Search

Purpose: The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain. Methods: We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test–retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS. Results: A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test–retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects. Conclusion: Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to estimate the comorbidity of mental disorders and chronic physical conditions and to describe the impact of these conditions on health-related quality of life (HRQoL) in a sample of older primary care (PC) attendees by gender.Methods: Cross-sectional survey, conducted in 77 PC centres in Catalonia (Spain) on 1192 patients over 65 years old. Using face-to-face interviews, we assessed HRQoL (SF-12), mental disorders (SCID and MINI structured clinical interviews), chronic physical conditions (checklist), and disability (Sheehan disability scale). We used multivariate quantile regressions to model which factors were associated with the physical component summary-short form 12 and mental component summary-short form 12.Result: The most frequent comorbidity in both men and women was mood disorder with chronic pain and arthrosis. Mental disorders mainly affected 'mental' QoL, while physical disorders affected 'physical' QoL. Mental disorders had a greater impact on HRQoL than chronic physical conditions, with mood and adjustment disorders being the most disabling conditions. There were some gender differences in the impact of mental and chronic physical conditions on HRQoL. Anxiety disorders and pain had an impact on HRQoL but only in women. Respiratory diseases had an effect on the MCS in women, but only affected the PCS in men.Conclusions: Mood and adjustment disorders had the greatest impact on HRQoL. The impact profile of mental and chronic physical conditions differs between genders. Our results reinforce the need for screening for mental disorders (mainly depression) in older patients in PC. [ABSTRACT FROM AUTHOR]

Purpose: To derive EQ-5D-5L Spanish population norms based on a national representative sample adjusted by age, gender and region.Methods: A representative sample of the Spanish general population (n = 21,007) was used in a cross-sectional study. The source of data was the Spanish National Health Survey 2011-2012. All socio-demographic factors and clinical characteristics were carried to a descriptive analysis. All variables were stratified by region, gender and age-group.Results: The utility value 1 is the most repeated (62%) in this representative population sample. This study showed a deterioration of health states as age increases. Overall, men reported better health status than women. In relation to ceiling effect by regions, there was little difference with the highest scores. Conversely, the lowest score corresponds to Galicia.Conclusions: The paper reports EQ-5D-5L normative data for Spanish general population, based on a national representative sample adjusted by region, gender and age-group. These results may serve as reference data of the population health status. A regional difference in health status could be observed, which might suggest that policies aiming to reduce regional inequalities are important. [ABSTRACT FROM AUTHOR]

