Psychometric Evaluation of the Hungarian Adaptation of the Diabetes Distress Scale in Individuals with Type 2 Diabetes.

Background and Purpose: Diabetes-specific distress (DD) is a crucial predictor of patients' self-care, necessitating reliable screening tools. The Diabetes Distress Scale captures typical sources of patients' distress effectively. Methods: The Hungarian Diabetes Distress Scale (HDDS) was employed in two studies with 450 type 2 diabetes patients. Study 1 explored DD's link to the specific quality of life, while study 2 examined its associations with depressive symptoms, anxiety, and illness perception. We evaluated HDDS's construct validity, internal consistency, and intercorrelations. Convergent validity and discriminant validity were analyzed in the second study. Results: Exploratory and confirmatory factor analyses validated HDDS's structure. Subscales exhibited strong internal consistency and correlated as expected with quality of life, anxiety, depression, illness perception, and demographic/medical data. Conclusions: The Hungarian DDS demonstrates robust psychometric properties, affirming its reliability and validity.

Associations Between Temporomandibular Pain and Biobehavioral Variables in Dental Students in Response to an External Stressor.

AIMS: To assess changes in temporomandibular disorder (TMD) pain and multiple biobehavioral variables relevant to TMDs in response to an external stressor. METHODS: Self-reported data using online DC/TMD questionnaires were collected from volunteer dentistry graduate students. Data collection was performed on two occasions: during a non-exam period of the semester and during the subsequent exam period. Changes in the proportion of students with pain, differences in pain grade, and severity of biobehavioral status were measured and compared over the two periods. The association between severity of non-exam-period biobehavioral status and pain presence was also tested to assess whether biobehavioral variables can predict pain occurrence or persistence. Chi-square test, Wilcoxon signed-rank test, ANOVA, and Kruskal-Wallis tests were used for data analysis. P < .05 was considered significant. RESULTS: Of the 213 enrolled students, 102 remained after data reduction. In the non-exam period, the proportion of individuals with pain was 24.5%; in the exam period, the proportion was 54.9%, and more students had a higher pain grade. The severity of all biobehavioral variables was higher in the exam period, but there was no association between changes in the presence of pain and changes in biobehavioral variables. Higher anxiety and parafunction levels were found in those who reported pain on both occasions. CONCLUSION: Exam periods initiate readily measurable changes in the psychologic status of many students, as well as alterations in their temporomandibular pain. Higher levels of anxiety and oral behaviors during non-exam periods seem to be predictors for persisting pain.

Validation and translation of the Hungarian version of the Australian Pelvic Floor Questionnaire (APFQ-H).

INTRODUCTION AND HYPOTHESIS: The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) on a Hungarian population. METHODS: The validation was performed in 294 women over 18 who agreed to answer the Hungarian version of the APFQ. The validation of the questionnaire included evaluation of content/face validity, internal consistency, construct validity, test-retest reproducibility, discriminant validity and convergent validity. RESULTS: Acceptable and good internal consistency was observed in all four dimensions [McDonald's ω (95% confidence interval) coefficients were > 0.7 for each dimension: bladder 0.888, bowel 0.790, prolapse 0.895 and sexual function 0.738]. Test-retest analyses revealed high reproducibility with intraclass correlation coefficients (bladder 0.83, bowel 0.92, prolapse 0.96 and sexual function 0.87). Prolapse symptom score correlated significantly with Pelvic Organ Prolapse Quantification (POP-Q), and bladder score correlated significantly with the results of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ UI SF) (convergent validity). Scores distinguished between patients with pelvic floor disorders and controls (high discriminant validity). CONCLUSIONS: Hungarian version of the self-administered APFQ is a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor dysfunction on the quality of life of Hungarian women.

Role of received social support in the physical activity of coronary heart patients: The Health Action Process Approach.

Physical activity (PA) plays a crucial role in the management of coronary artery disease (CAD). The Health Action Process Approach provides a useful framework for understanding and predicting the process of health behaviors. The aim of the current study was to unveil the role of received social support in the HAPA model, concerning the physical activity of CAD patients. A longitudinal sample of 117 CAD patients filled out a questionnaire during three measurement points (baseline, 2 months, and 6 months later). The constructs within the model were measured by the previously validated HAPA scales. PA was assessed with four items, which were also included in the HAPA questionnaire. To test the direct and indirect associations between the variables, structural equation modeling with latent variables was employed. Received social support was proven to have a significant and strong effect on both action planning and action control, suggesting a synergistic effect on the individual factors, as well as increasing the explained variance of PA. Results confirmed the important role of received social support in the PA of CAD patients. It could be presumed that strengthening the social support from family and friends could support the regular physical activity of CAD patients.

Validation and translation of the Hungarian version of the Female Sexual Function Index (FSFI-H).

