Good Internal Validity Research Articles

Validation of the Multidimensional Scale of Perceived Social Support among LGBT population in Serbia

Abstract Background Social support represents the belief that one is valued, cared for, and loved by others in a social network and a lack of it may lead to adverse outcomes such as a relapse into depression or emotional distress in physically ill patients. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument aimed to measure an individual’s perception of how much he or she receives outside social support. This study aimed to examine the validity and reliability of the Serbian version of MSPSS in a sample of LGBT population in Serbia. Methods The cross-sectional study included 504 respondents, members of the LGBT population living in Serbia. The instrument used was the MSPSS as a self-report measure, containing twelve items rated on a 7-point Likert scale. MSPSS consists of three sub-scales: Family, Friends, and Significant Others. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed with two independent random samples. Results The average score on the scale of social support was 5.58±0.84 (scale of social support by family 4.62±1.41, scale of social support by friends 5.93± 1.99, and scale of social support by the significant others 6.20±0.96, respectively). The Cronbach’s alpha for the entire social support scale was α = 0.772. The three-factor structure of the MSPSS was proved with EFA and CFA. The factor loadings varied between 0.630-0.817. The three factors explained a total of 52.68% of the variance (factor 1- 28.62%, factor 2. 13.16%, factor 3- 10,90%). The three-factor model was adopted during the CFA when the three-factor model CFI (comparative fit index) was 0.969. Conclusions The MSPSS has shown good reliability, internal validity and construct validity and can be used as a convenient measure of social support among the LGBT population. Both EFA and CFA yield a three-factor structure consistent with the theory underlying the measure’s development. Key messages • The results of the study suggest that the Multidimensional Scale of Perceived Social Support has acceptable psychometric properties for use with the LGBT population. • This study supports the use of the MSPSS for assessing community-based collaboration using the three-factor model among the LGBT population.

Turkish Translation And Validation of The Expectations of Aesthetic Rhinoplasty Scale.

The aim of this study was to translated, validate, and culturally adapt the original English version of the Expectations of Aesthetic Rhinoplasty Scale (EARS) into Turkish for use in Turkish-speaking communities. Fifty-one patients who wanted to undergo primary rhinoplasty and were literate in Turkish were included in the study. The control group consisted of 81 healthy volunteers who did not require rhinoplasty. A Turkish version of the EARS (EARS-T) was created. The participants completed the EARS-T questionnaire twice, four weeks apart. The internal consistency of the scale (Cronbach's α), the test-retest reliability (intraclass correlation coefficient [ICC]), and differences between the patient and control groups (Pearson's chi-square test) were analyzed. A statistically significant difference was found between the age and gender of the patient and control groups (p = 0.001 and p = 0.001, respectively). Univariate analysis showed that this significant difference did not affect the study results (age: p = 0.2; gender: p = 0.12). In addition, a statistically significant difference was found between the scale scores of the control and rhinoplasty groups (all p < 0.05). The EARS-T had good internal consistency, with high Cronbach's α scores ranging between 0.74 and 0.87. Test-retest reliability was demonstrated by high ICC scores ranging from 0.71 to 0.87. Our study revealed that the EARS-T has good internal consistency, reliability, and validity. Therefore, it can be used to assess the expectations of aesthetic rhinoplasty patients in preoperative consultation practice and in clinical studies related to rhinoplasty.

Psychometric properties of Japanese version15D and cultural characteristics of quality of life undergoing patients with hip and knee arthroplasty

BackgroundHealth-related quality of life (HRQoL) following total hip and knee arthroplasty (THA/TKA) may decline more in Asian countries due to lifestyle and housing factors compared with patients in Western countries. AimsTo evaluate the psychometric properties of the Japanese version of 15D and clarify the characteristics of HRQoL in Japanese patients who underwent THA/TKA compared with Finnish patients. MethodsThis longitudinal study included 182 patients between 2019 and 2021. Patients' HRQoL was measured using the 15D preoperatively and 3 months postoperatively. Student's t-tests were used to compare lifestyles between Japan and Finland. ResultsThe Japanese version of the 15D showed good internal consistency, reliability, construct validity, and responsiveness. Patients with many steps inside their house had worse HRQoL in the dimensions of mobility, distress, and vitality in Japan. There were significant differences in mobility, distress, vitality, and sexual activity dimensions between Japan and Finland 3 months postoperatively. ConclusionsThe lower HRQoL in Japan in the dimensions of mobility, distress, and vitality is likely due to Japan's traditional housing structure with many steps. Identifying differences in cultural and psychological characteristics, as well as by residential setting, will enable health care providers to help patients improve their HRQoL.

