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• Population ageing estimates an increase in institutionalized elderly. • This instrument allows for measuring the outcomes of care in these centres. • This study conducted cross-cultural adaptation and psychometric validation. • Is the first Spanish adaptation assesses well-being in older adults in nursing home. The objective of this study was to culturally adapt the Thriving of Older People Assessment Scale (TOPAS) instrument and evaluate its psychometric properties. The study was carried out in two phases: cross-cultural adaptation and psychometric validation and refinement through a cross-sectional study conducted between 2018 and 2020 with 314 participants. The refinement resulted in an abbreviated version of TOPAS, maintaining the original 5 factors with 16 items. Cronbach alpha was 0.91. Composite reliability (0.72–0.89) and average variance extracted (0.57–0.81), supporting discriminant validity. Maximum shared variance for the factors (0.22–0.50) and average shared variance (0.16–0.31), demonstrating discriminant validity. The abbreviated version of TOPAS showed evidence of being a valid and reliable instrument for measuring the adaptability of elderly residents in institutions. Implementing this instrument in Spanish nursing homes allows for a continuous evaluation of residents' well-being in relation to their environment, a construct not previously assessed with available scales. [ABSTRACT FROM AUTHOR]

To make a cross-cultural adaptation of the National Early Warning Score 2 (NEWS 2) from English to Angolan Portuguese. A methodological research of cross-cultural adaptation was conducted, involving sequential stages of forward translation, translation synthesis, back-translation, and the application of the Delphi Panel methodology for analyzing semantic, idiomatic, experiential, and conceptual equivalence between the translated and the original versions. This process culminated in the development of a pre-final version, which subsequently underwent testing in a cohort of nurses (n = 37). The Intraclass Correlation Coefficient was calculated to assess inter-rater reliability of ratings. Cronbach's alpha was used for evaluating the internal consistency and reliability within the items of the NEWS 2 score. The cross-cultural adaptation process allowed us to prepare the final version of this tool. The data collected during the testing phase facilitated the examination of inter-rater reliability of ratings and the internal consistency and reliability within the items of the NEWS2 score. The Intraclass Correlation Coefficient observed at this step was 0.992. The Cronbach's alpha was 0.993. The cross-cultural adaptation of the NEWS 2 scoring system to Angolan Portuguese was successful, providing healthcare professionals in Angola with the means to effectively use the tool. [ABSTRACT FROM AUTHOR]

Sleep is essential for athletes' physical performance as well as their general health, well-being, and quality of life. To assess athletes' sleep behaviors, the Athlete Sleep Behavior Questionnaire (ASBQ) was developed in the English language. However, a validated Arabic-version of the ASBQ is lacking. This study aimed to translate the ASBQ into Arabic (ASBQ-AR) and evaluate its reliability and validity among Arabic-speaking athletes. A total of 458 participants (254 athletes, 202 non-athletes) from four Arabic countries completed the ASBQ-AR and the Insomnia Severity Index (ISI) questionnaires. The psychometric properties of the ASBQ-AR were examined using unidimensional reliability analysis, confirmatory factor analysis (CFA), Item Response Theory (IRT), and convergent validity. The ASBQ-AR had acceptable internal consistency (Cronbach's α = 0.723, McDonald's ω = 0.725) and a factorial structure, confirming its construct validity. CFA demonstrated improved model fit indices after the removal of two potentially misfitting items (items 4 and 13); however, the model's fit to the data remains suboptimal. IRT results indicated that the majority of items demonstrated a good model fit, suggesting effective measurement of the intended construct without significant interference, except for ASBQ-AR 4. Additionally, ASBQ-AR 4 appears to present the highest level of difficulty for respondents. In terms of convergent validity, the mean ASBQ-AR global score was correlated with the mean ISI global score (r = 0.5, p < 0.0001). The ASBQ-AR is a reliable and valid tool for assessing maladaptive sleep practices among Arabic-speaking athletes. Additional refinements to the ASBQ-AR are warranted to optimize its psychometric properties. • We translated the Athlete Sleep Behavior Questionnaire (ASBQ) into Arabic. • The ASBQ-AR had acceptable internal consistency and factorial structure. • Item Response Theory indicated that the items demonstrated a good model fit. • The mean ASBQ score was correlated with the mean Insomnia Severity Index. • The ASBQ is a reliable and valid tool for assessing maladaptive sleep among Arabic athletes. [ABSTRACT FROM AUTHOR]

Spiritual pain and financial distress are two important dimensions of cancer care that are often overlooked. Both dimensions can have a significant impact on the quality of life of patients with cancer and their families. This study conducted a cross-cultural adaptation, feasibility study, and psychometric properties of the Edmonton Symptom Assessment System-Financial and Spiritual (ESAS-FS) in a Spanish-speaking population with advanced cancer. The ESAS-FS is a patient-reported outcome measure that assesses 12 symptoms, including spiritual pain and financial distress. In the cross-cultural adaptation process, the terms "spiritual pain" and "financial distress" were refined to "sufrimiento espiritual" and "preocupación por asuntos económicos" respectively, with strong professional consensus and high patients' acceptancy (relevant questions 80%, appropriate terms 91%). A cohort of 100 onco-hematologic patients revealed that 70% experienced spiritual pain (mean 2.9/10), while 49% reported financial distress (mean 2.2/10). Symptomatic analyses illustrated significant associations of spiritual pain with various symptoms like fatigue, drowsiness, and depression. Similarly, financial distress correlated notably with drowsiness, depression, and anxiety. Moreover, a distinct correlation was observed between spiritual pain and financial distress. The findings of this study suggest that the ESAS-FS is a valuable tool for assessing spiritual pain and financial distress in Spanish-speaking patients with advanced cancer. The tool can be used to identify patients who are experiencing these dimensions of distress and to provide them with appropriate care. [ABSTRACT FROM AUTHOR]

Deprescribing is part of ensuring appropriate medication use and may reduce medication-related harm. Capturing the beliefs and attitudes of patients towards deprescribing by using a validated tool may support optimizing medication use in practice. To translate, culturally adapt and validate the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Romanian and to investigate the attitudes and beliefs of older adults towards deprescribing. The rPATD questionnaire was translated using forward-backward translation into Romanian and culturally adapted. The psychometric properties were evaluated in older adults ≥65 years of age. Structural validity was assessed by item load on factors using an exploratory factor analysis (EFA) which was compared to the original English version and the internal consistency by Cronbach's alpha. Construct validity was evaluated by calculating the Spearman's rank correlation coefficients between the factor scores obtained using the revised version of the Romanian rPATD and scores on the Beliefs about Medicines Questionnaire (BMQ) Specific Concerns Romanian version. Floor and ceiling effect were also examined. We translated the questionnaire and administered it to 224 participants (median age 72 years [interquartile range: 68.0; 77.0]). In the EFA individual items loaded onto 4 factors, grouped similarly to the English version (Involvement, Burden, Appropriateness, Concerns about Stopping factors). Two items from each of the Involvement and Appropriateness factors were removed to improve factor loading and avoid cross-loading. The Cronbach's alpha values for the 4 factors ranged between 0.522 and 0.773. The scores for Burden and Concerns about Stopping factors were found to be positively correlated with BMQ Specific Concerns score. We identified a ceiling effect for one of the four factors (Involvement) and no floor effects. The Romanian rPATD was validated in 4 factor structure similar to the original English questionnaire. The Romanian version of the questionnaire may support the health care professionals in Romania to initiate and support patient-centered deprescribing. [ABSTRACT FROM AUTHOR]

• The PRWE is translated into Tamil with semantic equivalence. • The PRWE-T showed good reliability, internal consistency, and construct validity. • The PRWE-T can be used with Tamil-speaking patients, in clinical settings and research settings. [ABSTRACT FROM AUTHOR]

The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) is a reliable and sensitive measure of disability to determine functional status and evaluate curative effects in low back pain, it has now been cross-cultural translated into many other languages and adapted for use in different countries. We aim to evaluate the translation procedures and measurement properties of cross-cultural adaptations of the JOABPEQ. Studies related to cross-cultural adaptation of the JOABPEQ in a specific language/culture were searched in PubMed, Embase, CINAHL, SciELO, PsycINFO, SinoMed, and Web of Science from their inception to March 2022. The Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and the Consensus-based Standards for the Selection of Health Status Measurement Instruments guideline were used for evaluation. Nine different versions of cross-cultural JOABPEQ adaptations in 8 different languages/cultures were included. The adaptation process was not strictly performed, such as standard forward translation and expert committee review were rarely reported. Content validity (8/9), floor and ceiling effects (3/9), reliability (4/9), and interpretability (6/9) were assessed in most of the adaptations, while agreement (2/9), responsiveness (2/9), and the internal consistency (2/9) were not. JOABPEQ can replace functional and quality of life score to reduce the burden of scientific research. We recommend Persian-Iranian, simplified Chinese–Chinese Mandarin, Thai and Gunaydin G's Turkish adaptations for application. The numerical pain rating scale/visual analogue scale in low back pain and lower extremities, as well as numbness in lower extremities could not be neglected in JOABPEQ adaptations. [ABSTRACT FROM AUTHOR]

