Turkish Version of the Jefferson Scale of Empathy Psychometric Properties

Empathy is an important component of medical education and could be taught throughout the years of medical study. Empathy is a skill that allows establishing a communication by evaluating the views, experiences and worries of the patients’ cognitively. Empathy can improve physicianpatient communication, increase patient satisfaction, establish greater patient compliance, decrease litigation, improve physician’s job satisfaction and prevent physician’s burnout. Therefore measurement of this skill is important. Jefferson Scale of Empathy is an instrument for this purpose and has been translated into 45 languages and used in more than 70 countries. The objective of this study was to evaluate the reliability and construct validity of the Jefferson Scale of Empathy Turkish version. The scale was administered to 600 medical students in one medical school. Cronbach’s alpha coefficient of the Jefferson Scale of Empathy was 0.85 which means a good reliability. Competing models of the latent structure of the Jefferson Scale of Empathy were derived from theoretical and empirical sources and evaluated using confirmatory factor analysis. The best fitting model of the latent structure of the Jefferson Scale of Empathy consisted of three correlated factors corresponding to the “perspective taking”, “compassionate care” and “standing in patient’s shoes” dimensions. The reliability coefficients of these dimensions were 0.84, 0.73 and 0.62 respectively. The Turkish version of the Jefferson Empathy Scale is a reliable and valid measure of the constructs it was intended to assess. This measure was found useful for evaluating empathy among medical student

“The Doctor” Teaches Humanities to Medical Students

Education in humanities is an important part of medical curriculum. With traditional didactic approaches, it is difficult to teach humanities. Using movies and other audio-visual materials can make the teaching of humanities for medical students easier. We used “The Doctor” movie during our family medicine course for educating the last year medical students about communication and patient-doctor relationships, which belongs to the core elements of medical humanities. The movie was evaluated by the students through a questionnaire with structured and open-ended questions and was discussed in the classroom. This study reports the findings of the students’ selfreports and discussions. The overall rating of the movie was 2.5 on a five point Likert scale. There was no significant difference in terms of rating among male and female students. Most of the students found this movie little or not at all emotional. Most of the students reported a positive emotional impact of the movie. Most of the students found the movie more useful than lectures (90.9 %) and journal articles (90.9 %) in teaching the patient-doctor relationships. This proportion was 54.5 % compared to bedside rounds and this finding revealed that students accept the bedside rounds as an important component of learning patient-doctor relationships. We concluded that movies should be an enhancement tool for the curriculum, but not the curriculum. The curriculum with some instructional goals such as understanding, reasoning, critical thinking, and reflection should guide the use of movies

Social Exclusion and Quality of Life: An Empirical Study from Turkey

Quality of life, Social exclusion, WHOQOL-BREF,

Functional health literacy in a group of Turkish patients: A pilot study

Background: There is currently no objective original measure developed in the Turkish language for evaluating health literacy. However, some instruments originally developed in Western countries and translated into Turkish do exist. Aims: The aim of this study was to translate and adapt the Test of Functional Health Literacy (TOFHLA) into the Turkish language and validate it among a group of Turkish patients. Methods: Interviews were held in an outpatient clinic. Illiterate patients, those with previously diagnosed mental illness and inadequate visual acuity were excluded. Results: Internal consistencies of the reading comprehension and numeracy items were 0.89 and 0.77, respectively. Inadequate health literacy was determined in 28.0% of participants, marginal in 30.0%, and adequate in 42.0%. Among the possible socio-demographic predictors of health literacy, the most significant predictor was the educational level. Participants with lower levels of education had significantly lower levels of health literacy. In general, reading comprehension scores were lower than the numeracy scores. The most disadvantaged groups were women and older people (≥40 years of age) because of their lower levels of education. Discussion: The TOFHLA in the Turkish language seems to be a valid measure. Functional health literacy was found to be inadequate or marginal. Without enhancing the overall educational level, especially of women, efforts to improve health literacy seem to be ineffective. Conclusions: Functional health literacy is related to education. Non-written visual materials should be considered as a temporary solution to improve health literacy in populations with low literacy

