Kuder-Richardson Coefficient Research Articles

Validation of the Spanish Version of the Nurses' Global Assessment of Suicide Risk Scale (NGAR) in Nonclinical Settings.

To validate the Nurses' Global Assessment of Suicide Risk (NGASR) in Spanish for an early detection identification of the risk of suicide. A descriptive cross-sectional survey design was used for this work through face-to-face clinical interviews with each participant. Following EQUATOR TRIPOD checklist, the index was translated and administered to a sample of 30 mental health experts and 151 university students. To examine the psychometric properties of the NGASR, the questionnaires also included other standardised scales such as BDI, SBQ and SEEQ. The research was conducted between 2022 and 2023. The content validity index-scale (CVI-S) was 81% and the NGASR presented high reliability with a Kuder-Richardson coefficient of 0.83. Exploratory factor analysis (EFA) returned a six-factor structure for the NGASR items. The results showed that 21.7% of the students assessed had an intermediate to very high suicide risk. This study also revealed that people with mental health problems and depression had a higher risk of suicide. Beyond the sociolinguistic Spanish validation of the scale, it should be noted that it is carried out on a young population in a nonclinical environment, something that many authors have been requesting in their previous validations. The NGASR is a useful prevention tool in university educational settings.

Examining the relationship between health literacy and pesticide protective behaviors among farmers in Thailand

Background The use of chemical pesticides without proper health literacy (HL) and necessary pesticide protective behaviors (PPB) can result in adverse effects on human health. Methods This study aims to determine if there is a correlation between HL and PPB among farmers in the Nakhon Ratchasima province, using a random sample of 464 farmers. Structured interviews consisted of three parts: 1. General information, 2. Health literacy (including knowledge, understanding, and other sub-aspects), and 3. Protective behaviors against chemical exposure. Each part of the questionnaire had a reliability index of 0.60 or higher. The reliability of the 2nd and 3rd parts of the questionnaire were as follows: sub-sections of part 2 had a Kuder-Richardson (KR-20) coefficient of 0.79 and Cronbach’s alpha (α) coefficient of 0.85-0.86, while part 3 had an α of 0.88. Risk of chemical exposure was assessed using a Cholinesterase Reactive Paper test administered by a finger-prick blood test. Data was analyzed using the Spearman correlation and binary logistic regression. The study was reviewed by the Human Research Ethics Committee with the approval date: August 9, 2021, and expiry date: August 9, 2022. Results Most participants had moderate levels of overall HL (48.8%) and PPB (44.6%). There was a statistically significant positive correlation between HL and PPB (rs(478) = 0.70, p<.005). Logistic regression analysis demonstrated that HL had a statistically significant positive association with PPB (p<.001, OR = 6.57, 95% CI 3.95, 10.94) and was associated with blood cholinesterase levels. Conclusions These findings highlight the need for increased health literacy among farmers in Thailand to ensure correct protective behaviors against chemical exposure and reduce the adverse effects of pesticide exposure on human health.

Digital Teaching Competence and Foreign Language Learning in Students of a National University in Lima

The research shows the relationship between digital teaching competence and foreign language learning in students at a national university from Lima. It is a non-experimental descriptive study with a cross-sectional correlational design, applied to a sample of 151 students from Enrique Guzmán y Valle National University of Education. To collect data for the first variable, it was built a questionnaire with the response parameters of the Likert scale. Based on the Cronbach's Alpha test, this instrument reached a reliability index of 0,780. For the second variable, a test was applied and the reliability level was measured through the Kuder-Richardson coefficient, showing an index of 0,865, so it is inferred that these instruments had a high level of reliability. About the general hypothesis, Spearman's correlation coefficient was 0,705, a high positive correlation. The investigation result allows to confirm that there is a direct and significant association between teaching digital competence and foreign language learning, that is, the higher the level of teaching digital competence, the better the learning achievements of the students.

