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The use of questionnaires as measuring tools involves the use of language. Spanish intralinguistic variation entails differences in the ways of perceiving the world, analyzing events and behaving, which must be taken into account when designing and adapting questionnaires. The IA-PCAT (Primary Care Assessment Tools for Iberomerica) harmonization process differs from the cross-cultural adaptation scenarios described in the scientific literature, since it intends to obtain a single Spanish product suitable for multiple target populations, that emanates from questionnaires previously adapted in several populations. Hence, this work requires the use of new analysis categories. The aim of this methodological note is to propose discriminant definitions of conceptual equivalence, practical equivalence and linguistic acceptability as analysis categories of the data collected during cognitive interviews to assess the questionnaires' comprehension, carried out with health professionals and users of healthcare services., (Copyright © 2020 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To evaluate the measurement characteristics of the Spanish and Catalan versions of the 10-Item Primary Care Assessment Tool for adults (PCAT-A10), shortened from the original Primary Care Assessment Tool (PCAT), with a new mental health item., Design: Cross-sectional observational study., Location: The city of Barcelona., Participants: Of the 3,496 people over 14 years of age from the representative random sample of the Barcelona population, from the 2016-17 Barcelona Health Survey, those who declared they had a family doctor, and had visited a specialist at some time in their lives, and had answered more than 50% of PCAT-A10 items were selected (n=3,107)., Main Measurements: Item descriptive analysis, analysis of internal consistency, corrected item - total correlation, of the PCAT-A10 index and the 10 items that make it up. Three scenarios for non-response to treatment were analysed: substitution by 0, by the intermediate value, and excluding people who did not answer any item., Results: The PCAT-A10 index obtained Cronbach alphas of 0.73, 0.79, and 0.85 in the three mentioned scenarios, correlation item total corrected between 0.41 and 0.66, and 20.8% non-responses to the mental health item., Conclusions: The new version of PCAT-A10 has a high reliability with a higher response in the mental health item compared to the previous version., (Copyright © 2019 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To validate the Brazilian short version of the PCAT for adult patients in Spanish., Design: Analysis of secondary data from studies made to validate the extended version of the PCAT questionnaire., Location: City of Córdoba, Argentina. Primary health care., Participants: The sample consisted of 46% of parents, whose children were enrolled in secondary education in three institutes in the city of Cordoba, and the remaining 54% were adult users of the National University of Cordoba Health Insurance., Main Measures: Pearson's correlation coefficient comparing the extended and short versions. Goodness-of-fit indices in confirmatory factor analysis, composite reliability, average variance extracted, and Cronbach's alpha values, in order to assess the construct validity and the reliability of the short version., Results: The values of Pearson's correlation coefficient between this short version and the long version were high .818 (P<.001), implying a very good criterion validity. The indicators of good global adjustment to the confirmatory factor analysis were good. The value of composite reliability was good (.802), but under the variance media extracted: .3306, since 3 variables had weak factorials loads. The Cronbach's alpha was acceptable (.85)., Conclusions: The short version of the PCAT-users developed in Brazil showed an acceptable psychometric performance in Spanish as a quick assessment tool, in a comparative study with the extended version., (Copyright © 2016 Elsevier España, S.L.U. All rights reserved.)

Evaluation of Primary Care (PC) must include different perspectives. The objective of the study was to know the assessment of the PC in Catalonia and detecting whether or not a pattern of social inequality exists, through user's experience. A cross-sectional study was conducted, in a representative sample (n = 13,292) of the Catalonia population (aged 15), who identify a reference professional. It was studied an index of experience with PC by personal variables and variables about the reference professional. Negative binomial regression models (bivariate and multivariate) were adjusted to obtain the prevalence ratios and confidence intervals of 95%. The index gained an average of 71 (scale 0-100). A rating above 70 was associated with higher age, greater number of visits in the last year, more time with the same professional and living in an area of lower population density. Items with lower scores: telephone attention and availability of mental health services. We concluded that factors associated with a better experience are associated with more frequent visits to professionals. We did not detect social inequalities., (Copyright © 2011 Elsevier España S.L. All rights reserved.)

