Short-form Version Research Articles

Validation of the Short Form Shoulder Instability Return to Sport After Injury (SIRSI-5) and Its Association With Return to Sports

Background: Psychosocial readiness is thought to be important in establishing whether athletes are ready to return to sports (RTS). The 5-item Shoulder Instability–Return to Sport After Injury (SIRSI-5) is a short-form version of the 12-item questionnaire (SIRSI-12), which was validated in a postoperative Argentinian population and associated with psychological readiness to RTS. It is unknown if the SIRSI-5 is valid in surgical and nonsurgical populations in other geographic locations. Purpose: To establish whether the SIRSI-5 is valid in another population and if it is associated with RTS. Study Design: Cross-sectional study (diagnosis); Level of evidence, 3. Methods: A total of 79 participants with anterior shoulder instability managed operatively and nonoperatively were included. The SIRSI-5 and SIRSI-12 total scores were calculated. Intraclass correlation coefficients (ICCs) and Pearson correlations assessed convergent validity between SIRSI-5 and SIRSI-12. Logistic regression was used to assess the discrimination ability (leave-one-out cross-validation [LOOCV]) of a preexisting SIRSI-5 cut point score (≥59/100) to determine participants who had returned to their preinjury level of sport. In addition, the discrimination ability (LOOCV) of multivariable machine learning models including age, sex, time since injury (months), SIRSI-5 (continuous score), surgery, and contact/noncontact sport to predict return to preinjury level sport was also assessed. The Youden index was calculated to assess the models’ performance. Results: Of the 79 participants, 62 (78.5%) were male and 27 (34%) had been treated surgically. Only 32% (n = 25) of participants had returned to preinjury level sport. The SIRSI-5 and SIRSI-12 were highly correlated ( r > 0.9) with high levels of agreement (ICC, 0.90; 95% CI, 0.76-0.95). The prediction accuracy of the SIRSI-5 cut point score model was 66% (Youden index, 0; sensitivity, 4%; specificity, 94%). The best prediction accuracy obtained through a machine learning model (multilayer perceptron) was 72% (Youden index, 0.4; sensitivity, 64%; specificity, 76%). Conclusion: The SIRSI-5 has excellent convergent validity with the SIRSI-12 to measure psychological readiness to RTS and can be used clinically with less patient burden than the SIRSI-12. However, in a population of surgically and nonsurgically treated contact athletes, the SIRSI-5 with a cut point of ≥59/100 had low levels of prediction accuracy for RTS at preinjury level. The SIRSI-5 should not be utilized in isolation to determine readiness to RTS, and clinicians should consider other factors such as age, type of sport, and time since injury to underpin their clinical reasoning when deciding for RTS.

Development of a Short-Form Hwa-Byung Symptom Scale Using Machine Learning Approaches

Background/Objectives: Hwa-byung (HB), also known as “anger syndrome” or “fire illness”, is a culture-bound syndrome primarily observed among Koreans. This study aims to develop a short-form version of the HB symptom scale using machine learning approaches. Methods: Utilizing exploratory factor analysis (EFA) and various machine learning techniques (i.e., XGBoost, Logistic Regression, Random Forest, Support Vector Machine, Decision Tree, and Multi-Layer Perceptron), we sought to create an efficient HB assessment tool. A survey was conducted on 500 Korean adults using the original 15-item HB symptom scale. Results: The EFA revealed two distinct factors: psychological symptoms and somatic manifestations of HB. Statistical testing showed no significant differences between using different numbers of items per factor (ANOVA: F = 0.8593, p = 0.5051), supporting a minimalist approach with one item per factor. The resulting two-item short-form scale (Q3 and Q10) demonstrated high predictive power for the presence of HB. Multiple machine learning models achieved a consistent accuracy (90.00% for most models) with high discriminative ability (AUC = 0.9436–0.9579), with the Multi-Layer Perceptron showing the highest performance (AUC = 0.9579). The models showed balanced performance in identifying both HB and non-HB cases, with precision and recall values consistently around 0.90. Conclusions: The findings of this study highlighted the effectiveness of integrating EFA and artificial intelligence via machine learning in developing practical assessment tools. This study contributes to advancing methodological approaches for scale development and offers a model for creating efficient assessments of Korean medicine.

