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Volinn E. When Patients' Assessments of Treatment for Subjective Symptoms are At Odds with Authoritative Assessments in the Biomedical Literature: The Case of Patients Treated with Acupuncture for Low Back Pain in a Traditional Chinese Medicine Clinic in China (and Story of a Bewildered Chicken). J Eval Clin Pract 2023; 29:1073-1082. [PMID: 36647197 DOI: 10.1111/jep.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/27/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023]
Abstract
Assessments of treatments for 'subjective symptoms' are problematic and potentially contentious. These are symptoms without ascertainable pathophysiology, also referred to as 'medically unexplained.' Treatments of them may be assessed from different perspectives, and an assessment as seen from one perspective may be discrepant with an assessment as seen from another perspective. The observational study described in the paper represents one perspective. Patients in the study were treated with acupuncture for the subjective symptom of low back pain in a Traditional Chinese Medicine Clinic in China; acupuncture is a form of TCM, which is indigenous to China. Shortly after treatment began and six months afterward, patients reported 'clinically important improvements' on a variety of standard, cross-culturally validated outcome measures, including pain intensity, physical functioning, and emotional functioning; this assessment is consistent with numerous assessments of acupuncture in China and other Southeastern Asian countries. On the other hand, clinical trials represent another perspective from which to assess acupuncture. Although assessments based on trials are not uniform, several assessments based on them, including those published in journals such as Lancet and New England Journal of Medicine, conclude that acupuncture is not effective. These trials, however, were mainly situated in the U.S., western European countries, and other WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries. This is notable, because the population of China, the indigenous context of acupuncture, is greater than populations of WEIRD countries combined. Patients' expectations of a treatment such as acupuncture and their prior familiarity with it vary among contexts, and patients' experiences of treatment outcomes may vary accordingly. In short, although clinical trials constitute a test of truth in biomedicine and inform authoritative assessments in WEIRD countries, they do not necessarily represent the truth from the perspective of those experiencing outcomes of especially indigenous treatments for subjective symptoms in non-WEIRD contexts.
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Adashi EY, Cohen IG. The FDA Initiative to Assure Racial and Ethnic Diversity in Clinical Trials. J Am Board Fam Med 2023; 36:366-368. [PMID: 36801846 DOI: 10.3122/jabfm.2022.220290r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 02/23/2023] Open
Abstract
On April 13, 2022, the Food & Drug Administration (FDA) issued a new draft guidance for industry for "developing plans to enroll more participants from underrepresented racial and ethnic populations in the U.S. into clinical trials ." In so doing, the FDA reaffirmed the reality that racial and ethnic minorities remain underrepresented in clinical trials. FDA Commissioner Robert M. Califf, MD offered that the "U.S. population has become increasingly diverse, and ensuring meaningful representation of racial and ethnic minorities in clinical trials for regulated medical products is fundamental to public health." Commissioner Califf went on to pledge that "achieving greater diversity will be a key focus throughout the FDA to facilitate the development of better treatments and better ways to fight diseases that often disproportionately impact diverse communities." This Commentary is dedicated to a thorough review of the new FDA policy and the implications thereof.
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Affiliation(s)
- Eli Y Adashi
- From the Professor of Medical Science, Former Dean of Medicine and Biological Sciences, Brown University, Providence, RI (EYA); Attwood and Leslie Williams Professor of Law, Harvard Law School, Faculty Director, Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, MA (IGC).
| | - I Glenn Cohen
- From the Professor of Medical Science, Former Dean of Medicine and Biological Sciences, Brown University, Providence, RI (EYA); Attwood and Leslie Williams Professor of Law, Harvard Law School, Faculty Director, Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard University, Cambridge, MA (IGC)
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Volcy J. The Warmth of Strangers. J Am Board Fam Med 2022:jabfm.2022.AP.220058. [PMID: 36007957 DOI: 10.3122/jabfm.2022.ap.220058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/15/2022] [Accepted: 05/02/2022] [Indexed: 03/21/2023] Open
Abstract
I present a reflection of my last months with my mother as I cared for her during her battle with breast cancer. A practicing internist, I made the decision to bring my mother from New Jersey to Georgia so that I could continue working and so that my husband and I would be able to continue caring for our 2 sons, who were ages 3 and 5 at the time. The following describes the warmth my mother felt and I witnessed in the office waiting room from other patients-strangers, ready to extend genuine Southern hospitality and love for my mother from the first appointment and how I cared for her during that time. Although this was a difficult time for my mother, it strangely was also a special time of bonding between us even though we were always close. I had the honor of caring for a woman who gave everything for her children and I had the chance to be there for her in a role reversal. As the second oldest of 4 daughters, I was always sharing my mother. I had the unique pleasure of having her all to myself and I treasured that.
