IntroductionThe EuroQol five dimensions questionnaire (EQ-5D) is widely used as a health-related quality of life (HRQoL) measure worldwide, but its sensitivity in detecting changes in health status among individuals with chronic obstructive pulmonary disease (COPD) remains suboptimal. Adding additional HRQoL dimensions (bolt-on items) to EQ-5D may enhance its sensitivity to specific diseases while preserving the original EQ-5D descriptive system. This study protocol documents the identification, development, selection and psychometric testing of respiratory-related bolt-on items for assessing COPD in China.Methods and analysisWe will conduct a content review of the COPD disease-specific instruments to identify potential deficiencies in dimensions covered by the EQ-5D. Drawing from the dimensions identified in the content review, we will consult with clinical experts and conduct qualitative interviews with patients to identify and develop candidate bolt-on items that are relevant to COPD. Then, in the quantitative phase, we will assess the psychometric properties of the candidate bolt-on items among patients with COPD in China. Test–retest reliability will be examined using intraclass correlation coefficients for total scores and weighted kappa statistics for item-level agreement. Construct validity will be evaluated through convergent and divergent validity analyses using Spearman’s rank correlations. Known-groups validity will be tested by comparing five-level EQ-5D version (EQ-5D-5L) and EQ-5D-5L plus bolt-on scores across clinically defined subgroups using analysis of variance. The dimensional structure will be explored using exploratory factor analysis with maximum likelihood extraction and Promax rotation. Explanatory power will be assessed through ordinary least-squares regression with EQ visual analogue scale as the dependent variable, supported by Shorrocks–Shapley decomposition to quantify the contribution of each item to the explained variance.DiscussionBased on the EQ-5D, Our study offers a new approach to measuring HRQoL in patients with COPD. Furthermore, it may offer valuable insights and serve as a reference for the development of bolt-on items for other diseases.Ethics and disseminationThis study has received ethical approval from the Ethics Committee of the Centre for Health Management and Policy Research at Shandong University (no. ECSHCMSDU20240301).

Objectives. Assessing psychosocial risks in the workplace is essential for promoting employee well-being and occupational safety. This study validates the psychosocial risk factors scale (INSAT_ERPS), a comprehensive instrument developed to identify and measure diverse psychosocial risks in occupational settings. Methods. A cross-sectional study was conducted between February 2023 and May 2024 with 1739 Portuguese workers from various sectors. Data analysis included descriptive statistics, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Missing data were imputed using the expectation–maximization algorithm. EFA employed maximum likelihood extraction with oblimin rotation and Kaiser normalization, supported by a Bartlett Kaiser–Meyer–Olkin value of 0.961 (p < 0.001). Results. CFA confirmed the seven-factor structure identified in EFA, encompassing 44 items across key dimensions: ‘Work Intensity’, ‘Working Hours’, ‘Autonomy and Initiative’, ‘Social Work Relations’, ‘Employment Relations’, ‘Emotional Demands’, and ‘Work Values’. The model demonstrated strong psychometric properties, with Cronbach's α ranging from 0.851 to 0.917. Factor loadings (0.422–0.911) indicated statistically significant and meaningful contributions to their respective dimensions. Conclusions. Despite minor cross-loadings, the factorial structure was robust, confirming the INSAT_ERPS as a valid and reliable tool for diagnosing and managing psychosocial risks in occupational health.