Longitudinal associations of daily activities and presenteeism among teleworkers in Japan

Abstract Objectives Many workers had to switch their standard work from the office to home-based telework during the COVID-19 pandemic. Previous studies reported that telework was associated with increased sickness presenteeism. Several studies have examined the association between lifestyle behaviors and presenteeism among workers. However, there are few studies investigating the relationship among teleworkers. Thus, this study examined the association between daily activities and presenteeism in a longitudinal cohort of teleworkers in Japan. Methods A prospective cohort study with a two-year observation was conducted. The participants were 831 workers belonged to five companies in Japan. For both surveys, self-administered questionnaire surveys on daily activities and presenteeism were conducted. Presenteeism was assessed using the short-form Japanese version of the World Health Organization Health and Work Performance Questionnaire. The data were analyzed using a generalized estimating equation approach, controlling for potential confounders such as age, gender, working hours, position, and health status. Results 742 participants who teleworked in both surveys with no missing answers were analyzed. Among male workers (n = 427), chatting (β = 5.30, 95% CI: 1.52-9.07) and setting daily goals (β = 4.16, 95% CI: 1.52-9.07) were associated with decreased presenteeism. Among female workers, exercise (β = 4.33, 95% CI: 0.95-7.71) was associated with decreased presenteeism. Conclusions Although gender differences were observed, there is preliminary evidence from longitudinal studies that frequent activities such as chatting, setting daily goals, and exercising may protect against presenteeism among teleworkers. Our findings could be used to educate daily telework activities to prevent sickness presenteeism. Key messages • Daily activities during telework may worsen or improve presenteeism. • Social isolation may be an important indicator of presenteeism during telework.

Psychometric Properties of Turkish Versions of the Non-Attachment Scale Short Form

This study aimed to examine the psychometric properties of the Non-Attachment Scale Short Form in a Turkish sample. With the participation of 244 adults over 18 years of age, the Short Form of the Nonattachment Scale, the Resilience Scale and the Ontological Addiction Scale were used as data collection tools. Cronbach's alpha and McDonald's omega coefficient were used for the reliability of the Non-Attachment Scale Short Form. According to the results of the analyses, the internal consistency coefficient and McDonald's value were found to be .77 and .78, respectively. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to test the construct validity of the scale. The results of the analyses showed that the model fit and Kaiser-Meyer-Olkin (KMO) values were at an acceptable level. Item factor loadings ranged between .40 and .67 and the scale was found to have a single factor structure. The statistically significant difference between the 27% lower and upper groups among the participants showed that the item discrimination index of the scale was at a good level. According to the correlation findings conducted to test the criterion validity of the scale, non-attachment was found to have positive significant relationships with resilience (r = .60) and negative significant relationships with ontological dependence (r = -.39). As a result, adaptation of the Short Form of the Non-Attachment Scale can be said to be a valid and reliable measurement tool.

The Vaginal Penetration Skills Scale (VPSS): a paradigm shift in genito-pelvic pain/penetration disorder screening, assessment, and stratification.

Receptive vaginal penetration skills have been implicated in the etiology, explanatory models, and treatment of genito-pelvic pain penetration disorder (GPPPD). However, there are no psychometric skills measures designed to screen, assess, and stratify GPPPD. We aimed to develop and psychometrically evaluate a new scale-the Vaginal Penetration Skills Scale (VPSS)-to screen, assess, and stratify GPPPD. This study included 148 Brazilian females with GPPPD symptoms (113 lifelong and 35 acquired) and 251 Brazilian females without sexual complaints. We conducted factor analyses considering all participants (n= 399). Then, we conducted latent class analysis within the GPPPD group to identify clusters of individuals with similar VPSS profiles. We assessed convergent validity through intercorrelation with the Brazilian versions of the Female Genital Self-Image Scale (FGSIS) and the 6-item Female Sexual Function Index (FSFI-6). We developed complete and short-form versions of the VPSS (VPSS-29 and VPSS-SF11, respectively), each with 3 dimensions, to screen, assess, and stratify GPPPD. Factor analysis yielded a 3-factor VPSS model with the "Nonsexual Genital Self-Exploration," "Nonsexual Vaginal Penetration Skills," and "Sexual Vaginal Penetration Skills" dimensions for both VPSS versions. The reliability was excellent for the VPSS-29 (ω= 0.981, α= 0.981) and the VPSS-SF11 (ω= 0.959, α= 0.961). All 3 dimensions could detect significant differences between patients with GPPPD and healthy females. They also differentiated the patients with GPPPD, distinguishing gradient levels. For convergent validity, we found moderate to strong correlations (rho = 0.715-0.745) between the VPSS, FGSIS, and FSFI-6. The VPSS can be applied easily in both clinical and research settings. The VPSS provides a concise and thorough evaluation of receptive vaginal penetration skills in both sexual and nonsexual contexts among patients with GPPPD. The sample had limited diversity regarding gender and sexual orientation; therefore, it is important to validate the use of this scale in populations beyond the cisgender heterosexual female population to ensure its applicability in diverse settings. These results support the reliability and psychometric validity of the VPSS as a self-report measure to screen, assess, and stratify GPPPD symptoms.