Purpose: The main objective is to study the health-related quality of life (HRQoL) as a positive approach to health in adult adoptees. We will also consider comparison with population norms, relation to chronic medical conditions, the role of sociodemographic variables, and gender differences among the variables in this study.Methods: This was a cross-sectional study of 179 adult domestic adoptees from Spain aged between 18 and 44. They were recruited from a longitudinal study, which was on its third wave. They answered an interview and the self-report measure Health Survey Short Form (SF-12). ANOVAs and t test analyses to compare groups, and multiple regression to determine predictors of HRQoL, were performed.Results: Adoptees are not different from the general population in terms of perceived physical health (PH) and mental health (MH). Both PH and MH are related to different variables (e.g., current age is negatively associated with PH, as is the number of chronic medical conditions with MH). Despite the absence of gender differences in MH perception, there were common and different predictor variables for males and females. The number of chronic medical conditions predicts HRQoL regardless of gender. For women, employment is also a predictor, and for men, other variables are being in a romantic relationship, having children, and low income.Conclusions: Adult adoptees are comparable to general population in terms of HRQoL, but there are associated variables (chronic medical conditions and gender) that should be considered. Post-adoption services should promote health and support in life transitions for this group. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose of this research was to examine the longitudinal measurement invariance of the Satisfaction With Life Scale (SWLS) in adolescence.Method: The sample was composed by 484 adolescents from Spain, 46.7% were males. All participants belonged to six academic levels from Grade 7 to Grade 12, and answered the questionnaires at two different times: at the beginning (Mage1 = 14.95, SD1 = 1.81) and at the end of the school year (Mage2 = 15.61, SD2 = 1.81). The reliability of the scale was obtained through Cronbach's alpha, Guttman lambda, and MacDonald's Omega total. The multiple group confirmatory factor analysis (MGCFA) was used to examine the fit of the unifactorial model to data and to test the measurement of longitudinal invariance of the scale across two time points (at the beginning T1, and the end T2, of the academic year), and the time points and groups (gender and age).Results: The values of the single-factor SWLS structure were T1 (CFI1 = 1.000, TLI1 = .997, RMSEA1 = .080, and SRMR1 = .028), and T2 (CFI2 = .997, TLI2 = .995, RMSEA2 = .032, and SRMR2 = .034). On the other hand, values of the reliability and composite reliability when analyzing both time points together as well as separately were as follows: Cronbach's alpha = .86, Guttman's lambda = .84, McDonald's Omega total = .89. Results confirmed the longitudinal invariance of SWLS. The differences in gender and age were not significant and the small differences across time points showed that the means of the latent factor remained the same over time in both variables.Conclusion: The present study confirmed the single-factor structure of the SWLS in Spanish adolescents, as well as a good reliability and composite reliability. The full longitudinal measurement invariance was also found and there were negligible differences across time points considering gender and age. If these findings are further replicated, the scale could be used to compare the life satisfaction across two time points considering different age and gender groups. [ABSTRACT FROM AUTHOR]

Purpose: Health-related quality of life (HRQOL) in childhood is defined as an individual's subjective perception of the impact of health status on physical, psychological and social functioning. Nowadays, measuring of HRQOL has become an important outcome indicator in evaluating health-care. However, in younger children, the role of cardiorespiratory and other physical fitness components on HRQOL is unclear. The aims of this study were to analyse the association between components of physical fitness and HRQOL, as well as to determine which component of physical fitness was the best predictor of higher HRQOL.Methods: This was a cross-sectional study of 1413 schoolchildren (4 to 7 years old) from Spain. HRQOL was evaluated with the KINDL-R questionnaire for parents. Cardiorespiratory fitness, muscle strength and speed-agility were assessed using the ALPHA-Fitness battery. ANCOVA models were used to assess differences in HRQOL across physical fitness categories, controlling for age and BMI, by gender. Multiple linear regression was used to determine the independent association between the different physical fitness components and HRQOL.Results: Children with high physical fitness levels had better scores in physical well-being, school and total HRQOL score than those who had low physical fitness levels. The best predictor of HRQOL (total score) was muscular strength in boys and speed-agility among girls.Conclusions: Children with high physical fitness levels have higher HRQOL, although the association between components of physical fitness and HRQOL varies according to gender. Improving physical fitness could be a good strategy for improving HRQOL in children. [ABSTRACT FROM AUTHOR]

Purpose: To compare health-related quality of life (HRQoL) between hepatitis C patients who achieve sustained virological response (SVR) to direct-acting antivirals and a sex- and age-paired sample of the general population.Methods: HRQoL was evaluated in patients recruited in Navarre, Spain, from May 2016 to April 2017 at baseline and after SVR, using the EQ-5D-5L questionnaire. Both results were compared to those of general population of the same sex and age obtained from the 2011/12 National Health Survey in Spain. Observed/expected (O/E) ratios for health dimensions and differences between O-E in EQ-5D utility and visual analogical scale (VAS) scores were calculated.Results: 206 patients were studied. Before treatment, patients had more problems than the general population in every domain of EQ-5D-5L, except in self-care dimension (O/E = 1.1). After SVR, patients continued having more limitation, especially for usual activities (O/E = 3.1), anxiety/depression (O/E = 2.8) and EQ-5D utility (- 0.086, p < 0.001); however, differences in VAS score between patients and general population disappeared (74.8 vs 76.5, p = 0.210). F0-F1 patients with SVR had minor differences with the general population in EQ-5D-5L dimensions, utility and VAS score. Although cirrhotic patients also reduced that difference, they still had worse HRQoL, especially in usual activities, self-care, EQ-5D utility (- 0.152, p < 0.001) and VAS score (- 8.5, p = 0.005).Conclusions: HRQoL of chronic hepatitis C patients remains lower than that of the general population despite viral clearance, with primary problems in usual activities and anxiety/depression. Knowledge of these on-going problems despite cure serves to guide healthcare interventions and patient's follow-up. [ABSTRACT FROM AUTHOR]