Development of a scale for measuring psychosocial vulnerability in disaster-prone areas

IntroductionDisaster vulnerability is a complex concept influenced by both natural forces and societal factors, including psychosocial aspects that shape an individual's resilience to natural hazards. Despite technological advancements, assessing psychosocial vulnerability remains challenging, necessitating specialized scales. This study attempted to develop a psychosocial vulnerability assessment scale, recognizing the intricate interplay of physical, psychological, and social factors. MethodsThe study was conducted in two disaster-prone wards in Cuttack, India, susceptible to cyclones, earthquakes, and floods. The scale development process involved two stages: instrument design and judgmental evidence. During the instrument design phase, qualitative data on psychosocial vulnerabilities were gathered through Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). These insights led to the generation of 44 items, which were subsequently refined to 35 items through expert consultation. The judgmental evidence phase included content validity assessment, internal consistency analysis, and test-retest reliability estimation. Exploratory Factor Analysis (EFA) identified the instrument's factor structure, with items retaining factor loadings exceeding 0.4. Data collection involved 400 individuals selected through multistage sampling, with strict adherence to ethical considerations. ResultData collected in the initial instrument design stage revealed key psychosocial vulnerability themes. These themes informed the creation of a 35-item scale categorized into three domains: Physical, social, and psychological vulnerability. The instrument underwent rigorous validation processes, demonstrating strong content validity agreement among experts. Internal consistency analysis revealed good reliability, as indicated by the Kuder-Richardson coefficient (KR20 = 0.904). Test-retest reliability further established the stability of responses over time, with an ICC of 0.82. EFA confirmed the scale's three-factor structure, explaining 60 % of the variance. After removing three items with low factor loadings, the scale proved reliable and valid, effectively categorizing vulnerabilities into these distinct domains. ConclusionThe scale developed in this study offers a comprehensive tool for understanding the unique challenges people living in disaster-prone areas face. It addresses the often-overlooked psychosocial components of vulnerability, filling a critical gap in existing research and measurement scales. Its application helps in planning psychosocial interventions and improving disaster risk reduction strategies.

Psychometric properties of persian version of the cardiff fertility knowledge scale (CFKS–P)

BackgroundThe level of fertility knowledge of reproductive-age people is low to moderate, and the inadequate knowledge of infertility-related factors may cause some people to unconsciously engage in activities that reduce their fertility. Given the significance of fertility knowledge, and the lack of standard instruments to evaluate it in Iran, the present study aimed at determining psychometric properties of the Persian version of the Cardiff Fertility Knowledge Scale (CFKS–P) in Iranian population. Materials and methodsIn this cross-sectional study, a total of 280 participants (comprising 140 couples) attending mandatory pre-marriage educational sessions at two public health centers in Tehran were consecutively sampled from July to September 2021. The study examined the face, content, and structural validity (through confirmatory factor analysis) of the questionnaire. The reliability of the questionnaire was assessed using measures of internal consistency. ResultsThe structural validity of CFKS-P was approved with 13 items and two factors (basic knowledge of fertility and misconception about fertility) based on confirmatory factor analysis (RMSEA = 0.023, 90 % CI = 0.053–0.082, TLI = 0.916 and CFI = 0.972, χ 2 = 148.345). Kuder–Richardson coefficient of the scale was calculated to be 0.85. The overall percentage of correct answers for fertility knowledge was 50.76 %. ConclusionThe CFKS-P is a valid and reliable instrument for measuring the fertility knowledge in Iranian men and women. This scale can help the health care providers to assess the fertility knowledge of their clients or the quality of health education provided.

