Development of the German social attitude barriers and facilitators to participation-scales: an analysis according to the Rasch model.

BACKGROUND: Social attitudes experienced by people with disabilities can strongly impact upon their health and quality of life. The extent to which social attitude measurement transcends specific cultures is unknown. Thus, the aim of the study was to develop German item banks to assess social attitude barriers and facilitators to participation and compare the construct definition with that developed in the United States. METHODS: The American version of the two item banks assessing social attitudes that act as barriers and facilitators in persons with disabilities was translated into German and culturally adapted. The sample consisted of 410 in- and outpatients treated for spinal diseases at a German University Hospital. The psychometric properties of the resulting 53 items-item pool were evaluated using Rasch analysis. A special focus was placed on the investigation of unidimensionality, local independence, differential item functioning (DIF) and targeting. To evaluate convergent and divergent validity correlations with perceived social support, depression and pain interference were calculated. RESULTS: Unlike the American version, both the barriers and facilitators item banks had to be divided into two subscales assessing attitudes that individuals with disabilities experience as being directed towards them (individual perception) or attitudes that respondents experience as being directed towards people with disabilities as a social group (societal perception). Four unidimensional scales were constructed. Fit to the Rasch model required item deletion and forming testlets to account for extensive local dependence. There was no evidence of DIF with regard to gender or age. Targeting of the subscales was moderate to good. CONCLUSIONS: Results support a distinction between social attitudes at the individual and societal level, allowing a more specific assessment than is possible when this distinction is ignored.

Stigmatisation associated with COVID-19 in the general Colombian population.

BACKGROUND: As the COVID-19 pandemic progresses, the fear of infection increases and, with it, the stigma-discrimination, which makes it an additional problem of the epidemic. However, studies about stigma associated with coronavirus are scarce worldwide. AIMS: To determine the association between stigmatisation and fear of COVID-19 in the general population of Colombia. METHOD: A cross-sectional study was carried out. A total of 1,687 adults between 18 and 76 years old (M = 36.3; SD = 12.5), 41.1% health workers, filled out an online questionnaire on Stigma-Discrimination and the COVID-5 Fear Scale, adapted by the research team. RESULTS: The proportion of high fear of COVID-19 was 34.1%; When comparing the affirmative answers to the questionnaire on stigma-discrimination towards COVID-19, it was found that the difference was significantly higher in the general population compared to health workers in most of the questions evaluated, which indicates a high level of stigmatisation in that group. An association between high fear of COVID-19 and stigma was evidenced in 63.6% of the questions in the questionnaire. CONCLUSION: Stigma-discrimination towards COVID-19 is frequent in the Colombian population and is associated with high levels of fear towards said disease, mainly people who are not health workers.

[Use of components of the transitional care model in geriatric cross-sectoral care in Germany-Results of a survey]. / Der Einsatz von Komponenten des "Transitional Care Model" in der geriatrischen transsektoralen Versorgung Deutschlands ­ Ergebnisse einer Umfrage.

BACKGROUND: The inclusion of transitional care professionals to improve the sectoral interface management is politically supported. The nine components of the transitional care model (TCM) originating from the USA, are used in a randomized controlled trial within the TIGER project, which is funded by the Federal Joint Committee of Germany. Geriatric patients are accompanied prior to discharge from hospital and up to 12 months after discharge in the home environment. OBJECTIVE: Within the framework of the TIGER project a nationwide survey was carried out on the use of the TCM components in the accompanied transition from hospital to home in the field of geriatrics. MATERIAL AND METHODS: A data collection was set up to establish contact with people from the immediate and care policy environment of geriatrics. In a 2-stage process, the first question was whether a geriatric project was known that focuses on the transition from hospital to home in geriatric patients. After confirmation, a questionnaire could be filled out online or by post. RESULTS: A total of 31 different projects out of 39 answered questionnaires were identified. Principally, all TCM components were used in the projects. The TCM component 9 that describes the coordination of support and aids, was mentioned most often (n = 30). The TCM components 6 (improvement in self-management) and 8 (promoting continuity) were used in only 19 projects. CONCLUSION: Management of the transsectoral transition is a current topic in the field of geriatrics in Germany. The TCM components that have proved to be important in reducing hospital readmission rates have predominantly been used in the projects.