Purpose: We analyze the influence of the dramatic changes in the Spanish labor market during the crisis on the perceived health of the Spanish population.Methods: We use the longitudinal Living Conditions Survey database and multilevel longitudinal logistic models between 2007 and 2011, before and during the economic crisis in one of the European countries most affected by its consequences.Results: Unemployment (OR 1.75; p < 0.001), job insecurity (OR 1.38; p < 0.001), and being part of a household with severe material deprivation (OR 1.87; p = 0.004) increase the risk of having worsened perceived health. Available income, on the other hand, is a protective factor (OR 0.72; p < 0.001). Public expenditure policies have little impact on the perceived health. Labor market reforms reducing the degree of job insecurity and unemployment, together with income transfers to those at greater risk of social deprivation, can be more effective in improving the health of the population than the increase of aggregated social or health care expenditure.Conclusions: This study provides evidence of the influence that unemployment, job insecurity, and poverty exert on the perceived health of individuals, with data collected in Spain after the onset of the financial crisis. In addition, after analyzing public social expenditure, only expenditure on FPS seems to influence self-reported health, although to a very limited degree. [ABSTRACT FROM AUTHOR]

Purpose: To test whether the systematic monitoring of health-related quality of life (HRQOL) in clinical practice in Spanish pediatric patients with T1DM helps improve their daily life in a multicenter longitudinal study.Methods: One hundred thirty-six patients participated, recruited from five centers in Barcelona, Spain (72 girls, mean age 13.4 years). Complete data were collected for 119 patients (85%). Pediatricians were randomly assigned to the HRQOL intervention (n = 70), or control group (n = 49). The intervention group discussed the results of HRQOL face to face with the physician, quarterly over a year. The control group received care as usual. HRQOL was assessed using KIDSCREEN-27 collected online. Standardized mean differences (effect size, ES) and generalized estimating equation (GEE) were computed to compare group differences between baseline and follow-up, taking into account sociodemographic and clinical variables.Results: Statistically significant higher scores were seen in the intervention group at follow-up for the dimensions of Psychological well-being (ES = 0.56), School environment (ES = 0.56), and the KIDSCREEN-10 index (ES = 0.63). No differences were found in the control group. GEE analysis showed an improvement in HRQOL at follow-up with statistically significant association of the intervention on Psychological well-being (B = 4.32; p 0.03 for the interaction of group by follow-up) and School environment (B = 4.64; p 0.02 for the same interaction term).Conclusions: Routine assessment and face-to-face patient-physician discussion of HRQOL results improved HRQOL scores after a year of follow-up, especially in Psychological well-being and school environment. The results support the routinary use of HRQOL assessment in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH.Methods: Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index.Results: The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function.Conclusions: Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care. [ABSTRACT FROM AUTHOR]

