. So far, there is no single neuropsychological instrument that comprehensively assesses the domains of inhibitory control, cognitive flexibility, working memory, and reading comprehension. To assess executive functions related to reading, the "Assessment of Reading and Executive Functions" (AREF) was developed. In this study, we show initial evidence of validity and reliability for four subtests - Graphophonological-Semantic Flexibility, Inhibitory Control, Flexibility, and Working Memory. A total of 93 students from 4th to 9th grade, aged 8-14, in public (n = 61) and private (n = 32) schools were evaluated. Tasks from the AREF instrument, as well as measures of reading comprehension, inhibitory control, cognitive flexibility, working memory, and intelligence, were administered. Correlations between AREF scores and the other measures were performed to assess external construct validity. Performance differences between school groups on AREF subtests were analyzed using ANOVA, t-test, and Mann-Whitney tests, and the internal consistency of the instrument's tasks was evaluated using Cronbach's alpha coefficient. The scores of the AREF subtests demonstrated significant positive correlations with reading measures (ranging from 0.339 to 0.367) and executive functions (ranging from 0.209 to 0.396). Significant differences were found in the performance of some AREF tasks when comparing individuals from public and private schools, as well as between 4th and 5th graders compared to students in higher grades. The internal consistency of the tasks was low for Graphophonological-Semantic Flexibility (Cronbach's α = 0.566), moderate for Inhibitory Control and Flexibility (Cronbach's α = 0.768), and high for Working Memory (Cronbach's α = 0.881). The results provide initial evidence of construct validity and reliability for the AREF subtests. It is expected that this new neuropsychological test will contribute to the assessment of reading skills and executive functions, assisting in guiding clinical and educational interventions for individuals with and without neurodevelopmental disorders.

Revisiting the English Short Measure for Adult Playfulness (SMAP): An Investigation of Reliability, Validity, and Cross-Cultural Comparisons

Adult playfulness describes the personality of the quick initiation and strong intensity of enjoyable experiences coupled with the frequency of engaging in playful behaviors. In addition to examining the reliability and validity of the Short Measure for Adult Playfulness (SMAP), we compared the psychometric properties of the SMAP across (a) 4- and 7-point answer formats; (b) German and English language versions; and (c) gender. The SMAP and criterion validity measures were distributed across three independent samples from Canada (N total = 1,177) and a German sample (N = 660). Results supported a unidimensional solution with strong factor loadings for all items (>.50 across all samples) and high test-retest reliability (r = .67, BF10>100). In item response theory analyses, high discrimination parameters were found across the latent continuum. Although both the four-point and seven-point Likert scale versions showed robust item properties, the seven-point Likert scale version yielded more precise measurement of higher playfulness (θ > 1.50). No significant differential item functioning was located across gender or language. Finally, results supported external construct validity via associations with broad personality traits, humor, and orientations to happiness. The present investigation provides support for the reliability and validity of the English SMAP for concise adult playfulness measurement.

Introduction and validation of the open symptom framework: a public domain modular framework for patient-reported measurement of symptoms related to cancer and its treatment

PurposeWe provide an initial description and validation of some public domain patient-reported outcome (PRO) items to assess cancer symptom burden to address immediate barriers to symptom assessment use in clinical practice and facilitate future research.MethodsWe created the Open Symptom Framework (OSF), a flexible tool for clinical cancer-related symptom assessment. The items comprise six components: recall period, concept, symptom, qualifier(s), a definition, and a 5-point Likert-type response. We recruited patients receiving cancer therapy in the United States and United Kingdom. We assessed external construct validity by comparing OSF scores to the PRO-CTCAE measure and assessed reliability, scalability, dimensionality, and item ordering within a non-parametric item response theory framework. We tested differential item functioning for country, age, gender, and level of education.ResultsWe developed a framework alongside clinical and psychometric experts and debrieifed with 10 patients. For validation, we recruited 331patients. All items correlated with the PRO-CTCAE equivalents (r = 0.55–0.96, all p < 0.01). Mokken analysis confirmed the scalability and unidimensionality of all symptom scales with multiple items at the scale (Ho = 0.61–0.75) and item level (Hi = 0.60–0.76). Items are interpreted consistently between demographic groups (Crit = 0 for all groups).ConclusionThe public domain OSF has excellent psychometric properties including face, content, and criterion validity and can facilitate the development of flexible, robust measurements to fulfil stakeholder need. The OSF was designed specifically to support clinical assessment but will function well for research. Further work is planned to increase the number of symptoms and number of questions per symptom within the framework.