Psychometric evaluation of the Interpersonal Needs Questionnaire (INQ) using item analysis according to the Rasch model.

The Interpersonal Needs Questionnaire (INQ) assesses Thwarted Belongingness (TB) and Perceived Burdensomeness (PB), two predictors of suicidal thoughts. Up to now, the use of item response theory (IRT) for the evaluation of the INQ has been restricted to a single study with clinically depressed and suicidal youth. Therefore, the psychometric properties of the two INQ-15-subscales TB and PB were now evaluated in a general population sample (N = 2508) and a clinical adult population sample (N = 185) using IRT, specifically the Rasch model (RM) and the graphical log-linear Rasch model (GLLRM). Of special interest was whether the INQ-subscales displayed differential item functioning (DIF) across the two different samples and how well the subscales were targeted to the two sample populations. For the clinical sample, fit to a GLLRM could be established for the PB-subscale and fit to a RM was established for a five-item version of the TB-subscale. In contrast, for the general population sample fit to a GLLRM could only be achieved for the PB-subscale. Overall, there was strong evidence of local dependence (LD) across items and of some age- and gender-related DIF. Both subscales exhibited massive DIF related to the sample, indicating that they don't work the same across the general population and clinical sample. As expected, targeting of both INQ-subscales was much better for the clinical population. Further investigations of the INQ-15 under the Rasch approach in a large clinical population are recommended to determine and optimize the scale performance.

Estigma hacia la tuberculosis: validación psicométrica de un instrumento para su medición / Stigma towards tuberculosis: psychometric validation of an instrument for its measurement

Introducción. El estigma hacia la tuberculosis afecta la búsqueda de atención médica oportuna y la adherencia al tratamiento por temor al rechazo familiar, social o institucional. Objetivo. Validar un instrumento para medir el estigma hacia la tuberculosis aplicando la metodología Rasch. Métodos: Estudio de corte transversal. El análisis se basó en los aspectos sugeridos por Messick y operacionalizados por Wolfe y Smith con la metodología Rasch; se empleó el modelo dicotómico, donde se evaluaron los estimados de ajuste de los ítems, coherencia en la medida, índices de separación y confiabilidad, invarianza, unidimensionalidad y la relación persona-ítem. Resultados. Se entrevistaron 250 personas, 195 sin tuberculosis y 55 con tuberculosis. Se evaluaron 35 ítems, de los que 10 fueron excluidos por presentar desajustes y funcionamiento diferencial del ítem. Se obtuvieron 25 ítems validos con ajustes apropiados entre 0,5 y 1,5, correlación >0,3, porcentaje de coherencia >40% e invarianza en la medición de importantes variables exógenas. El índice de separación en ítems fue de 6,5 y confiabilidad de 0,98. En las personas fue de 1,51 y 0,69 respectivamente. Conclusiones. Se obtuvo un instrumento válido con medida unidimensional del estigma hacia la tuberculosis para uso en población general y en pacientes con tuberculosis, soportado en la rigurosidad estadística del modelo Rasch.

Introduction. The stigma towards tuberculosis affects the search for timely medical care and adherence to treatment for fear of family, social or institutional rejection. Objective. To validate an instrument to measure the stigma towards tuberculosis applying Rasch methodology. Methods. Cross-sectional study. The analysis was based on the aspects suggested by Messick and operationalized by Wolfe and Smith with Rasch methodology; the dichotomous model was used, where adjustment estimates of the items, coherence in the measure, separation and reliability indices, invariance, unidimensionality and the person item relation were evaluated. Results. 250 people were interviewed, 195 without tuberculosis and 55 with tuberculosis. Thirty-five items were evaluated, of which 10 were excluded for showing mismatches and differential functioning of the item. Twenty-five valid items with appropriate adjustments between 0,5 and 1,5, correlation >0,3, percentage of coherence >40% and measurement invariance in important exogenous variables were obtained. The separation index in the items was 6,5 and reliability of 0,98. In individuals was 1,51 and 0,69 respectively. Conclusions. A valid instrument with unidimensional measure of the stigma towards tuberculosis for use in the general population and patients with tuberculosis was obtained, supported by the statistical rigor of the Rasch model.