Objective:To analyze the evidences of construct validity of the Katz Index for the retrospective assessment of activities of daily living (ADL) by informants, to assist neuropathological studies in the elderly. Method: A cross-sectional study analyzed the functional ability of ADL measure by the Katz Index, of 650 cases randomly selected from the Brazilian Brain Bank of the Ageing Brain Study Group (BBBABSG) database. Sample was divided in two subsamples for the analysis (N=325, each) and then stratified according to cognitive decline assessed by the Clinical Dementia Rating Scale (CDR). Factor analyses with calculations of internal consistency and invariance were performed. Results: Factor analysis evidenced a unidimensional instrument with optimal internal consistency, in all subgroups. Goodness of fit indices were obtained after two treatments of covariance, indicating adequacy of the scale for assessing ADL by informants. The scale is invariant to cognitive decline meaning that it can be used for subjects with or without cognitive impairment. Conclusion: Katz Index is valid for the retrospective assessment of basic ADL by informants, with optimal reliability.

ObjectiveThe objective of this study was to investigate the psychometric properties of the Oral Health Literacy Assessment in Spanish (OHLA-S) for the Brazilian-Portuguese language using robust analysis and with the results disclose possibilities to develop a shorter and more valid instrument.MethodsOHLA-S is an oral health literacy instrument comprising a word recognition section and a comprehension section. It consists of 24 dental words. It was translated into the Brazilian-Portuguese language (OHLA-B) and its psychometric properties were evaluated in a random sample of 250 adults aged 20–59 years. To assess the dimensionality and factor structure were tested by means of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Reliability was assessed using two indicators: Cronbach's alpha and McDonald’s Omega.ResultsEFA and CFA demonstrated that the OHLA-B with 24 items did not present an adequate adjustment of the model, compromising its validity. In addition, reliability values at 0.50 for Cronbach's alpha and 0.67 for McDonald's omega were below the minimum acceptable rate of 0.70. As no support was found for the original structure, we decided to proceed with the withdrawal of individual items and successive reanalysis of the model until the indicators were adjusted in a shorter instrument. A new structure with 15 items produced an instrument with two dimensions and a better goodness of fit than the original instrument. The Alpha and Omega reliability index values increased to 0.83 and 0.80, respectively, and all scores were better in the OLHA-B with 15 items than in the instrument with 24 items.ConclusionOLHA-B with the original structure composed by 24 items did not show acceptable construct validity. The shorter version with 15 items showed more promising results for assessing oral health literacy levels in the Brazilian population.

BackgroundSexual desire is one of the domains of sexual function with multiple dimensions, which commonly affects men and women around the world. Classically, its assessment has been applied through self-report tools; however, an issue is related to the evidence level of these questionnaires and their validity. Therefore, a systematic review addressing the available questionnaires is really relevant, since it will be able to show their psychometric properties and evidence levels.MethodA systematic review was carried out in the PubMed, EMBASE, PsycINFO, Science Direct, and Web of Science databases. The search strategy was developed according to the following research question and combination of descriptors and keywords, including original studies with no limit of publication date and in Portuguese, English, and Spanish. Two reviewers carried out the selection of articles by abstracts and full texts as well as the analysis of the studies independently. The methodological quality of the instruments was evaluated by the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.ResultsThe search resulted in 1203 articles, of which 15 were included in the review. It identified 10 instruments originally developed in the English language. Unsatisfactory results on methodological quality were evidenced in cultural adaptation studies with no description of the steps of the processes and inadequacy of techniques and parameters of adequacy for models. The Principal Component Analysis with Varimax rotation predominated in the studies.ConclusionsThe limitation of the techniques applied in the validation process of the reviewed instruments was evident. A limitation was observed in the number of adaptations conducted and contexts to which the instruments were applied, making it impossible to reach a better understanding of the functioning of instruments. In future studies, the use of robust techniques can ensure the quality of the psychometric properties and the accuracy and stability of instruments. A detailed description of procedures and results in validation studies may facilitate the selection and use of instruments in the academic and/or clinical settings.Systematic review registrationPROSPERO CRD42018085706.Electronic supplementary materialThe online version of this article (10.1186/s12874-018-0570-2) contains supplementary material, which is available to authorized users.