Cross-cultural adaptation and psychometric evaluation of the social frailty scale in Iranian older adults

BackgroundSocial frailty is a holistic concept encompassing various social determinants of health. Considering its importance and impact on health-related outcomes in older adults, the present study was conducted to cross-culturally adapt and psychometrically evaluate the Social Frailty Scale in Iranian older adults in 2023.MethodsThis was a methodological study. The translation and cross-cultural adaptation of the Social Frailty Scale 8-item (SFS-8) was conducted according to Wild’s guideline. Content and face validity were assessed using qualitative and quantitative methods. Then, 250 older adults covered by comprehensive health centers were selected using multistage random sampling. Participants completed the demographic questionnaire, the Abbreviated Mental Test score, the SFS-8, and the Lubben Social Network Scale. Construct validity was assessed by principal component analysis (PCA) and known-group comparisons. The Mann‒Whitney U test was used to compare social frailty scores between the isolated and non-isolated older adults. Internal consistency, equivalence, and stability were assessed using the Kuder-Richardson method, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the minimum detectable change (MDC). The ceiling and floor effects were also assessed. The data were analyzed using JASP 0.17.3.ResultsThe ratio and index of content validity and the modified kappa coefficient of all the items were 1.00. The impact score of the items was greater than 4.6. PCA identified the scale as a single component by removing two questions that could explain 52.9% of the total variance in the scale score. The Persian version of the Social Frailty Scale could distinguish between isolated and non-isolated older adults (p < 0.001). The Kuder–Richardson coefficient, ICC, SEM, and MDC were 0.606, 0.904, 0.129, and 0.358, respectively. The relative frequencies of the minimum and maximum scores obtained from the scale were 34.8 and 1.2, respectively.ConclusionsThe Persian version of the Social Frailty Scale (P-SFS) can be used as a valid and reliable scale to assess social frailty in Iranian older adults.

Development and psychometric evaluation of a questionnaire for assessment of exposure to chemical hazards in operating room nurses

BackgroundOccupational hazards are a significant cause of death in the world. Healthcare workers are highly exposed to a variety of physical, chemical, biological, ergonomic and psychological risks. Chemical hazards are one of the threatening factors for operating room nurses and cause many complications for their health. ObjectivesThe present study aimed at developing the psychometric properties of a questionnaire for evaluation of exposure to chemical hazards in operating room nurses. MethodsThe present methodological study was performed in two stages: first, the items of the questionnaire were developed based on the findings of a qualitative study and a literature review; and second, the psychometric properties of the questionnaire were measured using the methods to evaluate face, content, and construct validities. To assess construct validity of the questionnaire, the researchers measured divergent validity. The reliability was measured through an assessment of the internal homogeneity and consistency of the questionnaire. ResultsIn the first stage of the study, 35 items were developed according to the results of a qualitative study, review of relevant literature and several meetings with experts. The content validity ratio (CVR) of all the items was greater than 0.49. The content validity index (CVI) of all the items was over 0.79. The average CVI (S-CVI/Ave) of the questionnaire with 13 items was 0.98. Kuder-Richardson coefficient for the internal homogeneity of the instrument was found to be 0.70 and the results of the test–retest showed its consistency to be 0.88. ConclusionsThe results of the current study showed that the present questionnaire is sufficiently valid and reliable to evaluate the exposure to chemical hazards in operating room nurses.

Development and validation of the Adult cirrhosiS Knowledge Questionnaire.

Assessing a patient's knowledge regarding liver cirrhosis is important to improve patient outcomes. This study aimed to develop and validate the Adult cirrhosiS Knowledge Questionnaire (ASK-Q) to assess patients' knowledge regarding liver cirrhosis from multiple aspects. A 24-item ASK-Q with four domains: self-understanding (5 items), aetiology (5 items), complications (5 items) and management (9 items) of liver cirrhosis was developed based on literature review and expert panel input. It was then piloted in five English-speaking patients with liver cirrhosis. These patients commented that the font size was too small. Hence, the font was enlarged and the final version of the ASK-Q was administered to English-speaking patients with liver cirrhosis, aged ≥18 years, with or without decompensation, at a tertiary hospital, from September 2020 to November 2021, at baseline and fortnight later. Patients with encephalopathy were excluded. 120/135 patients agreed to participate (response rate = 88.9%). The overall median score was 59.1 (45.6-68.2). A total of 7/22 (31.8%) items were "easy", 14/22 (63.6%) items were "moderately easy" and 1/22 (4.5%) items were "difficult". Exploratory factor analysis extracted nine factors, and two items were omitted. The ASK-Q was able to discriminate the knowledge level of patients with and without tertiary education [59.1 (50.0-72.7) vs. 54.5 (36.4-63.6); P < 0.05]. The overall Kuder-Richardson coefficient was 0.760, indicating adequate internal consistency. At retest, 77/120 patients participated (response rate = 64.2%) and 15/22 items were not statistically significant, indicating adequate reliability. The ASK-Q was found to be a valid and reliable questionnaire for evaluating the knowledge of liver cirrhosis among English-speaking adult patients.