Patient-reported outcome measures (PROMs) are increasingly recognized as an indicator of healthcare quality and safety. Over the past decades, there has been a growing interest in using PROMs in Arabic-speaking populations. However, there is a paucity of data regarding the quality of their cross-cultural adaptation (CCA) and measurement properties. To identify PROMs that have been developed, validated or cross-culturally adapted to Arabic and evaluate methodological qualities of CCA and measurement properties. MEDLINE, EMBASE, CINAHL, PsycINFO, IPA, and ISI Web of Science were searched using search terms 'PROMs', 'Arabic countries', 'CCA', and 'psychometric properties'. Measurement properties were evaluated using COSMIN quality criteria and CCA quality was assessed using the Oliveria rating method. This review included 260 studies with 317 PROMs, focusing on psychometric testing (83.8%), CCA (75.8%), utilizing PROMs as outcome measures (13.4%), and developing PROMs (2.3%). Out of the 201 cross-culturally adapted PROMs, forward translation was the most frequently reported component of CCA (n = 178), followed by back translation (n = 174). Out of the 235 PROMs that reported measurement properties, internal consistency was the most frequently reported measurement property (n = 214), followed by reliability (n = 160) and hypotheses testing (n = 143). Other measurement properties were less reported, including responsiveness (n = 36), criterion validity (n = 22), measurement error (n = 12), and cross-cultural validity (n = 10). The strongest measurement property was hypotheses testing (n = 143), followed by reliability (n = 132). There are several caveats regarding the quality of CCA and measurement properties of PROMs included in this review. Only 1 out of 317 Arabic PROMs met CCA and psychometric optimal quality criteria. Therefore, there is a need to improve the methodological quality of CCA and measurement properties of PROMs. This review provides valuable information for researchers and clinicians when choosing PROMs for practice and research. There were only 5 treatment-specific PROMs, indicating the necessity for more research focusing on development and CCA of such measures. [ABSTRACT FROM AUTHOR]

The Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) is an instrument that aims to quantify behaviors related to social comparison, specifically comparisons related to the body, eating and exercise, and was originally developed using a nonclinical population of American university women. The objective of this study was to perform a cross-cultural adaptation and verify the psychometric qualities of the BEECOM for young Brazilian adult women aged 18–35 years. In the present study, the cross-cultural adaptation of the instrument was performed through its translation, back-translation and evaluation by the target population. The instrument proved to be easy to understand among young women. Then, the psychometric qualities of the instrument were evaluated using a sample of 716 women (M age = 22.47 ± 3.10). Exploratory and confirmatory factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. The BEECOM presented an invariant measurement across white vs. nonwhite and physically active vs. non-active individuals. In addition, the instrument showed adequate reliability and convergent validity. In conclusion, the BEECOM is a useful tool to evaluate social comparison behaviors related to eating disorders and body image in young Brazilian female adults, enabling further research on these constructs and supporting the development of preventive strategies. • The BEECOM was rigorously translated into Brazilian Portuguese. • The scale underwent validation among Brazilian female university students. • Exploratory and confirmatory factor analyzes confirmed the 3-factor structure of the BEECOM and 18 items. • Adequate reliability and convergent validity indices was demonstrated. • The BEECOM showed adequate internal consistency. [ABSTRACT FROM AUTHOR]

• The Chinese version of the Health Personality Assessment (HPA) showed good psychometric properties that can be used as a reliable, simple, and convenient instrument to identify health personality. • Cross-cultural generalization of the assessment provides experimental evidence for Five-Factor Model and Personality Trait Theory. • HPA gives some new implications for the health domain from the personality perspective, which can be implemented cross-culturally in both research and health practice. The Health Personality Assessment (HPA) is a reliable and brief instrument to evaluating personality in the health domain, but it has not been used in China. To cross-culturally adapt and evaluate the psychometric property of HPA among Chinese older adults. The Chinese version of HPA was generated following Beaton's guidelines. The psychometric evaluation of the HPA was conducted on 482 community-dwelling older adults. The Chinese version of HPA showed good internal consistency, item-total correlations, criterion validity, and test-retest reliability within a 2-week interval. Results of confirmatory factor analysis indicated a satisfactory model fit, convergent validity and discriminant validity were also in the acceptable range. HPA showed good reliability and validity among the Chinese population. The generalization of the HPA may provide a new tool for health practitioners from the personality perspective. [ABSTRACT FROM AUTHOR]

Society has increasingly come to appreciate the relationship between people and pets, and therefore, the demand for research into this subject has also been growing. In Brazil, tools designed to assess the human-animal relationship are still scarce, and so far, there is no tool, adapted for the Brazilian context, designed to evaluate the bond between people and their animals. The Lexington Attachment to Pets Scale (LAPS) is a scale that aims to measure the degree of attachment that an owner has for their pet. It is one of the most used tools to assess the emotional bond between people and their animals. The aim of this study, therefore, was to translate, cross-culturally adapt, and evaluate the psychometric properties of the LAPS for the Brazilian population (LAPS-B). For this purpose, confirmatory factor analysis and reliability tests were conducted on a sample of 2526 dog and cat owners from all over the country, of whom 81.87% were female and who had a mean age of 33.85 years old (standard deviation = 12.81). The comparison between the models showed that the 3-factor correlated model and the hierarchical model had better metrics than the others, and that the hierarchical model was the most suitable. In conclusion, the Brazilian version of the LAPS is a reliable measure of the attachment to dogs or cats, and can be used to assist research and studies that address the human-animal relationship. Future research should investigate the psychometric properties of the scale on other animal species. [ABSTRACT FROM AUTHOR]

Neuropathy-and foot ulcer-specific quality of life instrument (NeuroQoL) is not available in Hindi language which is one of the most spoken languages in the world. Hence, we aimed to translate, cross-culturally adapt and content validate NeuroQoL into Hindi language (NeuroQoL-H). NeuroQoL is translated and cross-culturally adapted into Hindi language (NeuroQoL-H) using the guidelines proposed by Beaton and colleagues. Both item and scale levels content validity index (I-CVI & S-CVI) were reported for the validation and pretesting was performed with, n = 51 patients with diabetes. Floor and ceiling effects were reported. Total score of content validated and pretested, NeuroQoL-H with, n = 51 patients with diabetes is, 60 (36,109). For all the items in NeuroQoL-H, I-CVI ≥ 0.8 and S-CVI = 0.95. The floor effect is (24 %) while the ceiling effect is (1 %). NeuroQoL-H scale is a valid outcome measure among Hindi speaking patients with diabetes. • Neuropathy- and foot ulcer-specific quality of life instrument (NeuroQoL) is translated into Hindi language, NeuroQoL-H. • NeuroQoL-H is translated, cross-culturally adapted and content validated using standard guidelines. • Useful among Hindi speaking people with diabetes without difficulty. [ABSTRACT FROM AUTHOR]

• Frailty is emerging as an important determinant of human health. • The Geriatric 8 (G8) questionnaire, originally produced in English, has not yet been used in China, partly due to a lack of a Chinese version. • The Chinese version of the G8 (C-G8) questionnaire was generated using Brislin's model of translation. • The C-G8 questionnaire was demonstrated to have acceptable validity and reliability and hence could be used in Chinese hospitalized older adults with cancer. To translate, cross-culturally adapt, and validate the Geriatric 8 (G8) questionnaire in Chinese hospitalized older adults with cancer. The Chinese version of the G8 (C-G8) was produced following Brislin's guidelines. The psychometric properties of the C-G8 were evaluated among 296 eligible patients. The content validity index of the C-G8 was 0.8∼1 at the item level and 0.975 at the scale level. The C-G8 identified more frail individuals among these older (>75 years) participants compared to their younger (65∼75 years) counterparts (frailty prevalence: 87.1% vs. 70.9%, P =0.010). The convergent validity of the C-G8 was tested by correlating it with the FRAIL scale (r =-0.592, P <0.001). The C-G8 had a lower internal consistency (Cronbach's α coefficient=0.501) but higher test-retest reliability and inter-rater reliability (intraclass correlation coefficient=0.913 and 0.993, respectively, P <0.001). The C-G8 questionnaire presented acceptable validity and reliability and could be used in Chinese hospitalized older adults with cancer. [ABSTRACT FROM AUTHOR]

Background: Deprescribing is a patient-centered approach to managing inappropriate polypharmacy that faces several barriers, including patients' attitudes and beliefs about medications that need to be considered. For this purpose, the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a helpful instrument, but until now, there is no Portuguese version.Objectives: To translate and validate the rPATD questionnaire (older adults version) to Portuguese.Methods: The rPATD questionnaire was translated and cross-culturally adapted using forward-backward translation and pre-testing. A cross-sectional study with 192 older adults aged ≥65 years taking at least 1 regular medication was conducted for validity assessment. Participants were recruited by convenience sampling in 3 Portuguese outpatient rehabilitation medicine clinics. Psychometric properties were evaluated through face and content validity; construct validity, by assessing structural validity through exploratory factor analysis, hypotheses testing, including concurrent validity and cross cultural validity; reliability with internal consistency; and item-total correlation. Floor and ceiling effects were examined.Results: The exploratory factor analysis (EFA) revealed a 4-factor structure that explains 51.08% of the total variance, as in the original rPATD. These 4 factors are related to the level of involvement in medication management, beliefs in the appropriateness of medication, perceived burden of medication, and concerns about stopping medications. Factor loadings ranged from 0.226 to 0.800; 2 items scored <0.3, and no cross-loading was found. The exclusion of the 2 items loading <0.3 in the EFA showed no significant improvement in factor loading or internal consistency, so the item structure was maintained. In hypothesis testing, 78% of the correlations were correctly predicted. The 4 factors internal consistency was generally acceptable, with Cronbach's alpha ranging from 0.638 to 0.830. The item-total correlation ranged between 0.223 and 0.7.Conclusion: The Portuguese rPATD questionnaire for older adults presents globally good or acceptable psychometric properties. [ABSTRACT FROM AUTHOR]