Background Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC). Methods The items were developed based on a qualitative exploratory analysis. A total of 172 items were prepared and submitted to a panel of specialists, with content validity analyzed with the Content Validity Ratio (CVR), resulting in an the initial version of the instrument composed by 41 items. Internal structure validity was analyzed by Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and by applying 3 reliability indicators (Cronbach’s Alpha, McDonald's Omega and Greatest Lower Bound – GBL), with a sample of 1227 individuals. Results The final configuration indicated a scale of 15 items divided into 4 dimensions (overall health, oral health, infrastructure, and healthcare services) with explained variance of 72.11%. The factor loads varied from 0.37 to 0.96. The model adjustment indices were set at × 2/df(51) = 3.23, NNFI = 0.95, CFI = 0.98, GFI = 0.96, AGFI = 0.97, RMSEA = 0.04 and RMSR = 0.03. Conclusion DVS presented satisfactory evidence of validity, indicating its suitability to be used by healthcare professionals, students and managers to plan oral health actions and services at PHC.

Objective: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. Method: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. Results: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. Conclusion: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Background Mental health disorders represent the top leading causes of burden worldwide. At this context, initiatives to identify Care Needs in Mental Health (CNMH) are urgent, to assure integral and quality care. Nonetheless, there is a gap in valid tools to support primary healthcare (PHC) professionals’ decision-making to the provision of the proper mental health care, at the right place. The present study aimed to develop and search for evidences about the validity of the Brazilian Scale for Evaluation of Mental Health Care Needs (MHcare-BR). Methods Considering CNMH as the latent variable, a group of experts developed 130 dichotomous items, which were submitted to assessment by a heterogeneous panel of judges from different regions in Brazil (n = 73). Collected data subsidized the Content Validity Ratio (CVR) calculation, which resulted in a second version of the scale comprising 43 items. Subsequently, it was applied to 879 individuals to find evidences about the internal-structure validity by using the Exploratory Factor Analysis (EFA). Dimensionality was assessed through Robust Parallel Analysis and the model was tested through cross-validation to find MHcare-BR final version. Further, the MHcare-BR’s score was subjected to normalization. Results The final version of MHcare-BR comprised 31 items, which were divided in two blocks: “self-referred” block, with 5 dimensions (social relationships; functionality; autonomy; impulsiveness and aggressiveness”; and spirituality); and “health professional evaluation” block, comprising 3 dimensions (violence; self-aggression and suicidal behavior; and caregiving plan). Model explained variance reached 62.70%. Closeness of dimensionality values pointed out a multi-dimensional model (UNICO = 0.79; ECV = 0.0.69 and MIREAL = 0.22). All indicators were within adequate and satisfactory limits, without any cross-loading, Heywood Case or collinearity/multi-collinearity issues capable of pointing out items redundancy and overlapping. Reliability indices also reached adequate levels (α = 0.82; ω = 0.80; glb = 0.93 and ORION ranging from 0.79 to 0.95, between domains). MHcare-BR’s score normalization pointed towards four CNMH strata (Low CNMH: 0 to 1; Moderate CNMH: 2 to 3; High CNMH: 4 to 6; Very High CNMH: 7 or more). Conclusions The MHcare-BR scale is a synthesized instrument, comprising users’ self-evaluation and PHC professionals’ clinical assessment. It showed satisfactory validity evidences, which were consistent, reliable and robust; capable of accurately measuring CNMH in the primary care territory, in Brazil.

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O objetivo foi desenvolver um modelo hierárquico de vulnerabilidade para o esporte. Foram realizadas entrevistas In-depth com 21 participantes do esporte de alto rendimento (13 mulheres). Foi aplicada a análise de conteúdo com a categorização e hierarquização das temáticas. Resultados: A categorização gerou 1 metaclasse (Formação Educacional); os resultados foram organizados em 5 classes: Instituição e Políticas, Comunicação e Marketing, Desenvolvimento Esportivo, Aspectos Psicossociai e Desempenho Esportivo, que totalizaram 25 categorias; uma categoria foi denominada de transcategoria (Assédio). Depreende-se que a vulnerabilidade está mais presente no ambiente esportivo do que a literatura tem relatado e por meio do modelo podemos identificar as formas de manifestação.