Depression and anxiety among medical students: Examining scores of the beck depression and anxiety inventory and the depression anxiety and stress scale with student characteristics

To evaluate the psychological well-being of medical students a relatively new self-report questionnaire (the depression, anxiety, and stress scale) was used alongside an established instrument (the beck depression and anxiety inventories) in a group of medical students. A total of 928 medical students (49.4% female; 50.6% male) participated voluntarily into this cross-sectional study. Students completed the Turkish versions of the depression anxiety stress scale (DASS), beck depression, and anxiety inventories together with a questionnaire about their socio-demographic characteristics. Mild and moderate levels of depression were found in 30.5% and severe and extremely severe levels of depression in 8.5% of students. Mild and moderate levels of anxiety and stress were present in 35.8% of the participants. Depression and anxiety were more frequently reported by female students. Depression was more frequent among first-year students, students in a poor economic situation and those who were not satisfied with their medical education. The frequency of depression and anxiety were seen to decrease with increasing grades. Bland and Altman plots showed an agreement between beck inventories and depression, anxiety, and stress scales, whereas the agreement between anxiety scales was found to be better than that of depression scales. Depression and anxiety are seen frequently among medical students in Turkey. The psychological distress was influenced only to a modest degree by traditional socio-demographic characteristics. Either the traditional beck inventories or the newer depression anxiety and stress scales can be used for non-clinical screening purposes in individuals

Qualité de vie des immigrés turcs en Suède: étude d’évaluation des propriétés métriques de l’instrument 100 de la qualité de vie de l’OMS

Many instruments have been developed to measure the multidimensional construct of quality of life. One of them has been developed by the World Health Organization (WHOQOL-100) and adapted into different languages and cultures around the world. The authors of this study wanted to assess the measurement properties of the Turkish version of WHOQOL-100, to find out the latent factors underlying quality of life, and to determine the direction and magnitude of the interdependent effects among these factors by using structural equation modeling (SEM). The measurement properties of the Turkish version of WHOQOL-100 scale were assessed on 520 voluntary participants who were immigrants in Stockholm/Sweden. SEM gave us one second-order factor QOL and the five correlated first-order factors labelled: physical, social relations, psychological, environment and independence. In the model for total participants, all the factor loadings were high (ranging from 0.60 to 0.92 except for “sexuality” which was 0.47), indicating a strong association between each of the latent factors and their respective items. In the models which were separately constructed regarding birthplace, the authors found a strong association between each of the latent factors and their respective items. The most substantial possible effect on QOL was psychological domain (0.93), which was larger than physical health (0.84), social relations (0.82), level of independence (0.91) and environment (0.73). The effect of psychological domain on the overall quality of life is greater than those of other domains.Za mjerenje višedimenzionalnoga konstrukta kvalitete života razvijeni su mnogi instrumenti. Jedan od njih, WHOQOL-100, razvila je Svjetska zdravstvena organizacija te ga prilagodila raznim jezicima i kulturama širom svijeta. U ovom radu autori su željeli provjeriti metrijske karakteristike turske verzije WHOQOL-100 te odrediti latentne faktore koji se nalaze u podlozi kvalitete života, smjer i veličinu međusobno ovisnih učinaka tih faktora metodom modeliranja strukturalnih jednadžbi (SEM). Metrijske karakteristike turske verzije upitnika WHOQOL-100 procijenjene su na uzorku od 520 dobrovoljnih sudionika – imigranata u Stockholmu u Švedskoj. Rezultati SEM-a upućivali su na postojanje jednog faktora drugog reda, koji je interpretiran kao QOL, i pet međusobno povezanih faktora drugog reda označenih kao: tjelesni, društveni odnosi, psihološki, okolina i neovisnost. U modelu formiranom na ukupnom uzorku sva faktorska opterećenja bila su visoka (od 0,60 do 0,92, osim za »seksualnost«, 0,47) upućujući na visoku povezanost pojedinih latentnih faktora i njima pripadajućih čestica. U modelima konstruiranim na poduzorcima prema mjestu rođenja, dobivena je visoka povezanost između pojedinih latentnih faktora i njima pripadajućih čestica. Najveći učinak na QOL imala su moguća djelovanja psihološke domene (0,93), veći od učinka tjelesnog zdravlja (0,84), društvenih odnosa (0,82), stupnja neovisnosti (0,91) i okoline (0,73). Učinak psihološke domene na ukupnu kvalitetu života veći je od učinaka u drugim domenama.De nombreux instruments ont été développés afin de mesurer le construit multidimensionnel de la qualité de vie (QDV), dont l’un a été mis au point par l’Organisation mondiale de la Santé (OMS), le WHOQOL-100, et adapté à une diversité de langues et de cultures à travers le monde. Les auteurs de l’étude ont eu pour ambition d’évaluer les propriétés métriques de la version turque de l’instrument précité dans le but de découvrir les facteurs latents sous-jacents à la qualité de vie et de déterminer la direction et l’ampleur des effets interdépendants parmi ces facteurs par l’application du modèle d’équations structurelles (MES). L’étude a été réalisée sur un échantillon de 520 volontaires, tous immigrés à Stockholm en Suède. Le MES a abouti à l’existence d’un facteur de second ordre de la qualité de vie ainsi que de cinq facteurs de premier ordre en corrélation, les domaines : physique, relations sociales, psychologique, environnement et indépendance. Le modèle appliqué à l’ensemble des participants a révélé des scores élevés de facteurs (variant entre 0,60 et 0,92 à l’exception de la « sexualité » de l’ordre de 0,47), révélateurs d’une forte corrélation entre chacun des facteurs latents et leurs items respectifs. Dans les modèles élaborés séparément en fonction du lieu de naissance, les auteurs ont conclu à une forte corrélation entre chaque facteur latent et ses items respectifs. Les effets probablement les plus importants sur la qualité de vie étaient ceux émanant du domaine psychologique (0,93), plus élevés que ceux de la santé physique (0,84), des relations sociales (0,82), du degré d’indépendance (0,91) et de l’environnement (0,73). En conclusion, l’effet du domaine psychologique sur la qualité de vie générale a été supérieur à celui des autres domaines