Objectives: As in Greek settings there is a need to develop validated patient-reported outcomes (PROs) for pelvic floor dysfunction, this study's aim was to cross-culturally adapt and validate the Australian Pelvic Floor Questionnaire (APFQ) into Greek, a 42-item PRO for routine urogynaecological evaluation of four domains; bladder, bowel, prolapse and sexual function.Study Design: Cross-cultural translation was completed through official multistage forward and back-translation process. Validation involved administering the adapted APFQ (APFQ_GR) to women visiting Greek community-based healthcare settings. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was also administered. Comparison between women with and without pelvic floor dysfunction (symptomatic versus control) was also undertaken for exploring discriminatory validity. Test-retest reliability was explored by re-administering APFQ_GR 10-15 days following initial testing and internal consistency was explored against each domain separately as well as total items' score.Results: Greek APFQ translation was successfully performed and piloted to a women sample with varying levels of education for comprehensibility, thus, satisfying the questionnaire's face validity. 100 women (53.7 ± 13.1 years-old) participated in validation, 63 of which predominantly complained of urinary incontinence (UI) and 37 were asymptomatic. There were no ceiling effects. Floor effects were detected for women without symptoms. Moderate to very strong correlations were yielded between APFQ_GR total score and bladder domain, respectively, with ICIQ-UI SF single-item and total score (ρ = 0.403-0.758, p < 0.001), indicating satisfactory criterion-related validity. Moderate correlations were yielded for the sexual function domain with APFQ_GR total score and weaker correlations were found in the other two domains. Independent samples t-test yielded significant differences across the questionnaire's scores (p < 0.001), indicating good discriminatory validity between symptomatic and asymptomatic women. Test-retest reliability was excellent (ICC3,1 = ≥0.998). Internal consistency was very good for each domain and total items' score (Cronbach's α = 0.714-0.924).Conclusions: The Greek APFQ was proven appropriate, comprehensible, valid and reliable for women with urinary incontinence and can thus, be used across Greek healthcare settings. Prolapse and bowel domains merit further research. [ABSTRACT FROM AUTHOR]

• FNS-PK can be used to assess novel food phobia in Pakistani mothers. • We adapted cross-cultural reliability and validity of 8-item FNS-PK for mothers in Pakistan. • Pakistani preschoolers' food neophobia linked to mothers' levels. • Mothers' food neophobia inversely relates to controlled feeding behaviors. Maternal food neophobia, a significant influencing factor in modeling maternal feeding practices, also plays a vital role in regulating preschoolers' food neophobia. This cross-sectional study was conducted to culturally adapt and validate the Food Neophobia Scale for Pakistani mothers (FNS-PK), assess the prevalence of maternal food neophobia, and explore the correlation between maternal food neophobia, maternal controlling feeding practices and preschoolers' food neophobia. The 10-item food neophobia scale was translated into the Urdu language following WHO guidelines, and various measures of validity (construct validity and discriminant validity) and reliability (internal consistency, test–retest consistency, and composite reliability) were used to test the scale. Afterward, a cross-sectional study was performed to assess the prevalence and correlation between maternal food neophobia, feeding practices and preschoolers' food neophobia. A total of 260 preschool children and their mothers were recruited for the cultural adaptation of the FNS-PK. The original 10-item FNS was modified to an 8-item FNS-PK, which exhibited good scale validity (χ2/ df = 1.113; TLI = 0.998; RMSEA = 0.021; AVE > 0.05) and reliability (Cronbach's α = 0.857). In a cross-sectional study involving 347 mother–child pairs, 15.9 % of the mothers and 8.0 % of the preschoolers exhibited food neophobia. Furthermore, there was a significant negative correlation between maternal food neophobia and controlling feeding practices, while there was a significant positive correlation between maternal and preschoolers' food neophobia. The adapted 8-item FNS-PK is a reliable tool for assessing food neophobia in Pakistan, and the significant correlation between maternal and preschoolers' food neophobia warrants further research. [ABSTRACT FROM AUTHOR]

Although more and more ethnic minority group (EMG) users are willing to present cultural content on live streaming platforms and advertise cultural products, the influence of their cultural content is still weak compared to mainstream culture. To narrow the research gap, it is essential for the current study to analyse online viewers' intention to watch EMGs' cultural content. This paper extends the Theory of Planned Behaviour (TPB) model based on the cross-cultural adaptation theory. It adds the propensity to cross-cultural adaptation factor and cross-cultural adaptation factor, aiming to clearly explain online viewers' psychological changes. The data analysis based on the partial least squares path modelling and variance-based structural equation modelling (PLS- SEM) supports that the propensity to cross-cultural adaptation positively affects online viewers' cross-cultural adaptation. Meanwhile, the cross-cultural adaptation will positively influence online viewers' attitudes towards EMG cultural streaming, motivate their watching intention, and drive their final behavioural responses. More findings are uncovered via the importance-performance map analysis (IPMA), and the cross-cultural adaptation factor has significantly high performance and importance for online viewers' watching intention. • Transfer ethnic minority groups' (EMGs) cultural resources to video streaming content. • Explore the mechanism of cross-cultural adaptation with the motive of watching EMG cultural streaming. • An integration of the Theory of Planned Behaviour and the cross-cultural adaptation theory. • Test samples based on the partial least squares path modelling and variance-based structural equation modelling. • The cross-cultural adaptation factor has significantly high performance and importance for online viewers' watching intention. [ABSTRACT FROM AUTHOR]

Perceived cultural distance (PCD) has been established as a significant factor influencing academic performance; however, limited knowledge exists regarding the intricate mediating and moderating mechanisms that underlie this relationship. The present study seeks to contribute to the existing literature by exploring the potential mediating role of cross-cultural adaptation and the moderating influence of cultural intelligence (CQ) in the relationships between PCD and academic performance among international students in China. The theoretical model was tested using survey data that measured international students' PCD, CQ, and cross-cultural adaptation in academic, psychological, and sociocultural domains, along with their academic performance. The findings revealed that (1) PCD exhibits a direct and negative influence on academic performance; (2) Three dimensions of cross-cultural adaptation, namely academic, psychological, and sociocultural adaptation, operate as mediators in the link between PCD and academic performance; (3) CQ, functioning as a moderator, weakens the negative association between PCD and academic performance. These results underscore the pivotal role of PCD in the realm of cross-cultural learning for international students, particularly those engaged in educational pursuits within the Chinese higher education landscape. The study also highlights the protective effects of all four aspects of CQ (metacognitive, cognitive, motivational, and behavioral CQ) on the adaptation processes and academic performance of these sojourning students in the face of cultural differences. [ABSTRACT FROM AUTHOR]

This paper reports results from a systematic review that organizes existing knowledge about re-entry stress and adaptation to one's heritage culture after returning from abroad. In this review, we sought to describe the prevalence of re-entry stress, how stress levels change over time and identify factors associated with reacculturation. We searched seven subject-specific and multidisciplinary databases for English language, peer-reviewed papers, and theses/dissertations with original qualitative or quantitative data, published from 2009. Fifty-five studies met the selection criteria. The prevalence of re-entry stress ranged between 40 % and 92 %. Studies used various scales with distinct characteristics to measure re-entry stress. Longitudinal information about patterns of changes in re-entry stress levels was insufficient. The analysis provided information about the variety of situational, demographic, intrapersonal, interpersonal/intergroup, and contextual factors associated with re-entry stress and adaptation. The literature to date has mostly focused on situational and intrapersonal factors while explorations of the broader cultural context have been scarce. Current knowledge is largely limited to more privileged groups of returnees, such as students and employees from the Global North. This paper highlights important gaps in the literature and provides scope for future research. We argue that inconsistencies in reacculturation research are mainly due to a lack of clear conceptual and theoretical frameworks. [ABSTRACT FROM AUTHOR]