There is a growing body of evidence on positive outcomes related to refugees' traumatic experiences, such as posttraumatic growth (PTG). However, there is a lack of studies exploring PTG among refugees in transit context, where contextual specifics differ from destination countries, and include threatened safety and prolonged state of alert. Two aims of this study were to assess PTG among refugees in transit and explore the psychometric properties of the Posttraumatic growth inventory used in this context. Two hundred forty-nine refugees residing in transit countries along the Balkan route, 76% men, with an average age of 29.65 years completed PTGI, assessing PTG, Refugee Health Screener-15, assessing psychological vulnerability, and the World Health Organization-Five Well-Being Index, assessing psychological well-being. The results showed a moderate to high presence of PTG among participants. Exploratory factor analysis (maximum likelihood extraction, Promax factor rotation), suggested the retention of three factors, which accounted for 44.88% of the total items variance-changes in self-perception, changes in interpersonal relationships, and changed philosophy of life. To test the predictive power of PTGI for well-being, over and above psychological difficulties, hierarchical linear regression was performed, showing changes in interpersonal relationships and changed philosophy of life significantly added to the prediction of well-being, over and above measures of symptomatology. The study showed that PTG can be developed under highly stressful and uncertain circumstances, demonstrating the potential for positive psychological change among refugees in transit. These findings highlight the need for comprehensive mental health interventions fostering well-being and recovery. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction and Objective: Youth receiving BFST for diabetes experienced improved diabetes self-management, parent-adolescent communication, and HbA1c. The BFST Skills Inventory (BFST-SI) was developed to assess intervention fidelity and family skills. While this measure has been used in numerous intervention studies for youth with diabetes, it has yet to be validated. This study aimed to examine the psychometric properties of the BFST-SI in youth participating in Novel Interventions in Children’s Health Care (NICH), a health equity intervention for youth with diabetes experiencing high social needs, medical risks, and healthcare costs. Methods: Youth participating in NICH at 3 academic medical centers completed the BFST-SI (N=127) and the Diabetes Strengths and Resilience Measure (DSTAR; N=48). The 20 BFST-SI items were examined using exploratory factor analysis with maximum likelihood extraction and direct oblimin rotation. Items with low item-to-total correlations and factor loadings (&amp;lt;0.3) were removed. Results: Youth with complete demographic data had a mean age of 15.4+1.9 years and mean HbA1c of 11.9+2.1%, with 96% on Medicaid. Fifteen items were retained and loaded onto 3 factors. Cronbach’s α was reliable for the total scale (α=.90) and each factor (α=.82-.89), which we labeled Family Problem Solving (6 items), Challenging Family Patterns (4 items), and Family Respect and Collaboration (5 items). BFST-SI total scores were correlated with DSTAR scores (r=.47, p&amp;lt;.01). Conclusion: The BFST-SI is a psychometrically sound measure used to assess BFST-D fidelity and family skill outcomes. This study adds to the extant literature demonstrating that family communication and problem-solving are critical skills for families of youth with diabetes. Screening for BFST skills will help identify families needing additional communication intervention and aid in treatment development and evaluation for youth with diabetes and their families. Disclosure K.A. Torres: None. J. Shapiro: None. F.S. Richey: None. D. Naranjo: Consultant; Sanofi. A. Reed: None. J.C. Wong: Research Support; Abbott, Dexcom, Inc., Tandem Diabetes Care, Inc. M. Gonzales Granados: None. M.E. Hilliard: None. M.A. Harris: None. D.V. Wagner: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust

One’s housing must align with personal competencies/abilities, needs, and preferences to age-in-place. The Dwelling Usability for Equitable Living (DUEL©) Survey was developed to subjectively assess home spaces. Adults (N = 504; aged 40-92) responses to the DUEL© were analyzed using exploratory factor analyses and principal axis factoring with maximum likelihood extraction. DUEL© space-specific subscales demonstrated good-excellent suitability (KMO range = 0.62-0.92) and accounted for 50.4-70.4% of the variance. Reliability ranged from α = 0.66-0.93. Subscales indicated two-three factors (i.e., Perceived In/Effectiveness, Perceived In/Efficiency, and dys/functionality (kitchen)). The DUEL© Survey demonstrates good utility as a measure of home usability and captures multidimensional perceptions of one’s home spaces.

