Psychological approaches to the study of armed conflict have focused on analyzing post-traumatic stress outcomes, and on evaluating the intensity of exposure to violent confrontation. Nevertheless, psychometrically valid tools required for measuring these traumatic experiences are scarce To validate the Extreme Experiences scale (EX 2 ) for armed conflict contexts for its use in Colombia, and to provide a framework for validation in conflict contexts around the world This Cross-sectional aims to validate the scale with 187 participants, study of validate with 187 participants, comprising population with high exposure to conflict (former combatants and a set of armed conflict victims) and low conflict-exposed individuals (control group). Structures of two domains and 18 items were confirmed: Direct Extreme Experiences (dEX 2 ) and Indirect Extreme Experiences (iEX 2 ); these dimensions were also validated by expert judgment, producing 14-item version. Good levels of internal consistency were found, with a KR-20 of 0.80 for the 18-item version, and 0.77 for the 14-item. The scale differentiates between population with 'high exposure to conflict' from population with 'low exposure' (d np > 0.5 and area under the ROC >0.90). The scale scores have significant correlation with some mental health constructs. The EX 2 scale has good internal consistency, as well as structural validity with regard to exposed groups. This scale can be potentially validated for its use in countries with armed confrontation history. In future versions, the scale may include additional items in order to improve content validity.

Determinar la capacidad explicativa de las metacogniciones y las creencias del dolor sobre la funcionalidad, el afrontamiento y la intensidad del dolor, siguiendo el Modelo de Funciones Ejecutivas de Autorregulación (FEAR) en una muestra de mujeres con fibromialgia de Medellín y su Área Metropolitana. Método: Se aplicaron: Escala de Metacogniciones acerca del Control de Síntomas, Cuestionario de Autoeficacia al Dolor, Escala de Catastrofización al Dolor Crónico, Cuestionario de Afrontamiento al Dolor Crónico, Escala WHODAS 2.0 y Escala numérica de la intensidad del dolor. La muestra estuvo representada por 108 mujeres entre 24 y 60 años con diagnóstico de fibromialgia. Se realizó un proceso de modilización por medio de un análisis de ecuaciones estructurales. Resultados: El modelo final no logra ajustarse. A pesar de ello, el análisis sugiere que las metacogniciones negativas y la autoeficacia al dolor tienen un efecto sobre la tendencia a la catastrofización. Esta última y la autoeficacia al dolor son las principales mediadoras en los efectos de funcionalidad. La intensidad del dolor no está determinada por las metacogniciones relacionadas con este.

Objective The purpose of this study was to develop and validate a questionnaire to identify the perceived barriers in the implementation of the Clinical Practice Guidelines for the lower limb amputee (CPGAMP). Study design and setting: The study consisted of two stages: first, the development of the questionnaire based on a meta-review of the literature and interviews with patients and health providers. Second, the evaluation of its psychometric properties was performed. Participants included health providers from hospitals and clinics, prosthetic workshops, and academic institutions in Colombia. Results A total of 90 items were obtained from the literature review and interviews. Validation of a preliminary 66-item questionnaire was performed with 545 participants. After the factorial analysis a 25-item questionnaire with four domains was developed. Internal consistency was adequate in the four domains, with Cronbach's alpha values between 0.76 and 0.83. Test-retest reliability in 58 participants yielded intraclass correlation coefficients between 0.51 and 0.59. Conclusions A 25-item questionnaire with four domains (health system; guidelines; institutional and individual) was proposed to measure the perception of barriers to the CPGAMP. The conceptual framework and the questionnaire can be used to identify barriers of other CPG and to help design strategies aimed at improving its implementation.