Development of a brief core set for knee dysfunction based on the International Classification of Functioning, Disability and Health: assessing construct validity and measurement potential

BackgroundThe comprehensive core set for knee dysfunction was developed to classify the functioning of people with any knee dysfunction. To be used as a clinical instrument to measure the functioning of people with knee dysfunction, the construct validity of the core set still needs to be assessed. The purpose of this study was to analyze the construct validity of the comprehensive core set for knee dysfunction as an instrument to measure functioning.MethodsA cross-sectional study with 200 participants with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. Participants were assessed using the comprehensive core set for knee dysfunction with 25 categories, the subjective form from the International Knee Documentation Committee scale, and measures of self-perceived general health and functioning. The construct validity of the core set was assessed by Rasch analysis, and the external construct validity was assessed by correlation between the score of the brief core set for knee dysfunction with the subjective form from the International Knee Documentation Committee scale, and scores of self-perception of health and functioning.ResultsTwelve categories were consistent with a unidimensional construct, with no difference in the response pattern for age, sex, educational level, and time of complaint. These categories were included in the brief core set for knee dysfunction. The mean score of the brief core set was 37 ± 21 points, a value classified as moderate impairment regarding functioning. Correlations with the subjective form from the International Knee Documentation Committee scale and scores of self-perception were adequate (p < 0.01; r > 0.5).ConclusionThe brief core set for knee dysfunction, a set with 12 categories, can be used as a clinical instrument to measure and score the functioning of people with knee dysfunction, aged between 18 and 89 years, with adequate construct validity.

Psychometric properties of the Oxford Happiness Questionnaire Short Form (OHQ-SF) in a Greek student sample

BackgroundThe purpose of the current study was to adapt and explore the psychometric properties of the Oxford Happiness Questionnaire Short Form (OHQ-SF) in a Greek student sample.AimThis quantitative cross-sectional study was applied in order to translate and validate the Oxford Happiness Questionnaire Short Form (OHQ-SF) into Greek and to assess the psychometric properties.MethodThe English version of OHQ-SF was translated into Greek using the forward and backward translation. The sample was consisted of 88 adult students from the Public Educational Training Institution in Thessaloniki. Two self-report measures the Greek version of OHQ-SF and the Greek version of the Life Orientation Test Revised (LOT-R—to check the construct validity) were completed twice, for test and retest assessment, in full anonymity and confidentiality.Statistical analysisThe psychometric properties of OHQ-SF/GR, namely the internal–external reliability and construct validity, were assessed, and the expected unidimensional structure was tested with Confirmatory Factor Analysis (CFA).Results and discussionThe Greek version of OHQ-SF (OHQ-SF/GR), for both test and retest, has adequate internal reliability, satisfactory structural validity, and adequate construct validity. The CFA indicated the unidimensional structure of the OHQ-SF/GR, and the fit indexes displayed good fit with the data. One item was removed due to poor correlation with the latent factor of happiness. The current study reveals that the final seven-item OHQ-SF/GR has very satisfactory psychometric properties being useful instrument to measure happiness levels in Greek adult students and is a valid tool that can be utilised in research field.