5184 Tirzepatide Improved Mental and Psychosocial Health-Related Quality of Life in Adults with Obesity or Overweight: Results from the SURMOUNT-4 phase 3 Trial

Abstract Disclosure: T.M. Gibble: Employee; Self; Employment and stockholder, Eli Lilly and Company. D. Cao: Employee; Self; Employment and stockholder, Eli Lilly and Company. M. Murphy: Employee; Self; Employment and stockholder, Eli Lilly and Company. I. Jouravskaya: Employee; Self; Employment and stockholder, Eli Lilly and Company. B. Liao: Employee; Self; Employment and stockholder, Eli Lilly and Company. Background: Tirzepatide is a once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved in the U.S. for treatment of type 2 diabetes (T2D) and obesity. In the phase 3 SURMOUNT-4 trial with randomized withdrawal of tirzepatide maximum tolerated dose (MTD) after the first 36 weeks, continuing tirzepatide for a total of 88 weeks led to a mean weight reduction of 25.3% from baseline compared to 9.9% for those who switched to placebo (PBO).[1] This analysis evaluated the effect of tirzepatide versus PBO on mental and psychosocial health-related quality of life (HRQoL) outcomes using the SURMOUNT-4 trial data. Methods: Adults (n=783) with body mass index ≥30 or ≥27 kg/m2 and ≥1 obesity-related complication (excluding T2D) were enrolled in an open-label lead-in period to receive tirzepatide once weekly subcutaneously for 36 weeks, escalated to MTD (10 mg or 15 mg). At week (W) 36, 670 participants were randomized 1:1 to continue tirzepatide MTD (n=335) or were switched to PBO (n=335) for 52 weeks. HRQoL was evaluated from W0 to W88 using the Short Form-36 Version 2 Health Survey (SF-36 v2) acute form and Impact of Weight on Quality of Life-Lite-Clinical Trials Version (IWQOL-Lite-CT), where the last observation before discontinuation was carried forward. Higher scores of SF-36v2 (Mental Component Summary [MCS], role-emotional, and mental health), and IWQOL-Lite-CT (psychosocial composite) reflected better levels of mental function. Least square mean (LSM) changes and estimated treatment differences (ETD) between tirzepatide and PBO were calculated using an analysis of covariance model. Results: LSM changes in mental domain scores for SF-36 v2 and IWQOL-Lite-CT were comparable during lead-in (W0 to W36) between participants randomized to tirzepatide and PBO. Significant improvements were observed from W36 to W88 in SF-36v2 mental domain scores for tirzepatide versus PBO, with LSM scores ( ETD) as follows: MCS, 54.6, 52.9 (1.7, p=0.001); role-emotional, 53.0, 51.1 (1.9, p=0.001), and mental health, 55.4, 52.9 (2.4, p<0.001), respectively. LSM change from W36 to W88 in SF-36 v2 mental domain scores for tirzepatide and PBO were: MCS, 0.1 and -1.6; role-emotional, 0.6 and -1.2, and mental health, 0.3 and -2.1, respectively. Tirzepatide showed significant improvements in IWQOL-Lite-CT psychosocial scores versus PBO from W36 to W88, with LSM scores ( ETD) of 87.7, 75.6 (12.1; p<0.001), respectively. LSM change from W36 to W88 in IWQOL-Lite-CT psychosocial scores for tirzepatide and PBO were 5.1 and -7.0, respectively. Conclusion: In the SURMOUNT-4 trial, adults with overweight or obesity continuing on tirzepatide MTD showed significant and sustained improvements in mental and psychosocial HRQoL compared to those switching to placebo. [1] Sattar N. 59th Annual Meeting European Association for the Study of Diabetes; Oct 2023; Hamburg, Germany. Presentation: 6/1/2024

9229 Tirzepatide Improved Mental and Psychosocial Health-Related Quality of Life in Adults with Obesity or Overweight: Results from the SURMOUNT-4 phase 3 Trial