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Alves ALC, de Paula JJ, de Miranda DM, Romano-Silva MA. The Autism Spectrum Quotient in a sample of Brazilian adults: analyses of normative data and performance. Dement Neuropsychol 2022; 16:244-248. [PMID: 35720649 PMCID: PMC9173798 DOI: 10.1590/1980-5764-dn-2021-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/11/2021] [Indexed: 11/21/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by difficulties in social interaction and inflexible behaviors/interests. To quantify ASD traits in adults with preserved intelligence, the Autism Spectrum Quotient (AQ) was developed, which is a self-report instrument and one of the most used and recommended tools.
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Affiliation(s)
- Ana Luíza Costa Alves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Jonas Jardim de Paula
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Débora Marques de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
| | - Marco Aurélio Romano-Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Medicina Molecular, Belo Horizonte MG, Brazil
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Torres RM, Faria SI, Cavalheiro LM, Lopes Ferreira P, Soles Gonçalves R. Cross-cultural Adaptation and Validation of the European Portuguese Version of the Western Ontario Shoulder Instability Index (WOSI). ACTA MEDICA PORT 2022; 35:522-528. [PMID: 35180048 DOI: 10.20344/amp.15119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/05/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The Western Ontario Shoulder Instability Index (WOSI) is a self-administered questionnaire specifically used to determine the impact of shoulder instability on quality of life. The aim of this study was to translate the WOSI into European Portuguese and analyze its validity and reliability in a population with shoulder instability. MATERIAL AND METHODS The WOSI was translated and culturally adapted from its original version into European Portuguese (WOSIPT). Internal consistency and test-retest analyses were conducted to determine the level of reliability of the scale. WOSI-PT, Quick-DASH, and SF-12 questionnaires were applied to 81 patients with symptomatic shoulder instability to assess validity, and reliability was tested by randomly selecting 50 patients within 72 hours using a test-retest design. RESULTS The reliability of the WOSI-PT was very high, with Cronbach´s alpha equal to 0.97 and an intraclass correlation coefficient of 0.98. Regarding the construct validity, the correlation between the WOSI-PT and QuickDASH was high and negative (-0.79). The correlations between WOSI-PT and SF-12 were positive, respectively, moderate with physical (0.66) and low with mental (0.34) health. CONCLUSION WOSI-PT is a reliable and valid instrument for assessing the functional impact of shoulder joint instability on quality of life.
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Affiliation(s)
- Rui Manuel Torres
- Department of Physiotherapy. CESPU. North Polytechnic Institute of Health. Paredes; Department of Physiotherapy. Center for Rehabilitation Research. Polytechnic Institute of Oporto. Oporto. Portugal
| | - Sara Isabel Faria
- Department of Physiotherapy. School of Health. Polytechnic Institute of Oporto. Oporto. Portugal
| | - Luís Manuel Cavalheiro
- Department of Physiotherapy. Coimbra Health School. Polytechnic Institute of Coimbra. Coimbra. Centre for Health Studies and Research. University of Coimbra. Coimbra. Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research. University of Coimbra. Coimbra. Faculty of Economics. University of Coimbra. Coimbra. Coimbra. Portugal
| | - Rui Soles Gonçalves
- Department of Physiotherapy. Coimbra Health School. Polytechnic Institute of Coimbra. Coimbra. Centre for Health Studies and Research. University of Coimbra. Coimbra. Portugal
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Alem MER, da Silva JB, Beleza ACS, Chaves TC, Driusso P. Cross-cultural adaptation and measurement property analysis of the Brazilian Portuguese version of the Three Incontinence Questionnaire. Int Urogynecol J 2022; 33:3053-3060. [PMID: 34985535 DOI: 10.1007/s00192-021-05036-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The differential diagnosis of urinary symptoms may allow health professionals to establish a therapeutic objective and to choose the appropriate treatment for the patient's complaint. The aim of this study was to cross-culturally adapt the Three Incontinence Questionnaire (3IQ) into Brazilian Portuguese (3IQ-Br) and to analyze test-retest reliability, construct, and criterion validity in women. METHODS The cross-cultural adaptation of the 3IQ-Br included forward-translation, back-translation, and consensus among an expert committee. Participants with and without urinary incontinence (UI) completed the 3IQ-Br, King's Health