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Objective: To analyze the psychometric properties of the Pictorial Pain Interference Questionnaire (PPIQ) for evaluating functional interference in the population with chronic low back pain (CLBP)., Design: Cross-sectional study., Setting: Rehabilitation Unit in a hospital., Participants: Ninety-nine patients with CLBP., Interventions: Not applicable., Main Outcome Measures: Functional interference was assessed using PPIQ. The following data were also collected: sociodemographic data; pain intensity (Numeric Pain Rating Scale [NPRS]); physical functioning (30-s arm curl, 30-s chair stand [30CST], and timed Up and Go [TUG] tests), fitness (International Physical Activity Questionnaire); quality of life (Short-Form 12 Health Survey version 1 [SF-12v1]); sleep quality (Spanish-validated 12-item Medical Outcomes Study Sleep scale [12-MOS Sleep]); anxiety and depression (Hospital Anxiety and Depression Scale [HADS]); and social support (Duke-UNK Functional Social Support Questionnaire). Internal consistency was analyzed using Cronbach's alpha, structural validity using exploratory factor analysis (EFA), and discriminant and convergent validity using bivariate analysis., Results: Ninety-nine patients with CLBP were included (age [mean ± SD]: 54.37±12.44 y); women, 67.7%). The EFA extracted 2 factors: "physical function and "social and sleep," which explained 57.75% of the variance. Excellent internal consistency was observed for the overall PPIQ score (Cronbach's α=0.866). Convergent validity was observed between the PPIQ and other functional measures (ρ: 0.52 and -0.47 for the TUG and 30CST, respectively; P<.001) and with the following variables: physical and mental component summaries of the SF-12v1 (ρ: -0. 55 and -0.52, respectively (P<.001); anxiety and depression of the HADS (ρ: 0.47 and 0.59, respectively (P<.001); NPRS (ρ: 0.45; P<.001); and index 9 of the 12-MOS Sleep scale (r: 0.49; P<.001)., Conclusions: The PPIQ is a valid instrument with good psychometric properties for measuring functional interference in people with CLBP. This questionnaire appears to be a feasible alternative when language or communication barriers exist in CLBP population., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: To estimate the prevalence of diagnosed and undiagnosed chronic low back pain (CLBP-D and CLBP-UD, respectively) in the general adult population in Spain and to compare the characteristics of these two groups with subjects without CLBP symptoms (No-CLBP). To establish CLBP-D patient sub-groups according to their self-perceived health status, mental health, level of pain and the impact of their pain on daily activities., Methods: Data were obtained from the National Health Survey of Spain 2017 with a sample of 23,089 adults. Three groups were defined: CLBP-D, CLBP-UD and No-CLBP. In the CLBP-D group, a cluster analysis was performed to identify sub-groups. A multinomial regression model was constructed to determine the factors associated with each of the sub-groups identified., Results: The prevalence of CLBP-D was 22% (95% CI 21.5-22.5) and that of CLBP-UD was 1.4% (95% CI 1.2-1.5). CLBP-D was more common in middle-aged females with a low educational level. They have a worse perceived health status, report more comorbidities, have worse mental health and more limitations in comparison with the populations without CLBP and with CLBP-UD. Three sub-groups of CLBP-D subjects were identified. Women and older subjects with a lower educational level, more occupational stress, less social support and with more physical limitations were the most likely subjects to be included in the group worst-affected., Conclusions: There is a high prevalence of CLBP among the adult population in Spain. Occupational stress and a lack of social support are common factors among subjects' worst-affected of CLBP-D and identifying the subjects with these risks is therefore a recommended strategy for improving the healthcare provided to CLBP patients.