External validation of an artificial intelligence multi-label deep learning model capable of ankle fracture classification

BackgroundAdvances in medical imaging have made it possible to classify ankle fractures using Artificial Intelligence (AI). Recent studies have demonstrated good internal validity for machine learning algorithms using the AO/OTA 2018 classification. This study aimed to externally validate one such model for ankle fracture classification and ways to improve external validity.MethodsIn this retrospective observation study, we trained a deep-learning neural network (7,500 ankle studies) to classify traumatic malleolar fractures according to the AO/OTA classification. Our internal validation dataset (IVD) contained 409 studies collected from Danderyd Hospital in Stockholm, Sweden, between 2002 and 2016. The external validation dataset (EVD) contained 399 studies collected from Flinders Medical Centre, Adelaide, Australia, between 2016 and 2020. Our primary outcome measures were the area under the receiver operating characteristic (AUC) and the area under the precision-recall curve (AUPR) for fracture classification of AO/OTA malleolar (44) fractures. Secondary outcomes were performance on other fractures visible on ankle radiographs and inter-observer reliability of reviewers.ResultsCompared to the weighted mean AUC (wAUC) 0.86 (95%CI 0.82–0.89) for fracture detection in the EVD, the network attained wAUC 0.95 (95%CI 0.94–0.97) for the IVD. The area under the precision-recall curve (AUPR) was 0.93 vs. 0.96. The wAUC for individual outcomes (type 44A-C, group 44A1-C3, and subgroup 44A1.1-C3.3) was 0.82 for the EVD and 0.93 for the IVD. The weighted mean AUPR (wAUPR) was 0.59 vs 0.63. Throughout, the performance was superior to that of a random classifier for the EVD.ConclusionAlthough the two datasets had considerable differences, the model transferred well to the EVD and the alternative clinical scenario it represents. The direct clinical implications of this study are that algorithms developed elsewhere need local validation and that discrepancies can be rectified using targeted training. In a wider sense, we believe this opens up possibilities for building advanced treatment recommendations based on exact fracture types that are more objective than current clinical decisions, often influenced by who is present during rounds.

Стандартизация методики «Перцептивное моделирование» для детей 5-6 и 6-7 лет

&lt;p&gt;In modern sociocultural conditions, reliable diagnostic tools are needed to assess the mental development of a child, which would at the same time make it possible to adjust the objectives of educational work. The article reflects the results of adaptation and standardization of the "Perceptual modeling" test included in the diagnostic set for assessing the mental development of preschoolers (L.A. Wenger and colleagues). The study sample consisted of two groups: children 5-6 (N=1003) and children 6-7 (N=1516) years old. In these groups, children were offered various test options based on their age-related perceptual modeling capabilities. The adaptation of the "Perceptual modeling" test involved converting it into electronic form, changing the system for evaluating the results obtained and statistically verifying the possibility of using it in this form to solve diagnostic problems. The test standardization procedure has shown good external and internal validity, and its diagnostic reliability. Statistical analysis revealed the absence of significant gender differences in the performance of the test and the presence of significant differences between children with normal development and children with disabilities (speech, hearing impairment and mental retardation). As a result of standardization, age norms for mastering perceptual modeling actions for children with normal development and children with disabilities were determined by children of the sixth and seventh years of life.&lt;/p&gt;

International Validation of the Vascular Registry of Switzerland, Swissvasc: A VASCUNET Report