Background Context: Idiopathic scoliosis (IS) can significantly alter the quality of life of adolescents. Some of the available questionnaires in French measuring the quality of life in this population show weak psychometric properties. The newly developed Italian Spine Youth Quality of Life (ISYQOL) questionnaire promises better properties.Purpose: To provide a French-Canadian version of the ISYQOL and to verify its psychometric characteristics.Study Design: Prospective validation of a cross-cultural adaptation of the ISYQOL questionnaire.Patient Sample: A total of 111 participants with idiopathic scoliosis (77.5% female, 10-18 years old, mean Cobb angle=28°) were included in the study.Outcome Measure: The French-Canadian version of the Italian Spine Youth Quality of Life (ISYQOL-F) questionnaire.Materials and Methods: The ISYQOL was translated into French using a forward-backward approach. We then verified the understanding of the translated items with two scoliosis experts and 10 adolescents. Afterward, 111 adolescents with IS were recruited by convenience at the scoliosis clinic and they completed the ISYQOL on three occasions (before seeing the specialist, 1 week, and 2 weeks after). Cronbach's alpha, intra-class (ICC), and Pearson correlation coefficients were used to respectively determine internal consistency, test-retest reliability, and concurrent validity with the SRS-22r and SF-12. The standard error of measurement (SEM) and 95% confidence minimal detectable change (MDC95) were also calculated. The ceiling effect was quantified as the percentage of participants who scored the maximum on ISYQOL-F.Results: The ISYQOL-F showed good internal consistency with a Cronbach alpha of 0.81 and 0.85 respectively for items 1-13 (n=55; ISYQOL-F mean score ± SD = 63.9±13.5) and 1-20 (n=56; ISYQOL-F mean score ± SD=60.7±10.3). Test-retest reliability was excellent (ICC3,1=0.94). The SEM is 3.1 and the MDC95 is 8.6. Correlations between ISYQOL-F and SRS-22r and between ISYQOL-F and SF-12 were moderate for total scores (r=0.56 and 0.50 respectively, p<.001), but low for each domain (between 0.20 and 0.48, p<.05). No significant ceiling effects were observed for ISYQOL-F (≤2.5%). In contrast, ceiling effects ranged from 3.6% to 30.6% for SRS-22r and 0%-68.5% for SF-12.Conclusions: The internal consistency and reliability of ISYQOL-F are good. The total score correlates moderately with the SRS-22r and SF-12. Unlike SRS-22r, the ISYQOL-F does not appear to have a ceiling effect. The ISYQOL-F may thus be suitable to assess quality of life in a population of French-Canadian adolescents with IS. [ABSTRACT FROM AUTHOR]

This autoethnography seeks to explore the multicultural identity development of the author, as a sojourner, with a focus on the additive and layered nature of an expanding cultural repertoire. I view multicultural identity as shaped by and through communication, and as subjective and rooted in self-identification. I examine my journey of self-discovery, first as an au pair and later as an international student, and how these experiences have expanded and transformed my cultural identity. I do so to make a case for the proposition that sojourners develop a multicultural identity as a function of cross-cultural adaptation. Scholarship on assimilation, acculturation, and identity transformation is presented. Then, I advance an argument for the examination of sojourners' multicultural identity development during cross-cultural adaptation in adaptation and intercultural communication research. [ABSTRACT FROM AUTHOR]

Pressure injury (PI) related knowledge can be used as an outcome indicator of a PI education program. In Malaysia, no scale has been translated and validated for measuring PI-related knowledge among patients with a PI. The purpose of this study was to cross-culturally adapt, translate and determine the validity and reliability of the Malay version of the revised-Skin Management Need Assessment Checklist (revised-SMnac). The instrument was initially written in English and translated into the Malay language. The internal consistency, construct validity, and test-retest reliability were examined after the item and scale's cross-cultural equivalence and content validity were evaluated. Construct validity was determined through the administration of the instrument amongst 170 hospitalised patients with a PI. Content validity index (CVI) was further determined through validation by a panel of five wound care experts. The instrument's stability was determined by the test-retest model with a two-week interval. The content validity of the item-CVI (I-CVI) was >79%, indicating that all 17-items were appropriate, while the scale-CVI (S-CVI) of >0.83 indicated an acceptable scale. The Cronbach's Alpha was.994 indicated good internal consistency. Test-retest showed a good intra-class correlation coefficient, ICC = 0.955 with 95% CI [0.992–0.996]. The Malay version of the revised-SMnac demonstrated to be a valid and reliable tool to measure PI-related knowledge among the Malay-speaking patient population in Malaysia. The tool is recommended for use to measure the effectiveness of education programs related to PI care in future studies. • The revised-SMnac-M is deemed a valid and reliable tool with good repeatability to measure PI-related knowledge. • The revised-SMnac-M is an appropriate tool to guide nurses in planning PI education programs for patients. • The revised-SMnac-M can be used to measure the effectiveness of a PI education program. [ABSTRACT FROM AUTHOR]

The high incidence of potentially traumatic events (PTEs) in Indonesia warrants early identification of those with probable trauma-related disorders in order to tailor prevention and intervention for trauma-related symptoms. This study aims to adapt and validate a novel brief transdiagnostic screener, the Global Psychotrauma Screen (GPS), in Indonesian undergraduate students. An online survey was administered among Indonesian undergraduate students (N = 322). Exploratory factor analysis, reliability analyses, clinical validity analyses, and correlational analyses were performed to evaluate the construct validity, reliability, clinical validity, and convergent-divergent validity of the Indonesian GPS. Hierarchical multiple regression was conducted to assess the relationship between risk factors and trauma-related symptoms. The relationship between four categories of trauma-related symptom severity and social/work functioning was measured using Analysis of Covariance. Exploratory factor analysis yielded a single-factor solution. The Indonesian GPS demonstrated good internal consistency, test-retest correlation, and absolute agreement, indicating good reliability. The Indonesian GPS also had an acceptable area under the curve, sensitivity, and specificity for a probable diagnosis of Post-Traumatic Stress Disorder (PTSD), Complex-PTSD (CPTSD), depression, and generalized anxiety disorder (GAD). We also established evidence for the convergent and divergent validity of GPS. The GPS risk factors (low psychological resilience, other stressful events, history of mental illness, and low social support) contributed to predicting trauma-related symptoms after controlling for gender, age, employment status, and faculty background. Additionally, in comparison to participants from the mild and low categories of GPS symptoms scores, participants from the severe and moderate category reported impaired lowered social/work functioning. The current findings indicate that the Indonesian GPS is a valid and reliable transdiagnostic trauma screener for Indonesian undergraduate students. This first comprehensive validation of the GPS in Indonesia calls for more research in Lower-middle Income Countries (LMICs) as a way towards prevention and early intervention for trauma-related symptoms. • The Global Psychotrauma Screen (GPS) was adapted and psychometrically validated in Indonesian • One-factor model was confirmed as the best solution for the Indonesian GPS • The Indonesia GPS was accurate in screening for PTSD, Complex-PTSD, depression, and GAD • The Indonesian GPS might be implemented as part of a prevention and early intervention program [ABSTRACT FROM AUTHOR]

The principal instructional leadership describes how school principals oversee the curriculum, instruction, and assessment. The main aims of the current study were translation and evaluation of the psychometric properties of the Principal Instructional Leadership Scale (PILS) in a Saudi Arabian population. The translation and cross-cultural adaptation process has been conducted in five stages, including forward translation, translation synthesis, backward translation, expert committee, and pilot testing. Face, content, construct, and convergent validity were used to establish validity. Cronbach's alpha coefficient and McDonald's omega (Ω) were used for internal consistency. To validate the PILS structure, the total sample (N = 724) was randomly split into two subgroups, each comprising 362 individuals, for Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). Five factors obtained from EFA explain 71.07 % of the variance in PILS. The PILS encompasses domains of improving curriculum quality, teaching, and enhancing the effectiveness of adaptive learning, adding to the dimensions covered by previous instructional leadership measures. The five components show strong internal consistency (0.93 to 0.97). Both first-order and second-order CFAs confirmed the 5-factor model, meeting criteria (CFI > 0.91, GFI > 0.9, IFI > 0.9, RMSEA<0.05). All 21 items displayed suitable internal consistency (Cronbach's α > 0.8, McDonald's omega >0.7). Second-order average variance extracted validity (0.50) indicated PILS validity. Gender invariance analysis revealed no significant differences (∆CFI < 0.01, ΔRMSEA<0.01) in PILS structure between genders. The reliability and validity of the Arabic rendition of PILS are commendable, making it suitable for evaluating principal instructional leadership in Saudi Arabia. [ABSTRACT FROM AUTHOR]

A case study approach was used to investigate the adaptation experiences of Turkish international students (TIS), which may vary according to the host culture, in two different cultures: Hungary (n = 14) and the United States (US) (n = 12). The findings of the data analysis yielded four broad overlapping categories: (1) experiences in academic setting, (2) interaction with others in the host country, (3) political reflections in the host country, and (4) everyday matters in the host country. According to findings, depending on the factors in the institutional, social and physical environment, and societal contexts, both the psychological and sociocultural adaptation experiences of the participants in Hungary and the US differed. The study revealed that studying in Hungary, which offers english mediuim instruction programs, poses some serious difficulties for TIS compared to their co-nationals studying in an English-speaking country, such as in-school separation from local students. However, due to a shared historical background between Hungarians and Turks, TIS in Hungary have experienced many cultural similarities in their relations and daily lives unlike TIS in the US. Additionally, the positive attitudes of some Hungarian politicians toward Turkey and Turkish ethnicity have contributed to TIS' perceived low cultural distance and positively affected their cross-cultural adaptation process. Whereas, TIS in the US experienced stress that hindered adaptation due to certain political developments in the US and their political relations with Turkey. [ABSTRACT FROM AUTHOR]