Development and psychometric properties of the supporting mental health in sport instrument

Mental health conditions are a significant global health concern. To address this concern, sport settings are increasingly being viewed as environments in which to support individual mental health and wellbeing. Not all sports settings are, however, conducive to supporting mental health. Efforts to improve mental health in sport settings are likely to be less effective if the club culture, policy, and environment do not promote behaviors known to support mental health. Understanding the extent to which sport clubs offer environments conducive to mental health and wellbeing is important for mental health initiatives targeting sport clubs. Currently and to our knowledge, there is no known instrument that captures member/participant perceptions of how supportive the sport setting is regarding mental health and wellbeing. This study explored the content validity, internal construct validity and external construct validity of the Supporting Mental Health in Sport Instrument (SMHSI) intended to measure the extent to which sport clubs provided a supportive environment for mental health promotion. A process of reliability analysis, principal component analysis and Rasch analysis was conducted confirming the psychometric fit of the items to the overall construct. The instrument could distinguish between two sport club environments providing different levels of mental health support, demonstrating external construct validity. The instrument can be used to evaluate the effectiveness of the sport club context to support mental health, to identify suitable club targets for mental health programs, to better determine training needs, or to better understand the impact of mental health programs on wider club contexts. Lay summary: Mental health promotion in sport clubs is becoming increasingly popular. The effectiveness of these promotion efforts may be compromised by the contexts in which they are delivered. This paper describes the properties of the Supporting Mental Health in Sport Instrument designed to measure the contextual support for the promotion of mental health in sport clubs.

Rasch analysis, reliability, and validity of the Turkish version of the Lumbar Spine Instability Questionnaire.

Lumbar instability is an important condition that can be seen frequently in people with low back pain, affecting both the progression and the choice of appropriate exercise. The Lumbar Spine Instability Questionnaire (LSIQ) is a simple and low-cost tool for evaluating disturbed back stability in people with low back pain. The aim of this study is to develop the Turkish version of the LSIQ (LSIQ-T) and to evaluate its psychometric properties using the Rasch model. One hundred participants with chronic low back pain completed the LSIQ-T. The LSIQ-T was repeated for 30 participants after 1 week to establish its test-retest reliability. While internal and external construct validity were investigated using Rasch analysis and the Spearman correlation coefficient, respectively, reliability was evaluated in terms of internal consistency by Cronbach's alpha and the Person Separation Index (PSI). All items of the LSIQ-T were found to fit the Rasch model (chi-square: 34.07 (df = 15), p = 0.0033). The internal construct validity was good, the overall mean item fit residual was 0 (SD: 0.765), and the mean person fit residual was 0.322 (SD: 1.123). Internal consistency reliability was low with a PSI of 0.63 although Cronbach's alpha was acceptable (0.68). When the test-retest reliability was examined via differential item functioning (DIF) by time, none of the items showed DIF. The LSIQ-T is a valid unidimensional scale for the Turkish population. Although the LSIQ-T had low internal consistency, it demonstrated unidimensionality and is appropriate for use. Therefore, the LSIQ-T can be used in clinical practice and scientific research.

Psychometric Properties of the Persian Version of Social Anxiety Scale for Social Media Users (SAS-SMU).