Data validity and completeness is essential for registry data, and a meaningful interpretation of differences between countries can only be made if the data are robust within each of the countries. Therefore, the VASCUNET collaboration has performed validation of several vascular registries and has so far published the validation results of national vascular registries of Sweden, Denmark, and Malta. The findings of the validation of the Swissvasc Registry, the vascular registry of Switzerland, are presented here. Five of 34 hospitals participating in Swissvasc were visited by two international validators. Independent evaluation of the procedures of carotid endarterectomy, infrarenal abdominal aortic aneurysm (AAA) repair, and bypass surgery for lower extremity arterial disease (LEAD) was performed. Local administrative data and Swissvasc Registry data were compared for external validation, as well as registry data of 15 randomly picked cases within each group with data from individual patient records for internal validation. Hospital administrative data identified 265 carotid, 399 AAA, and 399 LEAD procedures, whereas Swissvasc identified 265 carotid, 398 AAA, and 395 LEAD procedures. Four LEAD procedures were found in hospital administrative data but not in Swissvasc. External validity was 100% for carotids, 99.8% for AAA, and 99% for LEAD. In internal validation, 5.2% of the variable data were missing in Swissvasc, and 2.4% were different from data in patient records, resulting in external validity of 92.8% for carotids, 94.4% for AAA, and 90.1% for LEAD. The VASCUNET template was used for international validation of registry data, and demonstrated that Swissvasc is a reliable system of quality data collection for the participating vascular centres, with excellent external validity and good internal validity. Quality in the Swissvasc registry data was clearly superior to local administrative data.

NAVIGATING THE METAVERSE: UNRAVELING ITS IMPACT ON TOURISM

This study aims to explore the influence of perceived usefulness, perceived ease of use, social norms and attitudes towards the use of metaverse on the behavioural intention to use Metaverse in tourism, providing valuable insights into the potential impact of metaverse on the future of the tourism industry. To assess the influence of the variables, a questionnaire was administered to 50 participants from generations X, Y and Z with a gender distribution of 54% male and 46% female participants. The survey demonstrated good internal reliability and validity. The results indicate that perceived usefulness, perceived ease of use and attitude have an impact on participants' behavioural intentions. However, the influence of social norms on behavioural intention was not found to be significant in this study. These results provide valuable insights into understanding the factors that influence people's behavioural intentions when using metaverses in tourism. Further studies with more refined questions and larger samples need to be conducted.

Psychometric Properties of the Italian Version of the Interpersonal Sensitivity Measure (IPSM)

The Interpersonal Sensitivity Measure (IPSM) is used to assess interpersonal sensitivity. This study explored the factor structure, internal consistency, and criterion validity of the Italian version of the IPSM (IPSM-It) in non-clinical emerging adults. 374 participants aged between 18 and 31 years (64.4% female; M = 21.96, SD = 2.91) were included in the study. They completed the IPSM, the Beck Depression Inventory-I, the Beck Anxiety Inventory, the State-Trait Anger Expression Inventory-II, and the Satisfaction with Life Scale. Confirmatory factor analysis indicated that the original structure of the measure did not fit the data well. An exploratory factor analysis was also conducted and the results supported a 27-item version of the IPSM and a three-factor structure (Interpersonal Worry and Dependency, Low Self- Esteem, and Unassertive Interpersonal Behavior). The IPSM-It showed good internal consistency and criterion validity. The IPSM-It appeared to be a reliable and valid measure for assessing IPS in Italian culture.

Development of a self-assessment tool to address the functioning of community-dwelling older adults in general practice: a validation study of the EFA23 questionnaire

BackgroundMultimorbidity is increasingly prevalent among ageing patients, leading to reduced daily functioning. To address the challenges posed by multimorbidity in older adults, a person- and context-centred approach is needed. This study aimed to develop a questionnaire as a self-assessment tool for older adults focusing on functioning in general practice based on the International Classification of Functioning, Disability and Health (ICF).MethodsA mixed-methods approach was employed in the development and validation of the German EFA23 (Erfassung Funktionaler Gesundheit im Alter – 23 Fragen; Assessing Functional Health in Old Age – 23 questions) questionnaire. Based on an ICF subset developed in a preparatory phase and consensus study, questionnaire items were formulated and tested in a qualitative pretest, followed by a validation study. A workshop with general practitioners (GPs) was held to develop a supplementary manual for GPs on how to interpret the questionnaire results and discuss them with the patients.ResultsA total of 69 items were developed and tested in the qualitative pretest with 15 respondents, resulting in 37 items for the validation study. The validation study, involving 237 older adults, showed the presence of one significant principal component. It demonstrated good internal consistency (Cronbach’s alpha = 0.967) and construct validity, showing positive correlations with established assessment tools. Descriptive statistics showed differences between the means of self-assessment by patients and an external GP assessment. The final EFA23 questionnaire consists of 23 items assessing limitations in functioning.ConclusionsThe EFA23 questionnaire can be used as a valid self-assessment instrument to measure functioning in older adults, supporting a person- and context-centred approach in general practice.