Real-Life Testing of the Prescription Opioid Misuse Index in French Primary Care.

Analgesic opioid (AO) misuse by patients ranges from 0% to 50%. General practitioners are the first prescribers of AO. Our objective was to validate the Prescription Opioid Misuse Index (POMI) in primary care. We conducted a psychometric study in patients with chronic pain who had been taking AOs for at least 3 months and were followed in general practice. Patients responded to the POMI at inclusion and after 2 weeks. The reference used was the DSM-V. Sixty-nine GPs included 160 patients (87 women, 54.4%), mean age 56.4 ± 15.2 years. The total POMI score was 1.50 ± 1.27, and 73/160 (45.6.0%) had a score ≥ 2 (misuse threshold). Internal validity was measured with the Kuder-Richardson coefficient, which was 0.44. Correlations between each item and the total score ranged from 0.06 to 0.35. Test-retest reliability was determined from 145 patients: Lin's concordance coefficient was 0.57 [0.46, 0.68]. Correlation with the DSM-V (Spearman's coefficient) was 0.52. The POMI does not have sufficient psychometric properties to be recommended as a tool to identify the misuse of AOs in primary care. This study clearly showed that there is a need to create a monitoring tool specific to primary care.

Adaptación y validación de un instrumento de evaluación de la competencia del consejo breve para dejar de fumar. BTI-Prof©

ObjectiveAdaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. DesignCross-sectional study of adaptation and psychometric validation of a criterion-referenced test. SettingPrimary Health Care. ParticipantsOne hundred fifty-five general practitioners and nurses working at Primary Health Care. InterventionsThree clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. Main measuresCompetence in brief tobacco intervention measured by the BTI-Prof©. ResultsResults related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test–retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734–0.923), p<0.0001, for scenario 2 0.829 (95% CI 0.676–0.909), p<0.001, and for scenario 3 0.869 (95% CI 0.76–0.928), p<0.0001. ConclusionsThe BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.

Psychometric Properties of the MacArthur-Bates Communicative Development Inventories-III (CDI-III) in 30 to 37 Months Old Persian-Speaking Children