Abstract Disclosure: T.M. Gibble: Employee; Self; Employment and stockholder, Eli Lilly and Company. D. Cao: Employee; Self; Employment and stockholder, Eli Lilly and Company. M. Murphy: Employee; Self; Employment and stockholder, Eli Lilly and Company. I. Jouravskaya: Employee; Self; Employment and stockholder, Eli Lilly and Company. B. Liao: Employee; Self; Employment and stockholder, Eli Lilly and Company. Background: Tirzepatide is a once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved in the U.S. for treatment of type 2 diabetes (T2D) and obesity. In the phase 3 SURMOUNT-4 trial with randomized withdrawal of tirzepatide maximum tolerated dose (MTD) after the first 36 weeks, continuing tirzepatide for a total of 88 weeks led to a mean weight reduction of 25.3% from baseline compared to 9.9% for those who switched to placebo (PBO).[1] This analysis evaluated the effect of tirzepatide versus PBO on mental and psychosocial health-related quality of life (HRQoL) outcomes using the SURMOUNT-4 trial data. Methods: Adults (n=783) with body mass index ≥30 or ≥27 kg/m2 and ≥1 obesity-related complication (excluding T2D) were enrolled in an open-label lead-in period to receive tirzepatide once weekly subcutaneously for 36 weeks, escalated to MTD (10 mg or 15 mg). At week (W) 36, 670 participants were randomized 1:1 to continue tirzepatide MTD (n=335) or were switched to PBO (n=335) for 52 weeks. HRQoL was evaluated from W0 to W88 using the Short Form-36 Version 2 Health Survey (SF-36 v2) acute form and Impact of Weight on Quality of Life-Lite-Clinical Trials Version (IWQOL-Lite-CT), where the last observation before discontinuation was carried forward. Higher scores of SF-36v2 (Mental Component Summary [MCS], role-emotional, and mental health), and IWQOL-Lite-CT (psychosocial composite) reflected better levels of mental function. Least square mean (LSM) changes and estimated treatment differences (ETD) between tirzepatide and PBO were calculated using an analysis of covariance model. Results: LSM changes in mental domain scores for SF-36 v2 and IWQOL-Lite-CT were comparable during lead-in (W0 to W36) between participants randomized to tirzepatide and PBO. Significant improvements were observed from W36 to W88 in SF-36v2 mental domain scores for tirzepatide versus PBO, with LSM scores ( ETD) as follows: MCS, 54.6, 52.9 (1.7, p=0.001); role-emotional, 53.0, 51.1 (1.9, p=0.001), and mental health, 55.4, 52.9 (2.4, p<0.001), respectively. LSM change from W36 to W88 in SF-36 v2 mental domain scores for tirzepatide and PBO were: MCS, 0.1 and -1.6; role-emotional, 0.6 and -1.2, and mental health, 0.3 and -2.1, respectively. Tirzepatide showed significant improvements in IWQOL-Lite-CT psychosocial scores versus PBO from W36 to W88, with LSM scores ( ETD) of 87.7, 75.6 (12.1; p<0.001), respectively. LSM change from W36 to W88 in IWQOL-Lite-CT psychosocial scores for tirzepatide and PBO were 5.1 and -7.0, respectively. Conclusion: In the SURMOUNT-4 trial, adults with overweight or obesity continuing on tirzepatide MTD showed significant and sustained improvements in mental and psychosocial HRQoL compared to those switching to placebo. [1]Sattar N. 59th Annual Meeting European Association for the Study of Diabetes; Oct 2023; Hamburg, Germany. Presentation: 6/1/2024

5183 Tirzepatide Improved Health-Related Quality of Life in People with Obesity or Overweight: Results from SURMOUNT-4 Phase 3 Trial

Abstract Disclosure: T.M. Gibble: Employee; Self; Employment and stockholder, Eli Lilly and Company. D. Cao: Employee; Self; Employment and stockholder, Eli Lilly and Company. M. Murphy: Employee; Self; Employment and stockholder, Eli Lilly and Company. I. Jouravskaya: Employee; Self; Employment and stockholder, Eli Lilly and Company. B. Liao: Employee; Self; Employment and stockholder, Eli Lilly and Company. Background: Tirzepatide is approved in the U.S. for treatment of type 2 diabetes (T2D) and obesity. In the phase 3 SURMOUNT-4 trial with randomized withdrawal of tirzepatide maximum tolerated dose (MTD) after the first 36 weeks, continuing tirzepatide for 88 weeks led to a mean weight reduction of 25.3% from baseline compared to 9.9% for those who switched to placebo (PBO).1 This analysis evaluated the effects of tirzepatide versus PBO on health-related quality of life (HRQoL) outcomes using the SURMOUNT-4 trial data. Methods: Adults (n=783) with body mass index ≥30 or ≥27 kg/m2 and ≥1 obesity-related complication (excluding T2D) were enrolled in an open-label lead-in period to receive tirzepatide once weekly for 36 weeks, escalated to MTD (10 mg or 15 mg). At week (W) 36, 670 participants were randomized 1:1 to continue tirzepatide MTD (n=335) or were switched to PBO (n=335) for 52 weeks. HRQoL was evaluated using Short Form-36 Version 2 Health Survey (SF-36 v2) acute form and Impact of Weight on Quality of Life-Lite-Clinical Trials Version (IWQOL-Lite-CT), where last observation before discontinuation was carried forward. Higher scores reflected better levels of functioning. Least square means (LSM) and estimated treatment differences (ETD) between tirzepatide versus PBO were calculated using an analysis of covariance model. Proportion of people achieving clinically meaningful improvement (CMI) in SF-36v2 physical functioning score (change from baseline ≥5.76) was also assessed. Results: LSM changes in SF-36 v2 and IWQOL-Lite-CT scores were comparable during lead-in (W0 to W36) between people randomized to tirzepatide and PBO. Significant improvements were observed from W36 to W88 in SF-36v2 Physical Component Score (PCS), Mental Component Score (MCS), and all domains for tirzepatide versus PBO, with LSM (ETD) as follows: PCS, 54.9, 53.1 (1.8); MCS, 54.6, 52.9 (1.7); physical functioning, 54.2, 51.6 (2.6); role-physical, 54.3, 53.3 (1.1); bodily pain, 54.7, 53.1 (1.6); general health, 56.7, 54.1 (2.6); vitality, 57.0, 55.4 (1.6); social functioning, 54.2, 52.9 (1.3); role-emotional, 53.0, 51.1 (1.9), and mental health, 55.4, 52.9 (2.4), respectively; all p<0.05. Proportion of people achieving CMI (%) in SF-36v2 physical functioning from W0 to W88 was higher for tirzepatide than those who switched to PBO (≥ 5.76, 52.0 and 36.2). Tirzepatide showed significant improvements in IWQOL-Lite-CT scores versus PBO from W36 to W88, with LSM scores (ETD) as follows: total, 86.4, 75.3 (11.1); psychosocial, 87.7, 75.6 (12.1); physical function, 85.7, 76.2 (9.4); and physical, 83.8, 74.7 (9.1), respectively; all p<0.001. Conclusion: In SURMOUNT-4 trial, adults with overweight or obesity continuing on tirzepatide showed significant and sustained improvements in HRQoL versus those switching to PBO. 1Sattar N. 59th Annual Meeting European Association for the Study of Diabetes; Oct 2023; Germany. Presentation: 6/3/2024

