Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer.

Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald's omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

International Trauma Questionnaire and Posttraumatic Cognitions Inventory-9: validity evidence and measurement invariance of their Brazilian versions.

BACKGROUND: The International Trauma Questionnaire (ITQ) is used to measure posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) symptoms, and the Posttraumatic Cognitions Inventory-9 (PTCI-9) is used to measure posttraumatic cognitions. Both tools have been translated for use in Brazil. However, the psychometric properties of the Brazilian versions were not investigated, and no study has verified the invariance of these tools for many traumatic event types. OBJECTIVE: This study examined the validity, reliability, and measurement invariance of the Brazilian versions of the ITQ and the PTCI-9 for trauma type, gender, race, age group, education level, and geographical region. METHODS: A total of 2,111 people (67.74% women) participated in an online survey. The scale models were tested via confirmatory factor analyses and measurement invariance through multigroup analyses. Pearson's correlation analyses were used to examine the relationships between PTSD, CPTSD, posttraumatic cognitions, and depressive symptoms. RESULTS: Except for the affective dysregulation factor, the reliabilities of the ITQ and PTCI-9 dimensions were adequate. Models with six correlated dimensions for the ITQ and three correlated dimensions for the PTCI-9 showed adequate fit to the data. The ITQ and PTCI-9 exhibited scalar invariance for gender, race, age group, education level, and geographical region. The ITQ also demonstrated full invariance for trauma type. The factors of both instruments were related to each other and to depressive symptoms, with higher effect sizes for posttraumatic cognitions and complex posttraumatic stress disorder symptoms. CONCLUSION: We recommend using the Brazilian versions of the ITQ and PTCI-9, which are crucial tools for assessing and treating trauma-related disorders.

A scoping review of the questionnaires used for the assessment of the perception of undergraduate students of the learning environment in healthcare professions education programs.

The learning environment (LE) includes social interactions, organizational culture, structures, and physical and virtual spaces that influence the learning experiences of students. Despite numerous studies exploring the perception of healthcare professional students (HCPS) of their LE, the validity evidence of the utilized questionnaires remains unclear. This scoping review aimed to identify questionnaires used to examine the perception of undergraduate HCPS of their LE and to assess their validity evidence. Five key concepts were used: (1) higher education; (2) questionnaire; (3) LE; (4) perception; and (5) health professions (HP). PubMed, ERIC, ProQuest, and Cochrane databases were searched for studies developing or adapting questionnaires to examine LE. This review employed the APERA standards of validity evidence and Beckman et al. (J Gen Intern Med 20:1159-1164, 2005) interpretation of these standards according to 5 categories: content, internal structure, response process, relation to other variables, and consequences. Out of 41 questionnaires included in this review, the analysis revealed a predominant emphasis on content and internal structure categories. However, less than 10% of the included questionnaires provided information in relation to other variables, consequences, and response process categories. Most of the identified questionnaires received extensive coverage in the fields of medicine and nursing, followed by dentistry. This review identified diverse questionnaires utilized for examining the perception of students of their LE across different HPs. Given the limited validity evidence for existing questionnaires, future research should prioritize the development and validation of psychometric measures. This will ultimately ensure sound and evidence-based quality improvement measures of the LE in HP education programs.

The Broad Autism Phenotype-International Test (BAP-IT): A two-domain-based test for the assessment of the broad autism phenotype.

LAY ABSTRACT: The broad autism phenotype refers to a group of behaviors related to autism spectrum disorder, but that appear to a lesser extent. Its assessment has been performed through outdated broad autism phenotype/autism spectrum disorder definitions and tests. To address this problem, this study presents the development of a new test, the Broad Autism Phenotype-International Test, a 20-item measure consisting of two dimensions, SOCIAL-BAP and RIRE-BAP, targeting the two-domain operationalization of autism spectrum disorder in Spain and the United Kingdom. Unlike the Broad Autism Phenotype Questionnaire, this test received empirical support as a quick and effective broad autism phenotype measure that can facilitate both broad autism phenotype/autism spectrum disorder research and interventions. This is the first step to studying the BAP in several Spanish and English-speaking countries.

Validating the virtual: a deep dive into ultrasound simulator metrics in otorhinolaryngology.

