Construct validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian population

Background The Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure Suboptimal Health Status has been used worldwide, but its construct validity has only been tested in the Chinese population. Applying Structural Equation Modelling, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population. Methods The study involved healthy Ghanaian participants (n = 263; aged 20–80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups. Results The extracted domains were reliable with Cronbach’s $$\alpha$$ α of 0.846, 0.820 and 0.864 respectively, for fatigue, immune-cardiovascular and cognitive. The CFA revealed that the model fit indices were excellent $$\left( {{\text{RMSEA}} = 0.049~ < ~0.08,\,{\text{CFI}} = 0.903 > 0.9,\,{\text{GFI}} = 0.880 < 0.9,\,{\text{TLI}} = 0.907 > 0.9} \right)$$ RMSEA = 0.049 < 0.08 , CFI = 0.903 > 0.9 , GFI = 0.880 < 0.9 , TLI = 0.907 > 0.9 . The fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts were smaller than the corresponding maximum shared variance. The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases. Conclusion The validity tests suggest that the SHS-Q25 can measure SHS in a Ghanaian population. It can be recommended as a screening tool to early detect chronic diseases especially in developing countries where access to facilities is diminished.

Translation, Cultural Adaptation, and Psychometric Evaluation of the Persian Version of Foot Health Status Questionnaire

Objectives: Foot disorders, especially pain and deformities, are common patient complaints. Foot Health Status Questionnaire (FHSQ) was developed to assess general and foot health specifically in chronic foot disorders. The purpose of the current study was the cross-cultural adaptation of the FHSQ to Persian and evaluating the psychometric properties of the translated version. Methods: As per the International Quality of Life Assessment guideline, the forward and backward translations of the questionnaire were conducted by two independent translators. Accordingly, the final version was approved by a committee and confirmed by the developer. The psychometric properties of the Persian version of the FHSQ were tested in 101 participants (Mean±SD age: 42.98±15.03 y) with chronic foot disorders. Face validity by impact score calculation; criterion validity through correlation to the Manchester-Oxford Foot Questionnaire (MOXFQ) scores; internal consistency by Cronbach’s alpha coefficient, and test-retest reliability by calculating intra-class correlation were tested to describe the psychometric features of its Persian version. Results: Face validity was confirmed by impact scores of >1.5 for all items. The FHSQ was significantly correlated with the MOXFQ domains, supporting the criterion validity of the instrument, except for the shoe domain of the Persian FHSQ, i.e., not correlated with the pain domain of the MOXFQ (r=0.26). Cronbach’s alpha coefficients for pain, function, shoe, and general foot health were measured as 0.93, 0.92, 0.90, and 0.96 respectively. Thus, it suggested an excellent internal consistency for all domains. The intra-class correlation coefficient ranged from 0.73 to 0.93 for all domains, reflecting its good to excellent reliability. Discussion: The Persian version of the FHSQ is a valid and reliable patient satisfaction measurement instrument for evaluating foot conditions. Moreover, the current study results supported the potential of applying it as an appropriate instrument in research and clinical setting. Implementing this tool could help to evaluate the effects of an intervention or estimate the prevalence of a disorder in Persian-speaking populations

Effectiveness of Short Form-36 Health Status Questionnaire Versus WOMAC Arthritis Index Questionnaire on Chronic Knee Osteoarthritis Patients

Introduction: Osteoarthritis is a common disease of aged population and one of the leading causes of disability. Key causes include obesity or overweight along with aging. Knee osteoarthritis can cause significant pain and functional loss. As the disease progresses, it can cause chronic knee joint pain, muscle weakness, joint deformity and functional deficiency which leads to decreased quality of life. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) is a 24-item questionnaire with 3 sub-scales measuring pain (5 items), stiffness (2 items) and physical function (17 items). Health related quality of life is measured using Short Form-36, used to examine health status in following eight domains: Bodily pain, physical function, role limitations due to social problems, physical problems, general health, vitality, social function, mental health, role limitation due to physical problems. Aim: To find the effect of Short Form-36 Health Status Questionnaire versus WOMAC Arthritis Index Questionnaire to measure the pain, Range of Motion (ROM) and disability in subjects with chronic knee osteoarthritis patients treated with Contrast Bath and Knee Exercises. Materials and Methods: This study was a pre and post longitudinal cohort study. A total of 90 patients were divided into two groups of 45 each. Each patient was given treatment for four weeks. Each patient was treated with Contrast bath and Knee Exercises. Group A patients were instructed to fill the Short Form-36 Health Status Questionnaire and Group B patients were instructed to fill the WOMAC Arthritis Index Questionnaire and outcome measures were collected on day 1, at the end of 2nd week and at the end of 4th week. Data from study were analysed using the statistical package SPSS 19.0 (SPSS Inc., Chicago, IL) and level of significance was set at p<0.05. Results: Group B shows a mean of the total score of WOMAC Arthritis Index Questionnaire which was 74.66 (SD 10.01) on Day 1; mean of 49.02 (SD 12.08) at the end of the 2nd week and a mean of 20.68 (SD 12.23) at the end of 4th week. The p-value was found to be 0.0001. The percentage disability evaluated by the WOMAC Arthritis Index Questionnaire shows a mean of 78 (SD 10) on Day 1; mean of 51 (SD 12) at the end of 2nd week and a mean of 22 (SD 13) at the end of 4th week. On day 1 Short Form-36 Questionnaire, total score of group A was 88.24 (SD 6.72) and at the end of 2nd week and 4th week the mean score was 94.06 (SD 5.10) and 98.72 (SD 4.55), respectively with statistically significant difference p-value (0.0001). Conclusion: The present study showed that the WOMAC Arthritis Index Questionnaire had superior sensitivity in reducing pain and increasing range of motion and thus by decreasing the disability.