The aim was to develop a tool for the critical appraisal of epidemiological cross-sectional studies. Several recommendations or guidelines for assessing the strength of scientific evidence provided by observational studies were reviewed, like those from the Agency for Healthcare Research and Quality, the Scottish Intercollegiate Guidelines Group, the Osteba (Basque Office for Health Technology Assessment), and the STROBE Initiative. The tool has 27 items to assess: study question or objective, participants, comparability between groups, definition and measure of main variables; analysis and confusion, results, conclusions, external validity and applicability, and conflict of interest. This tool can be used to critically appraise research papers or to rate evidence during the elaboration of systematic reviews.

Background and Objective: This study assesses the reliability and validity of the KIDSCREEN-52, a new questionnaire of health-related quality of life (HRQoL), cross-culturally developed for children and adolescents in 13 European countries., Subjects and Method: The KIDSCREEN-52 was sent by post to a representative sample of the Spanish population aged 8-18 years old. Sociodemographic characteristics and other measures of HRQoL were collected. A health needs instrument was collected from parents. Psychome tric properties were assessed using the classical test theory, and item response theory approaches. Test-retest reliability was assessed in 10% of the sample 2-4 weeks later., Results: Response rate was 47% (n = 876). Cronbach's alpha values ranged from 0.74 to 0.86, and the intraclass correlation coefficient ranged between 0.55-0.79. Rasch analysis showed a good item-fit in each dimension (infit msq = 0.7-1.2). Confirmatory factor analysis confirms underlying structure of the 10 dimensions model (root mean square error of approximation [REMSEA] = 0.025; comparative fit index [CFI] = 0.94). KIDSCREEN scores were better in boys, in younger children, in those who did not report health care needs, and in those in the high socioeconomic level., Conclusions: The KIDSCREEN-52 questionnaire has acceptable levels of reliability and validity for the Spanish population aged 8-18. Further work is needed to assess sensitivity to change and its applicability in clinical settings.

Objective: To reduce, translate, and adapt transculturally, the short version of the PCAT questionnaire for users (PCAT Customer client version), in order to achieve an abbreviated version of the original instrument in Catalan and Castilian that is conceptually similar to the English original, culturally adequate and viable for use among the Spanish population, and useful for inclusion in the health surveys., Design: Translation and adaptation of one questionnaire. Three steps were followed: a) question selection; b) transcultural adaptation of the selected questions, by means of direct translations to Castilian and Catalan with subsequent re-translation to English; c) clarity, acceptability, and familiarity with content of the 2 pretest questionnaire versions were evaluated through cognitive interviews of persons with different profiles in the targeted population., Results: Fifteen questions were selected for the adult version and 24 for the <15 year-old version. These facilitated the identification of a primary health care provider and the collection of information on the dimensions of first contact, continuity of care, comprehensiveness of care and coordination., Conclusions: It is hoped that these instruments will be useful when included in the questionnaires of health surveys throughout Spain. The items selected facilitate evaluation of the degree to which primary health care succeeds as the first user contact with health services, maintains continuity of attention, coordinates and provides services, making them available when necessary. Furthermore, cultural competence will be evaluated.

Objectives: To analyze the reliability and validity of the domains of the Child Health and Illness Profile-Child Edition Parent Report Form (CHIP-CE/PRF) included in the Barcelona Health Survey conducted in 2000 and to obtain population-based reference values., Methods: Data were obtained from proxy-respondent interviews of children aged 5-14 years old (n = 836) participating in the Barcelona Health Survey 2000. The 4 subdomains of the parent version of the CHIP-PRF included in the health survey were: satisfaction with health, and physical discomfort, emotional discomfort, and limitation of activities of the discomfort domain. Internal consistency was assessed using Cronbach's alpha coefficients. An exploratory factor analysis was carried out and analysis of covariance was performed to assess the construct validity of the subdomains., Results: In all the subdomains assessed, Cronbach's alpha was above 0.70 (range, 0.76-0.98). In the factorial analysis, almost all the items (31/35) presented the highest load in their corresponding subdomain. Most of the expected mean differences among groups were confirmed. Girls aged 10-14 years old scored the lowest, both in satisfaction with health (48.93; 95% confidence interval [CI 95%], 47.40-50.47) and in discomfort (48.87; CI 95%, 47.51-50.22). No differences were found according to the social class of the head of the family., Conclusions: The present study provides a useful measure of perceived health status in a child health survey.