INTRODUCTION AND HYPOTHESIS: The Female Sexual Function Index (FSFI) has been used for clinical and research purposes in many countries. The aim of this study was to translate, adapt and perform a psychometric validation of a Hungarian version of the FSFI. METHODS: The FSFI was translated into Hungarian, and its precision was ascertained through reverse translation by an expert team. As a first step, 40 volunteers participated in an evaluation of the test-retest reliability of the Hungarian version over a 2-week period. After that, 418 (331 control and 87 with pelvic organ prolapse) women who had been in a stable sexual relationship in the previous 4 weeks participated in the study. The data were summarized using descriptive statistics. The structure validity was examined by confirmatory factor analysis, with which we tested the hypothesized original factor structure, using maximum likelihood model estimation. We calculated the Comparative Fit Index (CFI), root mean square error of approximation (RMSEA), standardized root mean residual and Akaike information criterion (AIC). To test the internal consistency, Cronbach's alpha coefficients of the full scale were determined. Spearman's rank correlation was used for testing divergent validity and Mann-Whitney U-test for examining discriminant validity. RESULTS: The FSFI was easily understandable and acceptable as well as capable of adequately evaluating and measuring various aspects of female sexual functioning. A high degree of internal consistency was demonstrated by the Cronbach's alpha value (0.963). CONCLUSION: The FSFI Hungarian version is a valid tool that measures the same functioning as the original English questionnaire.

[Defense Style Questionnaire (DSQ-40): factors, validity and reliability].

INTRODUCTION: Empirical research in defense mechanisms - a concept that stem from the work of Sigmund and Anna Freud and gave rise to a number of thematic approaches - dates back to the mid-20th century. From the psychometric measure instruments developed since that time, the present investigation was aimed to assess the short form of Defense Style Questionnaire that can be efficiently applied in clinical practice and that was supposed to be used as the sixth diagnostic factor of the new version of DSM. A multi-level validity analysis of DSQ-40 was carried out. METHODS: We applied trait assessing measures for anxiety, avoidant behavior, schizotypal traits and personality disorder diagnostic measures developed for DSM-5. To evaluate discriminant validity we applied instruments that assess the stability of self-esteem and the state of self and that can measure the clarity of self-representations. 670 healthy university students volunteered to participate in the investigation. RESULTS: Based on the applied questionnaires, it was revealed that its inner consistency and validity measures are adequate. Its factors that discriminate neurotic and immature defense styles can be applied to identify persons inclined to use either adaptive or maladaptive defense mechanisms. Our findings correspond to other international research results. CONCLUSION: Our results attest that DSQ-40 is a reliable instrument to assess defense style.

The role of social support in the dietary behavior of coronary heart patients: an application of the health action process approach.

Dietary behaviour plays a crucial role in both the onset and the management of coronary artery disease (CAD). To develop effective interventions to modify dietary behaviours of patients, it is fundamental to identify and examine the predictive factors that are relevant to healthy dietary behaviour. The Health Action Process Approach provides a useful framework for understanding and predicting the process of health behaviour. The aim of the current study is to clarify the role and effect of received social support in the HAPA model. A longitudinal sample of 117 CAD patients filled out a questionnaire at three time points. Along with HAPA constructs, dietary behaviour was assessed with a food frequency questionnaire. To investigate the longitudinal associations of the constructs, structural equation modelling with latent variables was employed. In the final model, outcome expectancies and pre-action self-efficacy jointly predicted behavioural intention. In the post-intentional phase, social support served as a mediator between intention and action planning. Moreover, coping planning mediated the relationship between action planning and dietary behaviour. These results confirmed the mediator role of social support in the intention-behaviour relationship. This finding suggests that social support can be a crucial component to facilitate healthy dietary behaviour.

Association of Exercise Capacity with Physical Functionality and Various Aspects of Fatigue in Patients with Coronary Artery Disease.

The aim of this study was to examine associations between exercise capacity-indexed as the metabolic equivalent of the task-and various aspects of subjective fatigue, physical functionality, and depression in patients with coronary artery disease. A cross-sectional design was used. Patients with stable coronary artery disease (N = 240) underwent an exercise stress test and completed self-report assessments of depression, subjective physical limitations, vital exhaustion, and the impact of fatigue on physical, social, and cognitive functions. Associations between exercise capacity and these self-report variables were assessed using bivariate correlations and a series of multivariate regressions. Exercise capacity was negatively associated with vital exhaustion, physical limitations, and impact of fatigue on physical and social functioning but not on cognitive functioning. There was a marginal association between exercise capacity and depression. The associations between exercise capacity and fatigue remained significant even after controlling for effects of age, body mass index, gender, education, and comorbid diabetes mellitus. The main conclusion of the study is that in patients with coronary artery disease, exercise capacity has the strongest predictability for physical fatigue, but, importantly, it also independently predicts the feeling of loss of energy and malaise.

Hungarian language validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR).