Purpose: Clinical studies suggest that foot pain may be problematic in one-third of patients in early disease. The Foot Health Status Questionnaire (FHSQ) was developed and validated to evaluate the effectiveness of conservative (orthoses, taping, stretching) and surgery interventions. Despite this fact, there are few validated instruments that measure foot health status in Spanish. Thus, the primary aim of the current study was to translate and evaluate psychometrically a Spanish version of FHSQ. Methods: A cross-sectional study was designed in a university community-based podiatric clinic located in south of Spain. All participants ( n = 107) recruited consecutively completed a Spanish version of FHSQ and EuroQoL Health Questionnaire 5 dimensions, and 29 participants repeated these same measures 48 h later. Data analysis included test-retest reliability, construct and criterion-related validity and factor analyses. Results: Construct validity was appropriate with moderate-to-high corrected item-subscale correlations (α = ≥0.739) for all subscales. Test-retest reliability was satisfactory (ICC > 0.932). Factor analysis revealed four dimensions with 86.6 % of the common variance explained. The confirmatory factor analysis findings demonstrated that the proposed structure was well supported (comparative fit index = 0.92, standardized root mean square = 0.09). The Spanish EuroQoL 5D score negatively correlated with the FHSQ pain ( r = −0.445) and positively with general foot health and function ( r = 0.261 − 0.579), confirming criterion-related validity. Conclusion: The clinimetric properties of the Spanish version of FHSQ were satisfactory. [ABSTRACT FROM AUTHOR]

The aim of the study was to develop a cross-cultural adaptation and to evaluate the validity and reliability of a Spanish version of the Quality of Life in Late-Stage Dementia (QUALID) scale. Observational and cross-sectional validation study. The QUALID was translated according to standardised procedures. Internal consistency was assessed using Cronbach’s alpha. The QUALID structure was assessed using a Principal Component Analysis (PCA). Inter-respondent (one rater asking two respondents) and inter-rater (two raters asking one respondent) reliability was assessed using the Intraclass Correlation Coefficient (ICC). The criterion validity (concurrent) was assessed by Spearman’s correlation between the QUALID score and the QoL-Visual Analogue Scale (QoL-VAS) score. The construct validity (convergent) was assessed by Spearman’s correlations between QUALID score and scores on the Pain-Visual Analogue Scale (Pain-VAS), on the Mini-Mental State Examination (MMSE) and on the Neuropsychiatric Inventory-Nursing Home (NPI-NH). A total of 160 elderly residents and 152 respondents at 8 long-term care centres in the province of Girona (Spain) participated in the study. Results showed satisfactory levels of internal consistency (Cronbach’s α coefficients 0.74) and evidenced the multidimensionality of the scale. Three factors were identified (behavioural signs of discomfort, behavioural signs of social interaction and signs of negative affective mood). Acceptable inter-respondent reliability (ICC = 0.74) and high inter-rater reliability (ICC = 0.95) were found. The QUALID score was associated with the QoL-VAS score, suggesting a good concurrent criterion validity, and also with the Pain-VAS, the MMSE and the NPI-NH scores, suggesting good construct validity. Our evaluation of the psychometric properties of the Spanish version of the QUALID indicates that it is a reliable and valid instrument with an adequate capacity to distinguish between different clinical status. [ABSTRACT FROM AUTHOR]

To estimate the comorbidity of mental disorders with chronic physical conditions and to assess their independent and combined effects on health-related quality of life (HRQOL). Face-to-face cross-sectional survey of adult attendants to public primary care (PC) centres from Catalonia (Spain). A total of 3,815 out of 5,402 selected patients provided data for this study. We report frequency of chronic physical conditions among participants with mental disorders and the contribution of each mental disorder and chronic physical condition to HRQOL. Chronic pain is the most frequent condition among those with mental disorders (74.54%). The effect of chronic physical conditions on HRQOL is rather minor when compared to the effect of mental disorders (especially mood disorders). However, chronic pain plays an important role in HRQOL loss. Mood disorders and chronic pain negatively affect HRQOL of PC patients. Especial efforts should be made to detect and treat mental disorders and chronic pain at this level. [ABSTRACT FROM AUTHOR]