Novel Predictive Scoring System for Bone Union Rate After Conservative Management of Lumbar Spondylolysis.

A single-center retrospective cohort study. To develop a predictive scoring system for bone union after conservative treatment of lumbar spondylolysis and assess its internal validity. Lumbar spondylolysis, a common stress fracture in young athletes, is typically treated conservatively. Predicting bone union rates remains a challenge. This study included patients aged ≤18 years with lumbar spondylolysis undergoing conservative treatment. A multivariable logistic regression analysis was used to develop a scoring system containing six factors: sex, age, lesion level, main side stage of the lesion, contralateral side stage of the lesion, and spina bifida occulta. The predictive scoring system was internally validated from the receiver operating characteristic (ROC) curve using bootstrap methods. The final analysis included 301 patients with 416 lesions, with an overall bone union rate of 80%. On multivariable analysis, the main and contralateral stages were identified as factors associated with bone union. The predictive scoring system was developed from the main side stage score (prelysis, early=0, progressive stage=1) and the contralateral side stage score (none=0, prelysis, early, progressive stage=1, terminal stage=3). The area under the curve was 0.855 (95% confidence interval: 0.811-0.896) for the ROC curve, showing good internal validity. The predicted bone union rates were generally consistent with the actual rates. A simple predictive scoring system was developed for bone union after conservative treatment of lumbar spondylolysis, based on the stage of the lesion on the main and contralateral sides. The predicted bone union rate was approximately 90% for a total score of 0-1 and ≤30% for a score of 3-4. This system demonstrated good internal validity, suggesting its potential as a useful tool in clinical decision making for the management of spondylolysis.

Development and validation of a clinical nomogram to predict prostatic inflammation in men with lower urinary tract symptoms.

Prostatic inflammation is an important etiological component of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). The Prostatic Inflammation Nomogram Study (PINS) aimed to develop and validate a nomogram for predicting the presence of prostatic inflammation in men with LUTS. This non-interventional, cross-sectional, prospective study was conducted in six secondary/tertiary centers across Cyprus, Greece, Italy, Portugal, and Spain. Men (≥40 years) with BPH/LUTS scheduled to undergo prostatic surgery or transrectal ultrasound-guided (TRUS) prostate biopsy were included. Fifteen demographic and clinical participant characteristics were selected as possible predictors of prostatic inflammation. The presence of inflammation (according to Irani score) in the prostatic tissue samples obtained from surgery/TRUS biopsy was determined. The effect of each characteristic on the likelihood a prostate specimen demonstrated inflammation (classified by Irani score into two categories, 0-2 [no/minimal inflammation] or 3-6 [moderate/severe inflammation]) was assessed using multiple logistic regression. A nomogram was developed and its discriminatory ability and validity were assessed. In total, 423 patients (mean age 68.9 years) were recruited. Prostate volume ultrasound (PVUS) > 50 mL, history of urinary tract infection (UTI) treatment, presence of diabetes, and International Prostate Symptom Score (IPPS) Storage score were statistically significant predictors of Irani classification. Logistic regression demonstrated a statistically significant effect for leucocytes detected via urine dipstick, presence of diabetes, PVUS > 50 mL, history of UTIs, and higher IPSS Storage score for the odds of an inflammatory score category of 3-6 versus 0-2. The nomogram had a concordance index of 0.71, and good internal validity. The nomogram developed from PINS had good predictive ability and identified various characteristics to be predictors of prostatic inflammation. Use of the nomogram may aid in individualizing treatment for LUTS, by identifying individuals who are candidates for therapies targeting prostatic inflammation.

