Spanish-speaking Population Research Articles

Women's satisfaction with maternity care during preterm birth.

Women's satisfaction with maternity care is strongly influenced by their sociodemographic characteristics, values, and attitudes. The arrival of a preterm baby is often a traumatic time, with unique factors involved. The Spanish Preterm Birth Experience and Satisfaction Scale (P-BESS) is a robust instrument capable of assessing women's satisfaction during preterm birth. The purpose of this study was to assess women's satisfaction with maternity care during labor and birth with preterm babies in a Spanish-speaking population. This is a cross-sectional study. Participants were 182 women who gave birth within 37weeks' gestation. Factors associated with satisfaction were studied through univariate and bivariate analyses and through multiple linear regression using the backward elimination method. Women reported high satisfaction with maternity care overall (average score of 84 out of 95). Women with a university education were generally less satisfied. Women were more satisfied if they were pregnant for the first time. Women who reported a previous premature birth or neonatal death were more satisfied, and women who had prior miscarriages were less satisfied compared with women without these experiences. The analysis confirmed that the majority of women surveyed were very satisfied with their childbirth experience. The Spanish P-BESS can be a useful way of prioritizing intervention measures, focusing on those aspects lowest scored by women, such as "information and explanations" and "confidence in staff," to improve maternity services for families experiencing preterm birth.

Normative Data for the Halstead Category Test in a Spanish-Speaking Adult Population Living in the U.S./México Border Region

Abstract Objective To provide norms applicable to Spanish-speakers living in the US- Mexico border region for the Halstead Category Test, a test of executive function. Participants and Method Healthy Spanish-speakers (n = 252) were recruited from the US–Mexico border regions (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.3, range 0-20; 58% female). Participants completed the Category Test as part of a larger neuropsychological test battery. Relationships between demographic variables and raw error scores were assessed using Spearman and Wilcoxon Rank-sum tests. Demographically corrected T-scores for the Category Test were normed using fractional polynomial equations accounting for age, education, and sex. For comparison, T-scores were also computed for the Spanish-speaking normative sample using published norms for English-speaking non-Hispanic Whites and African Americans, which were also adjusted for age, education and sex. Impairment rates based on -1SD (T < 40) were calculated using both, published and current, norms. Results Older age was significantly associated with higher number of errors (Spearman ρ = 0.32, p < .001) and higher education was associated with lower number of errors (Spearman ρ = -0.52, p < .001), with no other significant demographic effects. Applying non-Hispanic norms resulted in overestimation of impairment rates in the Spanish-speaking sample (impairment rate: 48% with White norms and 27% with African American norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using African American norms were comparable to those based on the newly developed norms. Conclusions The present study is the first to develop norms for the Category test in a sample of Spanish-speakers in the US-Mexico border region. These norms will provide tools for the assessment of executive function in this population. Research concerning generalizability of norms to other Spanish-speaking populations is needed.

Current Practices in Cross-Cultural Neuropsychology: A Survey of Providers' Use of Appropriate Normative Data and Views on a Web-based Approach to the Collection and Dissemination of Normative Data for Spanish-speaking Populations

Abstract Objective As the U.S. Spanish-speaking population grows, neuropsychologists provide assessment services to an increasingly diverse group of individuals. In response to the need for a centralized resource, NeuroShare, a no-cost website that collects and organizes cross-cultural neuropsychological normative data was created. The purpose of this study was to gather information on the current practices of cross-cultural neuropsychology, the utility of NeuroShare, and potential improvements that could be made to the platform. Participants and Method An anonymous survey was distributed to neuropsychologists and trainees through national and regional professional listservs. Participants’ demographics, clinical experience, and current practices (e.g. use of language specific normative data, assessment of acculturation/bilingualism) when providing neuropsychological services to Spanish-speaking populations were collected. The survey examined feedback on the NeuroShare database. Results 60 participants completed the survey, and they were primarily White/ Caucasian (62%), along with Hispanic/ Latino (36%), Black/African American (1%), and biracial/multiracial (1%). About 66% reported that they often search for Spanish language normative data depending on the patient’s demographics. 70% of respondents reported administering tests developed primarily for English-speaking populations, that are then adapted, when testing Spanish-speaking individuals. Some recommendations for improving Neuroshare included the incorporation of pediatric normative data and a normative data calculator tool. Conclusions This study highlights the needs and benefits of a comprehensive, easy to use system in collecting and organizing normative information for diverse populations. NeuroShare serves as a tool to facilitate the practice of cross-cultural neuropsychology, as well as a catalyst to improve neuropsychological services through the provision of improved access to appropriate normative measures for use with diverse populations.