Questionnaire (KHQ), and Questionnaire for Female Urinary Incontinence Diagnosis (QUID-Br). Only women with UI answered 3IQ-Br after 7-10 days. Test-retest reliability and construct validity were analyzed using the Cohen linear kappa (k). The 3IQ-Br accuracy was analyzed using the area under the curve (AUC) of the receiver-operating characteristic (ROC) curve, considering the sensitivity and specificity to correctly classify women with and without UI. RESULTS The reliability of each question from the 3IQ-Br was considered substantial in the test-retest. The agreement among 3IQ-Br, QUID-Br, and KHQ was almost perfect for UI diagnosis (k > 0.8). The 3IQ-Br was considered to have good accuracy in distinguishing women with UI considering the KHQ (AUC 0.83, 95% confidence interval [CI] 0.78 to 0.87, p < 0.001), and fair to the QUID-Br (AUC 0.73, 95% CI 0.68 to 0.78; p < 0.001). CONCLUSIONS The results of this study showed that this version of the 3IQ-Br has acceptable measurement properties for identifying and differentiating UI symptoms in Brazilian women.
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Affiliation(s)
- Michele Elisabete Rúbio Alem
- Women's Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, 235 km, São Carlos, SP, CEP 13565-905, Brazil
| | - Jordana Barbosa da Silva
- Women's Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, 235 km, São Carlos, SP, CEP 13565-905, Brazil
| | - Ana Carolina Sartorato Beleza
- Women's Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, 235 km, São Carlos, SP, CEP 13565-905, Brazil
| | - Thais Cristina Chaves
- Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, 235 km, São Carlos, SP, CEP 13565-905, Brazil.
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Sturges D, Patterson DG, Bennett IM, Cawse-Lucas J. Can Family Medicine's Counterculture History Help Shape an Anti-Racist Future? J Am Board Fam Med 2022; 35:169-72. [PMID: 35039423 DOI: 10.3122/jabfm.2022.01.210295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/08/2022] Open
Abstract
Family medicine prides itself on community engagement and has embraced its counterculture roots. After the racial and social reckoning of 2020, including the COVID-19 pandemic and the Black Lives Matters movement, family medicine, as a specialty, must embrace anti-racism as a core value to meet community needs. This article reflects on the foundational tenets of family medicine's origin. It highlights the current disparities regarding professional representation while offering equitable, intentional, and collaborative approaches to move toward and achieve anti-racism within the specialty, medical education, and the community.
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Pereira Pinto M, Martins S, Mesquita E, Fernandes L. European Portuguese Version of the Clinical Frailty Scale: Translation, Cultural Adaptation and Validation Study. ACTA MEDICA PORT 2021; 34:749-760. [PMID: 33565417 DOI: 10.20344/amp.14543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/29/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study aims to describe the translation and adaptation of the European Portuguese Clinical Frailty Scale and assess its convergent validity and test-retest reliability. MATERIAL AND METHODS This validation study included a sample of elderly people admitted in two convalescence units from the National Network of Integrated Continuous Care in Northern Portugal and followed in two outpatient clinics of social solidarity institutions. Convergent validity of the scale was evaluated, against Tilburg Frailty Indicator. Test-retest reliability, sensitivity and specificity were assessed. RESULTS Overall, 51 patients were included (mean age = 78 years old). The Clinical Frailty Scale identified 43.1% patients with frailty. Kappa values for test-retest reliability (non-frail/frail) was 1.00. The intraclass correlation coefficient for the 9-point total scale was 0.999. A correlation between Clinical Frailty Scale and Tilburg Frailty Indicator was also found (rs = 0.683; p < 0.001). The Cohen's kappa coefficient was 0.423 in the agreement analysis between these scales. The results for sensitivity and specificity defined that 62.0% of patients were true positives and 81.8% true negatives. The scale accuracy determined by the receiver operating characteristics curve analysis was 0.782. DISCUSSION This scale showed an excellent test-retest reliability. Robust results on convergent validity were also achieved, with a moderate correlation and agreement with the Tilburg Frailty Indicator, showing good sensitivity and accuracy, as well as high specificity. CONCLUSION This version has an excellent test-retest reliability and good convergent validity, and is both a reliable and valid test for application in clinical practice for assessing Portuguese elderly population admitted in convalescence units and outpatient clinics.