8366 Weight Reduction is Associated with Improved Quality of Life in Patients in SURMOUNT-3

Abstract Disclosure: T.H. Gibble: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. D. Cao: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. T.D. Forrester: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. J.F. Brumm: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. Tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, is approved in the US for treatment of type 2 diabetes and obesity. In SURMOUNT-3, a phase 3, 72-week, randomized, double-blind clinical trial in adults with obesity/overweight, after 12 weeks intensive lifestyle intervention, treatment with tirzepatide resulted in significantly greater weight reduction than placebo. This post-hoc analysis assessed whether weight reduction was associated with patient-reported outcomes (PRO) improvements in adults treated with tirzepatide. Of 806 adults with obesity (body mass index [BMI] ≥30 kg/m2)/overweight (BMI ≥27 kg/m2) + ≥1 obesity-related complication enrolled in SURMOUNT-3, 579 achieved ≥5% weight reduction with 12 weeks of intensive lifestyle intervention and were randomized to placebo (N=292) or tirzepatide (10/15mg, N=287) for 72 weeks. Adults completed patient-reported outcomes (PRO) questionnaires at randomization and endpoint (72 weeks or early discontinuation), including Short Form-36 Version 2 Health Survey acute form (SF-36v2) and Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT). Mean change in SF-36v2 norm-based and IWQOL-Lite-CT scores from randomization to endpoint were summarized descriptively by weight reduction targets (≥5%, ≥10%, ≥15%, ≥20%, ≥25%) for adults who received TZP, using the last observation carried forward method. At endpoint, adults with weight reduction showed improvements from randomization in most PRO scores. For SF-36v2, improvements by weight reduction target were seen for General Health (≥5%, 2.6; ≥10%, 2.7; ≥15%, 3.0; ≥20%, 3.3; ≥25%, 3.4), Physical Functioning (3.4, 3.4, 3.8, 4.4, 4.3), Mental Health (0.4, 0.4, 0.7, 0.8, 0.4), Bodily Pain (2.3, 2.5, 3.1, 3.7, 3.9), Role-Physical (1.9, 1.8, 2.2, 2.9, 2.8), Vitality (1.3, 1.3, 1.5, 1.8, 1.4), Social Functioning (0.8, 0.9, 1.1, 2.2, 2.4), Role-Emotional (0.9, 0.8, 1.0, 1.5, 0.9), and Physical Component Score (3.2, 3.3, 3.8, 4.5, 4.7); improvements were less consistent for Mental Component Score (-0.1, -0.2, -0.1, 0.3, -0.2). For IWQOL-Lite-CT, improvements by weight reduction target were seen for total (18.2, 18.6, 19.7, 22.9, 24.1), Physical Function composite (13.6, 14.1, 14.9, 17.1, 17.3), Physical Composite (14.3, 14.9, 15.7, 18.3, 19.3), Physical Pain/Discomfort Composite (16.0, 16.7, 17.8, 21.1, 24.1), and Psychosocial Composite Scores (20.3, 20.6, 21.8, 25.3, 26.7). Adults meeting greater weight reduction targets generally showed greater improvements from randomization in PRO scores. Weight reduction was associated with improvement in most domains of health-related quality of life, including those relating to physical function and mental health. Adults who lost the most weight generally showed the greatest quality of life improvements. Presentation: 6/1/2024

Sensitivity, specificity and clinical cut-off point of the Persian short form version of the Female Sexual Function Index (FSFI-6)

Sensitivity, specificity and clinical cut-off point of the Persian short form version of the Female Sexual Function Index (FSFI-6)

Effect of Social Support and Spiritual Well-being on the Quality of Life of Patients Undergoing Hemodialysis