Cross-sectional study. To evaluate the structural validity of the Arabic version of the Oswestry disability index (ODI) in patients with low back pain (LBP). The Arabic ODI is currently used in clinical and research settings to assess disability, but questions remain regarding its structural validity. Adult patients with LBP were recruited from physical therapy departments of two hospitals in Saudi Arabia. Participants completed the Arabic ODI and the numeric pain rating scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the factor structure of the ODI. Maximum likelihood extraction and parallel analysis were used in the EFA, and the goodness-of-fit indices [χ 2 statistics, Tucker-Lewis index (TLI), comparative-fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean residual (SRMR)] were assessed in the CFA to confirm the factor structure. A total of 113 patients (47.8% male, 52.2% female) participated. The EFA identified a unidimensional structure for the Arabic ODI, with one factor explaining 45.8% of the total variance. All items had significant factor loadings, with loadings ranging from 0.48 (sleeping) to 0.84 (sex life and social life). The CFA confirmed this unidimensional structure, yielding good fit indices [χ 2 =49.53, P <0.04; TLI=0.96; CFI=0.97; RMSEA=0.06 (90% CI=0.07-0.10), SRMR=0.04]. All ODI items exhibited significant positive loadings consistent with the expected correlation between the single latent variable (LBP-related disability) and the ODI items. A high error covariance was observed between items related to walking and standing. The Arabic Oswestry disability index demonstrates sufficient structural validity as a unidimensional measure of disability in Arabic-speaking patients with low back pain. These findings support the continued use of the Oswestry disability index for disability assessment in clinical and research settings and support the validity of using one total score representing the single underlying latent construct. Level III.

Previous studies have established that social capital plays a significant role in individual tax-related behaviors, including inclinations toward tax evasion and compliance. This study seeks to extend the understanding of tax morale in Spain using data from the Public Opinion and Fiscal Policy Survey (CIS, Study 3332). We use factor analysis with maximum likelihood extraction and Varimax rotation to identify key social capital variables and tax attitudes. We identify profiles based on their social capital and tax compliance using cluster analysis. We will apply hierarchical clustering with Ward's chaining and k-means clustering. The robustness of the resulting profiles will be confirmed by discriminant analysis and a multilayer perceptron neural network, which will look for higher rates of correct classification as an indicator of improved profile consistency. Our findings suggest that identifying Spanish tax citizens' profiles helps analyze social capital in tax policy. After our analysis, we have determined that enhancing the accumulation of social capital variables leads to better tax adherence.

Caring ability is one of the most important indicators regarding care outcomes. A valid and reliable scale for the evaluation of caring ability in mothers with preterm infants is lacking. The present study was conducted with the aim of designing and psychometric evaluation of the tool for assessing caring ability in mothers with preterm infants. A mixed-method exploratory design was conducted from 2021 to 2023. First the concept of caring ability of mothers with preterm infants was clarified using literature review and comparative content analysis, and a pool of items was created. Then, in the quantitative study, the psychometric properties of the scale were evaluated using validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 401 mothers with the mean age of 31.67 ± 6.14years to assess the construct validity. Initial caring ability of mother with preterm infant scale (CAMPIS) was developed with 64 items by findings of the literature review, comparative content analysis, and other related questionnaire items, on a 5-point Likert scale to be psychometrically evaluated. Face, content, and construct validity, as well as reliability, were measured to evaluate the psychometric properties of CAMPIS. So, the initial survey yielded 201 valid responses. The three components: 'cognitive ability'; knowledge and skills abilities'; and 'psychological ability'; explained 47.44% of the total observed variance for CAMPIS with 21 items. A subsequent survey garnered 200 valid responses. The confirmatory factor analysis results indicated: χ2/df = 1.972, comparative fit index (CFI) = 0.933, and incremental fit index (IFI) = 0.933. These results demonstrate good structural, convergent, discriminant validity and reliability. OMEGA, average inter-item correlation (AIC), intraclass correlation coefficients (ICC) for the entire scale were at 0.900, 0.27 and 0.91 respectively. Based on the results of the psychometric evaluation of CAMPIS, it was found that the concept of caring ability in the Iranian mothers with preterm infants is a multi-dimensional concept, which mainly focuses on cognitive ability, technical ability, and psychological ability. The designed scale has acceptable validity and reliability characteristics that can be used in future studies to assess this concept in the mothers of preterm infants.