Évaluation de la douleur des enfants et adolescents avec troubles du spectre de l’autisme : une revue systématique

ObjectivePain in children and adolescents with autism spectrum disorders remains underdiagnosed due to their inherent communication difficulties. The goal of this review is to identify the most suitable methods for assessing pain in this population and for evaluating the specific perceptions of, or behavioural reactions to, pain whilst considering disorder severity and specifiers (with or without accompanying intellectual impairment, with or without accompanying language impairment). MethodA systematic review and analysis of the international literature was conducted. ResultsFourteen studies were selected. No difference was found in pain-related behaviours based on the age or gender of children or adolescents with autism. Three studies showed pain-related behaviours in autism spectrum disorders to be similar to control groups. Other studies showed specific behavioural responses in autism spectrum disorders with a longer physiological and behavioural recovery time associated with an episode of acute pain in this population. Similarly, the three studies that focused on sensory perceptions of pain all showed differences in the autism spectrum disorders population compared to control groups. In hospital or daily life contexts, studies essentially showed idiosyncratic expressions, hypervigilance, motor agitation, negative emotional reactions, or vocalizations. Regarding the association of autism severity with hyposensitivity to pain, the results remain unclear even when language disorders or intellectual disabilities are also present (in conjunction with autism). The Non-Communicative Children Pain Checklist and its translation into French and Italian showed good internal validity and was used by almost half of the studies in hetero-assessment, mostly by parents. Studies recommend the inclusion of parents in the assessment in order to optimise the evaluation process. Similarly, analysis of parent/child/caregiver interviews from the studies highlights the importance of personalizing pain assessment of children and adolescents, taking into account subject-specific characteristics, pathology, and context. ConclusionAn integrative and personalized approach to pain assessment appears to be the most appropriate for enhancing the understanding and detection of pain in individuals with autism spectrum disorders. This approach aligns well with a care setting where a nominated professional with a good expertise in autism is responsible for pain assessment. Given the complexity of identifying pain in individuals with autism, further qualitative studies, in conjunction with new pain exploration technologies, are considered necessary as well as a more extensive categorization of the population studies.

Savižudiškų minčių intensyvumo skalė (SIDAS) ir Savižudiško elgesio klausimynas – patikslintas (SBQ-R): lietuviškų versijų psichometriniai rodikliai

The Suicidal Ideation Attributes Scale (SIDAS) and the Suicidal Behaviors Questionnaire-Revised (SBQ-R) are widely used psychological instruments for assessing people‘s suicidal ideation and suicidal behavior. The aim of this study was to examine the psychometric characteristics of the Lithuanian versions of the SIDAS and SBQ-R. We analysed data collected from four samples: a Lithuanian general population quota sample based on age, gender and place of residence (N = 697, 52.9% women, aged 18–79 years); a sample of students (N = 2013, 72 % women, aged 18–29 years); a clinical sample of suicidal patients (N = 35, 77.1% women, aged 18–59 years); and a test-retest sample of students who completed the instruments twice within a two-week period (N = 54, 70.4% women, aged 18–47 years). The participants answered questions on gender, and age and completed the SIDAS and SBQ-R. The data analysis revealed that the Lithuanian versions of the SIDAS and SBQ-R have good internal consistency, temporal stability, construct, convergent, and criterion validity. The Lithuanian versions of the SIDAS and SBQ-R can be used to measure suicidality in research settings, as well as in clinical work as auxiliary tools.

Assessing the health and economic burden of obesity-related complications in East-Asian populations: implementation of risk equations in the Core Obesity Model for Japan and model validation

ObjectiveObesity is associated with a significant clinical and economic burden and its prevalence has reached epidemic proportions worldwide. An ethnicity-specific impact of excess weight has been demonstrated, with Asian individuals...

COVID-19 vaccine attitudes among mental health professionals in the WHO’s global clinical practice network