PURPOSE: This study aimed to assess the validity of simulation-based assessment of ultrasound skills for thyroid ultrasound. METHODS: The study collected validity evidence for simulation-based ultrasound assessment of thyroid ultrasound skills. Experts (n = 8) and novices (n = 21) completed a test containing two tasks and four cases on a virtual reality ultrasound simulator (U/S Mentor's Neck Ultrasound Module). Validity evidence was collected and structured according to Messick's validity framework. The assessments being evaluated included built-in simulator metrics and expert-based evaluations using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. RESULTS: Out of 64 built-in simulator metrics, 9 (14.1%) exhibited validity evidence. The internal consistency of these metrics was strong (Cronbach's α = 0.805) with high test-retest reliability (intraclass correlation coefficient = 0.911). Novices achieved an average score of 41.9% (SD = 24.3) of the maximum, contrasting with experts at 81.9% (SD = 16.7). Time comparisons indicated minor differences between experts (median: 359 s) and novices (median: 376.5 s). All OSAUS items differed significantly between the two groups. The correlation between correctly entered clinical findings and the OSAUS scores was 0.748 (p < 0.001). The correlation between correctly entered clinical findings and the metric scores was 0.801 (p < 0.001). CONCLUSION: While simulation-based training is promising, only 14% of built-in simulator metrics could discriminate between novices and ultrasound experts. Already-established competency frameworks such as OSAUS provided strong validity evidence for the assessment of otorhinolaryngology ultrasound competence.

Simulation-based assessment of upper abdominal ultrasound skills.

BACKGROUND: Ultrasound is a safe and effective diagnostic tool used within several specialties. However, the quality of ultrasound scans relies on sufficiently skilled clinician operators. The aim of this study was to explore the validity of automated assessments of upper abdominal ultrasound skills using an ultrasound simulator. METHODS: Twenty five novices and five experts were recruited, all of whom completed an assessment program for the evaluation of upper abdominal ultrasound skills on a virtual reality simulator. The program included five modules that assessed different organ systems using automated simulator metrics. We used Messick's framework to explore the validity evidence of these simulator metrics to determine the contents of a final simulator test. We used the contrasting groups method to establish a pass/fail level for the final simulator test. RESULTS: Thirty seven out of 60 metrics were able to discriminate between novices and experts (p < 0.05). The median simulator score of the final simulator test including the metrics with validity evidence was 26.68% (range: 8.1-40.5%) for novices and 85.1% (range: 56.8-91.9%) for experts. The internal structure was assessed by Cronbach alpha (0.93) and intraclass correlation coefficient (0.89). The pass/fail level was determined to be 50.9%. This pass/fail criterion found no passing novices or failing experts. CONCLUSIONS: This study collected validity evidence for simulation-based assessment of upper abdominal ultrasound examinations, which is the first step toward competency-based training. Future studies may examine how competency-based training in the simulated setting translates into improvements in clinical performances.

Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery / Evidencia de la Validez y Fiabilidad de la Versión en Español de la Etapa deRecuperación Autoidentificada

Background: The Self-Identified Stage of Recovery (SISR) (Andresen, 2007) is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. Method: The Spanish version of the SISR was developed following the translation–back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. Results: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. Conclusions: This study supports the validity and reliability of the scores of the Spanish version of the SISR.(AU)

Antecedentes: La Self-Identified Stage of Recovery (SISR) (Andresen, 2007) es una escala que evalúa tanto la etapa de recuperación (SISR-A) como los componentes del proceso de recuperación personal (SISR-B). El objetivo del estudio fue desarrollar la versión en español de la SISR y obtener evidencias de validez y fiabilidad en una muestra de 230 usuarios de servicios comunitarios de salud mental. Método: La versión en español se desarrolló siguiendo el procedimiento de traducción-retrotraducción, con el apoyo de un comité de expertos por experiencia. Se examinó la estructura dimensional, consistencia interna, relaciones con otras variables (Escala de Evaluación de la Recuperación de Maryland [MARS-12] y Escala de Esperanza Disposicional [DHS]) y estabilidad temporal (n = 66). Se analizó el funcionamiento diferencial del ítem (DIF) por género. Resultados: El estudio confirmó la unidimensionalidad de la SISR-B y una adecuada consistencia interna de sus puntuaciones (ω = .83, α = .83). Las puntuaciones de la SISR-A y la SISR-B presentaron estabilidad temporal y la SISR-B mostró correlaciones elevadas con la MARS-12 (rs = .78) y la DHS (rs = .67). No se encontró DIF. Conclusiones: Este estudio apoya la validez y fiabilidad de las puntuaciones de la versión española de la SISR.(AU)