Literature suggests that there is poor awareness and uptake of the Human Papillomavirus (HPV) vaccine in India. The role of cancer patients as potent advocates for HPV vaccine in their community is vital due to their first-hand experience with the turmoil that accompanies cancer. Hence, we have developed a study tool to measure the psychometric constructs "Awareness" of HPV vaccine among cancer patients and "Intention" to recommend the vaccine. The theoretical concepts of the Health Belief Model were applied, feedback from oncologists at Basavatarakam Indo-American Cancer Hospital and Research Institute and public health experts at Indian Institute of Public Health to develop the study tool. A 24 items study tool was finalized following pre-testing and content validation. A sample size of 5:1 (participant:item) was considered adequate to conduct exploratory factor analysis (EFA). The pilot study tool was administered for validation to 150 cancer patients visiting the hospital during June-July 2023. The data were analysed using Jamovi (Version2.3). The McDonald's omega was 0.8, which indicates good internal consistency of the data. EFA using parallel analysis with maximum likelihood extraction method and Promax oblique rotation with factor loadings above 0.4 revealed a 3-factor solution with 21 items. Factors were named "Capability", "Awareness" and "Risk perception" respectively. The correlation between "Awareness" and "Risk Perception" was 0.28; between "Capability" and "Risk perception" 0.47. "Awareness" and "Capability" had a weak negative correlation(-0.02). The study tool could effectively measure individual constructs of awareness and intention. Notably, our findings indicate a weak correlation between awareness and one component of intention (capability), within this population. This aspect, rigorously measured and validated by our study tool, holds significance as it implies that despite a low level of awareness in this population, they may still be considered as potentially influential advocates for the HPV vaccine. The online version contains supplementary material available at 10.1007/s13224-024-01950-4.

With English being the modern lingua franca, educational policies in Saudi Arabia were recently changed in order to provide better English language education to Saudi students. In spite of the government’s efforts to improve English proficiency, most Saudi students do not benefit sufficiently from the new curricula. Language 2 Learning Motivation Self-System (L2MSS), proposed by Dörnyei, provides a potential framework for understanding determinants of English proficiency among Saudi students. The pilot study first addressed the internal reliability, factor structure and item-level performance (classical model and IRT) of two new questionnaires developed to complement L2MSS with measures of cognitive, emotional, and behavioral aspects of attitude towards English. The main study focused on relationship between L2MSS and related variables with performance on an English test based on TOEIC. The study has shown that, while Saudi students tend to be motivated to learn English, L2MSS scores are not related to performance on an objective test of English proficiency. Moreover, the two new questionnaires, while associated with L2MSS, are not associated with English test performance. Exploratory factor analysis (with maximum likelihood extraction and direct oblimin rotation) of all L2MSS items resulted in a general L2MSS factor (29% variance), factors 2 (7% variance) and 3 (3%) had mixed loadings of “ought-to self” and L2 experience items, while factor 4 (2.7%) mainly had unique ideal self-loadings.

B - 96 Assessing the Factor Structure of Social Connectedness and its Psychopathological Correlates.

ABSTRACT Partner engagement in antenatal care can improve care for pregnant people living with HIV. However, concerns about engaging unsupportive non-pregnant partners warrant further study to avoid engaging partners who pressure their pregnant partner to refuse testing or treatment and/or perpetuate intimate partner violence. We adapted established relationship functioning and partner behaviour questionnaires among pregnant people living with HIV initiating antenatal care in rural South Africa. We identified 13 previously validated psychometric scales with 255 items that assess relationship functioning and partner behaviour, but, to our knowledge, had not been used in Southern Africa. After item translation and cognitive interviewing with 30 pregnant people, we recruited an additional 208 pregnant people living with HIV receiving antenatal care. We conducted an exploratory factor analysis with maximum-likelihood extraction and oblique promax rotation with the 58 items and 10 scales that remained after translation and cognitive interviewing. We used parallel analysis, scree plots, and the Kaiser criterion to guide factor retention and assessed internal factor consistency via Cronbach’s alpha. Of the 208 participants recruited, 197 (95%) answered each question and were included in the analysis. Exploratory factor analysis revealed 7 factors that assessed partner social support, sexual relationship power, emotional intimacy, threatened or enacted violence, sexual intimacy, violence in relationships, and partner engagement in pregnancy care via 37 items. Factor absolute Spearman correlations ranged from 0.012 to 0.518 and Cronbach’s alpha ranged from 0.84 to 0.92. This preliminary analysis will guide further scale development. Future developments will also include relevant clinical outcomes to assess the predictive validity of the resulting measures. These steps will further refine these questions into a succinct screening tool to assess relationship functioning and partner behaviour. This screening tool may eventually guide the selection of partner-based interventions during pregnancy to improve outcomes for pregnant people and their partners.