Objective: In Parkinson's disease patients, fatigue is a disabling non-motor symptom whose prevalence ranges from 28% to 58%. The Fatigue Impact Scale for Daily Use (D-FIS), one of the various scales for quantifying fatigue. The aim of our study was to analyze the metric properties of the D-FIS in PD subjects and assess the impact of fatigue on their quality of life., Patients and Methods: The cohort in this study was comprised of 211 consecutive patients with a PD diagnosis regularly followed up at the Movement Disorders Unit of the Neurology Department at Carlos Andrade Marín Hospital (HCAM) in Quito, Ecuador, according to the United Kingdom PD Society Brain Bank criteria. Data Quality, Acceptability, Reliability, Stability (test-retest), Validity and Multiple linear regression analysis were determined., Results: The final sample consisted of 138 men (65.4%) and 73 women. Forty-six percent of these (98 patients) were in stage II of H&Y. We obtained a Cronbach's α value of 0.912 and an ICC value of 0.79. D-FIS was strongly correlated with depression (Spearman rho [Srho] 0.60), anxiety (Srho 0.59), quality of life (Srho 0.67), and non-motor symptoms (Srho 0.66). The scale's discriminant validity, assessed among the different stages of H&Y by the Kruskal-Wallis test, showed major significance (X 2  = 23.183, p ≤ 0.001). In the Multiple linear regression study, the resulting model proves that fatigue has a determining effect on quality of life., Conclusions: The D-FIS has good metric properties and demonstrates that fatigue significantly affects PD patients' quality of life and that its impact is independent from that of anxiety, depression, and sleep disorders., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The aim is to know the factors related to the evolution of Health Related Quality of Life (HRQL) in Coronary Patients (CP) from a longitudinal perspective using an appropriate method that handles missing data adequately when the mechanism of missingness is uncertain., Methods: Prospective study with repeated measures at baseline, 3 and 6months. 250 patients with acute myocardial infarction or unstable angina were studied. Sociodemographic and clinical data were collected at baseline. Mental health (GHQ-28) and HRQL (SF-36v1) were assessed during the follow-up. The missingness mechanism was tested. Friedman test and partial eta-squared were used to analyse changes in SF-36 scores and WGEE were used to identify the predictors of the evolution of HRQL., Results: 95 dropped out after 3months and 72 after 6months. The missingness was likely to be at random. All the dimensions of the SF-36 improved over time, except PF. The factors related to the evolution of HRQL were: being woman (B=-23.9 in RE; B=-6.9 in MCS), older age (B=-0.5 in BP; B=-0.3 in VT), being single/separated (B=-14.5 in GH; B=-14.1 in SF; B=-23.3 in MH) and widow(er) (B=-23.2 PF; B=-29.8 in SF), hypertensive (B=-19.8 in RP; B=-8.9 in VT), worse mental health (B=-3 in PF; B=-2.8 in RP; B=-3.1 in BP; B=-1.2 in PCS; B=-3.8 in VT; B=-2.6 in SF), previous history of CHD (B=-12.5 in PF; B=-5.2 in PCS), and performing heart-healthy physical activities (B=13.9 in PF)., Conclusions: HRQL improves over time. A global approach, including age, marital status, performing physical activities or hypertension, is required to improve HRQL in CP., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Missing data are a common problem in clinical and epidemiological research, especially in longitudinal studies. Despite many methodological advances in recent decades, many papers on clinical trials and epidemiological studies do not report using principled statistical methods to accommodate missing data or use ineffective or inappropriate techniques. Two refined techniques are presented here: generalized estimating equations (GEEs) and weighted generalized estimating equations (WGEEs). These techniques are an extension of generalized linear models to longitudinal or clustered data, where observations are no longer independent. They can appropriately handle missing data when the missingness is completely at random (GEE and WGEE) or at random (WGEE) and do not require the outcome to be normally distributed. Our aim is to describe and illustrate with a real example, in a simple and accessible way to researchers, these techniques for handling missing data in the context of longitudinal studies subject to dropout and show how to implement them in R. We apply them to assess the evolution of health-related quality of life in coronary patients in a data set subject to dropout. