The Center for Epidemiologic Studies-Depression Scale (CES-D) is the most frequently used scale for measuring depressive symptomatology in caregiving research. The aim of this study is to test its construct structure and measurement equivalence between caregivers from two Spanish-speaking countries. Face-to-face interviews were carried out with 595 female dementia caregivers from Madrid, Spain, and from Coahuila, Mexico. The structure of the CES-D was analyzed using exploratory and confirmatory factor analysis (EFA and CFA, respectively). Measurement invariance across samples was analyzed comparing a baseline model with a more restrictive model. Significant differences between means were found for 7 items. The results of the EFA clearly supported a four-factor solution. The CFA for the whole sample with the four factors revealed high and statistically significant loading coefficients for all items (except item number 4). When equality constraints were imposed to test for the invariance between countries, the change in chi-square was significant, indicating that complete invariance could not be assumed. Significant between-countries differences were found for three of the four latent factor mean scores. Although the results provide general support for the original four-factor structure, caution should be exercised on reporting comparisons of depression scores between Spanish-speaking countries. Keywords: Alzheimer, caregiving, dementia, depression, Spanish-speaking, Latino. La Escala del Centro para Estudios Epidemiológicos (CES-D) es la más utilizada para medir sintomatología depresiva en la investigación sobre cuidadores. El objetivo de este estudio es analizar su estructura dimensional y su equivalencia de medida entre cuidadores de dos países de habla hispana. Se entrevistó a 595 mujeres cuidadoras de familiares con demencia de Madrid, España, y Coahuila, México. La estructura del CES-D se analizó mediante análisis factoriales exploratorios (AFE) y confirmatorios (AFC). Se encontraron diferencias estadísticamente significativas entre las medias de 7 ítems. Los resultados del AFE con la muestra total respaldan claramente una solución de 4 factores. El AFC de la estructura de 4 factores revela cargas elevadas y significativas para todos los ítems (excepto el 4). Al imponer restricciones de igualdad para valorar la equivalencia entre países, el cambio en chi-cuadrado fue significativo, indicando que no se puede asumir una equivalencia completa. Se encontraron diferencias significativas entre países para tres de las cuatro puntuaciones medias en los factores latentes. Aunque los resultados proporcionan un apoyo general a la estructura original de cuatro factores, se debería tener una cierta cautela a la hora de informar sobre comparaciones en puntuaciones en depresión entre países de habla hispana.
This study examines the association between history of violence, attitudes toward pregnancy, and initiation of prenatal care (PNC). Pregnant women receiving their first PNC visit at a public prenatal clinic in Monterrey, Mexico, were enrolled in the study. Structured interviews collected information concerning demographics, reproductive history, current pregnancy, attitudes toward pregnancy, history of violence, and perceived barriers and benefits of PNC. Results showed that 35% of participants reported violence. A current or previous partner was the most common perpetrator. Of women experiencing abuse, 47% reported that abuse was ongoing during the current pregnancy. More women reporting violence were unmarried, did not live with a partner, and reported a lower monthly income. An experience of violence was associated with initiation of PNC, number of pregnancies, perception of barriers, and negative attitudes toward pregnancy. This issue should be emphasized in recognition of the important role that nurses and midwives have regarding violence.
The purpose of this study was to determine the effect of memory-learning on self-care activities in adults with type 2 diabetes moderated by previous education/ understanding in diabetes and to explore the explicative capacity of age, gender, schooling, diabetes duration, and glycemic control in memory-learning. MethodsA descriptive correlational study was conducted in a randomized sample of 105 Mexican adult patients with type 2 diabetes at a community-based outpatient clinic. Evaluation measures included the Wechsler Memory Scale for memory-learning; 2 questionnaires for self-care activities and previous education/understanding in diabetes, respectively; and glycosylated hemoglobin for glycemic control. Multiple linear regression analysis was used to examine the effect of memory-learning on self-care activities and the moderator capacity of previous education/understanding on diabetes. Multivariate analysis was used to identify the capacity of age, schooling, diabetes duration, and glycemic control in memory-learning types. ResultsA significant positive effect of memory-learning on selfcare activities was found. Education/understanding in diabetes moderated the relationship between immediate and delayed memory-learning and self-care in glucose
ResumenEste artículo describe el proceso de traducción y adaptación del inglés-español del instrumento "Woman Abuse Screen" para uso en investigación. El cuestionario original fue traducido al español por dos traductores e intérpretes bilingües, y posteriormente se condujo una revisión de contenido por expertos asegurándose que incluía elementos relevantes del concepto "violencia". El instrumento traducido "Cuestionario de Abuso en contra de la Mujer" (CACM) fue puesto a prueba con 217 mujeres que iniciaron su control prenatal en clínicas en Monterrey, México. El análisis factorial exploratorio con rotación Varimax agrupó nueve reactivos en tres factores (violencia sexual, física y psicológica) con varianza explicada de 79.87%. El coeficiente de confiabilidad obtenido fue 0.86 (Alfa de Cronbach). Se concluye que CACM es un instrumento fácil de contestar y que entrega información sobre el tipo de violencia que está siendo víctima la mujer en el presente o el pasado. CACM puede ser utilizado en investigación y/o práctica clínica. Palabras clave: violencia, instrumento, validación, embarazo, México. AbstractThis paper describes the process of English-Spanish translation and adaptation of the "Woman Abuse Screen" for use in research. The original screen was initially translated into Spanish by two bilingual translatorsinterpreters, followed by a content review conducted by experts to ensure that the screen included relevant aspects of the conceptualization of violence. The Spanish translation "Cuestionario de Abuso en contra de la Mujer" (CACM) was tested with 217 pregnant women initiating prenatal care in outpatient clinics in Monterrey, Mexico. Exploratory factor analysis with Varimax rotation grouped the nine items on three factors (sexual, physical and psychological violence) with an explained variance of 79.87%. A reliability coefficient of 0.86 was obtained (Cronbach Alpha). It is concluded that CACM is easy to answer and provides information on previous and present violence experienced by the women. CACM may be utilized in practice and research for screening of interpersonal violence.
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