Desenvolvimento e Evidências de Validade do Inventário de Avaliação dos Cinco Grandes Fatores e Facetas de Personalidade (IACGF-F) / Development and Validity Evidence of the Big Five Factors and Facets Personality Assessment Inventory (PAIBFF-F)

A personalidade é um construto central na pesquisa psicológica, podendo ser definida como uma estrutura relativamente estável do ser humano que influencia seus comportamentos diante de acontecimentos diários. Este estudo objetivou desenvolver e obter evidências de validade baseadas na estrutura interna do Inventário de Avaliação dos Cinco Grandes Fatores e Facetas de Personalidade (IACGF-F). A Teoria dos Cinco Grandes Fatores de Personalidade foi utilizada como referencial teórico para elaboração dos itens. Para o estudo piloto, 150 sujeitos responderam à versão do instrumento composta por 151 itens e questionário sociodemográfico. O estudo final contou com 285 sujeitos com média de idade de 22,6 anos que responderam à versão do IACGF-F com 129 itens, além do questionário sociodemográfico. Foi realizado um conjunto de sete análises fatoriais exploratórias, estimação da fidedignidade, bem como calibração dos parâmetros dos itens a partir da TRI. A versão final do instrumento ficou composta por 103 itens distribuídos em cinco fatores com variação de cinco a seis facetas por fator. Foram encontrados bons índices de fidedignidade (alfas entre 0,85 e 0,96), além de bons índices de dificuldade e discriminação. Sugere-se a utilização do IACGF-F em pesquisas nas quais a avaliação mais detalhada das facetas se faz necessária.

Personality is a central construct in psychological research and can be defined as a relatively stable structure of human beings that influences their behavior in the face of daily events. The purpose of this study wasd to develop and obtain validity evidence based on the internal structure of the Inventory for Assessment of the Big Five Personality Factors and Facets (PAIBFF-F). The Big Five Personality Factor Theory was used as the theoretical framework for item development. For the pilot study, 150 subjects answered the initial version of the instrument, which consisted of 151 items and a sociodemographic questionnaire. The final study included 285 subjects with a mean age of 22.6 years who answered a version of the PAIBFF-F with 129 items and sociodemographic questionnaire. Seven exploratory factor analyses, reliability estimation, as well as calibration of the item parameters from TRI were performed. The final version of the instrument was composed of 103 items distributed in five factors with a variation of five to six facets per factor. Good reliability indices were found (alphas between 0.85 and 0.96), in addition to good difficulty and discrimination indices. We suggest the use of the IACGF-P in research in which a more detailed evaluation of the facets is required.

Validation of the Spanish Version of the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) with Sexual Arousal Measures in Men.

Objective: Provide new validity evidence of the Spanish version of the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) by associating its scores with measures of sexual arousal. Method: In a sample of 48 men, using a quasi-experimental design, sexual functioning, propensity for sexual inhibition/excitation, subjective sexual arousal, and genital response (penile plethysmography recorded with Biopac MP150 equipment) were evaluated. Results: Arousal and erection scores correlated with sexual inhibition due to the threat of performance failure (r = .29; p < .05) and genital response (r = .31; p < .05), respectively. Participants with difficulties in sexual functioning indicated greater sexual inhibition due to the threat of performance failure (p = .04) and lower intensity in their genital response (p = .05). Conclusions: The validity of the measures obtained with the Spanish version of the MGH-SFQ is supported, showing the erection item to be useful for the detection of possible erectile disorders.