Objective: Social anxiety refers to an excessive concern or fear about social situations. It seems that social media, which has become one of the most popular and effective tools for communication today, can be one of the contexts of social anxiety. Due to the lack of a Persian instrument to assess social anxiety in the context of social networks, the current study was undertaken to analyze the psychometric criteria of the Iranian version of the Social Anxiety Scale for Social Media Users (SAS-SMU). The SAS-SMU is a 21-item questionnaire designed by Alkis and colleagues (2017) to measure social anxiety emerging from the social media platforms. Method : In this study, a total of 842 participants within the age range of 11 to 82 years old (mean age 33.11 ± 12.134), 59% female) answered the questions in an online survey. The original version of the scale was translated into Persian using the back translation procedure. All participants completed a Demographic Questionnaire, the SAS-SMU, and the Beck Anxiety Inventory. In order to analyze the collected data, internal and external consistency, factor analysis, construct validity, and confirmatory factor analysis (CFA) were examined. A significance level of less than 0.05 was considered to determine statistical significance. Results: Four subscales were obtained from the exploratory factor analysis (SCA, PCA, IA, and SEA), which were confirmed by the confirmatory factor analysis. Cronbach's alpha for internal consistency was found to be 0.931 for the total scale and 0.920, 0.846, 0.901, 0.828 for SCA, PCA, IA, and SEA, respectively. In addition, the test-retest scores of 30 participants (interval: between 2 to 3 weeks) for all four subscales (SCA = 0.641, PCA = 0.773, IA = 0.688, SEA = 0.727) indicated acceptable stability of the questionnaire over time. Conclusion: This study validates the Persian version of the SAS-SMU for use in studies in the field of psychological problems related to social media and online communications.

Psychometric properties of the persian version of the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS)

IntroductionThere are numerous cases where artificial intelligence (AI) can be applied to improve the outcomes of medical education. The extent to which medical practitioners and students are ready to work and leverage this paradigm is unclear in Iran. This study investigated the psychometric properties of a Persian version of the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) developed by Karaca, et al. in 2021. In future studies, the medical AI readiness for Iranian medical students could be investigated using this scale, and effective interventions might be planned and implemented according to the results.MethodsIn this study, 502 medical students (mean age 22.66(± 2.767); 55% female) responded to the Persian questionnaire in an online survey. The original questionnaire was translated into Persian using a back translation procedure, and all participants completed the demographic component and the entire MAIRS-MS. Internal and external consistencies, factor analysis, construct validity, and confirmatory factor analysis were examined to analyze the collected data. A P ≤ 0.05 was considered as the level of statistical significance.ResultsFour subscales emerged from the exploratory factor analysis (Cognition, Ability, Vision, and Ethics), and confirmatory factor analysis confirmed the four subscales. The Cronbach alpha value for internal consistency was 0.944 for the total scale and 0.886, 0.905, 0.865, and 0.856 for cognition, ability, vision, and ethics, respectively.ConclusionsThe Persian version of MAIRS-MS was fairly equivalent to the original one regarding the conceptual and linguistic aspects. This study also confirmed the validity and reliability of the Persian version of MAIRS-MS. Therefore, the Persian version can be a suitable and brief instrument to assess Iranian Medical Students’ readiness for medical artificial intelligence.

Validation of the Utah Photophobia Symptom Impact Scale (version 2) as a headache-specific photophobia assessment tool.

To present an updated version of the Utah Photophobia Symptom Impact Scale version 2 (UPSIS2), providing robust clinical and psychometric validation, to improve headache-specific evaluation of light sensitivity and headache-related photophobia. The original UPSIS filled a gap in available tools for assessment of headache-associated light sensitivity by providing patient-reported evaluation of the impact of light sensitivity on activities of daily living (ADLs). We have since revised the original questionnaire to provide a more robust item construct and refined validation approach. We conducted a psychometric validation of the UPSIS2 through a primary analysis of an online survey of volunteers with recurrent headaches recruited from the University of Utah clinics and surrounding community. Volunteers completed the original UPSIS and UPSIS2 questionnaire versions in addition to measures of headache impact, disability, and frequency. The UPSIS2 now includes a pre-defined recall period and a 1-4 Likert scale with standardized response anchors to improve clarity. Internal construct validity, external construct validity, and test-retest reliability, were evaluated. Responses were obtained from 163 volunteers, with UPSIS2 scores ranging from 15 to 57 (out of a possible 15-60) with a mean (standard deviation) of 32.4 (8.80). Construct validity was satisfactory, as evidenced by sufficient unidimensionality, monotonicity, and local independence. Reliability was excellent, with Rasch test reliability = 0.90 and Cronbach's alpha = 0.92, and an intraclass correlation of 0.79 (95% confidence interval 0.65-0.88) for participants who took the test twice. UPSIS2 correlates well with other headache measures (Spearman's correlations >0.50), as well as the original UPSIS (Spearman's correlation = 0.87), indicating good convergent validity. UPSIS2 scores differ significantly across International Classification of Headache Disorders (third edition) groups, indicating good known group validity. The UPSIS2 provides a well-validated headache-specific outcome measure for the assessment of photophobia impact on ADLs.