To assess changes in health-related quality of life (HRQoL) in children and adolescents over a 3-year period and to examine factors associated with change. A representative sample of Spanish children and adolescents aged 8–18 years and their parents completed the KIDSCREEN-52 questionnaire at baseline and again after 3 years. Data were also collected on gender, pubertal development (PD), and family socio-economic status (SES). Change in HRQOL over time was evaluated using effect sizes (ES). Generalized estimating equations (GEE) were used to analyze associations among changes in KIDSCREEN scores, socio-demographic factors, and pubertal development. Response rate at follow-up was 54% ( n = 454). Overall, HRQoL worsened in eight out of the ten KIDSCREEN dimensions, with ES ranging from −0.10 (Moods and Emotions) to −0.34 (Psychological Well-being). The decrease was most marked in the intermediate age group (13–17 years of age at follow-up) and in girls. In the GEE models, pubertal development more strongly impacted changes in girls than in boys. In this representative, population-based sample of children and adolescents, moderate decrements in HRQoL were observed after 3 years. Changes were particularly important among girls and in relation to pubertal development. These results could provide useful reference data for other longitudinal studies in population sub-groups. [ABSTRACT FROM AUTHOR]

Background: In spite of a well-established development of instruments, difficulty in interpreting health related quality of life scores may limit its use in clinical practice.Objective: To develop generalizable interpretation aids for a measure of perceived functional visual status, the VF-14 index.Design: Item Response Theory (Rasch analysis) was used to analyze the performance of VF-14 items. The 'ruler' aid was derived from the most difficult activity (item) a patient is able to do without difficulty; the 'clinical scenarios' aid, first identified all significantly different clusters of items within the index and then estimated the mean expected difficulty (responses) to perform a benchmark item in each cluster.Setting: The study was conducted in four hospitals and six ambulatory cataract surgery centers in Barcelona, Spain.Patients: One hundred and ninety-eight patients scheduled for first eye cataracts surgery.Measurements: The self-reported VF-14 index and clinical measures were used.Results: All VF-14 items were found unidimensional with three items showing only partial misfit. For a patient with a VF-14 Rasch score of 71, the 'ruler' aid indicated that 'doing fine handwork' would be the most requiring activity he/she would perform without difficulty. The 'clinical scenarios' aid estimated that such a patient would be unable to 'drive at night', would have some difficulty 'reading small print' and no difficulty 'doing fine handwork', 'watching TV' or 'recognizing people'. Concordance between modeled and observed responses was fair to substantial.Conclusions: Simple content-based interpretation aids for the VF-14 scores were developed that should facilitate its use in clinical practice. These aids should be easily generalizable to other quality of life instruments. [ABSTRACT FROM AUTHOR]

The feasibility, validity and reliability of the Time Trade-Off (TTO) and Visual Analogue Scale (VAS) methods in obtaining preference values for health states were compared in a random sample of the Spanish population (n = 294). Respondents valued 43 EuroQol-5D health states in face-to-face interviews. Convergent validity was assessed by examining the relationship between values, and the effect of sociodemographic and health variables on values was used as a means of assessing construct validity. Test-retest reliability was analysed in a subgroup of 50 respondents, using the intraclass correlation coefficient (ICC) and generalisability theory. Rates of non-response and missing data were low on both methods, though the VAS took considerably less time to administer. VAS and TTO values correlated highly (r = 0.92), though there were differences in the ordering of health states between methods, and in the number of health states rated worse than death. VAS values were compressed into a considerably smaller valuation space than TTO values. Respondents in higher educational categories assigned higher TTO values to 12 health states. Mean ICCs (95% CI) at individual level were 0.90 (0.88-0.92) and 0.84 (0.81-0.87) for the VAS and TTO, respectively. Generalisability analysis showed variance due to time to be 0 for both methods. In conclusion, the VAS was more feasible and slightly more reliable than the TTO, whilst doubt can be cast on the degree of convergent validity existing between the two methods. The compression of VAS values means that the TTO is likely to discriminate better between health states, and it may have greater construct validity if results from larger samples confirm that there are genuine differences between sociodemographic subgroups. [ABSTRACT FROM AUTHOR]