Quality of Life among Turkish Immigrants in Sweden: a Study for Assessing the Measurement Properties of the World Health Organization’s Quality of Life 100 Instrument

Many instruments have been developed to measure the multidimensional construct of quality of life. One of them has been developed by the World Health Organization (WHOQOL-100) and adapted into different languages and cultures around the world. The authors of this study wanted to assess the measurement properties of the Turkish version of WHOQOL-100, to find out the latent factors underlying quality of life, and to determine the direction and magnitude of the interdependent effects among these factors by using structural equation modeling (SEM). The measurement properties of the Turkish version of WHOQOL-100 scale were assessed on 520 voluntary participants who were immigrants in Stockholm/Sweden. SEM gave us one second-order factor QOL and the five correlated first-order factors labelled: physical, social relations, psychological, environment and independence. In the model for total participants, all the factor loadings were high (ranging from 0.60 to 0.92 except for “sexuality” which was 0.47), indicating a strong association between each of the latent factors and their respective items. In the models which were separately constructed regarding birthplace, the authors found a strong association between each of the latent factors and their respective items. The most substantial possible effect on QOL was psychological domain (0.93), which was larger than physical health (0.84), social relations (0.82), level of independence (0.91) and environment (0.73). The effect of psychological domain on the overall quality of life is greater than those of other domains

Qualité de vie des immigrés turcs en Suède: étude d’évaluation des propriétés métriques de l’instrument 100 de la qualité de vie de l’OMS