Schizophrenia, from its early conceptualization, has been described in distinct clinical subtypes. However, these categories were found not to be stable phenotypes over time, hence the dimensional option, whereas at cross-sectional level, the dimensions of psychopathology have been replicated across studies; there is dearth of data on the longitudinal stability of the factor structure of the symptoms of schizophrenia in African populations. This study examined the longitudinal stability of the factor structure of the 18-item Brief Psychiatric Rating Scale (BPRS) across intervals of 16-week naturalistic treatment follow-up. Consecutive incident cases that fulfilled the criteria for schizophrenia were recruited into the study. After a baseline assessment, 160 incident cases of schizophrenia were followed up 4 weekly for indicators of symptomatic outcome for 16 weeks. The Brief Psychiatric Rating Scale (BPRS) assessments were conducted in clinical interviews and with the Scale for Assessment of Negative Symptoms (SANS). Five BPRS assessments were made across the monthly intervals of follow-up. Exploratory factor analyses (EFA) using maximum likelihood extraction and varimax rotation with Kaiser normalization was used to extract the factors. A four-factor structure was found at baseline, namely negative, positive, depressive/anxiety, and manic symptom dimensions. From week 4, the manic and anxiety/depression dimensions remained invariant over time, while negative and positive symptoms merged into a psychosis dimension that was invariant. The persistence of the mood dimensions supports the DSM-5 recommendation to include these dimensions in the assessment of schizophrenia psychopathology. The longitudinal emergence and invariance of the psychosis factor echo the idea of unitary psychosis and, along with the prominence of mood dimensions over time, reflect recent molecular genetic findings about the sharing of genes by schizophrenia and mood disorders.

We present the validation of a questionnaire for compulsory secondary school students (seventh to tenth grade), designated “Educational learning environments for ESO pupils” (CEApA_ESO), for the purpose of evaluating learning environments. Although many instruments have been developed in this area, our work attempts to comprehensively cover some factors that most influence learning environments from the students’ perspective. Therefore, we included physical, learning, teaching and motivational elements, by adapting different already-validated scales to our intended overall approach and the Spanish context. We conducted a pilot study with 207 students from four grades (two classes per educational level). We performed descriptive and factor analyses with maximum likelihood extraction method and varimax rotation to identify factors underlying each scale. The factors extracted from each scale were used to evaluate the fit of the model, using the AMOS v.18 software for structural equation analysis, taking as reference the criteria set by Byrne (Structural equation modeling with AMOS: Basic concepts, applications, and programming, Taylor & Francis Group, 2010) and Kline (Principles and practice of structural equation modeling, The Guilford Press, 2010) (CMIN/DF between 2 and 5, CFI and IFI > 0.9, RMSEA < 0.06 and HOELTER > 200). Finally, we present the factorial validity of the complete scale and analyse the internal consistency of the scale and its subscales using Cronbach’s alpha coefficient. This instrument, with adequate psychometric properties, offers educators and researchers a valid tool for assessing the learning environments of their schools.