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Background: The role of gender differences in Health Related Quality Life (HRQL) in coronary patients is controversial, so understanding the specific determinants of HRQL in men and women might be of clinical importance. The aim of this study was to know the gender differences in the evolution of HRQL at 3 and 6 months after a coronary event, and to identify the key clinical, demographic and psychological characteristics of each gender associated with these changes., Methods: A follow-up study was carried out, and 175 patients (112 men and 63 women) with acute myocardial infarction (AMI) or unstable angina were studied. The SF-36v1 health questionnaire was used to assess HRQL, and the GHQ-28 (General Health Questionnaire) to measure mental health during follow-up. To study the variables related to changes in HRQL, generalized estimating equation (GEE) models were performed., Results: Follow-up data were available for 55 men and 25 women at 3 months, and for 35 men and 12 women at 6 months. Observations included: a) Revascularization was performed later in women. b) The frequency of rehospitalization between months 3 and 6 of follow-up was higher in women c) Women had lower baseline scores in the SF-36. d) Men had progressed favourably in most of the physical dimensions of the SF-36 at 6 months, while at the same time women's scores had only improved for Physical Component Summary, Role Physical and Social Functioning; e) the variables determining the decrease in HRQL in men were: worse mental health and angina frequency; and in women: worse mental health, history of the disease, revascularization, and angina frequency., Conclusions: There are differences in the evolution of HRQL, between men and women after a coronary attack. Mental health is the determinant most frequently associated with HRQL in both genders. However, other clinical determinants of HRQL differed with gender, emphasizing the importance of individualizing the intervention and the content of rehabilitation programs. Likewise, the recognition and treatment of mental disorders in these patients could be crucial.

Objective: To conduct a cross-national validation of the Scales for Outcomes in Parkinson's Disease-PsychoSocial questionnaire (SCOPA-PS) in four Latin American Countries., Methods: Data quality (missing items), scale assumptions (item-test correlation), internal consistency (Cronbach's alpha, item homogeneity), factor structure, content validity, and precision (standard error of measurement, SEM) of the scale were explored, as was convergent validity with motor symptoms (Clinical Impression of Severity Index [CISI-PD], Scales for Outcomes in Parkinson's Disease-Motor Scale), emotional status (Hospital Anxiety and Depression Scale) and health-related quality of life (Parkinson Disease Questionnaire-39). Known-groups validity was studied by category of severity, based on Hoehn and Yahr staging (HY), CISI-PD, and disease duration., Results: Three hundred thirty-one Parkinson's disease (PD) patients with usable data participated (mean age 64.7 years; 42.3% female; mean PD duration 8.5 years; HY, 1 to 5). Data quality (missing items <10%), scale assumptions (item-total correlation = 0.43 - 0.71) and internal consistency of SCOPA-PS (Cronbach's alpha = 0.87; item homogeneity = 0.38) were satisfactory. Factor analysis suggested a unifactorial structure. High convergent validity was found for depression (r(S) = 0.61), anxiety (r(S) = 0.62), and health-related quality of life (r(S) = 0.82). Known-groups validity analyses indicated a gradual influence of severity category and disease duration on SCOPA-PS scores (P < 0.0001). SEM value was 8.24 (7 to 12 in previous studies). These magnitudes may be indicative of the threshold for a real change and a minimum important difference., Conclusions: The Latin American versions of the SCOPA-PS displayed appropriate psychometric attributes.