Objective Early language skills predict the child’s future language skills and literacy. So, screening and assessment of speech and language at an early age are important. One cost-effective way of assessing a child’s communication is through parents reporting tools. MacArthur-Bates Communicative Development Inventories (CDIs) are the most widely used forms by professionals in more than 70 live languages worldwide to screen children’s communication skills. The main purpose of this study was to provide the Persian version of the third form of CDI (CDI-III) and determine its psychometric properties, including face and content validity and internal consistency in 30 to 37 months old Iranian Persian-speaking children. Materials &amp; Methods In a cross-sectional methodological study of instrument validation, a Persian-adapted form of CDI-III was developed. At first, the English form was adapted to Persian, and a Delphi method was used to provide the initial list of the items. The face and content validity rates were examined by asking the opinion of ten Persian-speaking speech and language pathologists with at least three years of clinical experience in the field of child speech/language development and disorders. The final form was compiled based on the results of the content validity ratio (CVR) and content validity index (CVI) of the items. The final form consisted of three sections, including vocabulary, sentences, and use of sentences. The parents of 356 Persian-speaking children aged 30 to 37 months recruited by multi-stage cluster random sampling from health centers in Isfahan City were asked to complete the form. The Kuder-Richardson coefficient assessed internal consistency, and the Spearman coefficient examined correlation. Results The items with CVIs≥0.7 and CVRs≥0.6 remained, and other items were reviewed or removed based on the suggestions of panelists and developers. The final form included 100 words, 22 pairs of sentences, and 16 questions about using sentences. A total of 356 children (mean±SD age: 34.03±2.12 months) were included in the study. According to the English CDI-III guidelines, the data were divided into four age groups with two-month intervals: 30-31, 32-33, 34-35, and 36-37. The internal consistency of the whole form was 0.97, and internal consistency values of vocabulary, sentences, and sentence usage were calculated as 0.98, 0.88, and 0.88, respectively. The Spearman correlation values between the scores of the form sections and each section with age indicated a significant positive correlation between all sections of the form. Also, the significant positive correlation between age and all three parts showed that the number of expressive words, the grammatical complexity of sentences, and the proper use of sentences increase with age. Conclusion The Persian CDI-III form possesses a good face and content validity and internal consistency to be used as a valid tool for screening language competence of 30-37 months old Persian-speaking children. The results of the mean and standard deviation of the current study can be used as a comparison for screening children suspected of being language deficient.

Validity and reliability of the Spanish version of the ACE tool for assessing competencies in evidence-based medicine in medical students

ObjectiveTo translate and culturally adapt the tool ‘Assessing Competency in evidence-based medicine (EBM)’ (ACE) to Spanish and to implement it in a cohort of medical students for the evaluation of...

Development and Validation of a Self-Administered Questionnaire Measuring Essential Knowledge in Patients With Axial Spondyloarthritis.

To develop and validate a patient knowledge questionnaire regarding axial spondyloarthritis (axSpA). Knowledge considered essential for patients with axSpA was identified through Delphi rounds among rheumatologists, healthcare professionals (HCPs), and patients, then reformulated to develop the knowledge questionnaire. Cross-sectional validation was performed in 14 rheumatology departments to assess internal validity (Kuder-Richardson coefficient), external validity, acceptability, reproducibility (Lin concordance correlation coefficient), and sensitivity to change (knowledge score before vs after patient education sessions and effect size). The Spondyloarthritis Knowledge Questionnaire (SPAKE) is a self-administered 42-item questionnaire with a 32-item short form, both scored 0 to 100, assessing knowledge of disease, comorbidities, pharmacological treatments, nonpharmacological treatments, self-care, and adaptive skills. In the validation study (130 patients; 67 [51.5%] male, mean age 43.5 [SD 12.9] yrs), the mean (SD) score of the long-form questionnaire was 71.6 (15.4), with higher scores (better knowledge) in nonpharmacological treatments and adaptive skills and lower scores in cardiovascular comorbidity and pharmacological treatments. Acceptability was good, with no missing data; the internal validity coefficient was 0.85. Reproducibility was good (0.81, 95% CI 0.72-0.89). SPAKE showed good sensitivity to change; scores were 69.2 (15.3) then 82.7 (14.0) after patient education sessions (Hedges effect size = 0.92, 95% CI 0.52-1.31). SPAKE is a knowledge questionnaire for patients with axSpA, developed with the involvement of HCPs and patients and reflecting current recommendations for the management of axSpA. SPAKE will be useful in assessing knowledge acquisition and self-management strategies in routine care and research.