Breast cancer survivors (BCS) may face functional alterations after surgical intervention. Upper Limb Disorders (ULDs) are highly prevalent even years after a diagnosis. Clinicians may assess the upper limbs after breast cancer. The Upper Limb Functional Index (ULFI) has been validated across different populations and languages. This study aimed to assess the psychometric properties of the Upper Limb Functional Index Spanish version (ULFI-Sp) in the BCS. Methods: A psychometric validation study of the ULFI-Sp was conducted on 216 voluntary breast cancer survivors. The psychometric properties were as follows: analysis of the factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA). Results: The factor structure was one-dimensional. ULFI-Sp showed a high internal consistency for the total score (α = 0.916) and the regression score obtained from MLE (α = 0.996). CFA revealed a poor fit, and a new 14-item model (short version) was further tested. The developed short version of the ULFI-SP is preferable to assess upper limb function in Spanish BCS. Conclusions: Given the high prevalence of ULD in this population and the broader versions of ULFI across different languages, this study’s results may be transferred to clinical practice and integrated as part of upper limb assessment after breast cancer.

A valid and reliable culture-based scale for the evaluation of risky sexual behaviours for married Iranian women is lacking. This study aimed to develop, and psychometrically test, a risky sexual behaviour scale for married Iranian women. A mixed-method sequential exploratory design was conducted from 2016 to 2020 in Tehran, Iran. First, a qualitative study was employed to define the concept of risky sexual behaviour using 16 semi-structured individual interviews and 10 focus group discussions (n = 100). Then, an item pool was generated, and the scale was developed. Finally, in the quantitative study, the psychometric properties of the scale were evaluated by validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 400 sexually active married women to assess the construct validity. The six components: (i) ‘quality of sexual relations’; (ii) ‘unusual pleasures in sexual relations’; (iii) ‘sexual coercion’; (iv) ‘verbal violence in sexual relations’; (v) ‘self-care in sexual relations’; and (vi) ‘concealment in sexual relations’ could explain 57.49% of the total observed variance. The findings showed that the 27-item Risky Sexual Behaviour Scale (RSBS-MW) for married women in Iran has excellent internal consistency (α = 0.94) and stability (ICC = 0.98). Health care providers can use it to access risky sexual behaviours in married Iranian women.

Foreign language anxiety impedes language acquisition. Previous studies in various cultural contexts have found significantly negative and moderately high correlations between scores on the Foreign Language Classroom Anxiety Scale (FLCAS) and foreign language grades. This study aims to investigate the factor structure of the FLCAS in the Saudi Arabian context and to determine whether the main FLCAS factors predict English language achievement, as operationalised by university grades. A total of 257 Saudi students (19–21 years old) studying accounting and business administration completed a Saudi Arabian version of the FLCAS. Simultaneously, these students provided their most recent grades from university English courses. Maximum likelihood extraction with direct oblimin rotation was performed, and three main factors (trait anxiety, situation-specific anxiety, and communication apprehension and confidence) were identified, accounting for 17.5%, 18.6%, and 4.1% of the total FLCAS variance, respectively. The linear regression model with these factors as predictors and language achievement as a criterion was non-significant (F = 0.479; p = 0.685), indicating that the main FLCAS factors were not connected to English language achievement. The study highlights specific areas (trait anxiety and situation-specific anxiety) that English teachers in Saudi Arabia need to address using better-targeted techniques and strategies.

PurposePractitioners have reported a minimal and non-use of building information modelling (BIM), especially in small and medium-sized organisations and BIM infant construction industries. This development calls for a reappraisal of organisations’ strength in capabilities required for BIM uptake towards the target of global construction digitalisation. This study aims to assess the BIM Level 2 uptake capability of organisations in a BIM infant construction industry and identify the underlying interactions between the capability criteria.Design/methodology/approachThe study used a multivariable analysis of fifteen descriptors identified from the people, process, policy, finance and technology domain. Data collection was done in the BIM infant construction industry in Nigeria. Verification of the descriptors and an evaluation of BIM uptake capability in organisations was done. Seventy-three responses were received within the selected context, and data analysis was done with mean weighting and exploratory factor analysis. Maximum Likelihood extraction and Direct Oblimin rotation were used.FindingsFactor analysis revealed three factors that explained 53.28% of the total variance in the BIM Level 2 uptake capability of construction organisations. The factors are workforce capacity and continuous development, an affinity for innovation and strength in physical and operational facilities.Research limitations/implicationsThis study provides an overarching and insightful discussion on BIM uptake capability and construction digitalisation with evidence from a BIM-infant construction industry.Practical implicationsThe findings of this study are a piece of valuable empirical evidence on Level 2 BIM uptake capability. This empirical situation analysis will inform the advocacy for the advancement of BIM and enhanced utilisation of building information. Evidence on the capability performance of the BIM infant industry has been revealed.Originality/valueThe outcome is expected to stir debate on the preparedness of organisations to further exploit the benefits of BIM in the BIM infant construction industry. Examination of the capability for a particular phase of BIM is scanty in the literature.