Objetivo: Aportar nuevas evidencias de validez a la versión española del Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ), asociando sus puntuaciones a medidas de la excitación sexual. Método: En una muestra de 48 hombres, mediante un diseño cuasiexperimental, se evaluó el funcionamiento sexual, la propensión para la excitación/inhibición sexual, la excitación sexual subjetiva y la respuesta genital (pletismografía peniana registrada con un equipo Biopac MP150). Resultados: Las puntuaciones en excitación y erección del MGH-SFQ correlacionaron significativamente con la inhibición sexual por miedo al fallo en el rendimiento sexual (r = .29; p < .05) y con la respuesta genital (r = .31; p < .05), respectivamente. Los participantes con dificultades en el funcionamiento sexual, en comparación con los que mostraron un adecuado funcionamiento, indicaron mayor inhibición sexual por miedo al fallo en el rendimiento sexual (p = .04) y menor intensidad en su respuesta genital (p = .05). Conclusiones: Se avala la validez de las medidas obtenidas con la versión española del MGH-SFQ, mostrándose el ítem de erección útil para la detección de posibles trastornos eréctiles.

Gathering validity evidence for a 3D-printed simulator for training of myringotomy and ventilation tube insertion.

Objectives: This study aimed to gather validity evidence according to Messick's framework for a novel 3D-printed simulator for myringotomy with ventilation tube insertion for use in technical skills training of otorhinolaryngology (ORL) residents. Methods: The study included 15 junior ORL residents (trainees) and 13 experienced teaching otolaryngologists (experts). Experts and trainees first received an identically structured introduction to the procedure, simulator, and simulation setup. Five procedures performed by each participant were video-recorded and ordered randomly for blinded rating by two independent raters. The rating tools used were a global rating scale (GBRS) and a task-specific checklist. Validity evidence was collected according to Messick's framework. Differences in time consumption and performance scores were analyzed. Finally, a pass/fail standard was established using the contrasting groups' method. Results: Trainees used significantly more time per procedure (109 s, 95% CI: 99-120) than experts (82 s, 95% CI: 71-93; p < .001). Adjusted for repetition and rater leniency, experts achieved an average GBRS score of 18.8 (95% CI: 18.3-19.2) out of 20 points, whereas trainees achieved an average of 17.1 points (95% CI: 16.6-17.5; p < .001). In contrast to the task-specific checklist, the GBRS score discriminated between repetition number and participant experience. The pass/fail standard for the GBRS was established at 18.4 points. Conclusion: We established educational validity evidence for a novel 3D-printed model for simulation-based training of ventilation tube insertion and established a reliable pass/fail standard. Level of Evidence: 1b.

European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context.

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald's omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.

RESUMO: Literacia em saúde (LS) refere-se ao conhecimento, motivação e competências para entender, avaliar e aplicar informações de saúde, possibilitando a tomada de decisões adequadas na vida diária para o cuidado e promoção de saúde. Estudos apontam que a LS está associada a diversos determinantes sociais, desfechos em saúde e promoção da saúde. No Brasil ainda são escassos os estudos no tema. Dessa forma, o presente estudo objetivou adaptar, buscar evidências de validade, fidedignidade e estimar os parâmetros dos itens do European Health Literacy Survey Questionnaire Short Form (HLS-Q12) para o contexto brasileiro. Participaram 770 indivíduos, recrutados por meio de anúncios nas mídias e redes sociais, 82,1% mulheres, com idades entre 18 e 83 anos (M = 35,5, DP = 13,52), de 21 Unidades Federativas do Brasil e do Distrito Federal. Os sujeitos responderam a HLS-Q12 e questionário sociodemográfico. A análise fatorial exploratória indicou uma estrutura unifatorial com bons parâmetros psicométricos (GFI = 0,98; CFI = 0,98; RMSEA = 0,08; RMSR = 0,07). Os indicadores de fidedignidade alfa de Cronbach, lambda 2 de Guttman e ômega de McDonald foram iguais a 0,87. Conclui-se que o HLS-Q12 apresenta-se como um instrumento adequado para aferir o nível de LS na população brasileira.

Alpine ski technique observation instrument: reliability and validity / Instrumento de observación de la técnica en esquí alpino: fiabilidad y validez

The aim of the study was to design an accurate and useful observational instrument for evaluating basic turn techniques in alpine skiing, and to determine its validity and reliability. A multi-step approach was used to design and validate the instrument: a literature revision; an expert meeting; a pilot test; the assessment of intra- and inter-observer reliability; a convergent validity test; and the responsiveness calculation with a pre- post-test. Results showed adequate values of intra-rater (P=0.80-0.83) and inter-rater reliability (P=0.86-0.97). For the convergent validity, a moderate statistically significant correlation for the speed and trajectory control dimensions were achieved (rho=0.58-0.65, p<0.001), but not for the balance position dimension (rho=0.24, p=0.166). The responsiveness was also acceptable (p<0.05, r=0.46-0.60). In conclusion, the Alpine Ski Technique Observation Instrument is a useful, reliable, valid, and responsive observational tool. (AU)

