Cultural adaptation to Bolivian Quechua and psychometric analysis of the Patient Health Questionnaire PHQ-9.

OBJECTIVE: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.

Differences in family functioning before and during the COVID-19 pandemic: an observational study in Peruvian families.

The COVID-19 pandemic has had a major impact on family relationships, as several families have lost family members due to COVID-19 pandemic and become physically and emotionally estranged due to lockdown measures and critically economic periods. Our study contrasted two hypotheses: (1) family functioning changed notably before and after the COVID-19 pandemic initiation in terms of cohesion, flexibility, communication and satisfaction; (2) balanced families have a greater capacity to strictly comply with quarantine (i.e., social confinement), compared to unbalanced families. We performed an observational study comparing family functioning between two independent groups, evaluated before and during the first wave of the COVID-19 pandemic in Peru. A total of 7,980 participants were included in the study. For the first hypothesis, we found that, during the pandemic, families became more balanced in terms of cohesion (adjusted before-during mean difference or ß1 = 1.4; 95% CI [1.0-1.7]) and flexibility (ß2 = 2.0; 95% CI [1.6-2.4]), and families were less disengaged (ß3 = -1.9; 95% CI [-2.3 to -1.5]) and chaotic (ß4 = -2.9; 95% CI [-3.3 to -2.4]). Regarding the second hypothesis, we confirmed that families with balanced cohesion (adjusted prevalence ratio or aPR = 1.16; 95% CI [1.12-1.19) and flexibility (aPR = 1.23; 95% CI [1.18-1.27]) allowed greater compliance with quarantine restrictions; while disengaged (aPR = 0.91; 95% CI [0.88-0.93]) and chaotic families (aPR = 0.89; 95% CI [0.87-0.92]) were more likely to partially comply or not comply with the quarantine. Finally, family communication (aPR = 1.17; 95% CI [1.11-1.24]) and satisfaction (aPR = 1.18; 95% CI [1.11-1.25]) also played a role in favouring quarantine compliance. This new evidence enlightens the family systems theory while informing future interventions for improving compliance with quarantine measures in the context of social confinement.

[Psychometric properties of the third version of family adaptability and cohesion evaluation scales (FACES-III): a study of peruvian adolescents]. / Propiedades psicométricas de la escala de funcionalidad familiar FACES-III: un estudio en adolescentes peruanos.

OBJETIVES.: Our aim was to evaluate the psychometric properties of the FACES-III among Peruvian high school students. MATERIALS AND METHODS.: This is a psychometric cross-sectional study. A probabilistic sampling was applied, defined by three stages: stratum one (school), stratum two (grade) and cluster (section). The participants were 910 adolescent students of both sexes, between 11 and 18 years of age. The instrument was also the object of study: the Olson's FACES-III. The analysis included a review of the structure / construct validity of the measure by factor analysis and assessment of internal consistency (reliability). RESULTS.: The real-cohesion scale had moderately high reliability (Ω=.85) while the real-flexibility scale had moderate reliability (Ω=.74). The reliability found for the ideal-cohesion was moderately high (Ω=.89) like for the scale of ideal-flexibility (Ω=.86). Construct validity was confirmed by the goodness of fit of a two factor model (cohesion and flexibility) with 10 items each [Adjusted goodness of fit index (AGFI) = 0.96; Expected Cross Validation Index (ECVI) = 0.87; Normed fit index (NFI) = 0.93; Goodness of fit index (GFI) = 0.97; Root mean square error of approximation (RMSEA) = 0.06]. CONCLUSIONS.: FACES-III has sufficient reliability and validity to be used in Peruvian adolescents for the purpose of group or individual assessment.

Propiedades psicométricas de la escala de funcionalidad familiar FACES-III: un estudio en adolescentes peruanos / Psychometric properties of the third version of family adaptability and cohesion evaluation scales (FACES-III): a study of peruvian adolescents

RESUMEN Objetivos. Evaluar las propiedades psicométricas del FACES-III en una población de estudiantes adolescentes peruanos. Materiales y métodos. El presente estudio es transversal, de tipo psicométrico. El muestreo aplicado fue probabilístico, definido en tres etapas: primer estrato (colegio), segundo estrato (grado), conglomerado (sección). Los participantes fueron 910 estudiantes adolescentes de ambos sexos, entre los 11 y 18 años. El instrumento es, a la vez, el objeto de estudio: el FACES-III de Olson. El análisis incluyó la revisión de la validez de estructura/constructo mediante análisis factorial y de la confiabilidad por consistencia interna (índices alpha, theta y omega). Resultados. La escala cohesión-real tiene confiabilidad moderadamente alta (Ω=0,85) mientras que la escala flexibilidad-real tiene confiabilidad moderada (Ω=0,74). Para la escala cohesión-ideal la confiabilidad es moderadamente alta (Ω=0,89), lo mismo que para la escala de flexibilidad-ideal (Ω=0,86). La validez de constructo se confirmó en la bondad de ajuste del modelo de dos factores (cohesión y flexibilidad) con 10 ítems cada uno [índice ajustado de bondad de ajuste (AGFI)=0,96; índice de validación cruzada esperada (ECVI)=0,87; índice de ajuste normado (NFI)=0,93; índice de bondad de ajuste (GFI)=0,97; raíz del error cuadrático medio de aproximación (RMSEA)=0,06]. Conclusiones. El FACES-III tiene confiabilidad y validez suficientes como para ser utilizado en población adolescente peruana con fines de evaluación grupal o individual.

ABSTRACT Objetives. Our aim was to evaluate the psychometric properties of the FACES-III among Peruvian high school students. Materials and Methods. This is a psychometric cross-sectional study. A probabilistic sampling was applied, defined by three stages: stratum one (school), stratum two (grade) and cluster (section). The participants were 910 adolescent students of both sexes, between 11 and 18 years of age. The instrument was also the object of study: the Olson's FACES-III. The analysis included a review of the structure / construct validity of the measure by factor analysis and assessment of internal consistency (reliability). Results. The real-cohesion scale had moderately high reliability (Ω=.85) while the real-flexibility scale had moderate reliability (Ω=.74). The reliability found for the ideal-cohesion was moderately high (Ω=.89) like for the scale of ideal-flexibility (Ω=.86). Construct validity was confirmed by the goodness of fit of a two factor model (cohesion and flexibility) with 10 items each [Adjusted goodness of fit index (AGFI) = 0.96; Expected Cross Validation Index (ECVI) = 0.87; Normed fit index (NFI) = 0.93; Goodness of fit index (GFI) = 0.97; Root mean square error of approximation (RMSEA) = 0.06]. Conclusions. FACES-III has sufficient reliability and validity to be used in Peruvian adolescents for the purpose of group or individual assessment.