Many instruments have been developed to measure the multidimensional construct of quality of life. One of them has been developed by the World Health Organization (WHOQOL-100) and adapted into different languages and cultures around the world. The authors of this study wanted to assess the measurement properties of the Turkish version of WHOQOL-100, to find out the latent factors underlying quality of life, and to determine the direction and magnitude of the interdependent effects among these factors by using structural equation modeling (SEM). The measurement properties of the Turkish version of WHOQOL-100 scale were assessed on 520 voluntary participants who were immigrants in Stockholm/Sweden. SEM gave us one second-order factor QOL and the five correlated first-order factors labelled: physical, social relations, psychological, environment and independence. In the model for total participants, all the factor loadings were high (ranging from 0.60 to 0.92 except for “sexuality” which was 0.47), indicating a strong association between each of the latent factors and their respective items. In the models which were separately constructed regarding birthplace, the authors found a strong association between each of the latent factors and their respective items. The most substantial possible effect on QOL was psychological domain (0.93), which was larger than physical health (0.84), social relations (0.82), level of independence (0.91) and environment (0.73). The effect of psychological domain on the overall quality of life is greater than those of other domains.Za mjerenje višedimenzionalnoga konstrukta kvalitete života razvijeni su mnogi instrumenti. Jedan od njih, WHOQOL-100, razvila je Svjetska zdravstvena organizacija te ga prilagodila raznim jezicima i kulturama širom svijeta. U ovom radu autori su željeli provjeriti metrijske karakteristike turske verzije WHOQOL-100 te odrediti latentne faktore koji se nalaze u podlozi kvalitete života, smjer i veličinu međusobno ovisnih učinaka tih faktora metodom modeliranja strukturalnih jednadžbi (SEM). Metrijske karakteristike turske verzije upitnika WHOQOL-100 procijenjene su na uzorku od 520 dobrovoljnih sudionika – imigranata u Stockholmu u Švedskoj. Rezultati SEM-a upućivali su na postojanje jednog faktora drugog reda, koji je interpretiran kao QOL, i pet međusobno povezanih faktora drugog reda označenih kao: tjelesni, društveni odnosi, psihološki, okolina i neovisnost. U modelu formiranom na ukupnom uzorku sva faktorska opterećenja bila su visoka (od 0,60 do 0,92, osim za »seksualnost«, 0,47) upućujući na visoku povezanost pojedinih latentnih faktora i njima pripadajućih čestica. U modelima konstruiranim na poduzorcima prema mjestu rođenja, dobivena je visoka povezanost između pojedinih latentnih faktora i njima pripadajućih čestica. Najveći učinak na QOL imala su moguća djelovanja psihološke domene (0,93), veći od učinka tjelesnog zdravlja (0,84), društvenih odnosa (0,82), stupnja neovisnosti (0,91) i okoline (0,73). Učinak psihološke domene na ukupnu kvalitetu života veći je od učinaka u drugim domenama.De nombreux instruments ont été développés afin de mesurer le construit multidimensionnel de la qualité de vie (QDV), dont l’un a été mis au point par l’Organisation mondiale de la Santé (OMS), le WHOQOL-100, et adapté à une diversité de langues et de cultures à travers le monde. Les auteurs de l’étude ont eu pour ambition d’évaluer les propriétés métriques de la version turque de l’instrument précité dans le but de découvrir les facteurs latents sous-jacents à la qualité de vie et de déterminer la direction et l’ampleur des effets interdépendants parmi ces facteurs par l’application du modèle d’équations structurelles (MES). L’étude a été réalisée sur un échantillon de 520 volontaires, tous immigrés à Stockholm en Suède. Le MES a abouti à l’existence d’un facteur de second ordre de la qualité de vie ainsi que de cinq facteurs de premier ordre en corrélation, les domaines : physique, relations sociales, psychologique, environnement et indépendance. Le modèle appliqué à l’ensemble des participants a révélé des scores élevés de facteurs (variant entre 0,60 et 0,92 à l’exception de la « sexualité » de l’ordre de 0,47), révélateurs d’une forte corrélation entre chacun des facteurs latents et leurs items respectifs. Dans les modèles élaborés séparément en fonction du lieu de naissance, les auteurs ont conclu à une forte corrélation entre chaque facteur latent et ses items respectifs. Les effets probablement les plus importants sur la qualité de vie étaient ceux émanant du domaine psychologique (0,93), plus élevés que ceux de la santé physique (0,84), des relations sociales (0,82), du degré d’indépendance (0,91) et de l’environnement (0,73). En conclusion, l’effet du domaine psychologique sur la qualité de vie générale a été supérieur à celui des autres domaines