Background: Although there is a wide range of specific health-related quality of life (HRQoL) measures for Parkinson's disease (PD), their psychometric attributes have never been compared., Objective: To compare the psychometric characteristics of the Parkinson's Disease Questionnaire-39 items (PDQ-39) and Parkinson's Disease Quality of Life Questionnaire (PDQL)., Methods: The PDQ-39 and PDQL were simultaneously applied to 187 PD patients. Additional assessments included Hoehn and Yahr staging, Schwab and England Scale (SES), Unified Parkinson's Disease Rating Scale, Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) and Hospital Anxiety and Depression Scale (HADS). Criteria for acceptability, scaling assumptions, reliability, construct validity and precision were drawn up., Results: Both the PDQ-39 and PDQL proved very similar in the following aspects: acceptability (no floor or ceiling effect); scaling assumptions (79.5% and 80% respectively of item-total correlations fitted the standard); internal consistency (PDQ-39 domains, alpha = 0.43-0.93; PDQL domains, alpha = 0.70-0.88); stability (intraclass correlation coefficient = 0.76-0.90); and internal validity (PDQ-39, r = 0.09-0.70; PDQL, r = 0.52-0.71). Convergent validity between the two questionnaires was moderate to high (r = -0.91 for summary indices). Precision was higher for the PDQ-39 Summary Index, and predictors were the same for both measures (mood disorders and disability)., Conclusions: Although the psychometric properties tested are quite similar in both measures, mainly insofar as summary indices are concerned, differences in some attributes and structural content should nevertheless be considered when comparing both instruments.

Objective: To validate the Ecuadorian Spanish-language version of the Parkinson's Disease Quality of Life Questionnaire (PDQL-EV)., Method: Cross-sectional study of patients with Parkinson's Disease attending a Movement Disorders Clinic. MEASURES APPLIED: Hoehn and Yahr (HY), Unified Parkinson's Disease Rating Scale (UPDRS-3.0), Schwab and England Scale (SES), Pfeiffer Questionnaire (SPMSQ), Hospital Anxiety and Depression Scale (HADS). PDQ-39 and PDQL-EV were applied, the latter after translation and back translation., Results: The study included 137 patients with an age range of 69.43 +/- 10.18 years (mean +/- SD), duration of illness 5.87 +/- 2.58 years, and HY 2.28 +/- 0.77. The PDQL-EV internal consistency (Cronbach's alpha) yielded: Parkinson's symptoms (PS) 0.85; systemic symptoms (SS) 0.69; social function (SF) 0.81; and emotional function (EF) 0.78. The correlation between measurements varied from 0.68 (PS-SS) to 0.46 (SS-EF), and total measurement correlation from 0.58 (EF) to 0.74 (PS) (altogether, p < 0.0001). The correlation of PDQL with clinical variables was: HY -0.62; UPDRS (subscales 1, 2 and 3) -0.55, -0.76, and -0.48, respectively; SES 0.65; SPMSQ -0.35; HADS-anxiety -0.55; HADS-depression -0.67; and PDQ-39 -0.91 (altogether p < 0.0001). PDQL-EV scores were significantly different (p < 0.0001) between moderate and advanced stages, for all domains except for EF (p = 0.006)., Conclusion: The PDQ-EV has satisfactory internal consistency, and converging and discriminating validity.

Introduction: Quality of life, a concept which has become increasingly important in recent years, refers to a patient's perception of himself in relation to his illness and its treatment. This is compared with the concept of quantity of life or survival. This approach is in keeping with the concepts of health of the World Health Organization. Hemifacial spasm is a disorder of movement with a prevalence of 7.4 and 14.5 per 100,000 men and women respectively., Objective: To evaluate the quality of life of patients with hemifacial spasm, study the occurrence of depression and ascertain whether it correlates with the severity, response to treatment and muscle groups involved., Patients and Methods: We present a cohort of 57 patients (average age 53.4 years) with hemifacial spasm, in whom the disorder had been present for an average of 3.7 years., Results: It was found that in these patients the quality of life and index of depression were worse when the severity of the disease was greater, response to treatment poorer and there was generalized hemifacial paralysis, (p < 0.00000) for each parameter. The deterioration in quality of life was correlated with depression (correlation 0.6) for the criteria of severity and muscle groups involved, but not with the response to treatment (correlation 0.3)., Conclusion: Hemifacial spasm significantly alters the quality of life of patients and is associated with depression. This should be taken into account when treating such patients.