Características psicométricas del módulo general del cuestionario FertiQoL en una muestra española de mujeres infértiles

Background: Fertility diagnosis and treatment have an impact on the quality of life (QoL) of individuals. FertiQoL is an internationally developed questionnaire to measure fertility-specific QoL. Obtaining reliable information on the impact of fertility issues enables social and health care systems to develop value-centered integrated care. Objective: The aim of the present study is to examine the dimensionality, validity and reliability of Core FertiQol in a sample of Spanish women undergoing fertility treatment. Methods: A cross-sectional study was conducted, administering the Core FertiQoL questionnaire to 564 women with fertility problems. Descriptive analyses were performed on sociodemographic and clinical data of the sample. The psychometric properties of the FertiQoL were tested by performing confirmatory factor analyses, calculating the average values of the variance extracted, validity, reliability and correlation coefficients between scales. Results: Four factors (Emotional, Mind/Body, Relational and Social) were obtained. All statistics presented adequate values (RMSEA and SRMR lower than 0.09 and CFI and TLI higher than 0.9). Reliability was demonstrated with the CR index of each factor higher than 0.7 and the AVE higher than 0.5. Conclusions: Core FertiQol presents an acceptable adjustment for Spanish women with fertility problems. It offers a communication channel between professionals and patients, as well as accurate information in its subscales on areas that may reflect QoL impairment. Core FertiQol is an instrument that allows the identification of areas requiring support, providing valuable information for the design of efficient social-health value-centered programs for people with infertility.Antecedentes: El diagnóstico y el tratamiento de la fertilidad repercuten en la calidad de vida de las personas. FertiQoL es un cuestionario desarrollado internacionalmente para medir la calidad de vida específica de la fertilidad. La obtención de información fiable sobre el impacto de los problemas de fertilidad permite a los sistemas sociales y sanitarios desarrollar una atención integrada centrada en el valor. Objetivo: El objetivo del presente estudio es examinar la dimensionalidad, validez y fiabilidad del Core FertiQol en una muestra de mujeres españolas en tratamiento de fertilidad. Método: Se realizó un estudio transversal, administrando el cuestionario Core FertiQoL a 564 mujeres con problemas de fertilidad. Se realizaron análisis descriptivos de los datos sociodemográficos y clínicos de la muestra. Se comprobaron las propiedades psicométricas del FertiQoL realizando análisis factoriales confirmatorios, calculando los valores medios de la varianza extraída, la validez, la fiabilidad y los coeficientes de correlación entre escalas. Resultados: Se obtuvieron cuatro factores (Emocional, Mente/Cuerpo, Relacional y Social). Todos los estadísticos presentaron valores adecuados (RMSEA y SRMR inferiores a 0.09 y CFI y TLI superiores a 0.9). La fiabilidad quedó demostrada con el índice CR de cada factor superior a 0.7 y el AVE superior a 0.5. Conclusiones: El Core FertiQol presenta un ajuste aceptable para las mujeres españolas con problemas de fertilidad. Ofrece un canal de comunicación entre profesionales y pacientes, así como información precisa en sus subescalas sobre áreas que pueden reflejar deterioro de la CdV. El FertiQol básico es un instrumento que permite identificar áreas que requieren apoyo, proporcionando información valiosa para el diseño de programas sociosanitarios eficientes centrados en valores para personas con infertilidad

Características psicométricas del módulo general de cuestionario FertiQoL en una muestra española de mujeres infértiles