Assessment of Verbal and Visuospatial Performance Predicting Cognitive Impairment in a Monolingual, Spanish-Speaking Sample

Abstract Objective The Batería Neuropsicológica en Español (BNE) – Digit Span (DS) and Spatial Span (SS) subtests are popular instruments used to measure the capacity of verbal and visuospatial attention/working memory. Although deficits in working memory performance have been found in cases of mild cognitive impairment and dementia in analogous versions of these tasks among English speakers, very few studies have assessed the ability of verbal and visuospatial span tasks to identify impairment within a mono-lingual Spanish-speaking population. This study investigated the clinical utility of the BNE verbal and visuospatial span tasks for discriminating those with and without cognitive impairment in a Spanish-speaking Hispanic population. Participants and Method Participants were 46 monolingual, Spanish-speaking Hispanics, 28 women (60.9%) and 18 (39.1%) men (M age = 63.41 (SD = 14.54); M education = 8.41 (SD = 4.39), referred for neuropsychological evaluations, which included the BNE-DS/SS. Three patients with invalid performances were excluded. Of the remaining 46, 17 were cognitively intact following evaluation, whereas 29 met criteria for a neurocognitive disorder. Results Logistic regression analysis revealed that although DS backward model was significant, both DS forward age/education-corrected T- scores (p = .878) and DS backward (p = .67), were not significant predictors of cognitive impairment. In contrast, both SS forward (p = .002) and backward (p = .022) were significant predictors of impairment status with respective classification accuracies of 63% and 76.1%. Conclusions Findings suggest better performance on visuospatial working memory (SS) is associated with generally intact cognitive abilities and decreased odds of cognitive impairment in a sample of monolingual Spanish-Speaking Hispanics; whereas verbal working memory (DS) findings were less robust.

Normative Data for Selected Subtests of the WAIS-R in a Spanish-Speaking Adult Population Living in the U.S. – Mexico Border Region

Abstract Objective Adaptations of the Wechsler Adult Intelligence Scale, Revised (WAIS-R) and accompanying norms exist for a limited number of Spanish-speaking populations, but none are available for US-dwelling Spanish speakers of Mexican origin, who make up the largest proportion of Latinas/os in the US. As part of a larger test adaptation and norming effort for Spanish-speakers from the US-Mexico border region, we generated and investigated demographically adjusted interpretive norms for selected WAIS-R subtests. Participants and Method Participants included 183 community-dwelling, primarily Spanish-speaking individuals, aged 20 to 55 (education range: 0-20 years; 58% female), who were residing in the US-Mexico border region. Participants completed the WAIS-R Spanish version (Block Design, Arithmetic, and Vocabulary subtests) as part of a larger neuropsychological battery. Demographically adjusted T-scores were calculated for these subtests using fractional polynomial equations, which controlled for age, education, and sex. We examined rates of neurocognitive impairment (T < 40) in our sample derived from the present demographically adjusted Spanish speaking norms and from the existing WAIS-R demographically adjusted norms for English-speaking Non-Latina/o White and Black adults. Results Based on the normalized distribution of T-scores, the newly developed regional Spanish-speaker norms yielded subtest rates of impaired performance between 13-16% (i.e., within the expected -1 SD). By comparison, the proportion of impaired subtest performances was between 4-6% when applying the existing English-speaking norms to our sample. Conclusions Regional normative data will improve interpretation of test performance on selected WAIS-R subtests for Spanish-speakers living in the US and will facilitate a more valid analysis of neuropsychological profile patterns in this population. Cross-validation with Spanish-speakers in other regions and/or with other national origins is needed.