El objetivo del estudio fue diseñar un instrumento de observación preciso y útil para evaluar la técnica de cambios de dirección básicos en el esquí alpino, y determinar su validez y fiabilidad. Para diseñar y validar el instrumento se siguieron los siguientes pasos: revisión de la literatura, valoración por comité de expertos, prueba piloto, evaluación de la fiabilidad intra e inter-evaluador, prueba de validez convergente, y cálculo de sensibilidad con una prueba pre y post-intervención. Los resultados mostraron valores adecuados de fiabilidad intra-evaluador (P=0,80-0,83) e inter-evaluador (P=0,86-0,97). Respecto a la validez convergente se obtuvo una correlación moderada para las dimensiones de control de la velocidad y de la trayectoria (rho=0,58-0,65, p<0,001), pero no para la dimensión de posición de equilibrio (rho=0,24, p=0,166). La sensibilidad fue aceptable (p<0,05, r=0,46-0,60). En conclusión, el Instrumento de Observación de la Técnica en Esquí Alpino es una herramienta útil, fiable, válida y sensible. (AU)

Learning insertion of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) catheter: Is clinical experience necessary? A prospective trial.

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging and potentially life-saving procedure, necessitating qualified operators in an increasing number of centres. The procedure shares technical elements with other vascular access procedures using the Seldinger technique, which is mastered by doctors not only in endovascular specialties but also in trauma surgery, emergency medicine, and anaesthesiology. We hypothesised that doctors mastering the Seldinger technique (experienced anaesthesiologist) would learn the technical aspects of REBOA with limited training and remain technically superior to doctors unfamiliar with the Seldinger technique (novice residents) given similar training. METHODS: This was a prospective trial of an educational intervention. Three groups of doctors were enroled: novice residents, experienced anaesthesiologists, and endovascular experts. The novices and the anaesthesiologists completed 2.5 h of simulation-based REBOA training. Their skills were tested before and 8-12 weeks after training using a standardised simulated scenario. The endovascular experts, constituting a reference group, were equivalently tested. All performances were video recorded and rated by three blinded experts using a validated assessment tool for REBOA (REBOA-RATE). Performances were compared between groups and with a previously published pass/fail cutoff. RESULTS: Sixteen novices, 13 board-certified specialists in anaesthesiology, and 13 endovascular experts participated. Before training, the anaesthesiologists outperformed the novices by 30 percentage points of the maximum REBOA-RATE score (56% (SD 14.0) vs 26% (SD 17%), p<0.01). After training, there was no difference in skills between the two groups (78% (SD 11%) vs 78 (SD 14%), p = 0.93). Neither group reached the endovascular experts' skill level (89% (SD 7%), p<0.05). CONCLUSION: For doctors mastering the Seldinger technique, there was an initial inter-procedural transfer of skills advantage when performing REBOA. However, after identical simulation-based training, novices performed equally well to anaesthesiologists, indicating that vascular access experience is not a prerequisite to learning the technical aspects of REBOA. Both groups would need more training to reach technical proficiency.

Evidence for Test Validation: A Guide for Practitioners / Evidencias Sobre la Validación de los Tests: una Guía Práctica

Background: Validity is a core topic in educational and psychological assessment. Although there are many available resources describing the concept of validity, sources of validity evidence, and suggestions about how to obtain validity evidence; there is little guidance providing specific instructions for planning and carrying out validation studies. Method: In this paper we describe (a) the fundamental principles underlying test validity, (b) the process of validation, and (c) practical guidance for practitioners to plan and carry out sufficient validity research to support the use of a test for its intended purposes. Results: We first define validity, describe sources of validity evidence, and provide examples where each of these sources are addressed. Then, we describe a validation agenda describing steps and tasks for planning and developing validation studies. Conclusions: Finally, we discuss the importance of addressing validation studies from a comprehensive approach.(AU)