Psychometric Evaluation of the Persian Version of the Self-rated Fall Risk Questionnaire for Iranian Older Adults

Background and Objectives Identification of the risk factors for falls to prevent the risk of fall and reduce the related costs in older adults is necessary. This study aims to translate and determine the validity and reliability of the Persian version of the self-rated fall risk questionnaire (FRQ) for Iranian older adults. Methods In this methodological study, participants were 60 older people who were selected from the Retirement Center in Qom, Iran in 2021 using a convenience sampling method. For translation, the backward/forward technique was used. Then, content validity, face validity, and construct validity were evaluated. To evaluate the construct validity, the known-groups validity (comparsion of groups with and without a history of fall), convergent and divergent validity were used. Reliability was determined by assessing internal consistency. Results The results of known-groups comparison showed that the mean score of FRQ in older people with a history of fall was higher than in older people without a history of fall. The significant correlation of the score of FRQ with the scores of timed up &amp; go test (r= 0.428, P&lt;0.001), and 30-second chair stand test (r=-0.333, P&lt;0.01) confirmed the convergent and divergent validity, respectively. The Kuder-Richardson coefficient (0.624) confirmed the internal consistency of the Persian FRQ. Conclusion The Persian version of the self-rated FRQ has satisfactory psychometric properties. It can be used to measure the risk factors of fall in fall prevention interventions for Iranian older adults.

Psychometric Evaluation of Self-assessment Persian Version of the Alzheimer Questionnaire (AQ).

Mild cognitive impairment (MCI) is a primary disorder intensified by aging. Rapid diagnosis of MCI can prevent its progression towards the development of dementia. Thus, the present study was conducted to evaluate the psychometric features of the self-assessment Persian version of the Alzheimer questionnaire (AQ) in the elderly to detect MCI. First, the AQ was translated into the Persian language; then, its content validity was evaluated by the content validity index (CVI) and content validity ratio (CVR) method, and face validity was determined by two checklists for expert panel and the elderly. The convergent validity of the self-assessment AQ with the Montreal cognitive assessment (MoCA) was assessed using the Pearson correlation. The test-retest and internal consistency reliability were evaluated using intra-class correlation (ICC) and Kuder-Richardson coefficients, respectively. Moreover, the receiver operating characteristic curve was used to determine the optimal cut-off point of self-assessment AQ. Among 148 older people who took part in this study, 93 met our inclusion criteria (aged 60 years old or older, had reading and writing skills, and were able to speak and communicate). A translated version of the questionnaire was named "M-check." The developed test showed good content and face validity. Statistically significant correlations were found between M-check and MoCA (r=-0.83, P<0.05). The Kuder-Richardson and ICC coefficients were obtained as 0.84 and 0.92, respectively. Area under the curve presented satisfactory values (Area under curve [AUC]=0.852, sensitivity=0.62, specificity=0.94). The M-check can be used as a valid and reliable instrument for assessing cognitive state and screening MCI in older adults. All questions achieved desired face validity.The convergent validity of Alzheimer Questioner (AQ) was confirmed with high correlation.The AQ is statistically significant with Montreal Cognitive Assessment (MoCA).The AQ had acceptable stability, repeatability, and reliability.All findings demonstrated that the M-Check had high values in predicting MCI in the early stages. Mild cognitive impairment (MCI) is a subset of mental disorders that is an early condition that may lead to dementia. People with MCI are usually prone to forgetfulness in a short time. If MCI is not detected in the early stages, it can progress to dementia or Alzheimer's to higher degrees. On the other hand, cognitive decline and MCI can cause major problems for patients and their families. So it is essential to act out as soon as possible. It is considered that a tool for the early identification of MCI that is self-assessed by individuals, without the presence of an expert and trained person to interpret the results, was not observed in Iran. Thus, the present study was conducted to evaluate the psychometric features of the self-assessment Persian version of the Alzheimer questionnaire (AQ) in the elderly. The results showed that the AQ is a simple one that can be quickly completed by any person at home or by family members of the elderly so that people can refer to the relevant specialist more soon if needed.

Cross-cultural adaptation and validation of the French version of the Spinal Cord Injury Pain Instrument (SCIPI).