Normative Data for two Verbal Fluency Tests in a Spanish-Speaking Adult Population Living in the U.S./México Border Region

Abstract Objective To investigate the impact of demographic factors and develop normative data for two verbal fluency tests in a sample of Spanish-Speakers living in the U.S./Mexico border region. Participants and Method The sample consisted of 252 adults (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.37, range 0-20, 59% female), living in the US-Mexico border region of Arizona and California. Participants completed the letter (letters P, M, and R) and semantic (Animal Naming) fluency tests as part of a larger neuropsychological test norming study. Normative T-scores were computed with fractional polynomial equations controlling for age, education, and sex. We also calculated the rates of impairment (T < 40) that would be obtained by applying the newly developed norms and available test norms for non-Hispanic English-speakers. Results Higher education was significantly associated with better raw scores on both verbal fluency tests (letter: r = 0.41, semantic: r = 0.36, ps < .001), and older age was significantly associated with higher raw scores on letter fluency (r = 0.14, p < .05). There were no other significant effects of demographic factors. The normalized distribution of T-scores with the new norms showed the expected impairment rate (16% letter and 15% semantic fluency). However, application of existing non-Hispanic White norms resulted in 23% impairment for letter fluency and 24% in semantic fluency. Using non-Hispanic Black norms resulted in 9% impairment in letter fluency and 2% in semantic fluency. Conclusions We provide norms for Spanish speakers living along the U.S-Mexico border region for two verbal fluency tests that are co-normed with a more extensive neuropsychological battery. We demonstrate that application of existing norms derived from English speaking samples yield inaccurate estimates of impairment. As such, these regional norms will improve the interpretation of verbal fluency performance in Spanish-speakers living in the US-Mexico borderland.

Exploring the Neuropsychological Profile of a Clinically Referred Sample of Children in Mexico

Abstract Objective The Wechsler Scale of Intelligence for Children (WISC-IV) is one of the most commonly used intelligence tests for children. A Spanish version of the WISC-IV exists, but a limited amount of published information is available on its utility when assessing pediatric clinical populations. Furthermore, little published research utilizes the WISC-IV in Spanish speaking populations residing outside the US. This study seeks to present the neuropsychological profile of a clinically referred sample of children residing in Mexico. Participants and Method The present study included 35 participants (15 females and 20 males, M age of 9.26 years, SD = 1.69). Participants were referred to clinic sites affiliated with the neuropsychology master’s program at Benemérita Universidad Autónoma de Puebla (BUAP). Participants were referred for assessment due to persistent academic/behavior difficulties and were included in this study if they were between the ages of 7 and 12, with no history of a psychiatric disorder. All participants were administered the WISC-IV. Procedures were approved by the ethics committee at BUAP. Informed consent was obtained prior to evaluation. Results Descriptive statistics show a Full-Scale IQ average (FSIQ) mean of 75.40 (SD = 12.42). Highest index scores were on Perceptual Reasoning (PRI) (M = 84.94, SD = 16.22) and Processing Speed (PSI) (M = 81.34, SD = 12.96) and lowest index score were on working memory (WMI) (M = 76.97, SD = 14.64) and Verbal Comprehension (VCI) (M = 76.54, SD = 12.42). Independent T-Tests showed no significant differences between genders. Conclusions Our results show a low average IQ for the sample but also identifies strengths in certain indices and specific subtests within the WISC-IV that can add rich details in the comprehension of cognitive functioning in this sample. In the future, we plan to continue the growth of our study via the utilization of a control group to compare with the clinical sample.

Adaptación al español de la Escala de Autocontrol y de la Escala de Autocontrol-Abreviada y evidencias de validez en población universitaria

El objetivo del estudio fue adaptar y validar la Escala de Autocontrol (EAC) y la Escala de Autocontrol-Abreviada (EAC-A) para población hispanohablante. Se trabajó con una muestra de 430 estudiantes de la Universidad Nacional de Mar del Plata (279 mujeres y 151 hombres) con una media de edad de 23.38 (DE = 5.69). El Análisis Factorial Exploratorio reveló en la EAC una estructura de tres factores que fueron denominados Control no reflexivo de los impulsos, Autodisciplina y Control reflexivo de los impulsos. En la EAC-A se halló una estructura de dos factores, que fueron denominados Autodisciplina y Control de los impulsos. Tanto la EAC como la EAC-A presentaron buenos índices de ajuste de modelo y adecuados valores de consistencia interna. Se presentan asimismo evidencias de validez concurrente y convergente a través de asociaciones con medidas de impulsividad y responsabilidad respectivamente. Se concluye que ambas escalas resultan válidas para la población bajo estudio.