To culturally adapt the VISA-A into a simplified Chinese version (VISA-A-CHN) and test its measurement properties. Methodological study; Hospital and university laboratory. 240 subjects were divided into the healthy (n = 80), at-risk (n = 80), and tendinopathy groups (n = 80). The internal consistency, test-retest reliability, construct validity, and the floor and ceiling effect of the VISA-A-CHN. The VISA-A-CHN showed adequate internal consistency (Cronbach's α = 0.73, 95% CI 0.63 to 0.81), excellent test-retest reliability (ICC 3A,1 = 0.97, 95%CI = 0.95 to 0.98), standard error of measurement of 2.2 points, minimum detectable change of 6.0 points, with no floor and ceiling effects. Two factors (pain/symptoms and physical function/activity) were extracted in exploratory factor analysis. There were moderate associations of VISA-A-CHN score with scores of Lower Extremity Functional Scale and SF-36 physical components (r s = 0.53–0.74, P < 0.01) but low associations with SF-36 mental components (r s = 0.12–0.22, P > 0.05). VISA-A-CHN mean score of Achilles tendinopathy group was significantly lower than those of healthy and at-risk groups (P < 0.01). The VISA-A-CHN is equivalent to the original version in terms of language and measurement properties. It can be used as the outcome measure for Chinese patients with Achilles tendinopathy. • The VISA-A has been culturally adapted from English into Chinese. • The Chinese version of the VISA-A shows acceptable reliability and validity. • The VISA-A-CHN can be used to assess the severity of Chinese patients with AT. [ABSTRACT FROM AUTHOR]

Background: The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire allows capture of the beliefs and attitudes of older adults and caregivers towards deprescribing.Objectives: To translate and validate the rPATD questionnaire into French.Methods: The French rPATD was translated using forward-backward translation. Psychometric properties were evaluated in both older adults ≥65 years living in the community or in institutions and who were taking at least one chronic medication and in caregivers of older adults with similar characteristics. Participants were recruited in four French-speaking countries (Belgium, Canada, France and Switzerland). Face and content validity were assessed during the translation process. Construct validity (exploratory factor analysis (EFA)) and internal consistency (Cronbach's alpha) were investigated in questionnaires without missing data. Test-retest reliability was evaluated using intra-class correlation coefficient (ICC) in a sample of participants.Results: In total, 320 questionnaires from older adults and 215 questionnaires from caregivers were included to evaluate construct validity and internal consistency. EFA extracted four factors in the older adults' and caregivers' versions of the questionnaire consistent with the English rPATD. The extracted factors related to the perceived burden of medication taking, the beliefs in appropriateness of medications, concerns about stopping medications and the level of involvement in making decisions and of knowledge of medications. Internal consistency was satisfactory for three factors for both versions (Cronbach's alpha >0.70), with lower internal consistency in the concerns about stopping factor. Test-retest reliability was overall good for all factors in the caregivers' version (ICC > 0.75) while for the older adults' version, moderate (ICC range: 0.75-0.50) to good ICC values were found.Conclusions: The French rPATD presents globally good psychometric properties and can be used to explore attitudes towards deprescribing in French-speaking older adults and caregivers. [ABSTRACT FROM AUTHOR]

Background: Knowledge about patients' attitudes towards deprescribing is essential for optimizing medication use. The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a 22-item self-report instrument capturing older patients' beliefs and attitudes towards deprescribing.Objectives: To translate and cross-culturally adapt the rPATD questionnaire into Danish and subsequently validate it in a cohort of nursing home residents.Methods: The rPATD questionnaire was translated and cross-culturally adapted during five stages of forward and backward translation. The validation study included 162 Danish nursing home residents (median age 84 years; 67% women). Validity was assessed through exploratory factor analysis (structural validity) and hypothesis testing (construct validity), while reliability was assessed through internal consistency. Floor and ceiling effects were examined.Results: The exploratory factor analysis revealed a 4-factor structure similar to the original rPATD questionnaire, with items loading into four factors related to level of involvement in medication use, perceived burden of taking medication, belief in appropriateness of using medication, and concerns about stopping medication. The questionnaire was adjusted to the Danish nursing home population and health care system by omission of two items, concerning medication expenses and inconvenience of taking medication, which resulted in a model with factor loadings ranging from 0.29 to 0.84 and only minor cross-loading. Construct validity correctly predicted 67% of the hypothesized correlations. Internal consistency of all factors was generally acceptable with Cronbach's α ranging from 0.67 to 0.78. No floor and ceiling effects were identified.Conclusions: Results suggest that the Danish modified model of the rPATD questionnaire generally has acceptable validity and reliability. [ABSTRACT FROM AUTHOR]

• The Brazilian heiQ showed acceptable reliability and internal consistency • The Brazilian heiQ showed acceptable construct validity in individuals with low back pain • Correlations between pain and functioning outcomes versus heiQ scales (≅40%) were significant • Correlations between affective and general health versus heiQ scales (75%) were significant • The minimum detectable difference for heiQ scales scores ranged from 2.84 to 4.94 There is no patient reported outcome measure available in Brazilian Portuguese to comprehensively assess outcomes following administration of patient education programs for people with chronic conditions. To describe the cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the Health Education Impact Questionnaire (heiQ), a multidimensional questionnaire designed for the evaluation of patient education programs, which was tested in people with chronic low back pain (LBP). One hundred thirty-seven individuals with non-specific chronic LBP (age: 38.7 ± 13.2) were enrolled in the study. The translation was performed according to international standards. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability, Cronbach's α to assess internal consistency, Pearson rank correlation to compare the heiQ scales with comparator scales, and confirmatory factor analysis (CFA) for structural validity. The test-retest analysis yielded ICC values ranging from 0.75 to 0.91. Cronbach's alphas for the seven scales ranged from 0.70 to 0.89. Significant correlations between affective and general health constructs and the heiQ scales (72%) were observed. For the majority of the scales, the CFA fit statistics showed to be good to excellent. Overall, the Brazilian Portuguese version of the heiQ showed acceptable reliability, internal consistency, construct validity, and structural validity in individuals with chronic LBP. The heiQ scales may serve as direct outcomes to assess education and self-management programs for the Brazilian Portuguese speaker population. [ABSTRACT FROM AUTHOR]

Adaptar transculturalmente y validar la metodología COPCORD en población indígena Wayuu del estado Zulia, Venezuela. Se realizó un estudio de corte transversal en indígenas Wayuu de los municipios Mara y Guajira del estado Zulia, Venezuela, se adaptó transculturalmente la versión venezolana del cuestionario COPCORD y se tradujo del español venezolano al wayuunaiki (idioma Wayuu). Cien indígenas Wayuu aceptaron participar y se les administró el instrumento, casa por casa, por personal de salud bilingüe capacitado. Los individuos COPCORD positivos fueron evaluados por reumatólogos. Se realizó análisis descriptivo de variables, se midieron alfa de Cronbach, correlación de Spearman, análisis de prueba de cribado (sensibilidad, especificidad, VPP y RVs+). El 66% fueron mujeres, edad promedio 41,4 años, el 20% monolingües, el 21% analfabetos, el 69% unidos/casados, el 57% con trabajo informal. El 62% reportaron dolor, el 56% con criterios de enfermedades reumáticas; las más frecuentes fueron: osteoartritis (32,3%), lumbalgia mecánica (13,9%) y síndrome doloroso regional reumático (12,3%). Cinco dimensiones del instrumento presentaron alfa de Cronbach > 0,7. La sensibilidad fue del 100% y la especificidad del 11,1%, VPP 14,3%, RVs+ 1,13%. El COPCORD es válido y útil como herramienta de cribado para la detección de malestares musculoesqueléticos y enfermedades reumáticas en la población indígena Wayuu. To adapt cross-culturally and validate the COPCORD methodology in the indigenous Wayuu population of Zulia state, Venezuela. A cross-sectional study was conducted on Wayuu indigenous people from the Mara and Guajira municipalities of the state of Zulia, Venezuela. The Venezuelan version of the COPCORD questionnaire was transculturally adapted and translated from Venezuelan Spanish to Wayuunaiki (Wayuu language). One hundred indigenous Wayuu, agreed to participate, they were administered the instrument, house by house, by health personnel, who were bilingual and previously trained. Positive COPCORD individuals were evaluated by rheumatologists. A descriptive analysis of variables was performed, Cronbach's alpha was measured, Spearman's correlation, screening test analysis (sensitivity, specificity, VPP and SVR+). 66% were women, average age 41.4 years, 20% monolingual, 21% illiterate, 69% in a couple/married, 57% with informal work. Sixty-two percent reported pain, 56% with criteria of rheumatic diseases, the most frequent were: osteoarthritis (32.3%), mechanical lower back pain (13.9%), and regional rheumatic pain syndrome (12.3%). Five dimensions of the instrument presented Cronbach's alpha > 0.7. The sensitivity was 100% and specificity 11.1%, VPP 14.3%, SVR+ 1.13%. The COPCORD is valid and useful as a screening tool for the detection of musculoskeletal complaints and rheumatic diseases in the indigenous Wayuu population. [ABSTRACT FROM AUTHOR]

