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Social disadvantage can result in healthcare gaps and primary care may be a suitable healthcare context to identify unmet social needs. A variety of screening tools exists but none of them is consolidated in clinical practice. After reviewing the available instruments, we conducted a rigorous translation and trans-cultural adaptation into Italian language of the EveryONE social need screening tool questionnaire of the American Academy of Family Physicians. The translated questionnaire was piloted among 45 patients consecutively recruited in two general practices in the northern Italian city of Modena in 2023 and obtained excellent scores in comprehension and acceptability. The cross-cultural adaptation presented in this study is a first step towards a complete validation. A full validation study is needed to safely adopt EveryONE in routine general practice and to evaluate its effects on health provision.
Accurately assessing the self-efficacy levels of palliative care professionals’ is crucial, as low levels of self-efficacy may contribute to the suboptimal provision of palliative care. However, there is currently lacking a reliable and valid instrument for evaluating the self-efficacy of palliative care practitioners in China. Therefore, this study aimed to translate, adapt, and validate the Palliative Care Self-Efficacy Scale (PCSS) among Chinese palliative care professionals.
Methods
This study involved the translation and cross-cultural adaptation of the PCSS, and the evaluation of its psychometric properties through testing for homogeneity, content validity, construct validity, known-groups validity, and reliability.
Results
A total of 493 palliative care professionals participated in this study. The results showed the critical ratio value of each item was >3 (p < 0.01), and the corrected item-total correlation coefficients of all items ranged from 0.733 to 0.818, indicating a good homogeneity of the items with the scale. Additionally, the scale was shown to have good validity, with item-level content validity index ranged from 0.857 to 1.000, and scale-level content validity index/Ave was 0.956. The exploratory factor analysis and confirmatory factor analysis (CFA) confirmed the 2-factor structure of the Chinese version of PCSS (C-PCSS), explaining 74.19% of the variance. CFA verified that the 2-factor model had a satisfactory model fit, with χ2/df = 2.724, RMSEA = 0.084, GFI = 0.916, CFI = 0.967, and TLI = 0.952. The known-groups validity of C-PCSS was demonstrated good with its sensitive in differentiating levels of self-efficacy between professionals with less than 1 year of palliative care experience (p < 0.001) or without palliative care training (p = 0.014) and their counterparts. Furthermore, the C-PCSS also exhibited an excellent internal consistency, with the Cronbach’s α for the total scale of 0.943.
Significance of results
The findings from this study affirmed good validity and reliability of the C-PCSS. It can be emerged as a valuable and reliable instrument for assessing the self-efficacy levels of palliative care professionals in China.
Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version.
Design:
An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment.
Setting:
Community settings in the UK.
Participants:
One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer’s disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI.
Measurements:
The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures.
Results:
Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score (Kendall’s Tau −.388, −.445, −.497, −.569). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures.
Conclusion:
The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.
Global mental health movements increasingly highlight social integration as a key outcome for mental health services. This creates a pressing need to better articulate and measure this outcome. Much of the work in social integration thus far has been in high-income countries (HIC), and is not directly applicable across diverse socio-cultural environments. We discuss promising concepts and measures of social integration with potential for global cross-cultural application. Then, we present some of the challenges of developing measures for global and cross-cultural use, and suggest ways to confront these challenges. Although we focus primarily on adults with severe mental disorders in low- and middle-income countries (LMIC), the questions we raise are also relevant to children, other mental disorders and HIC.
Findings.
We identify and describe four distinct conceptual frameworks for social integration that have emerged over the past decade. Then, we discuss the challenge of developing corresponding measures, and the further challenge of developing global cross-cultural measures. We suggest that a key concept shared across much previous and emerging work is active participation in community and civic life. As a platform for future development of global cross-cultural measures of this and other concepts, we propose guidelines and present examples of feasible, previously used strategies.
Summary.
Emerging concepts of social integration hold great promise, but as yet, there are no corresponding measures suitable for global cross-cultural use. We propose that it is feasible to develop such measures, and that their development will facilitate the advance of community mental health services and the science of global mental health.
Assessing the burden linked to caring for the frail elderly is becoming an important issue in rehabilitation. The purpose of this study was to translate/validate the Montgomery Borgatta Caregiver Burden Scale into French for use in Canada. This easy-to-use questionnaire evaluates aspects of burden such as objective, subjective stress and subjective demand burden. The instrument underwent: 1) parallel translation/back-translation; 2) expert's committee review leading to an experimental version; 3) pre-test to ensure wording clarity; and 4) study of psychometric properties with bilingual subjects (n = 27) and French-speaking subjects (n = 18). Results suggest that convergence between the original and the French versions is satisfactory for two of the three sub-scales of the MBCBS (ICC 0.83 et 0.96). The test-retest stability coefficients are also very good (ICC of 0.92 et 0.91), as is internal consistency (0.90, 0.66). The objective burden sub-scale correlates moderately with a measure of functional autonomy (SMAF). Results for the subjective burden scale linked to demand are, however, inadequate. All in all, two of the three sub-scales of the French-Canadian version of the Montgomery Borgatta Caregiver Burden Scale demonstrate adequate psychometric properties, thereby favouring its use in geriatric rehabilitation.
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