Antecedentes: La validez es un tema central en la evaluación psicológica y educativa. A pesar de que la literature disponible recoge numerosos recursos en los que se describe el concepto de validez, las fuentes de evidencia y se aportan sugerencias sobre cómo obtener evidencias de validez, apenas existen guías que proporcionen instrucciones específicas para planificar y desarrollar estudios de validación. Método: El presente artículo describe (a) los principios fundamentales en los que se sustenta la validez de los test, (b) el proceso de validación, y (c) una guía práctica para planificar y recoger evidencias de validez que apoyen el uso de un test para alcanzar el objetivo previsto. Resultados: En primer lugar, se describe el concepto de validez y las fuentes de evidencia, aportando ejemplos específicos donde se abordan cada una de ellas. A continuación, se describe una agenda de validación en la que se enumeran los pasos y tareas necesarios para planificar y completar un estudio de validación. Conclusiones: Finalmente, se discute la relevancia de adoptar una aproximación comprehensiva al abordar estudios de validación.(AU)

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients.

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.

Developing a Robotic Surgery Curriculum: Selection of Virtual Reality Drills for Content Alignment.

INTRODUCTION: Despite the importance of simulation-based training for robotic surgery, there is no consensus about its training curricula. Recently, a virtual reality (VR) platform (SimNow, Intuitive, Inc) was introduced with 33 VR drills but without evidence of their validity. As part of our creating a new robotic VR curriculum, we assessed the drills' validity through content mapping and the alignment between learning goals and drill content. METHODS: Three robotically trained surgeons content-mapped all 33 drills for how well the drills incorporated 15 surgery skills and also rated the drills' difficulty, usefulness, relevance, and uniqueness. Drills were added to the new curriculum based on consensus about ratings and historic learner data. The drills were grouped according to similar skill sets and arranged in order of complexity. RESULTS: The 33 drills were judged to have 12/15 surgery skills as primary goals and 13/15 as secondary goals. Twenty of the 33 drills were selected for inclusion in the new curriculum; these had 11/15 skills as primary goals and 11/15 as secondary goals. However, skills regarding energy sources, atraumatic handling, blunt dissection, fine dissection, and running suturing were poorly represented in the drills. Three previously validated inanimate drills were added to the curriculum to address lacking skill domains. CONCLUSIONS: We identified 20 of the 33 SimNow drills as a foundation for a robotic surgery curriculum based on content-oriented evidence. We added 3 other drills to address identified gaps in drill content.

European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Abstract Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald's omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.

Adaptation to Spanish of the "Relational Needs Satisfaction Scale": Translation and psychometric testing.

This article aims to adapt to Spanish the Relational Needs Satisfaction Scale (RNSS) and to test the factor structure with a clinical and a non-clinical sample. A total of 459 individuals completed the RNSS, a measure of life satisfaction and of psychological wellbeing. Results showed that the translation was adequate. An exploratory and confirmatory factor analysis was conducted followed by the test of three models that confirmed the five-factor structure and the second-order global factor proposed in the original study, and in adaptations to other languages. The advantages and disadvantages of these models are discussed. Correlations of the RNSS with life satisfaction and psychological wellbeing measures were in the expected direction, providing evidence of convergent validity. The Spanish version of the RNSS is a valid and reliable measure of the construct it was intended to measure, though some improvements in item wording could be incorporated and tested (for instance, item 18 should be positively worded as the rest of the items in order to avoid the effect of negative wording).

Validity Evidence for ENTRUST as an Assessment of Surgical Decision-Making for the Inguinal Hernia Entrustable Professional Activity (EPA).