Further Validity and Reliability of Turkish Version of the Mandibular Functional Impairment Questionnaire in Patients with Temporomandibular Dysfunction

Purpose: &#x0D; The aim of this study is to develop a new Turkish version of MFIQ (MFIQ-T-N) by adding the cut off value and improving the validation to the Turkish version of the Mandibular Functional Impairment Questionnaire (MFIQ-T) in patinets with Temporomandibular dysfunction.&#x0D; Methods: The psychometric properties of the MFIQ were examined in 242 participants diagnosed with TMD and 81 healthy participants. The internal construct validity was assessed with both exploratory and confirmatory factor analysis. External construct validity of the MFIQ-Tr-N was established by The Fonseca Anamnestic index (FAI), The Oral Health Impact Profile-14 (OHIP-14), and The patient health questionnaire-9 (PHQ-9). Predictive validity was examined using the receiver operating characteristic (ROC) to validate the cut-off value of the MFIQ-T-N for diagnosis of TMD. For the determination of reliability internal consistency, test-retest reliability and smallest real difference (SRD95) were investigated. &#x0D; Results: Factor analysis indicated that the MFIQ-T-N had three factors as masticatory, non-masticatory 1, and 2. The MFIQ-T-N was moderately correlated with the FAI (Spearman’s rho = 0.553, p &lt; .001) and OHIP-14 (rho = 0.534, p &lt; .001). The cut-off point for MFIQ-T-N was set at &gt;5 with 84% sensitivity and 87% specificity. The ICC and Cronbach’s α values were found as 0.913 and 0. 916, respectively. The SRD95 for Test-retest reliability was 7.004. &#x0D; Conclusions: The MFIQ-T-N had sufficient psychometric features and was appropriate to use for participants with TMD. In addition, this new version provides researchers with greater opportunities to evaluate mandibular functions in the TMD patient group.

The validity and reliability of the Pressure Ulcer Quality of Life instrument: A methodological study

AimThis study aimed to adapt the Pressure Ulcer Quality of Life instrument to Turkish and to determine the validity and reliability by using the Rasch model. Materials and methodsThis methodological study used forward translation, expert opinion, back translation, pilot testing, and finalization for the language adaptation of the instrument. Prior to back translation, the instrument was assessed by five experts certified in wound care nursing. Then, the comprehensibility of the instrument was tested in the pilot study. The study was conducted between March 2017 and September 2019 at one private, one state, and four university hospitals in Turkey. Eligible participants were patients 18 years of age or older, having pressure injury, and fully conscious. Data were collected from a total of 250 patients by using a demographic and clinical history form, the Pressure Ulcer Quality of Life instrument, and the World Health Organization Quality of Life - Brief Form Turkish scale. The instrument's internal construct validity using the Rasch model, the external construct validity, internal consistency, and test-retest reliability were assessed. ResultsThe final Turkish version of the Pressure Ulcer Quality of Life self-report instrument differed from the original, comprising 74 items under the following ten subscales: three regarding symptoms, plus one itchiness item; four regarding physical functioning; two regarding psychological well-being, self-consciousness, and appearance; and one regarding social participation. ConclusionThe Turkish version of the PU-QOL is a valid, reliable, and widely available instrument for measuring quality of life for patients with pressure injury.

Validation of the Pediatric Quality of Life Inventory 3.0 Cerebral Palsy Module (Parent Form) for use in Türkiye.