Using Electronic Referrals to Address Health Disparities and Improve Blood Pressure Control.

IntroductionMassachusetts developed and used bidirectional electronic referrals to connect clinical patients across the state to interventions run by community organizations. The objective of our study was to determine whether the use of Massachusetts’s electronic referral system (MA e-Referral) reached racial/ethnic groups experiencing health disparities and whether it was associated with improved health outcomes.MethodsWe assembled encounter-level medical records from September 2013 through June 2017 for patients at Massachusetts clinics funded by the Clinical Community Partnerships for Prevention into 2 cohorts. First, all patients meeting program eligibility guidelines for an e-Referral (N = 21,701) were examined to assess the distribution of e-Referrals among populations facing health disparities; second, a subset of 3,817 people with hypertension were analyzed to detect changes in blood pressure after e-Referral to an evidence-based community intervention.ResultsNon-Hispanic black (OR, 1.4; 95% confidence interval [CI], 1.2–1.6) and Hispanic patients (OR, 1.3; 95% CI, 1.1–1.4) had higher odds than non-Hispanic white patients of being referred electronically. Patients completing their hypertension intervention had 74% (95% CI, 1.2–2.5) higher odds of having an in-control blood pressure reading than patients who were not electronically referred.ConclusionClinical to community linkage to interventions through MA e-Referral reached non-Hispanic black, Hispanic, and Spanish-speaking populations and was associated with improved blood pressure control.

Dimensions underlying frailty indicators in the Kihon Checklist.

Frailty has become a current topic of debate in recent years among researchers as a key concept of clinical care in old age. One of the scales developed for its measurement is the Kihon Checklist (KCL). However, the dimensionality of the KCL has not been tested yet, and therefore the aim of the present study was to validate its dimensional structure. This was a cross-sectional study carried out between March and September 2018 in Valencia province (Spain). Participation in the study was voluntary. A total of 251 participants were sampled. They answered sociodemographic and medical indicators, as well as five frailty scales, including the KCL. Five confirmatory models with different dimensionalities were tested and none of them fit the data well. Therefore, all models were depurated. Goodness of fit indices showed that the best fitting model was a one-factor solution, with 15 items. This reduced model had very good estimates of internal consistency and showed good levels of criterion-related validity with four different measures of frailty. This work constitutes the first study on the dimensionality of the KCL and the first validation of the Spanish version in a Spanish sample of community-dwelling older adults. A translation exists into Spanish, but there are no data on the reliability and validity of the KCL for its use in Spanish-speaking countries. The KCL, once depurated, offers a valid and reliable measure of frailty to be used in Spanish-speaking populations. Geriatr Gerontol Int 2019; 19: 982-987.

Assessment and validation of a Spanish version of the Muscle Dysmorphia Disorder Inventory in Argentinian men who exercise: Inventario de Dismorfia Muscular

Despite an increase in body dissatisfaction and muscularity concerns among Latin American men, there is a paucity of research relating to muscle dysmorphia in this population. In this study we aimed to evaluate, for the first time in Latin America, the factor structure of the Muscle Dysmorphic Disorder Inventory (MDDI; Hildebrandt, Langenbucher, & Schlundt, 2004). A sample of 551 men who exercise completed measures of body dissatisfaction, disordered eating, and the MDDI. Exploratory factor analysis in a first split-half sample revealed a 3-factor solution similar to the original version, which was then tested through confirmatory factor analysis (CFA) in a second split-half sample. A re-specified model (allowing for error correlations between Items 10–13 and 11–13) presented adequate fit. Omega coefficients revealed adequate internal consistency (> .80) for the Drive for Size and Functional Impairment subscales. The internal consistency for the Appearance Intolerance subscale was .74 and .72 across subset samples. Associations with body dissatisfaction, disordered eating, body mass index, and frequency of training and rest days are presented as evidence of construct validity. Finally, multi-group CFA indicated that the model was invariant across type of exercise. Overall, these data suggest that the MDDI is suitable for use in Spanish-speaking Latin American male populations.

Development of a word accentuation test for predicting cognitive performance in Portuguese-speaking populations.