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Affiliation(s)
- Mário Pereira Pinto
- Programa Doutoral em Gerontologia e Geriatria. Instituto de Ciências Biomédicas Abel Salazar. Porto; Centro de Investigação em Tecnologias e Serviços de Saúde. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Sónia Martins
- Centro de Investigação em Tecnologias e Serviços de Saúde. Faculdade de Medicina. Universidade do Porto. Porto. Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto. Portugal
| | - Edgar Mesquita
- Departamento de Estatística. Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal
| | - Lia Fernandes
- Centro de Investigação em Tecnologias e Serviços de Saúde. Faculdade de Medicina. Universidade do Porto. Porto. Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Porto. Serviço de Psiquiatria. Centro Hospitalar Universitário São João. Porto. Portugal
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Koç M, Bazancir Z, Apaydın H, Talu B, Bayar K. Cross-cultural adaptation and validation of the Turkish Yellow Flag Questionnaire in patients with chronic musculoskeletal pain. Korean J Pain 2021; 34:501-508. [PMID: 34593668 PMCID: PMC8494960 DOI: 10.3344/kjp.2021.34.4.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 11/05/2022] Open
Abstract
Background Yellow flags are psychosocial factors shown to be indicative of longterm chronicity and disability. The purpose of the study was to evaluate the psychometric properties of the Turkish Yellow Flag Questionnaire (YFQ) in patients with chronic musculoskeletal pain (CMP). Methods The cross-cultural adaptation was conducted with translation and backtranslation of the original version. Reliability (internal consistency and test-retest) was examined for 231 patients with CMP. Construct validity was assessed by correlating the YFQ with the Hospital Anxiety and Depression Scale (HADS), Orebro Musculoskeletal Pain Questionnaire (OMPQ), and Tampa Kinesiophobia Scale (TKS). Factorial validity was examined with both exploratory and confirmatory factorial analysis. Results The YFQ showed excellent test/retest reliability with an Intraclass correlation coefficient of 0.82. The internal consistency was moderate (Cronbach's alpha of 0.797). As a result of the exploratory factor analysis, there were 7 domains compatible with the original version. As a result of confirmatory factor analysis, the seven-factor structure of YFQ was confirmed. There was a statistically significant correlation between YFQ-total score and OMPQ (r = 0.57, P < 0.001), HADS-anxiety (r = 0.32, P < 0.001), HADS-depression (r = 0.44, P < 0.001), and TKS (r = 0.37, P < 0.001). Conclusions This study's results provide considerable evidence that the Turkish version of the YFQ has appropriate psychometric properties, including test-retest reliability, internal consistency, construct validity and factorial validity. It can be used for evaluating psychosocial impact in patients with CMP.
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Affiliation(s)
- Meltem Koç
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
| | - Zilan Bazancir
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hakan Apaydın
- Department of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Burcu Talu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Kılıçhan Bayar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
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Smith JA, Basabose JD, Brockett M, Browne DT, Shamon S, Stephenson M. Family Medicine With Refugee Newcomers During the COVID-19 Pandemic. J Am Board Fam Med 2021; 34:S210-6. [PMID: 33622840 DOI: 10.3122/jabfm.2021.S1.200115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 11/08/2022] Open
Abstract
Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, financial constraints, racism, and higher likelihoods of living in relatively higher density and multigenerational dwellings. In addition, we describe the response to COVID-19 by a community-based refugee primary health center in Ontario, Canada. This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in the new context of COVID-19; (2) provide services through a trauma-informed lens; (3) increase focus on continuity of health and mental health care; (4) mobilize International Medical Graduates for triaging patients based on COVID-19 symptoms; and (5) diversify communication efforts to educate refugees about COVID-19.