Background: This study aims to assess the impact of social support and spiritual well-being on the quality of life of patients undergoing hemodialysis. Methods and Materials: A cross-sectional research design was adopted in Iraq, with 234 purposively selected patients, meeting the inclusion criteria. Kidney Disease, Quality of Life Short Form Version 36 (QOL SF-36) scale, the Multi-Dimension Perceived Social Support Scale (MDPSS), and the spiritual well-being scale (SWB) were used. Results: The regression model demonstrates a significant effect of social support and spiritual well-being (SWB) on the QOL. This can be inferred from the t-value that shows the differences between social support and QOL = (1.434), as also, as the differences between SWB and QOL = (1.906), and its associated p-value (0.038, 0.015). By referring to F (2,231) = 3.14 and its p-value = 0.034. All these explain the variations in the quality of life and the explanatory variables are referred to as R2 value = 0.45. Both variables added were statistically significant to the prediction, p < 0.05. Conclusion: The quality of life of patients undergoing hemodialysis was influenced by social support and spiritual well-being. Although the level of social support and spiritual well-being was high among the study participants, the quality of life was moderate.

Role of physical activity for glycemic control among patients with type 2 diabetes mellitus

Background: Lifestyle modification and physical activity are very important parts of diabetes management. Regular physical activity has been shown to improve glycemic control through increased insulin sensitivity and glucose tolerance. The aims of this study were to assess the glycemic level and pattern of physical activity among type 2 diabetic patients. Methods: This hospital-based cross-sectional study was carried out from July 2022 to October 2022 among 305 purposively recruited diabetic patients who came to receive care at the outpatient department of a teaching hospital in Dhaka, Bangladesh. A semi-structured questionnaire was used to describe socio-demographic information. Physical activity was assessed using the validated version of international physical activity questionnaire short form/ global physical activity questionnaire (IPAQ/GPAQ). Glycemic control was measured by HbA1C report done within 120 days of the interview. Blood pressure and body mass index were also measured at the time of inclusion. The physical activity level was categorized according to IPAQ scoring protocol as high level, moderate level and low level. Chi square test was carried out to determine the association of physical activity with type-2 DM, body mass index, glycemic and blood pressure control. Statistical significance was defined as p<0.05. Results: Among the participants only 0.3% had high level of physical activity. Moderate level of physical activity was found among 32.8% and low level of physical activity has been found among 66.9%. Among the participants 92.1% spent their time sitting during the weekdays while the time spent at home, at work, while doing course or class and during leisure activities. Among them 21% had the maximum 10 hours sitting time during the last week. The study showed that the persons who spent walking on at least 7 days has negative correlation with blood glycemic level and among them who spent time on sitting has positive correlation with blood glycemic level. Nearly two thirds of the respondents were female. The mean age was 53.09 ± 12.15 years. Majority of the participants were from urban area (69.83%) and the rest are from rural (21.31%) and sub urban (8.2%) area. There was no significant relation of level physical activity with any sociodemographic factors except monthly income, which showed low monthly income was associated with higher level of physical activity. Conclusion: The findings of our study focus on developing more awareness and providing facilities for physical activity to achieve the glycemic goal. BIRDEM Med J 2024; 14(3): 143-150

B - 123 Examining the Utility of a Short-Form Letter Fluency Task: a Lifespan Analysis Using the D-KEFS Verbal Fluency Test

Abstract Objective The D-KEFS Verbal Fluency Test (VF) is a commonly used measure of a variety of executive functions with three separate components: Letter Fluency (FAS), Category Fluency and Category Switching. This study will solely explore the FAS, a measure of phonemic fluency and lexical access. Prior research in cognitively impaired adults suggested a potential for a short-form version of the test. This project seeks to validate these findings across different age groups. The hypothesis predicts a positive correlation between words produced in the 1–15 second interval for the letter F and the total FAS score, which includes three 60-second intervals for each letter. Method The study involved 99 patients aged 10 to 88 (X ̅: 38.77; males = 50) referred for outpatient neuropsychological evaluation. Pearson’s correlation coefficient assessed the relationship between the initial 15-second FAS interval and the total raw score. Results The Pearson correlation coefficient shows a moderate positive correlation between the 15 second interval for the letter F and FAS total score (r = 0.435). Further, this correlation is significant, (p < 0.001). Conclusions The study suggests that the initial 15-second FAS interval effectively predicts overall performance across pediatric and adult populations. This underscores the potential for a short-form Letter Fluency component as a valuable addition to clinical assessments. Short forms could alleviate patient frustration and maintain motivation during testing, enhancing the utility of cognitive measures like the D-KEFS FAS in clinical settings.

