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Background: This study aimed to evaluate the relationship of selected clinical (i.e., body mass index, BMI) and psychological factors (i.e., anxiety, depression, and impulsiveness) with the quality of life (QoL) of elderly patients with cardiovascular disease (CVD) in a single clinical center in Italy., Methods: A total of 238 patients of older age (≥65 years) with CVD who voluntarily attended a single clinical center for weight loss and cardiac rehabilitation were sequentially recruited and tested upon admission to the hospital based on pre-established inclusion criteria., Results: The findings indicated that anxiety and depressive symptoms were moderately associated with lower QoL. Additionally, there were noteworthy but minor negative connections between impulsivity and QoL. Furthermore, BMI was inversely associated with the perceived QoL of the participants, and when incorporated into the regression analysis, BMI alone significantly accounted for 11.8% of the variability in QoL. This percentage increased to 18.4% with the inclusion of impulsiveness in the model and further to 34.3% with the addition of anxiety and depressive symptoms. However, after introducing anxiety and depression, the association between impulsivity and QoL ceased to be statistically significant., Conclusions: Integrating the routine assessment and treatment of psychological factors into the care of older patients with CVD is important for optimizing their overall health outcomes and improving their QoL.

Introduction: Providing informal care to one's romantic partner who is ill may become a highly distressing and demanding task. Based on the innovative dyadic coping model, several support interventions have been developed to alleviate informal caregivers' burden, including both caregivers' and care receivers' needs. Considering the unique challenges characterising the caregiving phenomenon, such as geographical barriers and time restrictions, digital solutions should be considered. However, there is a lack of research examining the effectiveness of dyadic digital solutions. Thus, this review aims to examine the existing literature on the efficacy of dyadic digital psychological interventions designed for caregivers and their care-receivers couples within the illness context., Methods and Analysis: Randomised controlled trials targeting caregivers' burden among dyads of informal caregivers and care receivers will be identified via an electronic search of the following databases: PubMed, Embase, the Cochrane Library, Cinhal, Scopus, PsycINFO, MEDLINE and supplemented by hand searching of previous systematic reviews. The search will be undertaken following the PICO (population, intervention, comparison and outcome) elements. If possible, a meta-analysis will be conducted to examine: (1) the effectiveness of dyadic digital psychological interventions for reducing caregivers' burden (primary outcome) among caregivers who are in a romantic relationship with the care receivers; (2) the effectiveness of dyadic digital psychological interventions on secondary outcomes such as anxiety, depression, stress, quality of life, well-being and self-efficacy among caregivers and care receivers; and (3) moderating effects of clinical and methodological factors on caregivers' burden. Prior to inclusion in the review, retrieved papers will be critically appraised by two independent reviewers. The Cochrane Risk of Bias tool will assess the risk of bias for randomised controlled trials., Ethics and Dissemination: Ethical approval is not required as no primary data will be collected. Findings will be disseminated through peer-reviewed publications, presentations at academic conferences and lay summaries for various stakeholders., Prospero Registration Number: CRD42022299125., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

This study aimed to evaluate the responsiveness of the Italian version of the Paediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS) to changes in BMI, fatigue and depressive symptoms in adult inpatients with obesity. 198 adults (81% female, mean age = 44.7 years) with obesity completed the PedsQL-MFS, the Fatigue Severity Scale (FFS) and the Centre for Epidemiologic Studies Depression Scale (CESD) before and after completing a 3-week body weight reduction program. Internal responsiveness was measured via paired t-tests, standardized mean response (SMR) and Glass's delta (d). Changes in FFS, CESD and BMI were used as anchors to categorize participants as "improved", "unchanged" or "deteriorated". External Responsiveness was assessed by comparing mean post-intervention PedsQL-MFS scores across change groups, adjusting for pre-intervention PedsQL-MFS scores and in area-under-curve (AUC) analysis. PedsQL-MFS Total, Sleep/Rest Fatigue and Cognitive Fatigue scores demonstrated significant reductions in response to an established body weight reduction program. Post-intervention PedsQL-MFS scale scores were lower among those who had improved on the CESD and FSS than among those whose CESD and FSS scores had not significantly changed. There was no difference in PedsQL-MFS scale scores according to whether participants had reduced their BMI by at least 5%. AUC analyses indicated that change in PedsQL-MFS scores was somewhat more predictive of improvement in CESD than FSS scores. The Italian version of the PedsQL-MFS demonstrated both internal and external responsiveness. It appeared more sensitive to improvement than deterioration in fatigue symptoms and its sensitivity to deterioration in depressive symptoms and weight loss could not be evaluated in the present study as there was no reliable deterioration in CESD scores and weight loss was modest. Future studies should include a control group to assess the sensitivity of the PedsQL-MFS more thoroughly., (© 2022. The Author(s).)