This study was planned to test the reliability and validity of the Turkish version of the Pediatric Quality of Life Inventory (PedsQL) 3.0 cerebral palsy (CP) module (parent form) in children with CP. In the validation study conducted between June 2007 and June 2009, 511 children (299 normal children, 212 children with CP) were assessed by the seven scales of PedsQL [daily activities (DA), school activities (SA), movement and balance (MB), pain and hurt (PH), fatigue (F), eating activities (EA), and speech and communication (SC)]. Reliability was tested by internal consistency and person separation index (PSI); internal construct validity by Rasch analysis and external construct validity by correlation with the Gross Motor Function Classification System (GMFCS) and Functional Independence Measure for Children (WeeFIM). Only 13 children with CP completed the inventory by themselves and thus were excluded. Consequently, 199 children with CP (113 males, 86 females; mean age: 7.3±4.2 years; range, 2 to 18 years) and 299 normal children (169 males, 130 females; mean age: 9.4±4.0 years; range, 2 to 17 years) were included in the final analysis. Reliabilities of the seven scales of the PedsQL 3.0 CP module were adequate, with Cronbach's alphas between 0.66 and 0.96 and the PSI between 0.672 and 0.943 for the CP group. In Rasch analysis, for each scale, items showing disordered thresholds were rescored; then testlets were created to overcome local dependency. Internal construct validity of the unidimensional seven scales was good with the mean item fit of -0.107±1.149, 0.119±0.818, 0.232±1.069, -0.442±0.672, 0.221±0.554, -0.091±0.606, and -0.333±1.476 for DA, SA, MB, PH, F, EA, and SC, respectively. There was no differential item functioning. External construct validity of the instrument was confirmed by expected moderate to high correlations with WeeFIM and GMFCS (Spearman's r=0.35-0.89). Turkish version of the PedsQL 3.0 CP module is reliable, valid, and available for use in clinical setting to evaluate health-related quality of life of children with CP.

Italian version of the Rasch-Built Overall Amyotrophic Lateral Sclerosis Disability Scale (ROADS): validation and longitudinal performance

ObjectiveTo validate an Italian version of the Rasch-Built Overall ALS Disability Scale (ROADS) in a broad population of patients and assess its longitudinal performance over time.Methods270 ALS patients referring to the Motor Neuron Disease Clinic of the University of Padova and Modena (Italy) accepted to compile the Italian version of the ROADS and results were correlated with the ALSFRSr and ALSAQ-40 scores, FVC values, and creatinine or albumin blood levels. To verify test–retest reliability, patients were asked to fill in a second copy of the scale within 5–7 days. Thirty-nine patients compiled a further copy of questionnaire during the follow up visit (after 133 days on average) which allowed us a longitudinal assessment of the scale.ResultsWe found a good external construct validity between ROADS and either ALSFRS-R (correlation coefficient = 0.85) or ALSAQ-40 (correlation coefficient = − 0.84). Test–retest reliability was excellent with a concordance-correlation coefficient of 0.93. Yet, we observed a significant correlation between changes over time of the ROADS normalised sum score (− 2.18 point loss per month) and those of both the ALSFRS-R (positive correlation; Rho = 0.64, p ≤ 0.0001) or the ALSAQ-40 (negative correlation; Rho = − 0.60, p = 0.014).ConclusionsThe Italian version of ROADS proved to be a reliable marker to monitor overall disability in ALS patients. Further studies are necessary to assess its longitudinal performance.