Predictors of Pulmonary Rehabilitation Completion in the UK

AimDetermine characteristics of people with COPD associated with completion of pulmonary rehabilitation (PR).MethodsCross-sectional analysis of 7060 people with COPD enrolled in PR between 03/01/2017 and 31/03/2017. Data were from a UK national audit of COPD care. Factors associated with PR completion were determined using mixed-effects logistic regression with a random intercept for PR service. Factors chosen for assessment based on clinical judgement and data availability were: age, gender, country, SES, Body Mass Index (BMI), referral location, programme type, start within 90 days, smoking status, oxygen therapy, GOLD stage, MRC grade, any exercise test, and any health status questionnaire.Results4635 (66%) people with COPD completed a PR programme. People that were 60 years or older, resident in Wales, referred within 90 days, an ex- or never smoker, received an exercise test, or received a health status questionnaire had significantly greater odds of completing PR. People that were in the most deprived quintile, underweight or very severely obese, enrolled in a rolling rather than a cohort programme, had a higher GOLD stage, and had a higher MRC grade had significantly lower odds of completing PR.ConclusionPeople with COPD were more likely to complete PR when best-practice guidelines were followed. People with more severe COPD symptoms and those enrolled in rolling rather than cohort programmes were less likely to complete PR. Referring people with COPD in the earlier stages of disease, ensuring programmes follow best-practice guidelines, and favouring cohort over rolling programmes could improve rates of PR completion.

Construct Validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian Population

Background: The Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure suboptimal health status has been used worldwide, but its construct validity has only been tested in the Chinese population. In this article, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population. Methods: The study involved healthy Ghanaian participants (n = 263; aged 20-80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups. Results: The extracted domains were reliable with Cronbach’s of 0.861, 0.821 and 0.853 respectively, for fatigue, immune-cardiovascular and cognitive, confirming the construct validity of the SHSQ-25 instrument. The CFA revealed that the model fit indices were excellent but the fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts (AVE) were smaller than the corresponding maximum shared variance (MSV). The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases. Conclusion: The validity tests provide evidence to endorse the credibility of the tool and suggest that the SHS-Q25 can measure SHS in a Ghanaian population. It can be recommended as a screening tool to early detect possible for chronic diseases especially in developing countries where the access to facilities is diminished.

Construct Validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian Population

Background: The Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure suboptimal health status has been used worldwide, but its construct validity has only been tested in the Chinese population. In this article, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population.Methods: The study involved healthy Ghanaian participants (n = 263; aged 20-80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups. Results: The extracted domains were reliable with Cronbach’s B of 0.861, 0.821 and 0.853 respectively, for fatigue, immune-cardiovascular and cognitive, confirming the construct validity of the SHSQ-25 instrument. The CFA revealed that the model fit indices were excellent a The fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts (AVE) were smaller than the corresponding maximum shared variance (MSV). The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases.Conclusion: The validity tests provide evidence to endorse the credibility of the tool and suggest that the SHS-Q25 can measure SHS in a Ghanaian population. It can be recommended as a screening tool to early detect possible for chronic diseases especially in developing countries where the access to facilities is diminished.

Construct Validity of the Suboptimal Health Status Questionnaire-25 in a Ghanaian Population

BackgroundThe Suboptimal Health Status Questionnaire-25 (SHS-Q-25) developed to measure suboptimal health status has been used worldwide, but its construct validity has only been tested in the Chinese population. In this article, we investigate aspects of the construct validity of the SHS-Q-25 to determine the interactions between SHS subscales in a Ghanaian population.MethodsThe study involved healthy Ghanaian participants (n = 263; aged 20-80 years; 63% female), who responded to the SHSQ-25. In an exploratory factor and parallel analysis, the study extracted a new domain structure and compared to the established five-domain structure of SHSQ-25. A confirmatory factor analysis (CFA) was conducted and the fit of the model further discussed. Invariance analysis was carried out to establish the consistency of the instrument across multi-groups.ResultsThe extracted domains were reliable with Cronbach’s B of 0.861, 0.821 and 0.853 respectively, for fatigue, immune-cardiovascular and cognitive, confirming the construct validity of the SHSQ-25 instrument. The CFA revealed that the model fit indices were excellent a The fit indices for the three-domain model were statistically superior to the five-domain model. There were, however, issues of insufficient discriminant validity as some average variance extracts (AVE) were smaller than the corresponding maximum shared variance (MSV). The three-domain model was invariant for all constrained aspects of the structural model across age, which is an important risk factor for most chronic diseases.ConclusionThe validity tests provide evidence to endorse the credibility of the tool and suggest that the SHS-Q25 is robust tool for measuring SHS in a different population.