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Al Maqbali M, Gracey J, Rankin J, Dunwoody L, Hacker E, Hughes C. Cross-Cultural Adaptation and Psychometric Properties of Quality of Life Scales for Arabic-Speaking Adults: A systematic review. Sultan Qaboos Univ Med J 2020; 20:e125-e137. [PMID: 32655904 PMCID: PMC7328836 DOI: 10.18295/squmj.2020.20.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/30/2019] [Accepted: 12/09/2019] [Indexed: 11/16/2022] Open
Abstract
This review aimed to explore the psychometric properties of quality of life (QOL) scales to identify appropriate tools for research and clinical practice in Arabic-speaking adults. A systematic search of the Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and PsycINFO (American Psychological Association, Washington, District of Columbia, USA) databases was conducted according to Preferred Reporting Items Systematic Reviews and Meta-Analysis guidelines. Quality assessment criteria were then utilised to evaluate the psychometric properties of identified QOL scales. A total of 27 studies relating to seven QOL scales were found. While these studies provided sufficient information regarding the scales' validity and reliability, not all reported translation and cross-cultural adaptation processes. Researchers and clinicians should consider whether the psychometric properties, subscales and characteristics of their chosen QOL scale are suitable for use in their population of interest.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK.,Ministry of Health, Al Buraimi Hospital, Oman
| | - Jackie Gracey
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Lynn Dunwoody
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Eileen Hacker
- School of Nursing, Indiana University, Indianapolis, USA
| | - Ciara Hughes
- Institute of Nursing and Health Research, Ulster University, Shore Road, Jordanstown Campus, Newtownabbey, UK
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Kim M, Khang YH. Inequalities in Longitudinal Health Trajectories in Middle to Later Life: a Comparison of European Countries and Korea. J Korean Med Sci 2020; 35:e141. [PMID: 32476301 PMCID: PMC7261695 DOI: 10.3346/jkms.2020.35.e141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/22/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study compared inequalities in the longitudinal trajectory of health measured by latent growth curves (LGCs) in Korea and six other developed European countries. METHODS Unconditional and conditional LGCs were fitted, with standardized self-rated health (SRH) as the outcome variable. Two nationally-representative longitudinal datasets were used: the Survey of Health, Aging and Retirement in Europe (2007-2015; 2,761 Swedish, 2,546 Danish, 2,580 German, 2,860 French, 2,372 Spanish, and 2,924 Italian respondents) and the Korean Longitudinal Study of Aging (2006-2014; 8,465 Korean respondents). RESULTS The unconditional patterns of SRH trajectory were similar and unfavorable for women across the countries. Social factors such as education and income generally exerted a significant impact on health trends among older adults. Korea showed less favorable results for the disadvantaged than the advantaged as compared with Denmark, Germany, and France, which was consistent with theoretical expectations. In contrast, the relative SRH trajectory of the disadvantaged as against the advantaged was better as compared with Sweden and worse as compared with Spain/Italy, which was inconsistent with theories that would predict Korea's results were worse than Sweden and similar to Spain/Italy. Women had good SRH trajectory in Denmark and poorer SRH trajectory in Spain, Italy, and Korea, which were consistent. However, women in Sweden showed poorer and mixed outcome, which does not correspond to theoretical predictions. CONCLUSION These findings suggest that it is inconclusive whether Sweden and Denmark (with the most generous welfare arrangements) have better trajectories of health, and Spain, Italy, and Korea (with the least advanced state policies) have worse SRH paths among older adults. However, it can be inferred that Korean governmental policies may have produced a relatively worse context for the less-educated than the six European countries, as well as poorer settings for women than Denmark in terms of their initial SRH status.