Capturing School Context Characteristics Using the Job Demands-Resources Model: Adaptation and Validation

&lt;p style="text-align:justify"&gt;Work environments are pivotal to teachers’ professional development. However, effective instruments assessing teachers’ perceived work context are still lacking. The principal aim of the present study was to validate a Work Environments Inventory for Teachers (WEIT) constructed using the Job Demands-Resources (JD-R) model. Two studies were implemented on two independent samples totaling 696 (232 for Study 1 and 464 for Study 2) schoolteachers in Mainland China. Both exploratory and confirmatory factor analyses were employed to cross-validate the WEIT. The external construct validity of the WEIT was estimated through investigating its connection with the Thinking Styles in Teaching Inventory. Findings indicated that the WEIT is an adequate measure to map the characteristics of work environments for schoolteachers. Limitations are discussed and implications for future studies are suggested.&lt;/p&gt;

EASE-NL: Cross-Cultural Adaptation and Validation of the Dutch Version of the Evaluation of Ability to Sing Easily

The Evaluation of the Ability to Sing Easily (EASE) is a self-rating tool that is used to assess the singer's perceptions of the current singing voice status. The purpose of this study was to develop and validate a Dutch translation of the EASE. The original version of the EASE was translated and adapted to Dutch according to the recommendations of the Quality of Life Special Interest Group - Translation and Cultural Adaptation group. Subsequently, the questionnaire was individually completed by 70 singers with a mean age of 35.2 years before and after a singing activity, together with a demographic questionnaire and the Dutch Singing Voice Handicap Index 10 (SVHI-10-NL). Two groups of singers were included between September and June 2020: a group of healthy singers (n=54) and a group of dysphonic singers (n=16). Internal and external consistency, construct and criterion validity, test-retest and split-half reliability were calculated using Cronbach's alpha coefficients, Student's t-test, the paired Wilcoxon tests and Pearson correlation coefficients. Furthermore, the impact of sex and age and the diagnostic accuracy of the EASE-NL was measured using the Mann Whitney U-test, the One Way ANOVA and the Brown Forsythe ANOVA-test. The internal consistency of the EASE was considered good. For the external consistency, the Pearson correlation coefficient showed a positive correlation between the total score of the EASE-NL and the SVHI-10-NL. Dysphonic singers scored significantly higher compared to singers without voice problems and no differences were found between the pre and post singing condition in both groups. Pearson correlations coefficients showed a strong positive correlation between the test and retest condition and between the subscales. A ROC-curve analysis showed a cut-off score of 12.5, with a sensitivity level of 75.0% and a specificity level of 74.1%. No differences for sex and age were found. The original English version of the EASE was translated and validated in Dutch. The EASE-NL is found to be a valid and reliable self-reported tool to assess singer's perceptions of the current status of their singing voice.

Prednisone for the prevention of tuberculosis-associated IRIS (randomized controlled trial): Impact on the health-related quality of life.

BackgroundTuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is an important complication in patients with HIV-associated tuberculosis (TB) starting antiretroviral treatment (ART) in sub-Saharan Africa. The PredART-trial recently showed that prophylactic prednisone reduces the incidence of paradoxical TB-IRIS by 30% in a population at high risk. This paper reports the impact of the intervention on health-related quality of life (HRQoL), a secondary endpoint of the trial, measured by an amended version of the PROQOL-HIV instrument—the instrument’s validity and reliability is also assessed.MethodsA total of 240 adult participants (antiretroviral treatment (ART)-naïve, TB-HIV co-infected with CD4 count ≤100 cells/μL) were recruited and randomized (1:1) to (1) a prednisone arm or (2) a placebo arm. In this sub-study of the PredART-trial we evaluated (1) the performance of an HIV-specific HR-QoL instrument amended for TB-IRIS, i.e., the PROQOL-HIV/TB in patients with HIV-associated TB starting ART (reliability, internal and external construct validity and invariance across time) and (2) the impact of prednisone on self-reported HR-QoL in this population through mixed models.ResultsThe PROQOL-HIV/TB scale displayed acceptable internal reliability and good internal and external validity. This instrument, including the factor structure with the eight sub-dimensions, can thus be applied for measuring HR-QoL among HIV-TB patients at high risk for TB-IRIS. Prophylactic prednisone was statistically significantly associated only with the ‘Physical Health and Symptoms’-subscale: a four-week course of prednisone resulted in an earlier improvement in the physical dimension of HR-QoL compared to placebo.ConclusionWe demonstrated that the PROQOL-HIV/TB scale adequately measures different aspects of self-reported HR-QoL in HIV-TB patients. Although more research is needed to understand how other domains related to HR-QoL can be improved, targeting patients at high risk for developing TB-IRIS with a four-week course of prednisone has a beneficial effect on the physical aspects of patient-reported quality of life.