Oswestry disability Index(ODI) is the commonest patient reported outcome for assessment of disability due to low back pain. Its application to non-English speaking Punjabi population is limited as a validated and cross culturally adapted Punjabi version of ODI is not available. The purpose of the study was to analyse the psychometric properties of Punjabi version of Oswestry disability index (ODI-P) in patients with mechanical low back pain. The translation and cross-cultural adaptation of Punjabi version of ODI was done according to well recommended guidelines. The prefinal version was tested on a set of 15 patients and suitable modifications were made. The final version was administered to 113 patients with mechanical low back pain of more than two weeks duration. Psychometric properties comprising of internal consistency, test retest reliability, floor and ceiling effect, construct validity and factorial structure of the questionnaire were determined. ODI-P showed excellent internal consistency (Chronbach alpha of ODI-P is 0.72), test retest reliability (ICC 0.891) and construct validity (Spearman correlation coefficient with VAS 0.424). Factor analysis proved the questionnaire to be having a 1-factor structure with a total variance of 48.61%. ODI (P) is a reliable and valid instrument for measurement of disability related to mechanical low back pain in Punjabi population. It can be used both in research and clinical care settings in future. Image 1 [ABSTRACT FROM AUTHOR]

Purpose: To adapt and validate the English version of the Foot and Ankle Outcome Score (FAOS) into Spanish FAOS-CL, following the WHO guidelines.Methods: A cross-sectional study including 318 outpatients with non-traumatic conditions. Validity, acceptability and internal consistency including correlations with the Medical Outcome Study Short Form 36 are reported.Results: The preliminary version resulted from the forward and back-translation and a pilot administration. Validation response rate was 99.22%. Substantial ceiling effects were observed for Symptoms and ADL and floor effect for QoL sub-scales. The FAOS-CL had excellent internal consistency (Cronbach's α = 0.98). The principal component analysis gave five factors explaining the 72.6% of the variance. The FAOS-CL items significantly correlate with their sub-scales. FAOS-CL sub-scales significantly correlated with SF-36 components and subcomponents.Conclusion: The first Spanish version of the FAOS was generated. Culturally adapted and validated with high reliability capable of evaluating different foot and ankle conditions. [ABSTRACT FROM AUTHOR]

Parental readiness is a requirement for discharge of the high-risk infant from the hospital. Currently, in Indonesia, there are no standard tools to measure parental readiness according to parents' perceptions. This study aimed to undertake cross-cultural adaptation and psychometric validation of the original version (English) of the Readiness for Hospital Discharge Scale (RHDS)-Parent into Bahasa Indonesia. The cross-cultural adaptation was comprised of seven steps: forward translation, forward translation review, blind-back translation, back translation review, pilot testing of the pre-final version with mothers of low birth weight (LBW) infants, expert panel for conceptual and content equivalence, and initial psychometric testing. In the fifth and sixth steps, content validity index was estimated. In the seventh step, exploratory factor analysis (EFA) and internal consistency reliability were conducted. In total, 146 mothers of LBW infants were included in the psychometric testing using convenience sampling. The 22 item Bahasa-RHDS-Parent emerged in a four-factor structure evident from EFA. This version has good reliability with Cronbach alpha values for knowledge and coping ability (0.92), physical-emotional readiness (0.89), pain and power (0.83), expected support (0.80) and 0.90 across the total Bahasa-RHDS-Parent. The Bahasa-RHDS-Parent presents good cross-cultural adaptation and initial psychometric properties for assessing parental readiness in parents with LBW infants before hospital discharge. This questionnaire can be used by nurses to measure readiness for discharge of parents of low birthweight babies. Further testing is needed with a larger sample and parents of children of other ages and conditions for instrument improvement. • Parental readiness is one requirement for discharging a baby from neonatal care. • There are no standard tools to measure parental readiness according to parents' perceptions in Indonesia. • The Bahasa Indonesia version of the RHDS-Parent Form,has acceptable reliability and validity for use with NICU parents. • Four factors were evident including knowledge and coping ability, physical-emotional readiness, pain and power and expected support. [ABSTRACT FROM AUTHOR]

• The MPOC-SP and MPOC-20 are now available in Brazilian Portuguese. • The MPOC-SP and MPOC-20 – Portuguese Brazil have overall adequate reliability. • The MPOCs can be used to assess family centered practice in rehabilitation. The Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries. To translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency. this study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil. Translation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n = 107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n = 50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n = 92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n = 62). The Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care. [ABSTRACT FROM AUTHOR]

• Indonesia lacks instruments to assess staff perception of psychiatric care quality. • Therefore, the Quality in Psychiatric Care-Inpatient Staff (QPC-IPS) was developed. • The factor structure of the Indonesian QPC-IPS corresponded to the Swedish original. • The QPC-IPS is a useful instrument for evaluating staff perception of care quality. • The QPC-IPS contributes to health care improvement in the field of psychiatry. The aim of the present study was to evaluate the psychometric properties and factor structure of the Indonesian version of the Quality of Psychiatric Care - Inpatient Staff (QPC-IPS) instrument. A sample of 192 permanently employed members of staff at two general psychiatric wards in Indonesia completed the QPC-IPS, which consists of 30 items covering six dimensions of quality. Confirmatory factor analysis revealed that the factor structure of the Indonesian version was equivalent to that proposed from the original Swedish QPC-IPS. Internal consistency for the full QPC-IPS was adequate, but poor for some of the factors. The results thus demonstrate that the concept of quality of care expressed in the QPC-IPS is to a large extent equivalent among staff in fundamentally different health care systems and cultural contexts. The Indonesian QPC-IPS is a useful instrument for evaluating staff perception of psychiatric inpatient care in Indonesia, and thus contributes to health care improvement in the field of psychiatry. The QPC-IPS can be used together with the Quality of Psychiatric Care- In-Patient (QPC-IP) instrument, which is completed by the inpatients themselves, to improve the quality of psychiatric inpatient care and national as well as international benchmarking. [ABSTRACT FROM AUTHOR]

Las espondiloartritis (EsA) son enfermedades discapacitantes, con una prevalencia del 1,9% en la población general; los índices diseñados para su seguimiento deben ser válidos, confiables y adaptados transculturalmente para decidir el tratamiento y la vigilancia adecuada. El cambiar un adjetivo o un pronombre en un cuestionario autoadministrado puede ser la gran diferencia cuando se quiere investigar el estado actual de la enfermedad. Desarrollar una versión venezolana de la versión original en inglés de BASDAI/BASFI, para evaluar su confiabilidad y validez en pacientes venezolanos con EsA. Se necesitaron lingüistas certificados para la traducción de una versión venezolana de BASDAI/BASFI. La evaluación de la confiabilidad y la validez se realizó mediante el cálculo de coeficientes de correlación, además de la correlación α de Cronbach, entre la puntuación de BASDAI y los parámetros clínicos (p. ej., ESR, CRP, índice de prueba de Schöber modificado, distancia occipucio-pared y recuento de entesis). Cuarenta pacientes, 31 hombres (77,5%) y 9 mujeres (22,5%), con una edad promedio ± desviación estándar 35,9 ± 12,0 años. Duración de la enfermedad fue de 11,5 ± 9,5 años. El 45% presentaba EsA indiferenciada, el 27,5% espondilitis anquilosante y el 20,0% artritis psoriásica. La artritis reactiva, la espondilitis anquilosante juvenil y la artritis enteropática representaron el 2,5% cada una. La confiabilidad test-retest del BASDAI y del BASFI fueron ambas de 0,99 (p < 0,0001). La consistencia interna para el BASDAI fue de 0,88 (p = 0,002), coeficiente de correlación intraclase para consistencia interna: 0,9867 (p = 0,001). Consistencia interna para el BASFI: α de Cronbach: 0,7985 (p = 0,002), coeficiente de correlación intraclase para consistencia interna: 0,9055 (p = 0,001). La validez de constructo del BASDAI fue de 0,84 para estado de bienestar general del paciente y 0,84 para el recuento de entesis (p < 0,0001). La versión venezolana del BASDAI/BASFI podría utilizarse en la investigación clínica para evaluar el curso de la actividad de la enfermedad en pacientes venezolanos con EsA. Spondyloarthropathies (SpA) are disabling diseases with a prevalence of 1.9% in the general population. The indices designed for monitoring the disease should be valid, reliable and cross-culturally adapted for decision-making concerning the appropriate treatment. Changing an adjective or pronoun in a self-administered questionnaire could be the big difference in condensing an idea in a few words and transmitting that concept to all those who share the same language. To develop a Venezuelan version of the original English version of the BASDAI/BASFI and to evaluate its reliability and validity in Venezuelan patients with SpA. Certified linguists were needed for the translation of a Venezuelan version of the BASDAI/BASFI. The evaluation of reliability and validity was performed by calculating correlation coefficients in addition to Cronbach's alpha correlation between the BASDAI score and the clinical parameters (for example: erythrocyte sedimentation rate, C -reactive protein, modified Schöber test, occiput-to-wall distance and enthesis count). We studied 40 patients including 31 men (77.5%) and 9 women (22.5%). The mean age was 35.9 years ± standard deviation (SD) 12.01 and the disease duration was 11.5 years (± SD 9.5). The most common diagnoses were undifferentiated spondyloarthritis (45%), ankylosing spondylitis (27.5%) and psoriatic arthritis (20%). The incidences of reactive arthritis, ankylosing spondylitis and juvenile Reiter's syndrome were 2.5% each. The test-retest reliability of the BASDAI and BASFI was high (R = 0.99 and 0.99, respectively; P <.0001). The internal consistency for the BASDAI was high (Cronbach's alpha = 0.88; P =.002) and the intraclass correlation coefficient for internal consistency: 0.9867 (P =.001). Internal consistency for the BASFI: Cronbach's alpha = 0.7985 (P =.002), intraclass correlation coefficient for internal consistency: 0.9055 (P =.001). Construct validity of the BASDAI was high for general well-being of the patient (R = 0.84) and for enthesis count (R = 0.84). Low back pain showed moderate correlation with BASDAI (R = 0.69; P <.0001) and the erythrocyte sedimentation rate showed a low correlation (R = 0.39683; P =.0112). The Venezuelan version of the BASDAI/BASFI could be used in clinical research to assess and evaluate the course of disease activity in Venezuelan SpA patients. [ABSTRACT FROM AUTHOR]