IntroductionPain catastrophizing scale (PCS) is the most used scale to measure pain catastrophizing. In breast cancer survivors (BCS), pain catastrophizing is related to upper‐limbs dysfunction and disability. This study aimed to assess the internal consistency, internal structure, and convergent validity of the Spanish version of the PCS in Spanish BCS.Material and MethodsBreast cancer survivors were recruited from the service of Medical Oncology of the University Clinical Hospital Virgen de la Victoria, in Málaga (Spain). The psychometric properties were evaluated with analysis factor structure by maximum likelihood extraction (MLE), internal consistency, and construct validity by confirmatory factor analysis (CFA).ResultsFactor structure was three‐dimensional, and one item was removed due to cross‐loading. The new 12‐item PCS showed a high internal consistency for the total score (α = 0.91) and a good homogeneity, and CFA revealed a satisfactory fit. PCS showed an acceptable correlation with FACS (r = 0.53, p < 0.01).ConclusionPain catastrophizing scale is a valid and reliable instrument to evaluate pain catastrophizing in Spanish BCS. This tool may help clinicians in the management of pain by assessing pain and by measuring the effect of interventions.

BackgroundThe upper limb functional index is broadly used outcome measure for musculoskeletal disorders of the upper limb. The main objective of the study was to translate and validate the upper limb functional index (ULFI) outcome measure in the Urdu language.MethodsUpper limb functional index was translated into Urdu language using Beaton et al. guidelines through forward and backward translation along with the expert committee reviews. Two fifty (n = 250) Urdu-speaking patients with sub-acute or chronic conditions of upper limb musculoskeletal disorders were included in the study. The mean age was 32.33 ± 4.67 years. The data were collected from the physical therapy department of The University of Lahore Teaching hospital. All participants completed the upper limb functional index-Urdu (ULFI-U), Numeric pain rating scale (NPRS), Quick Disability of arm, shoulder, and hand (QuickDash), and (health survey) SF-12 at baseline while only ULFI-U at day three. Reliability was assessed through internal consistency by Cronbach’s alpha and test-retest reliability by intra-class correlation (ICC). Content validity was measured by Lynn and Lawshee method. Spearman’s correlation has been used to measure criterion validity. The construct validity was measured through hypothesis testing. The structural validity has been explained through factor analysis by exploratory factor analysis (EFA) using Maximum likelihood extraction (MLE) with Promax rotation.ResultsThe English version of ULFI was translated into the Urdu language with minor alterations. The Urdu version ULFI has demonstrated high levels of reliability with intra-class correlation (ICC2,1= 0.91) and Cronbach’s alpha (α = 0.94). The content validity index found as 0.808, the criterion validity for ULFI-U correlating with quick Dash was found excellent (r = 0.845) and ULFI-U established strong correlation with 6 domains of SF-12(r = 0.697 to 0.767) and weak correlation with its 2 domains and NPRS(r = 0.520). A two-factor structure was obtained using EFA.ConclusionsThe ULFI-U is a valid and reliable patient-reported outcome (PRO) that can be used to assess upper limb musculoskeletal disorders in Urdu-speaking patients.Trial registrationThis study was registered in the U. S National Library on clinicaltrial.gov under registration no. NCT05088096. (Date: 21/10/2021).