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Affiliation(s)
- Minhye Kim
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
| | - Young Ho Khang
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
- Department of Health Policy and Management, Seoul National University, College of Medicine, Seoul, Korea
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Sakamoto A, Hoshi K, Gamada K. Transcultural Reliability and Validity of the Japanese-Language Version of the Pelvic Girdle Questionnaire. J Manipulative Physiol Ther 2020; 43:68-77. [PMID: 32061416 DOI: 10.1016/j.jmpt.2018.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/17/2018] [Accepted: 11/02/2018] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to validate a Japanese version of the Pelvic Girdle Questionnaire (PGQ) and to confirm that the Japanese version of the PGQ (PGQ-J) was as valid as the original version. METHODS This study involves 2 phases: (1) a cross-cultural adaptation study and (2) a cross-sectional study. The English PGQ was translated referring to the cross-cultural adaptation study process. Forty healthy pregnant or postpartum Japanese women participated. Women with pelvic girdle pain (PGP) completed the PGQ-J and 5 other instruments. Internal consistency, construct validity, test-retest reliability, ceiling and floor effects, and discrimination validity of the PGQ-J were analyzed. RESULTS The PGQ-J showed high internal consistency with a Cronbach α of .968, and an interclass correlation coefficient of .79. The content validity showed a high positive correlation with the Oswestry Disability Index and Disability Rating Scale. CONCLUSION The PGQ-J was reliable and valid with high internal consistency and content validity for assessing disability owing to PGP in Japanese pregnant and postpartum women. The PGQ-J is expected to facilitate research and clinical practice for PGP in Japan and contribute to the welfare of postpartum women.
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Affiliation(s)
- Asuka Sakamoto
- Graduate School of Medical Technology and Health Welfare Sciences, Higashi Hiroshima City, Hiroshima, Japan
| | - Kenji Hoshi
- Graduate School of Medical Technology and Health Welfare Sciences, Higashi Hiroshima City, Hiroshima, Japan
| | - Kazuyoshi Gamada
- Graduate School of Medical Technology and Health Welfare Sciences, Higashi Hiroshima City, Hiroshima, Japan.
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Stephenson J, Distelberg B, Morton KR, Ortiz L, Montgomery SB. Different Depression Treatment Recommendations and Adherence for Spanish- and English-Speaking Patients. J Am Board Fam Med 2019; 32:904-12. [PMID: 31704759 DOI: 10.3122/jabfm.2019.06.180323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 06/11/2019] [Accepted: 06/21/2019] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION National guidelines recommend primary care providers (PCPs) screen patients for depression with a standardized tool and address positive screenings. However, depression prevalence is lower in Latinos (8% to 15%, with Spanish speakers at 8%) than non-Latino whites (22%). As a result of these prevalence differences, PCPs may use ethnicity and language of the patient to determine depression screening behaviors. This study examined standard of care (SoC) depression treatment recommendations by ethnicity and language for patients who screened positive for major depression during a medical visit. METHODS 275 patients scored ≥10 on the Patient Health Questionnaire-9 screening; a chart review assessed treatment referrals, followed by semistructured interviews with 18 patients and 7 PCPs regarding depression treatment behaviors. RESULTS 138 patients (50%) received SoC treatment recommendations. After controlling for age, gender, and race, a binary logistic regression was performed to determine language and ethnicity effects on SoC depression treatment recommendations (psychotherapy/pharmacotherapy vs other). Spanish-speaking Latinos were 72% less likely to receive SoC recommendations than English speakers (odds ratio [OR] = 0.39). Interviews with Spanish-speaking patients confirmed that negative perceptions about medications, patient noncompliance, and a shortage of bilingual behavioral health providers within the clinic impacted SoC recommendations and uptake. CONCLUSIONS Spanish-speaking Latinos did not receive or follow through with SoC recommendations as often as English speakers regardless of ethnicity. Future studies should explore reasons why language is a barrier to SoC recommendations for Latinos and explore culturally and linguistically sensitive methods to effectively treat Spanish speakers for depression during a medical visit.
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Ota K, Furusho H, Mawaki A, Niimi Y, Ikegami C, Arakawa N, Maeda J. Health Information Sharing Among Muslim Women in a Japanese Mosque. Stud Health Technol Inform 2019; 264:1968-1969. [PMID: 31438432 DOI: 10.3233/shti190738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
With the increase of foreign residents in Japan, most of them are suffering from inadequate health information. In reference to an ethnography, we conducted fieldwork using a participant observation and an interview with 36 foreign Muslim women. Our study clarified they especially needed health information on childcare because of a lack of such information in their native languages, and needed the support of Japanese Muslims because of problems in communication with healthcare personnel.