OBJECTIVE: As the American Board of Surgery (ABS) moves toward implementation of Entrustable Professional Activities (EPAs), there is a growing need for objective evaluation of readiness for entrustment of residents. This requires not only assessment of technical skills and knowledge, but also surgical decision-making in preoperative, intraoperative, and postoperative settings. We developed and piloted an Inguinal Hernia EPA Assessment on ENTRUST, a serious game-based online virtual patient simulation platform to assess trainees' decision-making competence. DESIGN: This is a prospective analysis of resident performance on the ENTRUST Inguinal Hernia EPA Assessment using bivariate analyses. SETTING: This study was conducted at an academic institution in a proctored exam setting. PARTICIPANTS: Forty-three surgical residents completed the ENTRUST Inguinal Hernia EPA Assessment. RESULTS: Four case scenarios for the Inguinal Hernia EPA and corresponding scoring algorithms were iteratively developed by expert consensus aligned with ABS EPA descriptions and functions. ENTRUST Inguinal Hernia Grand Total Score was positively correlated with PGY-level (p < 0.0001). Preoperative, Intraoperative, and Postoperative Total Scores were also positively correlated with PGY-level (p = 0.001, p = 0.006, and p = 0.038, respectively). Total Case Scores were positively correlated with PGY-level for cases representing elective unilateral inguinal hernia (p = 0.0004), strangulated inguinal hernia (p < 0.0001), and elective bilateral inguinal hernia (p = 0.0003). Preoperative Sub-Scores were positively correlated with PGY-level for all cases (p < 0.01). Intraoperative Sub-Scores were positively correlated with PGY-level for strangulated inguinal hernia and bilateral inguinal hernia (p = 0.0007 and p = 0.0002, respectively). Grand Total Score and Intraoperative Sub-Score were correlated with prior operative experience (p < 0.0001). Prior video game experience did not correlate with performance on ENTRUST (p = 0.56). CONCLUSIONS: Performance on the ENTRUST Inguinal Hernia EPA Assessment was positively correlated to PGY-level and prior inguinal hernia operative performance, providing initial validity evidence for its use as an objective assessment for surgical decision-making. The ENTRUST platform holds potential as tool for assessment of ABS EPAs in surgical residency programs.

Development and Validation of a Brief Version of the European Bullying and Cyberbullying Intervention Project Questionnaires (EBIP-Q and ECIP-Q) / Desarrollo y Validación de una Versión Abreviada de los Cuestionarios European Bullying y Cyberbullying Intervention Project (EBIP-Q y ECIP-Q)

Background: In order to prevent school bullying and cyberbullying, brief measurement instruments with adequate psychometric properties are required. The objective of this study was to develop a combined reduced version of the European Bullying Intervention Project Questionnaire (EBIP-Q) and the European Cyberbullying Intervention Project Questionnaire (ECIP-Q) for its use in the screening of bullying-related behaviors at school. Method: The sample consisted of 1777 students, between 14 and 18 years of age (M = 15.71; SD = 1.26), of which 54.1% were female. Results: The resulting reduced version presents adequate psychometric properties with reliability coefficients between ω = .72 and ω = .82. Factor analyses indicate that both bullying and cyberbullying are structured around two factors: victimization and aggression. The correlations between the scores of the original version and the reduced version were adequate. Bullying and cyberbullying was associated with different indicators of socioemotional adjustment. Conclusions: The European Bullying and Cyberbullying Intervention Project Questionnaire Brief version (EBCIP-QB) seems to be brief, useful, and have adequate psychometric properties for the assessment of bullying and cyberbullying in Spanish adolescents.(AU)

Antecedentes: la prevención del acoso y ciberacoso escolar requiere disponer de instrumentos de medida breves y con adecuadas propiedades psicométricas. El objetivo del presente trabajo ha sido desarrollar una versión reducida conjunta de los instrumentos European Bullying Intervention Project Questionnaire (EBIP-Q) y European Cyberbullying Intervention Project Questionnaire (ECIP-Q) para su uso en el cribado de conductas relacionadas con el acoso escolar. Método: la muestra la integran 1,777 estudiantes, de entre 14 y 18 años (M = 15.71 años; DT = 1.26), de los que el 54.1% son mujeres. Resultados: la versión reducida presenta un comportamiento psicométrico adecuado. Los coeficientes de fiabilidad estimados oscilan entre ω = .72 y ω =.82. Los análisis factoriales indican que tanto el acoso como el ciberacoso escolar se articulan en torno a dos factores: victimización y agresión. Las correlaciones entre las puntuaciones de la versiones original y reducida fueron adecuadas. El acoso y ciberacoso escolar se asoció con diferentes indicadores de ajuste socioemocional. Conclusiones: el Cuestionario Proyecto Europeo de Intervención contra el Acoso y el Ciberacoso - Breve (EBCIP-QB) parece ser un instrumento breve, sencillo y con adecuadas propiedades psicométricas para la evaluación de las conductas de acoso y ciberacoso escolar en adolescentes españoles.(AU)