The Word Accentuation Test (WAT) has been used to predict premorbid intelligence and cognitive performance in Spanish-speaking populations. It requires participants to read a list of words without the accent marks that indicate the stressed syllable. Label="OBJECTIVE">As Portuguese pronunciation is also strongly based on accent marks, our aim was to develop a Brazilian version of the WAT. METHODS An initial pool of 60 items was constructed and a final version of 40 items (named WAT-Br) was derived by item response theory. A sample of 206 older adults underwent the WAT-Br and a standardized neuropsychological battery. Independent ratings were performed by two observers in 58 random participants. RESULTS The items showed moderate to high discrimination (α between 0.93 and 25.04) and spanned a wide range of difficulty (β between -2.07 and 1.40). The WAT-Br was shown to have an excellent internal consistency (Kuder-Richardson Formula 20 = 0.95) and inter-rater reliability (intraclass correlation coefficient = 0.92). It accounted for 61% of the variance in global cognitive performance. CONCLUSION A version of the WAT for Portuguese-speaking populations was developed and proved to be a valuable tool for estimating cognitive performance.

Areas of work-life in Spanish hostelry professionals: explanatory power on burnout dimensions

BackgroundResearchers have studied for decades workplace stress and burnout to identify their relationship to health and wellness. This research has focused on stress levels in people, as well as on environmental and personal factors that contribute to experiencing stress or burnout. In addition to the burnout measurement questionnaires (MBI-GS), Leiter and Maslach designed a model to evaluate the areas of work environment that relate to this construct (Areas of Worklife Scale-AWLS).The goal of the present research was to analyze the psychometric properties of a Spanish translation of the MBI (GS) and the AWLS with a Spanish-speaking population. This work makes a substantial contribution by addressing the need to use validated measures and methods when exploring the positive and negative aspects of organizations. These conditions provide a means to accurately evaluate the impact of interventions aimed to address stress and burnout.MethodCross-sectional study with self-report measures. The sample was comprised of 452 managers and employees (hotels, restaurants, catering) of Aragón (Spain). There were approximately equal numbers of women and men (45,4% vs. 54,6%). The average age of participants was 36.6 years (SD = 10.03). A battery of questionnaires was used: Socio-demographic and work characteristics, Scale of stress and health symptoms, Maslach Burnout Inventory-General Survey (MBI-GS), Areas of Worklife Scale (AWLS).ResultsThe results showed optimal psychometric properties in both questionnaires, especially in terms of the predictive capacity of the AWLS in each of the MBI-GS dimensions.ConclusionsThe best explained dimension is that of emotional exhaustion. The manageable load variable is the one that most contributes to predicting burnout levels. For future interventions, the results confirm the need to verify the levels of each area of work, in order to focus on the most deteriorated ones.

A-83 The Applicability of the Word Accentuation Test (WAT) in a Diverse Spanish Speaking Population: A Pilot Study

Abstract Objective A valid estimate of premorbid ability (PA) is important when attempting to identify cognitive decline. Measures of PA in English have been widely validated, but there is a lack of PA instruments for Spanish speakers. The findings of a pilot study assessing the feasibility of using the Word Accentuation Test (WAT) as a PA measure in a diverse, traditionally underserved, Spanish speaking population are described. Method The WAT was administered as part of comprehensive neuropsychological evaluations and neurobehavioral status exams (NBSE) completed with Spanish speaking patients at Montefiore Medical Center (MMC) in a 6-month period. Sixty-one patients completed the WAT- 12 as part of comprehensive testing (mean age 60 (SD 11.05) range 43-80, 67% female) and 49 during NBSEs within the context of multidisciplinary memory disorders clinics (mean age 74.35 (SD 8.60) range 51-93, 80% female). T-tests and correlations with WAT performances were completed. Results Overall, our population correctly read an average of 19.67 (SD 7.61) words. There was no statistical difference by gender or age, but years of education predicted WAT performance (p = .004). For those individuals who had comprehensive cognitive evaluations, WAT scores were correlated with performance on the vocabulary subtest of the EIWA-III (p = .003). All patients without severe dementia were able to complete the task. Conclusions Analysis of pilot data from our diverse Spanish population demonstrated that the WAT is an PA appropriate task that appears to have good correlation with years of education and vocabulary performance. Additional research is necessary to validate the measure in this cohort and other cohorts.