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Affiliation(s)
- Katsumasa Ota
- Department of Nursing Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Haruka Furusho
- Department of Nursing Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Ayana Mawaki
- Department of Nursing Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yukari Niimi
- Department of Nursing Science, Seirei Christopher University, Hamamatsu, Japan
| | - Chikako Ikegami
- Department of Nursing Science, Nagano College of Nursing, Komagane, Japan
| | - Naoko Arakawa
- College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Jukai Maeda
- Faculty of Nursing, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
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Breton J, Francescutti LH, Al-Weshahi Y. Teaching the Role of Health Advocate: Reflections on two cross-cultural collaborative advocacy workshops for medical trainees and instructors in Oman. Sultan Qaboos Univ Med J 2019; 18:e286-e290. [PMID: 30607267 DOI: 10.18295/squmj.2018.18.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/29/2018] [Accepted: 07/19/2018] [Indexed: 11/16/2022] Open
Abstract
In March 2014, medical educators from Canada and Oman collaborated to shape the foundation of health advocacy training in Oman. Using existing research and innovative tools, two workshops were developed, representing the first formalised approach to health advocacy for medical trainees in Oman. The development and application of the workshops highlighted many unique challenges and opportunities in advocacy training. This article summarises the process of developing and implementing the workshops as well as feedback from the participants and short-term consequences. Furthermore, this article seeks to explore the complexities of designing a cross-cultural curriculum. In particular, it reflects on how the role of health advocate may be perceived differently in various cultural and societal settings. Understanding and adapting to these influences is paramount to creating a successful health advocacy curriculum that is relevant to learners and responsive to the communities in which they work.
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Affiliation(s)
- Jessica Breton
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Yousef Al-Weshahi
- Department of Continuing Professional Development, Oman Medical Specialty Board, Muscat, Oman
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Alkhaldi TM, Al-Jumaili AA, Alnemer KA, Alharbi K, Al-Akeel ES, Alharbi MM, Alshabanah O, Juwair AB, Khoja A. Measuring the health literacy level of Arabic speaking population in Saudi Arabia using translated health literacy instruments. Pharm Pract (Granada) 2018; 16:1223. [PMID: 30416624 PMCID: PMC6207362 DOI: 10.18549/pharmpract.2018.03.1223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 01/10/2018] [Indexed: 11/14/2022] Open
Abstract
Background: Health literacy is an essential predictor of health status, disease control and adherence to medications. Objectives: The study goals were to assess the health literacy level of the general population in Saudi Arabia using translated Gulf Arabic version of the short-version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and Single Item Literacy Screener (SILS) tests and to measure the relationship between health literacy and education level. Methods: The study was a cross-sectional with a convenience sample of 123 participants from the general population in Riyadh. Data were collected using the modified (Gulf) Arabic versions of both S-TOFHLA and SILS. Fisher’s Exact test was used to measure the difference of the health literacy scores according to the education degrees and Cronbach’s alpha was used to measure the internal consistency of the S-TOFHLA items. Results: More than half (55.4%) of the participants were male, 50.4% had a middle school or less education level, and we found that 84.4% had adequate health literacy as measured by the S-TOFHLA, compared to 49.6% as measured by SILS. The Fisher’s Exact test showed a significant difference (P<.05) in the S-TOFHLA and SILS scores according to education categories. Conclusions: The level of education has a significant positive association with S-TOFHLA and SILS results. The Gulf Arabic version of S-TOFHLA is a reliable test with a good internal consistency and a significant positive correlation between the two parts of S-TOFHLA. We recommend the use of S-TOFHLA or SILS at the first patient visit.
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Affiliation(s)
- Talal M Alkhaldi
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Ali A Al-Jumaili
- College of Pharmacy, University of Iowa. Iowa City, IA (United States).
| | - Khalid A Alnemer
- Department of Cardiology, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Khalid Alharbi
- Department of Cardiology, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Elharith S Al-Akeel
- Department of Public Health and Family Medicine, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Mohammed M Alharbi
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Othman Alshabanah
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Abdullah B Juwair
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
| | - Abdullah Khoja
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU). Riyadh (Saudi Arabia).