The effect of loneliness on interpersonal sensitivity among nursing undergraduates: a chain mediation role of problematic internet use and bedtime procrastination

BackgroundLoneliness was associated with interpersonal sensitivity, but the factors contributing to this relationship in nursing students remain unclear. This study investigated the relationship between loneliness and interpersonal sensitivity among nursing undergraduates, with a specific focus on the mediating roles played by problematic internet use and bedtime procrastination.MethodThis study was conducted as a cross-sectional survey at a university in China between November and December 2022. Data were collected using a self-administered online questionnaire that included demographic characteristics, the Three-Item Loneliness Scale (T-ILS), the Chinese Version of Short Form of Interpersonal Sensitivity Measure (IPSM-CS), the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6), and the Bedtime Procrastination Scale (BPS). Pearson correlation analysis was employed to explore the relationships among loneliness, interpersonal sensitivity, problematic internet use, and bedtime procrastination. Structural equation modeling (SEM) was conducted using AMOS software to examine the mediating role of problematic internet use and bedtime procrastination between loneliness and interpersonal sensitivity.ResultsLoneliness was positively related to interpersonal sensitivity among nursing undergraduates (β = 0.44, P < 0.001). There was a significant chain mediation role of problematic internet use and bedtime procrastination in the relationship between loneliness and interpersonal sensitivity.ConclusionsThe study contributed to deepening the understanding of the relationship between loneliness and interpersonal sensitivity and provided valuable insights into the improvement of interpersonal sensitivity in nursing undergraduates.

Evaluating Emotional Eating in Children from the Perspective of Parents: Psychometric Properties of the Parent Version of the Emotional Eating Scale Adapted for Children and Adolescents.

Emotional eating is associated with adverse health outcomes in children, including elevated weight status. Currently, there is not a well-validated parent-report measure of emotional eating for young children. This study assessed the reliability and validity of the 10-item parent version of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form. The participants were 207 parents and 144 children from the southern United States. They completed the parent- and child-report EES-C Short-Form and responded to measures related to child eating behaviors, mood, and gratitude. The parent-report EES-C Short-Form demonstrated good internal consistency reliability (Cronbach's alpha = 0.94). Test-retest reliability was also supported, as evidenced by a medium correlation (ICC = 0.56, p < 0.001) between parent-rated emotional eating across two time points. Additionally, the measure demonstrated a significant correlation with a scale of emotional overeating (r = 0.25, p < 0.001)-a theoretically related construct. Supporting discriminant validity, the measure was not significantly related to a measure of parent-reported gratitude (r = 0.07, p = 0.30). A unidimensional model provided good fit for the data (CFI = 0.997, SRMR = 0.046). The results from the current study provide preliminary evidence supporting the reliability and validity of the parent version of the EES-C Short-Form. For the purpose of screening children in school or primary care settings, the EES-C Short-Form may be practical and helpful in identifying children who may be at risk of developing adverse health outcomes or more-severe eating disorder pathology.

An examination of the ohio scales, short form, hopefulness domain, youth- and caregiver-report versions in a community care setting

The current study examined the utility of the Ohio Scales, Hopefulness Scale (OS Hopefulness Scale; Ogles et al., 2004), a free multi-informant four-item measure of hopefulness used within a large statewide public mental health care system. Collectively, the six aims of this study (done for both youth- and caregiver-report versions) examined (a) the measure’s factor structure and (b) internal consistency, (c) the relationship between youth- and caregiver-reported hopefulness, (d) the measure’s relationships with numerous domains of psychopathology (e.g., depression, anxiety, delinquency) and (e) functioning, and (f) sensitivity to change. Using a sample of 986 participants, who were ethnically diverse (30.5 % multiethnic, n = 301), 61.0 % male (n = 601), with an average age of 12.74 (SD=3.46), the study found good factor structure, acceptable internal consistency, and a significant positive association between youth-reported and caregiver-hopefulness. Additionally, significant inverse relationships were found between caregiver-reported hopefulness with youth mental health problems and youth functioning; while youth-reported hopefulness was found to be significantly inversely related to youth mental health problems but not youth functioning. Finally, significant positive changes in hopefulness and significant inverse relationships with youth functioning were also evident at three-month follow up for both youth- and caregiver-reported hopefulness. The constellation of our findings demonstrates potential for this four-item measure of hopefulness to be a useful, efficient, and cost-effective tool with ethnically diverse samples, which are substantially different from samples included in previous studies of hopefulness. Implications and suggestions for future research are discussed.

Home-based EXercise and motivAtional programme before and after Liver Transplantation (EXALT): study protocol for phase II two-centre, randomised controlled trial

IntroductionPhysical frailty is associated with increased mortality and poor quality of life (QoL) before and after liver transplantation (LT). Evidence is lacking on how to tailor exercise and behavioural techniques...

Psychometric Properties of the EQ-5D-5L in Patients with Alopecia Areata.