INTRODUCTION AND HYPOTHESIS: Until now, no valid Hungarian questionnaire has existed to evaluate the sexual quality of life of women with pelvic floor disorders. The aim of this study was to translate the Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR), into Hungarian and to validate the translated PISQ-IR. METHODS: PISQ-IR was translated and validated using three steps, as guided by the IUGA international protocol: forward translation by two urogynecologists, a community review process consisting of one-on-one cognitive interviews with 20 patients, and backward translation by a native English speaker. The final version was approved by the IUGA Working Group comprising the original authors. RESULTS: Among sexually active women, good internal consistency was observed for all scales of the adapted instrument: global quality (Cronbach's α = 0.75), condition impact (α = 0.87), desire (α = 0.82), arousal/orgasm (α = 0.67), partner-related (α = 0.61) and condition-specific (α = 0.67). Among women who were not sexually active, internal consistency was valid for three scales: condition-specific (α = 0.70), global quality (α = 0.81) and condition impact (α = 0.86). Cronbach's α could not be determined in the partner-related domain because only two items were included. Criterion validity and reliability showed strong significant correlations with the UI at the Clinical-Q values and the FSFI and PFDI-20 tests. CONCLUSIONS: The PISQ-IR Hungarian version is a valid and reliable tool that is equivalent to the original English questionnaire and assesses sexual function in Hungarian women with pelvic organ prolapse, urinary incontinence and/or fecal incontinence.

[Occurrence of anxiety and depression disorders after acute cardiac events during hospital rehabilitation. Application of the Hospital Anxiety and Depression Scale as a screening instrument]. / A szorongásos és depressziós zavarok elofordulása akut kardiológiai állapotokat követo asztályos rehabilitáció során. A kórházi szorongás és depresszió skála szurotesztként történo alkalmazása.

UNLABELLED: Hospital Anxiety and Depression Scale (HADS) is one of the most frequently used screening instruments for comorbid psychiatric disorders in patients with somatic diseases. Depression and anxiety disorders occurring after acute coronary events predict a worse prognosis and rehabilitation outcome and impair the patient's quality of life. Therefore, diagnosis and treatment of depression and anxiety are important clinical issues. METHODS: Item characteristics, different aspects of reliability and validity of the HADS test parameters have been analysed on the basis of a follow-up study of 747 patients after acute coronary events participating in a hospital rehabilitation program. Short form of the Beck Depression Inventory, Spielberger State Anxiety Inventory, Hamilton Anxiety and Hamilton Depression Questionnaires were used as references. Criterion validity and cut-off points of HADS subscales were determined according to MINI+, a standardised diagnostic interview. RESULTS: The Depression (D) and Anxiety (A) subscales of the Hungarian version of HADS demonstrated high internal consistency (HADS-D: Cronbach =0,81, HADS-A: =0,85). Explorative factor analysis yielded a two-factor (1st: anxiety and 2nd: depression) structure. HADS subscales have shown high correlations with scales measuring similar constructs and validated in Hungarian. Empirical cut-off points of both subscales were determined with ROC analysis (HADS-D: 9 points, HADS-A 8 points). Sensitivity and specificity at these cut-off points fell into the acceptable 0.7 - 0.9 range. CONCLUSION: On the basis of these results, HADS can be used as a reliable and valid instrument for the measurement and identification of anxiety and depression symptoms and disorders in cardiac patients.

[What influences the rate of complications during phase II. residential cardiac rehabilitation after coronary events?]. / Koszorúér-eseményeket követo II. fázisú intézeti rehabilitációs kezelés alatt eszlelt szövodményeket befolyásoló tényezok.

AIM: The authors sought to investigate the occurrence of complications and adverse events among patients participating in phase II. Residential cardiac rehabilitation program after coronary event (myocardial infarction, transluminal coronary angioplasty or coronary artery bypass graft operation) and determine the factors, that can influence the rate and seriousness of these events. PATIENTS: 724 patients were included in the study prospectively, 302 after myocardial infarction (MI), 64 after coronary intervention (PCI), 358 after coronary artery bypass graft (CABG), respectively. RESULTS: During the rehabilitation program 25.5% of patients suffered from complication, the most frequent events were pleural effusion (5.6%), pericardial effusion (3.9%), Dressler's syndrome (3.5%), heart failure (2.9%), difficulties with wound healing (2.6%), angina pectoris (2.3%), and atrial fibrillation (2.1%). 168 patients (23.2%) could complete the rehabilitation program in spite of these complications, 19 patients (2.6%) had to be transferred to other hospital wards. There was no difference in complication rate among men and women. The rate of complications were different in the patient groups composed according to the last coronary event (16.6% after AMI, 6.2% after PCI, 37.2% after CABG, p < 0.001). Elderly patients (> or = 65 years) had higher complication rate (31.8% vs. 21.3%, p < 0.01). The rate of adverse events were between 0 and 42.6% in a data matrix, built up according to three categories (gender, coronary event, and age groups). CONCLUSION: With simple categories we can identify those patients, who had higher complication rate during phase II. Residential cardiac rehabilitation program after coronary event.