Metrics of sexual behavior stigma among cisgender men who have sex with men in Mexico: exploratory and confirmatory factor analyses

Cisgender gay, bisexual, and other men who have sex with men (MSM) in Mexico experience disparities in sexual health outcomes, perhaps most notably in HIV prevalence, HIV testing and status awareness, and condom use. Sexual behavior stigma, underpinned by socio-structural factors specific to Mexico (e.g., machismo), uniquely shapes these sexual health disparities. However, few reliable, valid measures are available to document, track, and ultimately mitigate sexual behavior stigma in this context. Exploratory and confirmatory factor analyses were performed on responses to a 13-item sexual behavior stigma scale from 15,681 MSM recruited online across Mexico. Associations with extracted factors were tested to assess construct validity. Three subscales were identified in exploratory factor analysis and validated in confirmatory factor analysis: “stigma from family and friends” (α = 0.65), “anticipated healthcare stigma” (α = 0.84), and “general social stigma” (α = 0.70). External construct validity was indicated through each subscale’s strong association (all p < 0.001) with perceived community intolerance of MSM and perceived community discrimination toward people living with HIV. These subscales show promise as reliable, valid measures for assessing sexual behavior stigma among MSM in Mexico, and as tools for documenting and tracking sexual behavior stigma trends, comparing regional burdens of sexual behavior stigma, and tracking the progress of stigma-mitigation interventions among MSM in Mexico. Future research is needed to understand the extent to which each subscale is differentially associated with sexual (and other) health outcomes, which can inform the development and implementation of uniquely tailored stigma-mitigation, HIV-prevention, HIV-care, and other needed interventions for MSM in Mexico.

Cross-cultural adaptation and validation of the Thai version of the functional index for hand osteoarthritis (FIHOA)

BackgroundThe Functional Index for Hand Osteoarthritis (FIHOA) is a simple tool to assess functional impairment for hand OA patients. The purpose of this study was to translate the FIHOA into the Thai language, and validate it in Thai hand OA patients.MethodsThe FIHOA was translated into Thai (T-FIHOA) according to the principles of cross-cultural adaptation and administered to 102 hand OA patients recruited between September 2020 and July 2021 together with the modified Health Assessment Questionnaire (mHAQ), Disabilities of the Arm, Shoulder and Hand (DASH), and visual analogue scale (VAS) for hand pain. Spearman’s correlation coefficient and intraclass correlation coefficient (ICC) were used to check the test-retest reliability of each item and the total scores in the translated questionnaire. The internal consistency reliability was evaluated using Cronbach’s alpha. The external construct validity was assessed using correlations between the T-FIHOA, mHAQ, DASH and hand pain VAS.ResultsThe T-FIHOA had a unidimensional structure. The ICC was > 0.9 and the Cronbach’s alpha of 0.92 indicated excellent reliability and internal consistency, respectively. The external validity tests indicated moderate correlation with the hand pain VAS (r = 0.37, P < 0.01) and moderate to strong correlations with the mHAQ (r = 0.63, P < 0.01), and DASH score (r = 0.52, P < 0.01). The T-FIHOA had the highest effect size (ES) and standardized response mean (SRM) (− 0.37 and − 0.58 respectively) among all questionnaires except for the VAS when assessing changes between baseline and week 4.ConclusionsThe T-FIHOA is a good and reliable assessment tool freely available for practitioners/researchers to evaluate functional impairment in Thai hand OA patients.