Background: Sleep-disordered breathing (SDB), including obstructive sleep apnea syndrome, is often underestimated because it requires a burdensome test (ie, polysomnography) to ensure diagnosis. To improve polysomnography referral, it is of utmost importance to validate efficient alternative screening tools. This study aimed to provide a translation and a cross-cultural validation of the Pediatric Sleep Questionnaire (PSQ) into French to obtain an easy-to-use and reliable screening tool. The psychometric properties of the French version were also determined.Methods: The process of cross-cultural adaptation was carried out following these steps: forward-backward translation, evaluation by an expert committee, and pretesting of the pre-final version. Reliability of the French-PSQ version was assessed by Cronbach's alpha coefficients and Spearman's correlation on a convenient sample of 201 children (aged between 2 and 17 years). Construct validity was determined by factor analysis of principal components.Results: Internal consistency was within an adequate range for all subscales: 0.711 for snoring, 0.559 for sleepiness, 0.682 for behavioral problems, and 0.776 for the whole questionnaire. Spearman's correlation analysis comparing questionnaires administered two weeks apart showed good correlation coefficients for all subscales (snoring: 0.642, sleepiness: 0.846, behavioral problems: 0.780, and entire SRBD scale: 0.835). Factor analysis performed to assess the structure of the French-SRBD scale confirmed the same four factors described in the original questionnaire ("breathing," "behavior," "sleepiness," and "other").Conclusion: The French version of the PSQ has been successfully cross-culturally adapted and showed good psychometric properties, suggesting that it is useful as a tool to screen sleep-disordered breathing in French-speaking children. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) is a comorbid condition with obesity that can produce deleterious effects on children's health and well-being. Unfortunately, valid instruments for screening OSA in obese Thai children are limited. This study aimed to translate and cross-culturally adapt, from English to Thai, the Sleep-Related Breathing Disordered-Pediatric Sleep Questionnaire (SRBD-PSQ) and to determine its psychometric properties.Methods: The SRBD-PSQ was translated into Thai and cross-culturally adapted. It was administered to 62 parents of obese children and adolescents 7-18 years of age who had polysomnographically confirmed OSA. The psychometric properties including validity, reliability, and diagnostic accuracy were examined.Results: The Thai SRBD-PSQ possessed excellent content validity index for scale (S-CVI = 0.95). An acceptable internal consistency (cronbach's α ≥ 0.7) and good to excellent test-retest reliability (intraclass correlation coefficients [ICCs] = 0.82-0.90) of the Thai SRBD-PSQ and subdomain were observed. There was a significant correlation between the SRBD scale and polysomnography (PSG) indices: apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) (r = 0.35, p < 0.01, and r = 0.27, p < 0.05, respectively). The Thai SRBD-PSQ had an area under the curve of 0.71 (p < 0.05) with a sensitivity of 72% and a specificity of 54%.Conclusion: The Thai SRBD-PSQ is a reliable and valid instrument for use in obese children with OSA. However, the Thai SRBD-PSQ should be used in combination with other investigations. [ABSTRACT FROM AUTHOR]

Summary Objective To evaluate the reliability and validity of the Italian version of the VTD scale (I-VTD scale). Study Design Cross-sectional, nonrandomized, prospective study with controls. Methods For the item generation, a cross-cultural adaptation and translation process was performed following the back translation process (phase 1). For reproducibility analysis (phase 2), 102 patients with dysphonia were recruited (internal consistency analysis); 57 of them completed the I-VTD scale twice (test-retest reliability analysis). Seventy-three vocally healthy participants completed the I-VTD scale for normative data generation (phase 3). For validity analysis (phase 4), the scores obtained by patients with dysphonia and by vocally healthy participants were compared (construct validity analysis); in addition, 45 patients with dysphonia completed both the I-VTD scale and the Italian version of the Voice Handicap Index for criterion validity analysis. Finally, for responsiveness analysis (phase 5), a cohort of 30 patients with muscle tension dysphonia was recruited, and scores of the I-VTD scale before and after voice therapy were compared. Results Both the internal consistency and the test-retest reliability of the I-VTD scale were satisfactory. The scores obtained by patients with dysphonia and vocally healthy participants were significantly different. Moderate correlations between the Italian version of the Voice Handicap Index and the I-VTD scores were found. Finally, the scores of the I-VTD scale obtained in pretreatment conditions appeared to be significantly higher than those obtained after successful voice therapy. Conclusion The I-VTD scale appears a reliable and valid instrument for the assessment of vocal tract discomfort in Italian-speaking patients. [ABSTRACT FROM AUTHOR]

Evaluation of the psychometric properties of a translated, culturally adapted questionnaire. Translating, culturally adapting, and validating the Italian version of the Cumberland Ankle Instability Tool (CAIT-I). Ankle sprains are one of the most common musculoskeletal injuries and can lead to chronic ankle instability (CAI). The International Ankle Consortium recommends the Cumberland Ankle Instability Tool (CAIT) as a valid and reliable self-report questionnaire assessing the presence and severity of CAI. At this moment, there is no validated Italian version of CAIT. The Italian version of the CAIT (CAIT-I) was developed by an expert committee. Test-retest reliability of the CAIT-I was measured in 286 healthy and injured participants within a 4–9-day period, by using Intraclass Correlation Coefficients (ICC 2,1). Construct validity, exploratory factor analysis, internal consistency and sensitivity were examined in a sample of 548 adults. Instrument responsiveness over 4 time points was determined in a subgroup of 37 participants. The CAIT-I demonstrated excellent test-retest reliability (ICC≥0.92) and good internal consistency (α =.84). Construct validity was confirmed. Identified cut-off for the presence of CAI was 24.75, with sensitivity= 0.77 and specificity= 0.65. There were significant differences across time for CAIT-I scores (P <.001), demonstrating responsiveness to change, but no floor or ceiling effects. The CAIT-I demonstrates acceptable psychometric performance as a screening and outcome measure. The CAIT-I is a useful tool to assess the presence and severity of CAI. • Chronic ankle instability is a common cause of morbidity and reduced QoL. • The CAIT helps discriminating simple ankle sprains from chronic ankle instability. • This is the first Italian translation of the CAIT. • CAIT-IT has good psychometric performance as an outcome and screening measure. [ABSTRACT FROM AUTHOR]

Resumen Objetivo Realizar una revisión sistemática de la calidad de los procedimientos de adaptación y de las propiedades psicométricas de los cuestionarios autoadministrados de valoración funcional de cadera adaptados a la población española. Material y método Se realizó una búsqueda en las bases de datos MEDLINE, EMBASE, CINAHL y Web of Science (desde su inicio hasta junio de 2016) para localizar todas las escalas adaptadas al español y analizar las diferentes fases del proceso de adaptación y sus propiedades psicométricas. Resultados Se identificaron 8 escalas que se agruparon en 3 apartados, según el tipo de patologías en las que se pueden utilizar, a) todo el miembro inferior: Lower Limb Functional Index (LLFI), Lower Extremity Functional Scale (LEFS) y Arthrose des Membres Inférieurs et Qualité de vie (AMICAL); b) rodilla y/o cadera: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index , Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) y Hip and Knee Questionnaire (HKQ), y c) exclusivas de cadera: Hip Outcome Score (HOS) e International Hip Outcome Tool-33 (iHOT-33). El procedimiento de adaptación transcultural fue aceptable en todos los casos, aunque algo menos riguroso para las escalas HKQ y LLFI. Ningún estudio evaluó todas las propiedades psicométricas. Conclusión Disponemos actualmente de 8 cuestionarios de valoración funcional de cadera adaptados al español con aceptables características psicométricas. Podemos medir la repercusión percibida por el paciente de su patología de cadera seleccionando, entre las diferentes opciones, aquellas alternativas que mejor se adapten a nuestros objetivos, ya sean clínicos o de investigación. Abstract Objective The aim of this study was to conduct a systematic review of the quality of the transcultural adaptation procedure and the clinimetric properties of the self-administered hip-disability functional assessment questionnaires adapted for the Spanish population. Material and method We searched the MEDLINE, EMBASE, CINAHL and Web of Science databases (from inception until June 2016) to locate all the scales adapted to Spanish and to analyze the different phases of the adaptation process and its psychometric properties. Results Eight scales were identified, and were grouped into three sections, according to the type of diseases in which they can be used: a) lower limb: Lower Limb Functional Index (LLFI), Lower Extremity Functional Scale (LEFS) and Arthrosis of Membres Inférieurs et Qualité de vi e (AMICAL); b) knee and/or hip: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) and Hip and Knee Questionnaire (HKQ); and c) specific for hip: Hip Outcome Score (HOS) and International Hip Outcome Tool-33 (iHOT-33). The transcultural adaptation procedure was satisfactory in all cases, albeit somewhat less rigorous for the HKQ and LLFI than for the remaining questionnaires. No study evaluated all the psychometric properties. Conclusion We currently have 8 hip-disability functional assessment questionnaires adapted to Spanish with satisfactory psychometric properties. We can measure the patient's perceived impact of his or her hip disease by selecting, among the different options, those alternatives that best fit our clinical or research objectives. [ABSTRACT FROM AUTHOR]