Background: Fertility diagnosis and treatment have an impact on the quality of life (QoL) of individuals. FertiQoL is an internationally de-veloped questionnaire to measure fertility-specific QoL. Obtaining reliable information on the impact of fertility issues enables social and health care systems to develop value-centered integrated care.Objective: The aim of the present study is to examine the dimensionality, validity and reliability of Core FertiQol in a sample of Spanish women undergoing fertility treat-ment. Methods: A cross-sectional study was conducted, administering the Core FertiQoL questionnaire to 564 women with fertility problems. De-scriptive analyses were performed on sociodemographic and clinical data of the sample. The psychometric properties of the FertiQoL were tested by performing confirmatory factor analyses, calculating the average values of the variance extracted, validity, reliability and correlation coefficients be-tween scales. Results: Four factors (Emotional, Mind/Body, Relational and Social) were obtained. All statistics presented adequate values (RMSEA and SRMR lower than 0.09 and CFI and TLI higher than 0.9). Reliability was demonstrated with the CRindex of each factor higher than 0.7 and the AVE higher than 0.5. Conclusions: Core FertiQol presents an acceptable ad-justment for Spanish women with fertility problems. It offers a communi-cation channel between professionals and patients, as well as accurate in-formation in its subscales on areas that may reflect QoL impairment. Core FertiQol is an instrument that allows the identification of areas requiring support, providing valuable information for the design of efficient social-health value-centered programs for people with infertility.Antecedentes: El diagnóstico y el tratamiento de la fertilidad re-percuten en la calidad de vida de las personas. FertiQoL es un cuestionario desarrollado internacionalmente para medir la calidad de vida específica de la fertilidad. La obtención de información fiable sobre el impacto de los problemas de fertilidad permite a los sistemas sociales y sanitarios desarrollar una atención integrada centrada en el valor. Objetivo: El objetivo del presente estudio es examinar la dimensionalidad, validez y fiabilidad del Core FertiQol en una muestra de mujeres españolas en tratamiento de fertilidad. Método: Se realizó un estudio transversal, administrando el cuestionario Core FertiQoL a 564 mujeres con problemas de fertilidad. Se realiza-ron análisis descriptivos de los datos sociodemográficos y clínicos de la muestra. Se comprobaron las propiedades psicométricas del FertiQoL realizando análisis factoriales confirmatorios, calculando los valores medios de la varianza extraída, la validez, la fiabilidad y los coeficientes de correlación entre escalas. Resultados: Se obtuvieron cuatro factores (Emocional, Mente/Cuerpo, Relacional y Social). Todos los estadísticos presentaron valores adecuados (RMSEA y SRMR inferiores a 0.09 y CFI y TLI superiores a 0.9). La fiabilidad quedó demostrada con el índice CR de cada factor superior a 0.7 y el AVE superior a 0.5. Conclusiones: El Core FertiQol presenta un ajuste aceptable para las mujeres españolas con problemas de fertilidad. Ofrece un canal de comunicación entre profesionales y pacientes, así como información precisa en sus subescalas sobre áreas que pueden reflejar deterioro de la CdV. El FertiQol básico es un instrumento que permite identificar áreas que requieren apoyo, proporcionando información valiosa para el diseño de programas sociosanitarios eficientes centrados en valores para personas con infertilidad

The association between loneliness and frailty among community-dwelling older adults in five European countries:a longitudinal study

BACKGROUND: Loneliness is described as the subjective experience of unfulfilled personal and social needs, with emotional and social domains. Frailty is a state of vulnerability to stressors, which is often characterised by impairment in the physical, psychological and/or social domain. OBJECTIVE: This study aims to examine the bidirectional association between loneliness and frailty across the different domains. METHODS: The study included 1735 older adults from the Urban Health Centres Europe project. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale. Frailty was assessed by the Tilburg Frailty Indicator. Multivariate linear regression and cross-lagged panel models were used to explore the associations between the social and emotional loneliness dimensions and overall, physical, psychological and social frailty. RESULTS: A bidirectional association existed between overall loneliness and overall frailty (loneliness to frailty: β = 0.09, 95% CI: 0.03, 0.15; frailty to loneliness: β = 0.05, 95% CI: 0.004, 0.10). Higher levels of overall loneliness at baseline were associated with higher levels of psychological frailty at follow-up (β = 0.05, 95% CI: 0.00, 0.10). The reverse association was not significant. A bidirectional association existed between overall loneliness and social frailty (loneliness to social frailty: β = 0.05, 95% CI: 0.01, 0.10; social frailty to loneliness: β = 0.05, 95% CI: 0.00, 0.09). CONCLUSION: This study confirms the importance of addressing loneliness among older adults. Interventions that increase social support, exercise engagement and promote healthy behaviours may be effective in reducing the risk of frailty among older adults and simultaneously preventing loneliness.</p

Factors associated with falls among hospitalized and community-dwelling older adults:the APPCARE study

Background: Falls are a leading cause of disability. Previous studies have identified various risk factors for falls. However, contemporary novel research is needed to explore these and other factors associated with falls among a diverse older adult population. This study aims to identify the factors associated with falls among hospitalized and community-dwelling older adults. Methods: Cross-sectional data from the ‘Appropriate care paths for frail elderly people: a comprehensive model’ (APPCARE) study were analyzed. The study sample consisted of hospitalized and community-dwelling older adults. Falling was assessed by asking whether the participant had fallen within the last 12 months. Multivariable logistic regression models were used to evaluate associations between socio-demographic characteristics, potential fall risk factors and falls. Results: The sample included 113 hospitalized (mean age = 84.2 years; 58% female) and 777 community-dwelling (mean age = 77.8 years; 49% female) older adults. Among hospitalized older adults, loneliness was associated with an increased risk of falls. Associations between female sex, secondary education lever or lower, multimorbidity, a higher score on limitations with activities of daily living (ADL), high risk of malnutrition and falling were found among community-dwelling participants. Conclusion: The results of this study confirm the multi-factorial nature of falling and the complex interaction of risk factors. Future fall prevention programs could be tailored to the needs of vulnerable subpopulations at high risk for falls.</p

Factors associated with health-related quality of life among community-dwelling older adults:the APPCARE study