Cross-sectional. To assess the reliability and validity of the French version of the Spinal Cord Injury Pain Instrument (SCIPI) and to determine its performance versus "Douleur Neuropathique 4 questions" (DN4) in diagnosing neuropathic pain (NeuP). Clinique romande de réadaptation, spinal cord injury (SCI) center in the French-speaking part of Switzerland. Backward and forward translation in French of the 4-itemSCIPI were performed by native speakers in both languages. Thirty persons with SCI were included in the validation study. Internal consistency was measured with the Kuder-Richardson (KR-20) coefficient. Cohen's kappa coefficients were used to assess the test-retest reliability and the agreement between SCIPI and DN4. Clinical assessment was used as the reference standard to diagnose NeuP. The area under the receiver operator characteristics curve (AUROC) was used to assess the performance of diagnostic tests. KR-20 coefficient of internal consistency was 0.50 (95% CI 0.26, 0.74). Test-retest reliability coefficient was 0.86 (95% CI 0.76, 0.95). The best cutoff value was 2 points, resulting a sensitivity of 88% (95% CI 69%, 98%) and a specificity of 92% (95% CI 75%, 99%). SCIPI had an AUROC of 0.90 (95% CI 0.82, 0.98), which was not significantly lower than the AUROC for DN4, 0.92 (95% CI 0.85, 0.99, p = 0.56). Agreement between SCIPI and DN4 was of 0.88 (95% CI 0.77, 1.00). The French version of the SCIPI is a reliable and valid tool that can identify the presence of NeuP in an individual with SCI.

Type 2 Diabetes Health Literacy Assessment Tool: Translation and Psychometric Evaluation of the Iranian Version

BackgroundAdequate health literacy can lead to self-care behaviors among patients with type 2 diabetes (T2D). Although there is an instrument for measuring the health literacy of patients with diabetes, there is no Persian version of the instrument in Iran.ObjectivesThe aim of this study was to translate the Chinese Health Literacy Scale for Diabetes (CHLSD) and evaluate the psychometric parameters of the Iranian version.MethodsIn this methodological study, using a standard forward-backward translation procedure, the original English language version of the questionnaire was translated into Persian. Face and content validity steps were performed for psychometric measurements. To perform construct (convergent) validity, a cross-sectional study was carried out with the participation of T2D patients admitted to the diabetes clinic (aged over 25 years old). To test the reliability, internal consistency was assessed by Kuder-Richardson (K-R) coefficient, and a test-retest was performed by Spearman correlation coefficient.ResultsA total of 283 patients with T2D (mean age: 52.4 years and standard deviation: 11.5) were included in the study. The factor loadings of the variables were checked by calculating the correlation value of the characteristics of a construct with that construct, whose value was greater than 0.4. The K-R coefficients for the whole instrument and its four subscales (remembering, application, analysis, and comprehension) were 0.8, 0.71, 0.73, 0.87, and 0.89, respectively. Re-testing of the instrument with an interval of two weeks indicated the acceptable stability of the instrument (ICC ≥ 0.8).ConclusionsOur findings showed that the Iranian version of CHLSD is a valid and reliable instrument for measuring the health literacy in patients with diabetes.

Development and validation of a self-administered questionnaire measuring essential knowledge in patients with rheumatoid arthritis

To develop and validate a questionnaire assessing patient knowledge in rheumatoid arthritis (RA). Knowledge considered essential for patients with RA was identified through a series of Delphi rounds among rheumatologists, health professionals (HPs), patients, and then reformulated to construct the knowledge questionnaire. Cross-sectional multicenter validation was performed in 12 rheumatology departments to assess internal validity (Kuder–Richardson coefficient), external validity, acceptability, reproducibility (Lin’s concordance correlation coefficient) and sensitivity to change (difference in total score before and after patient education sessions). Associations between patient variables and knowledge levels were evaluated. RAKE (RA Knowledge questionnairE) is a self-administered 45-item questionnaire scored 0–100, with a 32-item short-form survey assessing knowledge of disease, comorbidity, pharmacological treatments, non-pharmacological treatments, self-care and adaptative skills. Of 130 patients included in the validation study, 108 were women. Acceptability was good with < 5% missing data. Internal validity coefficient was 0.90. Mean (standard deviation) long-form score was 72.8 ± 17.8, with lower scores in comorbidity and self-care and higher scores in adaptive skills. Reproducibility was good (0.86 [0.80; 0.92]). RAKE score was positively correlated with the patients’ level of education and the HPs’ opinion on the patients’ knowledge. RAKE score showed good sensitivity to change: 66.8 ± 16.4 then 83.8 ± 12.7, representing a hedges effect size of 1.14 [95% CI 0.73; 1.55]. RAKE is an updated questionnaire assessing essential knowledge for patients with RA to enhance self-management according to current guidelines and the patients’ perspective. RAKE can usefully inform patient education interventions, routine care and research.