For many decision makers in Health Technology Assessment the EQ-5D-5L is the standard measure of health-related quality of life (HRQL). However, evidence has shown the limitations of the measure in certain disease areas, including dermatology. Alopecia areata (AA) is associated with a significant HRQL impact, partly due to the emotional impact of hair loss. This study explores the psychometric properties of the EQ-5D-5L in people with AA in reference to the short-form 36 version 2 (SF-36v2), the Alopecia Areata Patient Priority Outcomes (AAPPO), the Severity of Alopecia Tool (SALT) and the Patient Global Impressions of Change (PGI-C). Data from participants with AA enrolled in the ALLEGRO-2b/3 trial (NCT03732807) of ritlecitinib were analysed. Participants completed the AAPPO measure (an AA-specific measure assessing emotional symptoms and activity limitations), PGI-C, EQ-5D-5L and SF-36v2 across 48-weeks of follow up. Extent of scalp hair loss was assessed using the SALT. Ceiling effects, known groups validity, convergent validity and responsiveness were examined. Known groups were defined by SALT score and a PGI-C defined response from baseline. Exploratory factor analysis was also performed. Data were available from 612 adult participants. Ceiling effects were observed for the EQ-5D-5L (55.3-61.2%) and analyses suggested that the EQ-5D did not capture important differences between patients that the SF-36v2 did. The EQ-5D-5L very weakly correlated with SALT score, whereas the AAPPO correlated more strongly with the extent of hair loss. Compared with the EQ-5D-5L, the AAPPO was better able to discriminate between known groups defined by SALT and PGI-C. An exploratory factor analysis suggested that the EQ-5D-5L had limitations in content validity compared with the AAPPO. The EQ-5D-5L may not adequately measure the burden of AA on patients' HRQL. Insensitivity to the burden of AA suggests that the EQ-5D-5L may not measure treatment-related benefit with hair regrowth. Data from other measures could be considered if they are shown to be more relevant.

Efficacy of arch contouring foot orthoses for midfoot osteoarthritis: Protocol for a randomised controlled trial.

Midfoot osteoarthritis (OA) is a painful and disabling condition. Arch contouring foot orthoses have been recommended for midfoot OA, yet there is no high-quality evidence from randomised controlled trials to support their use. This clinical trial aims to evaluate the efficacy of arch contouring foot orthoses for midfoot OA. This will be a parallel-group randomised controlled superiority trial. One-hundred and forty community-dwelling people with painful midfoot OA will be randomised to receive either arch contouring foot orthoses or flat sham inserts. Outcome measures will be obtained at baseline, 4, 8 and 12weeks; the primary endpoint for assessing efficacy being 12weeks. The primary outcome measure will be average midfoot pain whilst walking over the last 7days on an 11-point numerical rating scale. Secondary outcome measures include function (walking/standing subscale of the Manchester-Oxford Foot Questionnaire), participants' perception of overall treatment effect (self-reported global rating of change on a 15-point Likert scale), physical activity (Incidental and Planned Exercise Questionnaire), general health-related quality of life (Short Form-12 Version® 2.0), use of co-interventions and adverse events. This trial will evaluate the efficacy of arch contouring foot orthoses for relieving pain and improving function, physical activity and health-related quality of life in people with midfoot OA. The findings will provide high-quality evidence as to whether arch contouring foot orthoses are efficacious and will help to inform clinical guidelines about the use of foot orthoses for midfoot OA. Australian and New Zealand Clinical Trial Registry (ACTRN12623000953639).

Validation and reliability of the Malay version of the painDETECT questionnaire (PDQ-M) among patients with neuropathic and nociceptive pain

Background: Neuropathic pain is chronic and debilitating. Early and accurate diagnosis is important for appropriate management. The painDETECT questionnaire (PDQ) is an effective screening tool for presence of neuropathic pain. We tested the validity and reliability of the translated Malay version of PDQ (PDQ-M). Methods: This was a multi-center cross-sectional study conducted over 24 months. The original English version of PDQ was translated into Malay version following international guidelines. Subsequently, patients with chronic pain were administered PDQ-M and Malay version of SF36 at baseline and 2-4 weeks later. The reliability, construct and criterion validity of PDQ-M were evaluated. Clinician diagnoses were used as gold standard for comparison of diagnostic accuracy. Multiple regression analysis was performed to determine correlation between PDQ-M and SF-36 scores. Results: A total of 97 patients were included in the study (53 with neuropathic pain, 44 with nociceptive pain). The EFA of PDQ-M produced three factors which explained 58.3% of the variance. It exhibited fair consistency with Cronbach’s alpha coefficient of 0.719 (for all 9 items) and 0.755 (for 7-item with Likert scale). PDQ-M is reliable with Cronbach’s alpha coefficient of 0.719 and 0.852 for test-retest reliability. A score of ≥17 was the best cut-off value for discriminating between neuropathic and non-neuropathic pain in PDQ-M (79.2% sensitivity, 50.0% specificity). Multiple regression analysis exhibited total PDQ-M score to have significant negative correlation with all components of SF-36 scores except role limitation due to physical health. Conclusions: PDQ-M is a reliable and valid self-administered screening tool for neuropathic pain.