This study aimed to identify the factors associated with health-related quality of life (HRQOL) among community-dwelling older adults. Physical and mental HRQOL were measured by the 12-item Short Form Health Survey (SF-12) at baseline and follow-up. Linear regression models were used to evaluate associations between socio-demographic, health, and lifestyle factors and HRQOL. The sample included 661 participants (mean age = 77.4 years). Frailty was negatively associated with physical HRQOL (B = − 5.56; P &lt; 0.001) and mental HRQOL (B = − 6.65; P &lt; 0.001). Participants with a higher score on activities of daily living (ADL) limitations had lower physical HRQOL (B = − 0.63; P &lt; 0.001) and mental HRQOL (B = − 0.18; P = 0.001). Female sex (B = − 2.38; P &lt; 0.001), multi-morbidity (B = − 2.59; P = 0.001), and a high risk of medication-related problems (B = − 2.84; P &lt; 0.001) were associated with lower physical HRQOL, and loneliness (B = − 3.64; P &lt; 0.001) with lower mental HRQOL. In contrast, higher age (B = 2.07; P = 0.011) and living alone (B = 3.43; P &lt; 0.001) were associated with better mental HRQOL in the multivariate models. Future interventions could be tailored to subpopulations with relatively poor self-reported HRQOL, such as frail or lonely older adults to improve their HRQOL.</p

Factors associated with health-related quality of life among community-dwelling older adults:the APPCARE study

This study aimed to identify the factors associated with health-related quality of life (HRQOL) among community-dwelling older adults. Physical and mental HRQOL were measured by the 12-item Short Form Health Survey (SF-12) at baseline and follow-up. Linear regression models were used to evaluate associations between socio-demographic, health, and lifestyle factors and HRQOL. The sample included 661 participants (mean age = 77.4 years). Frailty was negatively associated with physical HRQOL (B = − 5.56; P &lt; 0.001) and mental HRQOL (B = − 6.65; P &lt; 0.001). Participants with a higher score on activities of daily living (ADL) limitations had lower physical HRQOL (B = − 0.63; P &lt; 0.001) and mental HRQOL (B = − 0.18; P = 0.001). Female sex (B = − 2.38; P &lt; 0.001), multi-morbidity (B = − 2.59; P = 0.001), and a high risk of medication-related problems (B = − 2.84; P &lt; 0.001) were associated with lower physical HRQOL, and loneliness (B = − 3.64; P &lt; 0.001) with lower mental HRQOL. In contrast, higher age (B = 2.07; P = 0.011) and living alone (B = 3.43; P &lt; 0.001) were associated with better mental HRQOL in the multivariate models. Future interventions could be tailored to subpopulations with relatively poor self-reported HRQOL, such as frail or lonely older adults to improve their HRQOL.</p

Exploring the application of the navigation model with people experiencing homelessness: a scoping review

People experiencing homelessness are known to be at risk of disproportionately poor health outcomes and often face barriers in accessing healthcare. Patient navigation (PN) has been identified as a way to address health disparities and engage underserved populations with healthcare services . This scoping review aims to understand how PN models have been utilized with people experiencing homelessness and other comparable populations to date and more specifically identify (a) the defining features, (b) the barriers and facilitators in implementation, and (c) the outcomes associated with PN models. Database searches were conducted in Web of Science, PubMed and SCOPUS on 15th June 2021 and 21 papers, comprising nine reviews and 12 individual studies, were selected. Results indicate that PN has consistently been associated with improvements in a range of health-related outcomes, including timely access to healthcare. While the implementation and measurement of PN varies, a series of consistent features, facilitators and barriers are identified. Interventions to date have utilized a longitudinal approach and non-clinical navigators who share characteristics with the patient, and whose role is facilitatory. To maximize success in future use of PN, further research that focuses on the feasibility of the approach outside the USA is warranted

Barriers and facilitators to health care access for people experiencing homelessness in four European countries: an exploratory qualitative study

Background People experiencing homelessness (PEH) are known to be at higher risk of adverse health outcomes and premature mortality when compared to the housed population and often face significant barriers when attempting to access health services. This study aimed to better understand the specific health care needs of PEH and the barriers and facilitators associated with their timely and equitable access to health services in the European context. Methods We conducted an exploratory cross-national qualitative study involving people with lived experience of homelessness and health and social care professionals in Austria, Greece, Spain, and the UK. A total of 69 semi-structured interviews comprising 15 social care professionals, 19 health care professionals, and 35 PEH were completed, transcribed, and analysed thematically. Results Findings were organised into three overarching themes relating to the research question: (a) Health care needs of PEH, (b) Barriers to health care access, and (c) Facilitators to health care access. Overall, the general health of PEH was depicted as extremely poor, and mainstream health services were portrayed as ill-equipped to respond to the needs of this population. Adopting tailored approaches to care, especially involving trusted professionals in the delivery of care, was identified as a key strategy for overcoming existing barriers. Conclusions The results of this study indicate there to be a high degree of consistency in the health care needs of PEH and the barriers and facilitators associated with their access to health care across the various European settings. Homelessness in itself is recognized to represent an essential social determinant of health, with PEH at risk of unequal access to health services. Changes are thus required to facilitate PEH’s access to mainstream primary care. This can also be further complemented by investment in ‘in-reach’ services and other tailored and person-centred forms of health care. Trial registration This study was registered retrospectively on June 6, 2022, in the registry of ClinicalTrials.gov under the number NCT05406687