B-06 Attention and Verbal Memory Declines after Epilepsy Surgery Associated with Restricted Improvements in Cognitive, Energy and Medication Related Aspects of Quality of Life in Latino People with Epilepsy

Abstract Objective Explore neuropsychological and quality of life outcomes of epilepsy surgery in an underserved, primarily immigrant, Spanish-speaking cohort of people with epilepsy (PWE). Methods Pre- and postsurgical Neuropsychological Screening Battery for Hispanics (NeSBHIS) and Quality of Life in Epilepsy-31 (QOLIE-31; Spanish Version) results were compared for 22 adult Latinos (females = 50%), from Mexico (81.8%), El Salvador (9.1%) and Guatemala (9.1%). All participants were part of a comprehensive epilepsy center in Los Angeles. Mean surgical age was 33.5 years (SD = 8.5), while mean education was 8.7 years (SD = 3.1). Seizures were exclusively lateralized to right (59.1%) and left hemispheres (40.9%). Results One-tailed, paired t-tests demonstrated statistically significant differences between pre- and postsurgical raw scores for Digit Span, t(21) = -2.52, p = 0.02 (presurgical M = 8.05, SD = 1.70; postsurgical M = 7.32, SD = 1.43), and the Auditory Verbal Learning Test (AVLT) Delayed Recall, t(21) = -2.99, p < 0.01 (presurgical M=10.00, SD=2.51; postsurgical M = 8.55 SD = 2.61). Respective effect sizes were moderate (d = .54; d = .64). QOLIE-31 scores improved on all subscales, as expected. Significant changes |p < 0.05| were found on most QOLIE-31 subscales, i.e., Seizure Worry, Emotional Well-Being, Social Function and Overall Quality of Life. Remaining subscales did not significantly improve, i.e., Energy/Fatigue, Cognitive and Medication Effects. Conclusions Attention and verbal memory declines after epilepsy surgery were associated with limited improvements on QOLIE-31 subscales of Cognitive, Energy/Fatigue and Medication Effects in Latino PWE. Previous studies have not simultaneously examined neuropsychological and QOLIE-31 outcomes after epilepsy surgery in this unique, underserved, Spanish-speaking population. Further investigation is warranted.

Improving the Evaluation of Adult Mental Disorders in the Criminal Justice System With Computerized Adaptive Testing.

The authors sought to develop and validate a suite of dimensional measures of psychiatric syndromes for use in a criminal justice population. The previously validated Computerized Adaptive Test-Mental Health (CAT-MH) was administered to a sample of 475 defendants in the Cook County Bond Court. Item-level data were used to determine which test items exhibited differential item functioning in this population compared with the population used for the original calibration. After removal of nine items that exhibited differential item functioning from the CAT-MH, correlations between scores based on the original calibration from a nonjustice-involved population and the newly computed scores based on a sample of bond court defendants showed a correlation coefficient of r=0.96 to r=0.99. With a slight modification of the original CAT-MH, the tool was successfully used to measure severity of depression, anxiety, mania and/or hypomania, suicidality, and substance use disorder in an English- and Spanish-speaking criminal justice population.

Strategies for Teaching Linguistic Preparedness for Physicians: Medical Spanish and Global Linguistic Competence in Undergraduate Medical Education.

In accordance with Liaison Committee on Medical Education (LCME) curriculum content standards, medical schools are expected to teach physician communication skills and cultural competence. Given the sustained U.S. Spanish-speaking population growth, importance of language in diagnosis, and benefits of patient–physician language concordance, addressing LCME standards equitably should involve linguistic preparedness education. The authors present strategies for implementation of linguistic preparedness education in medical schools by discussing (1) examples of institutional approaches to dedicated medical Spanish courses that meet best practice guidelines and (2) a partnership model with medical interpreters to implement integrated global linguistic competencies in undergraduate medical curricula.