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Abstract
In this essay, I borrow the idea of universal precautions from infection control and suggest that family physicians use a set of considerations, based on the mnemonic UNIVERSAL, to nurture cultural humility, enter a metaphoric "space-in-between" in cross-cultural encounters, and foster global fluency. These UNIVERSAL considerations I base on my experiences in global family medicine, attending to economically poor and socially marginalized patients in both international and domestic settings. They are informed by readings in transcultural psychiatry, medical anthropology, development studies, and primary care. I invite others involved in global family medicine to reflect on what they have learned along their own professional paths, so as to enhance their therapeutic abilities as global family physicians, wherever they may be.
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Shifrer D, Sutton A. Region-Urbanicity Differences in Locus of Control: Social Disadvantage, Structure, or Cultural Exceptionalism? Sociol Inq 2014; 84:570-600. [PMID: 25382875 PMCID: PMC4219594 DOI: 10.1111/soin.12046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
People with internal rather than external locus of control experience better outcomes in multiple domains. Previous studies on spatial differences in control within America only focused on the South, relied on aggregate level data or historical evidence, or did not account for other confounding regional distinctions (such as variation in urbanicity). Using data from the National Education Longitudinal Study, we find differences in adolescents' loci of control depending on their region and urbanicity are largely attributable to differences in their social background, and only minimally to structural differences (i.e., differences in the qualities of adolescents' schools). Differences that persist net of differences across adolescents and their schools suggest the less internal control of rural Southern adolescents, and the more internal control of rural and urban Northeastern adolescents, may be due to cultural distinctions in those areas. Results indicate region is more closely associated than urbanicity with differences in locus of control, with Western and Northeastern cultures seemingly fostering more internal control than Midwestern and Southern cultures. These findings contribute to research on spatial variation in a variety of psychological traits.
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Affiliation(s)
- Dara Shifrer
- Houston Education Research Consortium, Kinder Institute for Urban Research Rice University
| | - April Sutton
- Department of Sociology, Population Research Center, The University of Texas at Austin
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Silva FG, Silva CR, Braga LB, Neto AS. Portuguese Children's Sleep Habits Questionnaire - validation and cross-cultural comparison. J Pediatr (Rio J) 2014; 90:78-84. [PMID: 24156836 DOI: 10.1016/j.jped.2013.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To validate the Portuguese version of the Children's Sleep Habits Questionnaire (CSHQ-PT) and compare it to the versions from other countries. METHODS The questionnaire was previously adapted to the Portuguese language according to international guidelines. 500 questionnaires were delivered to the parents of a Portuguese community sample of children aged 2 to 10 years old. 370 (74%) valid questionnaires were obtained, 55 children met exclusion criteria and 315 entered in the validation study. RESULTS The CSHQ-PT internal consistency (Cronbach's α) was 0.78 for the total scale and ranged from 0.44 to 0.74 for subscales. The test-retest reliability for subscales (Pearson's correlations, n=58) ranged from 0.59 to 0.85. Our data did not adjust to the original 8 domains structure in Confirmatory Factor Analysis but the Exploratory Factor Analysis extracted 5 factors that have correspondence to CSHQ subscales. CONCLUSION The CSHQ-PT evidenced psychometric properties that are comparable to the versions from other countries and adequate for the screening of sleep disturbances in children from 2 to 10 years old.
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Affiliation(s)
| | | | - Lígia Barbosa Braga
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, , Lisbon, Portugal
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Abstract
There is a need for tools to measure the information patients need in order for healthcare professionals in general, and particularly pharmacists, to communicate effectively and play an active part in the way patients manage their medicines. Previous research has developed and validated constructs to measure patients’ desires for information and their perceptions of how useful their medicines are. It is important to develop these tools for use in different settings and countries so that best practice is shared and is based on the best available evidence.
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Affiliation(s)
- Filipa A Costa
- Instituto Superior de Ciências da Saúde, ISCSEM . Caparica ( Portugal )
| | - Catherine Duggan
- School of Pharmacy, University of London , and Associate Director for Clinical Pharmacy, Development and Evaluation for East and South East England Specialist Services (NHS). London ( United Kingdom )
| | - Ian Bates
- School of Pharmacy, University of London . London ( United Kingdom )
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