The Persian Version of a Participation Scale: Is It Valid and Reliable Enough for Use among Iranian Patients with Multiple Sclerosis?

BACKGROUND AND PURPOSE: The aim of this study was to determine the face and criterion validity, stability reliability, and internal consistency of the Persian version of the Impact on Participation and Autonomy (IPA-p) scale among Iranian people with multiple sclerosis (MS). METHODS: Trained experts interviewed 364 MS patients and their relatives to assess the criterion validity, stability reliability, and internal consistency of the IPA-p scale. Ten specialists from different disciplines were also recruited to assess its face validity. A consent form was completed by the patients and their relatives. Internal consistency reliability was measured using Cronbach's alpha and stability reliability was assessed using interclass correlation coefficients (ICCs). The test-retest method was used to detect the reliability of the questioner. The study subjects completed the IPA-p scale on two occasions separated by an interval of 30-45 days. Study checklists were also used to assess the face validity, stability reliability, and internal consistency of the IPA-p scale. RESULTS: About 50% of the respondents reported their perceived overall participation to be "good" or "very good" and 60% of the specialists rated the ability of the IPA-p scale to measure what it was designed for as "excellent." Spearman correlation coefficients were >0.8 for all but one IPA-p domain. Cronbach's alpha between the mean IPA-p scale scores achieved on two separate occasions ranged from 0.858 to 0.913. The highest and lowest internal consistencies belonged to the "social relationships" and "education and learning" domains, respectively. The test-retest ICCs for the nine domains were between 0.789 and 0.919, and all were significant at p<0.001. CONCLUSIONS: The IPA-p questionnaire can be considered a valid and reliable instrument for assessing self-reported participation among Iranian MS patients.

effect of childhood viral infections on the incidence of multiple sclerosis

In this study, the history of viral infections of measles, chickenpox and mumps in childhood was compared between the two groups of adults with multiple sclerosis [MS] and healthy people. In this case-control study, a group of 45 MS patients and a group of 135 healthy people who were similar based on some variables were invited. Patients had a definite diagnosis of MS and control group consisted of people accompanying MS patients. Data were collected by a trained expert in face-to-face interview sessions. For data analysis, odds ratio index was calculated and 95% confidence interval was also computed. The mean age of respondents at the time of viral infections was also compared between the two groups. The proportions of infected people by measles, chickenpox and mumps among MS patients were 58%, 56% and 40%, respectively. These proportions in healthy group were 68%, 52% and 44%, respectively. There was not any significant difference between these proportions in the two groups. Mean age of morbidity for measles, chickenpox and mumps among patients were 6.8 +/- 3.1, 8.7 +/- 2.98 and 10.6 +/- 4.7 years, and were significantly higher that these mean ages [4.1 +/- 2.1, 5.3 +/- 3.1 and 8.4 +/- 2.8, respectively] among healthy people [p<0.001]. Although there was not any significant difference between the history of morbidity of measles, chickenpox and mumps in the two groups of MS patients and healthy people, the mean ages of these viral infections among MS patients were significantly higher than healthy people