Effect of Continuous Nursing Intervention of Artificial Intelligence on Discharged Patients after Heart Valve Replacement and Application of Omaha System (Preprint)

UNSTRUCTURED The purpose of this study is to explore the effect of continuous nursing system of artificial intelligence (AI) on patients discharged from hospital after heart valve replacement (HVR) and the application value of Omaha system. The patients undergoing HVR were taken as the research objects and divided into control group (routine nursing) and observation group (continuous nursing). Through the continuous nursing system of AI, the patients discharged from the hospital were monitored remotely, and the vital signs of patients were analyzed by AI. Different nursing methods were used to intervene the patients. Nursing evaluation data were used for nursing evaluation of patients undergoing HVR. Activity of Daily Life Scale (ADL) was used to evaluate patients' daily living ability, health status questionnaire was used to evaluate patients' health status, and World Health Organization Quality of Life-Brief version (WHOQOL-BREF) was used to evaluate patients' quality of life. The results showed that, before intervention, there was no significant difference in the scores of ADL between the control group and the observation group, with no statistical significance (P > 0.05). After intervention, the scores of ADL in the observation group were higher than those in the control group (P < 0.05), and the differences were statistically significant (P < 0.05); before intervention, the scores of ADL in the control group were higher than those in the control group, with statistical significance (P < 0.05). Before intervention, there was no significant difference in the health status questionnaire score between the control group and the observation group, without statistical significance (P > 0.05). After intervention, the health status questionnaire score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Before intervention, there was no significant difference in WHO quality of life evaluation score between the control group and the observation group, without statistical significance (P > 0.05). After intervention, the WHO quality of life evaluation score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After intervention, the KBS evaluation of nursing problem outcomes in the observation group was higher than that before intervention, and the difference was statistically significant (P < 0.05). In conclusion, the continuous nursing system of AI based on Omaha system can effectively evaluate the nursing problems of patients after discharge and improve the quality of life of patients, which has important application value.

Corticosteroid injection plus exercise versus exercise, beyond advice and a heel cup for patients with plantar fasciopathy: protocol for a randomised clinical superiority trial (the FIX-Heel trial)

Background Plantar fasciopathy has a lifetime prevalence of 10%. Patients experience sharp pain under the heel, often for several months or years. Multiple treatments are available, but no single treatment appears superior to the others. A corticosteroid injection offers short-term pain relief but is no better than placebo in the longer term (> 8 weeks). Heavy-slow resistance training has shown potentially positive effects on long-term outcomes (> 3 months), and combining exercises with an injection may prove to be superior to exercises alone. However, the effect of heavy-slow resistance training compared with a simpler approach of patient advice (e.g., load management) and insoles is currently unknown. This trial compares the efficacy of patient advice with patient advice plus heavy-slow resistance training and with patient advice plus heavy-slow resistance training plus a corticosteroid injection in improving the Foot Health Status Questionnaire pain score after 12 weeks in patients with plantar fasciopathy. Methods In this randomised superiority trial, we will recruit 180 patients with ultrasound-confirmed plantar fasciopathy and randomly allocate them to one of three groups: (1) patient advice and an insole (n = 60); (2) patient advice, an insole, and self-dosed heavy-slow resistance training consisting of heel raises (n = 60); or (3) patient advice, an insole, heavy-slow resistance training, and an ultrasound-guided corticosteroid injection (n = 60). All participants will be followed for 1 year, with the 12-week follow-up considered the primary endpoint. The primary outcome is the Foot Health Status questionnaire pain domain score. Secondary outcomes include the remaining three domains of the Foot Health Status Questionnaire, a 7-point Global Rating of Change, the Pain Self-Efficacy Questionnaire, physical activity level, health-related quality of life measured by the EQ-5D-5L, and Patient Acceptable Symptom State, which is the point at which participants feel no further need for treatment. Additionally, a health economic evaluation of the treatments will be carried out. Discussion This trial will test if adding heavy-slow resistance training to fundamental patient advice and an insole improves outcomes and if a corticosteroid injection adds even further to that effect in patients with plantar fasciopathy. Trial registration ClinicalTrials.gov, NCT03804008. Prospectively registered on January 15, 2019.