Objective: This study aims to adapt a questionnaire about the knowledge, beliefs and behaviors regarding HPV and related subjects into Brazilian Portuguese.Study Design: National Survey.Methods: The instrument was translated into Portuguese and retranslated into English separately. Experts assessed the validity of the content and cross-cultural adaptation of the instrument. The instrument was administered to 8580 male and female Brazilian adolescents and young adults (aged between 16 and 25 years) who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District.Results: The full questionnaire is composed of 30 questions, with a good absolute agreement between its two halves (61.16 ± 9.97). The preventive behavior section showed the lowest agreement. Men and women showed a difference concerning their knowledge about HPV (score for men 0.48 (± 8.93) vs. women 0.55 (± 4.51), p < 0.001).Conclusion: The proposed questionnaire is the first instrument able to describe the knowledge, beliefs and behaviors regarding HPV and related subjects in Brazilian women and men. This questionnaire appears to be adequate for use in future studies that may produce evidence and knowledge on these specific topics. [ABSTRACT FROM AUTHOR]

Background The Tilburg Frailty Indicator (TFI) is a 15-item scale. It diagnoses frailty in the elderly based on three domains: physical, psychological and social. A Spanish cross-cultural adaptation and its psychometric properties are presented here. Materials and methods Independent, non-institutionalized ≥70 year-olds were recruited. The TFI structure was assessed with Kuder-Richardson (KR-20) and confirmatory factor analyses. Sperman´s correlations (r s ) with Timed Up-and-Go, Self-assessed-health, Fried criteria, Short Physical Performance Battery, Gerontopole Frailty tool, assessed convergent validity. Known groups’ validity and test-retest reliability were tested. Results Based on n = 856 participants, domain and total scale KR-20 were <0.70. The social domain and certain physical items did not fit adequately. Most physical and total scale r s were 0.31-0.48. Social domain r s were <0.30. The TFI differentiated frail and no-frail subjects, but test-retest variation was considerable. Discussion TFI applicability at different social contexts and frailty stages are worth of additional study. Certain scale aspects should be reconsidered. [ABSTRACT FROM AUTHOR]

Purpose Many measurements have been developed to assess the quality of death (QoD). Among these, the Quality of Dying and Death Questionnaire (QODD) is the most widely studied and best validated. Informal carers and health professionals who care for the patient during their last days of life can complete this assessment tool. The aim of the study is to carry out a cross-cultural adaptation and a psychometric analysis of the QODD for the Spanish population. Methods The translation was performed using a double forward and backward method. An expert panel evaluated the content validity. The questionnaire was tested in a sample of 72 Spanish-speaking adult carers of deceased cancer patients. A psychometric analysis was performed to evaluate internal consistency, divergent criterion-related validity with the Mini-Suffering State Examination (MSSE) and concurrent criterion-related validity with the Palliative Outcome Scale (POS). Results Some items were deleted and modified to create the Spanish version of the QODD (QODD-ESP-26). The instrument was readable and acceptable. The content validity index was 0.96, suggesting that all items are relevant for the measure of the QoD. This questionnaire showed high internal consistency (Cronbach's α coefficient = 0.88). Divergent validity with MSSE (r = −0.64) and convergent validity with POS (r = −0.61) were also demonstrated. Conclusions The QODD-ESP-26 is a valid and reliable instrument for the assessment of the QoD of deceased cancer patients that can be used in a clinical and research setting. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to adapt and evaluate the psychometric properties and factor structure of the Indonesian version of the Quality in Psychiatric Care – Inpatient (QPC-IP) instrument. Methods The QPC-IP is based on a definition of quality of care from the patient’s perspective; it consists of 30 items covering six factors. A sample of 150 inpatients at general psychiatric wards in Indonesia completed the QPC-IP questionnaire. Results Confirmatory factor analysis revealed that the factor structure of the Indonesian version was equivalent to that of the original Swedish QPC-IP, with the exception of the secluded environment factor. The results thus demonstrate that the concept of quality of care expressed in the QPC-IP is to a large extent equivalent among inpatients in fundamentally different health care systems and cultural contexts. Internal consistency for the full QPC-IP was adequate, but poor for the separate factors. Conclusion The Indonesian QPC-IP is a useful instrument for evaluating psychiatric inpatient care, and thus contributes to health care improvement in the field of psychiatry. [ABSTRACT FROM AUTHOR]

Objective: Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:DTM) in Canada for people with mild to severe hip/knee osteoarthritis.Methods: Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up. Program fidelity was evaluated at four observations against a priori criteria. We conducted semi-structured interviews with therapists post-program.Results: 72 patients consented to participate, 59 started the program and one withdrew on physician advice. The remaining 58 provided follow-up data. Mean age was 67 years; 78% were female and 52% had body mass index (BMI) >25. The effect of the program was demonstrated: 40% improvement in pain with 59% achieving a clinically important improvement of ≥2 points on the Numeric Pain Rating scale. Statistically significant improvement also occurred in the Hip disability/Knee injury and Osteoarthritis Outcome Score subscales. 24% reported increased physical activity. Program fidelity was demonstrated with all criteria met. Therapists emphasized that rolling recruitment allowed appropriate supervision and resulted in participants encouraging each other. 99% of participants indicated they benefitted from and were satisfied with the program and 90% reported using the knowledge daily. 52% were willing to pay >$250 Cdn for the program.Conclusion: GLA:DTM implementation was feasible in the Canadian context with results similar to those of >7,000 participants in Denmark. Implementation and evaluation of GLA:DTM Canada is now occurring nationally. [ABSTRACT FROM AUTHOR]

Background A valid and reliable instrument for assessing exercise self-regulatory efficacy (Ex-SRE) is lacking in Taiwan. Objective To develop and validate a Chinese-version of the Ex-SRE scale ( Ex-SRES-Chinese ). Methods Published guidelines were followed for cross-cultural adaptation of Ex-SRES-Chinese . Psychometric testing was conducted in 76 subjects with chronic obstructive pulmonary diseases (COPD). Results Ex-SRES-Chinese achieved clarity, culture appropriateness, and functional equivalence for measuring Ex-SRE. The scale-level content validity index of the Ex-SRES-Chinese was 0.99. The internal consistency reliability (Cronbach's α) was 0.925. Factor analysis identified a single factor with a high eigenvalue of 7.6 accounting for 47.5% of the total variance. The construct validity of Ex-SRES-Chinese was supported by higher Ex-SRE in subjects who exercise regularly in the past than those who did not ( p = 0.033). In addition, Ex-SRE was positively associated with weekly exercise time ( r = 0.58; p < 0.0001). Conclusions Ex-SRES-Chinese is a useful cross-culturally adapted instrument with good psychometric properties for measuring Ex-SRE in COPD patients in Taiwan. [ABSTRACT FROM AUTHOR]

Although media use has been shown to have benefits in many contexts, including study abroad, it may also hinder cross-cultural transitions in academic sojourns. This study examines how music (as a form of communication media) may interfere with adaptation to the host culture and readaptation to the home culture. Focus groups and interviews with a total of 23 college students (twelve U.S. students and eleven international students) revealed that music hindered sojourners' ability to interact in social settings, as well as amplified negative feelings while abroad and during reentry. Participants experienced these temporary side effects in conjunction with (or as part of) their purposeful and functional use of music to escape from the social environment and alleviate negative emotions. [ABSTRACT FROM AUTHOR]

Living outside one’s home country may be stressful, and having strong social ties should help deal with this stress. However, social ties may be protective or harmful depending on whether the social group they evoke belongs to the host- or the home country context. The current study examines how social identification with different groups may either buffer or aggravate the negative effects of two stressors (perceived discrimination and symbolic threat) on sojourner adaptation. Two hundred and twenty international students sojourning in nine different countries responded to an online questionnaire. As expected, adaptation was negatively predicted by both stressors. Moreover, high identification with the group of international students attenuated the negative effects of perceived discrimination on psychological adaptation, while home country identification aggravated the negative effects of symbolic threat on sociocultural adaptation. [ABSTRACT FROM AUTHOR]