Although COVID-19 vaccines have demonstrated efficacy, there is variability in health professionals’ attitudes towards these agents. Factors associated with mental health professionals’ attitudes towards COVID-19 vaccination are not well understood. We investigated these factors by administering a newly developed measure, the COVID-19 Vaccine Attitudes Questionnaire (C-VAQ), to members of the World Health Organization’s Global Clinical Practice Network (GCPN) of mental health professionals. 1,931 GCPN members representing all world regions participated between July 28 and September 7, 2021. Mental health professionals’ attitudes towards COVID-19 vaccination were assessed in one of five languages (Chinese, English, French, Japanese, Russian, or Spanish) using the C-VAQ. Internal consistency, factor structure, and predictive validity of the C-VAQ were examined, and a multiple-linear regression model was employed to assess C-VAQ score predictors, including sociodemographic variables (age, gender, WHO region, country income level, profession, and years of professional experience) as well as country mortality rate and the stringency of each country’s response to COVID-19. The C-VAQ demonstrated good internal consistency and external validity. Items loaded on to a single factor. Having received a COVID-19 vaccine, higher country mortality rate, and higher stringency index was significantly associated with more positive vaccine attitudes. Lower age, residing in a low-and-middle income country, and living in Asia were all was significantly associated with less positive vaccine attitudes. The C-VAQ scores were negatively correlated with the number of concerns about the COVID-19 vaccination. The C-VAQ was useful in demonstrating the extent to which additional work is needed to improve mental health professionals’ attitudes towards COVID-19 vaccines globally. Relatively poorer attitudes toward vaccination among some mental health clinicians around the world suggests the need for broad, multi-pronged interventions.

Validation of screening instruments for common mental disorders and suicide risk in south African primary care settings

IntroductionIn South Africa, there is limited mental health infrastructure and resources. Valid screening tools are needed to facilitate identification and linkage to care. We evaluated the performance of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Primary Care Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5), and the Columbia Suicide Severity Rating Scale (C-SSRS) among adults in South Africa against a diagnostic gold standard. MethodsAdults present at healthcare facilities were screened with the PHQ-9, GAD-7, PC-PTSD-5, and the C-SSRS. Nurses used a structured diagnostic interview to identify depression, anxiety, panic disorder, PTSD and elevated suicide risk. We assessed the internal consistency, criterion validity, and the sensitivity and specificity of these tools. ResultsOf the 1885 participants, the prevalence of common mental disorders and suicide risk was 24.4 % and 14.9 %, respectively. The PHQ-9, GAD-7, and PC-PTSD-5 showed good internal consistency (0.80–0.89). All screeners demonstrated good criterion validity. For depression, a cut-off of ≥5 on the PHQ-9 yielded sensitivity of 84.24 %, while ≥10 yielded sensitivity of 48.77 %. For anxiety, the GAD-7 performed similarly. A cut-off of ≥4 on the PC-PTSD yielded sensitivity of 61.96 %. The C-SSRS yielded lower sensitivity than expected. LimitationsThe prevalence data is not generalizable to the larger South African adult population given the use of a targeted, healthcare facility-based sampling and recruitment strategy. ConclusionsThe performance of the PHQ-9, GAD-7, and PC-PTSD-5 demonstrated good internal consistency and criterion validity, though sensitivity and specificity trade-offs were enhanced with lower cut-offs. Further research into suicide risk screening is warranted.

Mental Illness in Refugee and Immigrant Women: A Midwife's Perspective on Culturally Competent Care

The assessment, diagnosis and referral for mental illness management have been recognized as indispensable roles within midwifery practice both in the United States and in Canada. War, civil unrest and natural disasters, have made mental health assessment crucial for refugee and new immigrant women who present as midwifery clients. Since 1991, National Depression Screening Day (NDSD) had been conducted in cities across the United States and Canada using the Harvard Department of Psychiatry National Depression Screening Day Scale (HANDS©). It facilitates the diagnosis of depression based on DSM-IV criteria. The HANDS© tool includes a 10-item interview guide which is a “self-report scale”. HANDS© demonstrated good internal consistency and validity and was 95 percent sensitive.33 Responses could indicate the need for thyroid screening, referral for mental health counselling or psychiatric care. Strategies for transforming midwifery practice are explored: taking a holistic approach, communication strategies, continuing education strategies, documentation and empowerment issues, multidisciplinary team approach, clinic environment issues, resources and referral base. As we develop expertise in the care of torture and trauma survivors, it behooves us to identify the experts amongst our ranks and to refer our clients to these midwives who will best meet their needs. Further research is needed to guide our incorporation of the skills for treating survivors in our educational programs for the midwives of the future.

The Validation of the Japanese Version of the Scoliosis Research Society-30 Questionnaire for Adolescent Idiopathic Scoliosis Patients.