The Caregivers Quality of Life Cancer-Index (CQOL-C) in Spain: An Exploratory and Confirmatory Factor Analysis for Caregivers of Ambulatory and Hospitalized Patients With Cancer

Purpose: The Caregivers Quality of Life Index- Cancer (CQOLC) is used worldwide to measure quality of life of caregivers of cancer patients, but is still not translated and validated in most countries, including Spain. Previous studies show different underlying structure across countries. This study proposes to translate, adapt, study, psychometric properties of a Spanish version, CQOLC-S. Methods: The CQOLC-S was translated-retro-translated, then administered to 289 primary caregivers of patients with all types of solid cancer, in all phases of the disease, in a Spanish hospital. The scale was analyzed via EFA and CFA. Other useful demographics for further studies were also collected for future subgroups comparisons. Results: Five factor analysis and a confirmatory analysis were conducted, revealing a 6-factors structure. Three factors were present in the original CQOLC scale, three new factors appear: F3-NEGATIVE EMOTIONS (distinct from BURDEN) and two factors labelled F5-CONNECTEDNESS and F6-AFFECT-SPIRITUALITY. Reliability is acceptable (alpha=0.796). Conclusions: Methodological contributions are discussed. CQOLC-S shows a structure distinct from US, Asian and other European scales, justifying studies process in each country. We provide an instrument validated in Spain which could now be tested in Latin-American and Spanish-speaking North-American populations. Cross-cultural differences are discussed, demonstrating the need for more research.

The Spanish Version of the Functional Rating Index in Patients With Low Back Pain: Preliminary Results of the Validation Study

ObjectiveTo assess the reliability, validity, and the psychometric properties of the Spanish version of the Functional Rating Index (Sp-FRI) in a preliminary cohort of patients with low back pain (LBP). DesignProspective observational multicenter study. SettingOutpatient physical therapy clinics and units from public and private settings. ParticipantsPatients with LBP (N=22; 52.5±12.5y) entered the study. InterventionsThe translation and cross-cultural adaptation were performed following international guidelines through a 5-step procedure. Main Outcome MeasuresThe Sp-FRI was administered along with the Spanish version of Roland-Morris Disability Questionnaire (Sp-RMDQ) and numeric pain rating scale (NPRS) index. Preliminary testing included readability, comprehensibility, ceiling and floor effects, reliability, and validity. Statistical analysis was based on the Fernandez-Huerta index, and the calculation of Cronbach alpha, intraclass correlation coefficient (ICC), and Spearmanś correlation coefficient, respectively. All patients completed the Sp-FRI again after 1-2 days to assess its test-retest reliability. ResultsNone of the participants requested clarification of any of the items at the time of completion. The test-retest reliability of the FRI score was substantial (ICC 0.77). Cronbach alpha was 0.859. Spearman correlation coefficient between Sp-FRI and Sp-RMDQ was 0.66; P<.0001, and between Sp-FRI and NPRS was 0.66; P<.0001. No ceiling or floor effects were detected. ConclusionsIn light of these preliminary data, the Sp-FRI appears to be linguistically accurate and has been adapted to the Spanish-speaking population. It demonstrated reliability and validity and is suitable for clinical and research use among Spanish patients with LBP, with an acceptable degree of internal consistency and concurrent validity.

Validation study of the Spanish version of the Last-7-d Sedentary Time Questionnaire (SIT-Q-7d-Sp) in young adults.

There are few valid instruments to assess domain-specific sedentary behaviours (SB) among Spanish-speaking populations. This study validated the original English version of the last 7 days SB questionnaire (SIT-Q-7d) into Spanish (Castilian). A total of 151 undergraduates (52% male, 21.19±2.57 yrs.) wore an activPAL3M (AP3M) for 7 days and subsequently completed the Spanish version of the SIT-Q-7d (SIT-Q-7d-Sp). A subsample of 30 participants (70% male, 22.89±1.54 yrs.) simultaneously wore the AP3M and used a domain-log to register the context where the SB occurred. The SIT-Q-7d-Sp differed significantly from the AP3M, overestimating sitting time by an average of 60.69 mins.d-1 (all p<0.016). No significant differences were observed between the two measures for weekend total sitting time. The SIT-Q-7d-Sp did not differ significantly from the AP3M +Log for meal, work, and transportation-based sitting time (all p>0.016). However, screen-based and other leisure-based sitting activities were significantly overestimated (ranging from 94.68 mins.d-1 to 234.08 mins.d-1, p<0.001). The SIT-Q-7d-Sp appears to provide acceptable estimates of sitting time during transportation, occupational and meal-based domains. The SIT-Q-7d-Sp is not an appropriate measure of SB when examining total sitting time and leisure-based SB in young adults. For total sitting time and leisure-based SB, the use of objective measures is recommended.