The Naming Assessment in Multicultural Europe (NAME): Development and Validation in a Multicultural Memory Clinic.

Traditional naming tests are unsuitable to assess naming impairment in diverse populations, given the influence of culture, language, and education on naming performance. Our goal was therefore to develop and validate a new test to assess naming impairment in diverse populations: the Naming Assessment in Multicultural Europe (NAME). We carried out a multistage pilot study. First, we generated a list of 149 potentially suitable items - e.g. from published cross-linguistic word lists and other naming tests - and selected those with a homogeneous age of acquisition and word frequency across languages. We selected three to four colored photographs for each of the 73 remaining items; 194 controls selected the most suitable photographs. Thirteen items were removed after a pilot study in 15 diverse healthy controls. The final 60-item test was validated in 39 controls and 137 diverse memory clinic patients with subjective cognitive impairment, neurological/neurodegenerative disease or psychiatric disorders in the Netherlands and Turkey (mean age: 67, SD: 11). Patients were from 15 different countries; the majority completed primary education or less (53%). The NAME showed excellent reliability (Spearman-Brown coefficient: 0.95; Kuder-Richardson coefficient: 0.94) and robust correlations with other language tests (ρ = .35-.73). Patients with AD/mixed dementia obtained lower scores on most (48/60) NAME items, with an area under the curve of 0.88. NAME scores were correlated with age and education, but not with acculturation or sex. The NAME is a promising tool to assess naming impairment in culturally, educationally, and linguistically diverse individuals.

Development of an instrument on psychosocial adaptation for people living in a disaster-prone area

BackgroundAdaptation is a process of adjusting to the current or expected climate change. The varied adverse outcomes enable people towards necessary adaptation. People living in disaster-prone areas go through a relatively higher frequency of emergencies and exigencies. Gradually people learn to cope with stress and over a while, they develop various strategies for adaptation. The ability to rapidly adapt to such changes helps people to better fit in the environment and prepare themselves for future emergencies. There is no instrument available to measure psychosocial adaptation objectively. The current study reports on the development and validation of psychosocial adaptation instrument. MethodsCross-sectional study design was adopted for the study. The study population consisted of people living in high-intensity hazard zones for cyclones, earthquakes, and floods in the Cuttack city of Odisha in India. The development of psychosocial adaptation instrument consisted of two phases. Content validity index, Kappa statistic, and intraclass correlation coefficient (ICC) were measured. Adopting the multistage sampling method a total of 400 participants were selected using the KISH method and were interviewed. Exploratory factor analysis was attempted to assess the factor structure. Further, the performance of items and total scale were analyzed using the item response theory approach. ResultsThe psychosocial adaptation instrument showed excellent validity of individual items (I-CVI range: 0.75 to 1.00) and good Kappa (Kappa range: 0.71 to 1.00). The Kuder-Richardson coefficient for the 50 items was (KR20 = 0.851) suggesting that the items have good internal consistency. The test-retest reliability ICC estimate of single measures was 0.916 (95% CI: 0.796, 0.959). Three items were removed as the discrimination parameters were found to be less than one in the item response theory analysis. ConclusionThe developed instrument is valid and has acceptable test-retest reliability. This instrument could pave a new way of quantifying the psychosocial adaption strategies that are widely used by people living in a disaster-prone area.