The Scoliosis Research Society-30 (SRS-30) is a questionnaire originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprised questions on five domains: function, pain, self-image, mental health, and satisfaction, with seven additional questions related to postoperative aspects. In addition to the original English version, translations in multiple languages have been effectively applied. Herein, we evaluated the internal consistency and external validity of the Japanese version of the SRS-30 for AIS patients. Among the 30 questions in SRS-30, the eight additional questions from SRS-22r were translated and back-translated to create a Japanese version of the SRS-30. This translated questionnaire was then used to survey patients with AIS who underwent corrective fusion surgery one year postoperatively. The internal consistency of the responses was evaluated using the Cronbach α coefficient. Additionally, the Spearman correlation analyses were conducted to assess the correlation between the scores obtained from the SRS-30 Japanese version and SRS-22r and the Oswestry Disability Index (ODI) for the overall scale and the five domains. A total of 81 cases (eight males and 73 females; mean age at surgery 14.4 years) were enrolled. The mean preoperative Cobb angle was 51.0°. The Cronbach α coefficient for the overall SRS-30 was 0.861, indicating high internal consistency, while the coefficients for each domain were as follows: function/activity, 0.697; pain, 0.405; self-image/appearance, 0.776; mental health, 0.845; and satisfaction, 0.559. The SRS-30 total score significantly correlated with the SRS-22r total (r=0.945, P<0.001) and the ODI (r=-0.511, P<0.001). The SRS-30 domains highly correlated with the corresponding SRS-22r domains, with correlations ranging from r=0.826 to 0.901 (all P<0.001). The Japanese version of the SRS-30 demonstrated good internal and external validity. The SRS-30 can be used as an assessment tool for health-related quality of life in AIS patients.

The development and validation of the food insecurity physical activity concerns scale

Food insecurity – defined as having limited access to nutritious foods – is linked with obesity. Previous research has also shown that food insecurity is associated with lower levels of leisure-time physical activity (physical activity performed outside of essential activities). This association may occur in part due to concerns about preserving levels of energy during times of food shortage. Currently, no scale exists which measures this construct. Therefore, we aimed to develop and validate such a scale – the food insecurity physical activity concerns scale (FIPACS). Participants (N = 603, individuals with food insecurity = 108) completed an online survey, consisting of the FIPACS, the International Physical Activity Questionnaire short-form (IPAQ), the restraint subscale of the Dutch Eating Behaviour Questionnaire (DEBQ), the amotivation subscale of the Behaviour Regulation In Exercise Questionnaire-2 (BREQ-2), and the Behavioural Inhibition System/Behavioural Approach System Reactivity scale (BIS/BAS) to assess convergent and divergent validity. An exploratory factor analysis revealed a four-factor model of the FIPACS - namely ‘Concerns relating to hunger’, ‘Concerns of replenishment and calories’, ‘Concerns of physiological effects of exercise’ and ‘Compensatory behaviours’ which was verified through a confirmatory factor analysis. To assess test-retest reliability, 100 participants completed the FIPACS again two weeks later. The FIPACS had good internal, test-retest reliability and divergent validity. However, there was limited evidence of convergent validity. Future studies could incorporate this scale when investigating the association between food insecurity and physical activity.

Measurement of perceived pressures in psychiatry: paper-and-pencil and computerized adaptive version of the P-PSY35 scale

PurposeFormal coercion in psychiatry is widely studied yet much less is known about pressures patients may experience, partly because of the very few measures available. The goal of this study was to validate the P-PSY35 (Pressures in Psychiatry Scale) and provide a paper-and-pencil and a computerised adaptive test (CAT) to measure pressures experienced by patients in psychiatry.MethodsThe P-PSY35 items were developed with users. Patients were evaluated during psychiatric hospitalisation or through an online survey. Mokken scale analysis and Item response theory (IRT) were used to select and estimate the items parameters. A Monte-Carlo simulation was performed to evaluate the number of items needed to transform the paper-and-pencil test into a reliable psychometric CAT.ResultsA total of 274 patients were assessed. The P-PSY35 demonstrated good internal validity, internal consistency, convergent and divergent validity. The P-PSY35 could be substantially shortened while maintaining excellent reliability using the CAT procedure.ConclusionThe P-PSY35 was developed in collaboration with users. It is a psychometrically rigorous tool designed to measure experienced pressures in French-language. The development and successful validation of the P-PSY35 represent a welcome step towards implementing and evaluating programs aimed at reducing negative consequences of coercion.