Objectives: Weight bias is defined as negative attitudes towards, and beliefs about, others because of their weight. Like other forms of stigma, weight stigma has a harmful impact on health, including depressive symptoms, disordered eating, body image disturbances and poor quality of life. Several instruments measuring weight-related attitudes have been developed, such as the Attitudes Toward Obese Persons (ATOP). The purpose of this study was to test the psychometric properties of the Italian version of the ATOP (I-ATOP)., Methods: The ATOP was adapted into Italian following the back-translation procedure. A total of 800 participants (M age =31.40; 54.9% females) completed the I-ATOP alongside the Weight Bias Internalization Scale (WBIS). Exploratory factor analysis (EFA) was conducted on half of the sample, while the remaining half was selected to cross-validate the resulting solution via confirmatory factor analysis (CFA). Factorial invariance tests across gender were computed using multi-group CFA., Results: EFA suggested a one-factor structure with four items excluded due to their low standardised loadings. The trimmed model was cross-validated showing an acceptable fit to the data: MLRχ2 = 159.467 (df=81); RMSEA= 0.049; CFI= 0.939; TLI= 0.910; SRMR= 0.046. An omega coefficient of 0.818 confirmed the strong reliability of the I-ATOP. Convergent validity was demonstrated by a significant and moderate correlation with the WBIS. Configural, metric, and scalar invariance across gender were established., Conclusions: I-ATOP demonstrated to be a valid and reliable instrument useful for both clinical and research practices, as well as to support the development of educational and therapeutic actions able to reduce the stigma among the general public., (Copyright © 2022 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.)

Objective: This study aimed to examine the factor structure, reliability, inter-rater agreement and convergent validity of the child and parent Italian versions of the paediatric quality of life inventory multidimensional fatigue scale (PedsQL-MFS) in paediatric inpatients with obesity and one of their parents., Methods: 100 pairs of children/adolescents (64% female, mean age = 15.34) with obesity and one of their parents completed the PedsQL-MFS and the Child Behaviour Checklist (CBCL) or the Youth Self Report., Results: Confirmatory Factor Analysis indicated that the three correlated first-order factors model corresponding to the published subscales demonstrated acceptable fit and achieved strict invariance across parent and child informants. Bifactor Analysis supported the multidimensionality and the reliability of the total and subscale scores as multidimensional composites. Parent-child agreement was low with latent means higher for parent reports. PedsQL-MFS total scores were strongly correlated with Somatic Complaints scores on the CBCL, and moderately associated with anxiety, depression, social problems and school problems., Conclusions: Total scores of the child and parent Italian versions of the PedsQL-MFS demonstrated good reliability and convergent validity in paediatric inpatients with obesity and their parents, and are complementary rather than interchangeable., Level of Evidence: No level of evidence., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.)

Purpose: This study was aimed to examine the psychometric proprieties of the Body Image Quality of Life Inventory (BIQLI) among Brazilian, Portuguese, Mozambican, and Italian college students., Methods: A total of 1630 subjects (Brazilians = 446; Portuguese = 480, Mozambicans = 360, and Italians = 344) completed the Portuguese (Brazilian, Portuguese, and Mozambican students) and the Italian versions (Italian students) of the BIQLI for measuring the effects of body image on one's quality of life. Psychometric testing included confirmatory factor analysis (CFA), discriminant and convergent validity, internal consistency, and composite reliability. The cross-national invariance of the BIQLI was assessed by multi-group analysis using ΔCFI. Moreover, the global score of the BIQLI for all countries was calculated by an algorithm and compared using the Welch's ANOVA and the Games-Howell post-test (α = 5%)., Results: CFA showed an inadequate fit of unifactorial model of the BIQLI. Therefore, an alternative model comprising nine first-order factors and one second-order factor was proposed and evaluated. This new model showed adequate fit in all samples, despite some limitations that were found with respect to its convergent and discriminant validity. The alternative BIQLI model was invariant among countries. Global scores for the influence of body image on quality of life were significantly different across countries, with the Italians presenting the lowest scores., Conclusions: The BIQLI factorial model found in this study represents a reliable and valid alternative to its original structure for the assessment of the effect of body image on college students' perceived quality of life. This model must be further tested in other populations., Level of Evidence: Level V, cross-sectional descriptive study.

Objective: This study was aimed to examine the feasibility, validity, and reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™ MFS) for adult inpatients with severe obesity., Methods: 200 inpatients (81% females) with severe obesity (BMI ≥ 35 kg/m2) completed the PedsQL MFS (General Fatigue, Sleep/Rest Fatigue and Cognitive Fatigue domains), the Fatigue Severity Scale, and the Center for Epidemiologic Studies Depression Scale immediately after admission to a 3-week residential body weight reduction program. A randomized subsample of 48 patients re-completed the PedsQL MFS after 3 days., Results: Confirmatory factor analysis showed that a modified hierarchical model with two items moved from the Sleep/Rest Fatigue domain to the General Fatigue domain and a second-order latent factor best fitted the data. Internal consistency and test-retest reliabilities were acceptable to high in all scales, and small to high statistically significant correlations were found with all convergent measures, with the exception of BMI. Significant floor effects were found in two scales (Cognitive Fatigue and Sleep/Rest Fatigue)., Conclusion: The Italian modified PedsQL MFS for adults showed to be a valid and reliable tool for the assessment of fatigue in inpatients with severe obesity. Future studies should assess its discriminant validity as well as its responsiveness to weight reduction., (© 2018 The Author(s) Published by S. Karger GmbH, Freiburg.)