Reliability and Validity of Simplified Chinese STOP-BANG Questionnaire in Diagnosing and Screening Obstructive Sleep Apnea Hypopnea Syndrome

The main purpose of this study was to assess the reliability and validity of the simplified Chinese STOP-BANG Questionnaire(SBQ)as a diagnosing and screening tool for obstructive sleep apnea hypopnea syndrome(OSAHS).Two hundred and ten patients with suspected OSAHS were recruited in this study.The simplified Chinese SBQ was completed twice before and after polysomnography(PSG)monitoring.SPSS 20.0 was used to analyze the test-retest reliability,discriminant validity,comparative validity and predictive validity of the SBQ.Fourteen patients were excluded on account of fragmentary data,and valid 196 were divided into four groups:non-OSAHS group(n=28,14.29%),mild OSAHS group(n=28,14.29%),moderate OSAHS group(n=31,15.81%)and severe OSAHS group(n=109,55.61%).The test-retest coefficient tor the first four items was 0.810,0.679,0.775,0.963 respectively and the total score of the STOP questionnaire was 0.854.The analysis of discriminant validity revealed that there were significant differences among four groups in the total score of the SBQ and scores of item 1,3,7 and 8,which were also validated between patients with normal blood oxygen saturation and different degrees of hypoxemia.The SBQ evaluation showed low consistency with diagnostic gold standard PSG(k=0.3O3,P<0.05).When taking apnea hypopnea index(AHI)≥5/h,≥15/h and≥30/h as cut-offs to evaluate the SBQ predictive value,the areas under ROC curve were 0.77,0.81 and 0.78,the sensitivity was 90.48%,93.57%and 93.33%,and corresponding negative predictive values were 40.74%,66.67%and 85.19%,respectively.It was suggested that the simplified Chinese version of SBQ had good reliability,and could distinguish the severity of OSAHS.Despite its limited diagnostic accuracy,the SBQ can be considered as an ideal tool for screening OSAHS with superior predictive validity.

Influence of BPPV and Meniere's Disease on Cognitive Abilities: A Questionnaire-Based Study

The vestibular system connects the inner ear to the midbrain and subcortical structures and can affect cognition. Patients with vertigo often experience cognitive symptoms such as attention deficits, memory problems, and spatial perception difficulties. This study aimed to explore the cognitive impairments associated with Benign paroxysmal positional vertigo(BPPV) and Meniere's Disease(MD). A non-experimental group comparison design was used with 107 participants divided into three groups: Group I(clinically normal), Group II(BPPV), and Group III(MD). Participants completed a questionnaire with 10 cognition-related questions, and their responses were scored. The data were found to be non-normally distributed. The analysis revealed a significant difference in scores between Group I and both Group II and Group III. Chi-square tests showed that the responses to cognition-related questions varied among the groups, with Group II exhibiting more cognitive problems. Associated conditions like hypertension, diabetes, and hearing loss did not significantly influence the responses within each group. This study suggests a significant relationship between cognitive problems and patients with BPPV and MD. However, there was no association found between the cognitive problems experienced in BPPV and MD patients. These findings align with previous research indicating that vestibular disorders can lead to deficits in spatial memory, attention, and other cognitive functions. By understanding the link between cognition and vestibular disorders, we can improve diagnosis and rehabilitation services to enhance the quality of life for these patients.

Transcultural Validation and Adaptation of the Academic Stress Questionnaire (CEA) in Students of Puerto Rico

Background: There are multiple questionnaires to measure academic stress in university students, which have been used in nursing students. In Puerto Rico, a questionnaire valid in content and reliability was required to measure the variable of academic stress in nursing students. Purpose: The aim of this study was to adapt transculturally and validate the Academic Stress Questionnaire (CEA) for its use in Puerto Rico. Materials and Methods: Used for the first phase of this study consisted in the evaluation of the validity of content and appearance, whereas the second phase was the actual administering of the questionnaire to 20 (twenty) nursing students, to pilot test its internal consistency using the Cronbach’s α test. Results: Validity of content and appearance allowed for the modification of the questionnaire into one, consisting of 42 items, thus eliminating 34 premises from the original 76 items the questionnaire was composed of. Furthermore, the appearance of the questionnaire was modified by placing the measuring scales in columns, adapting social, demographic, and academic data to the required Puerto Rican reality. The sections meant to measure the academic stress variables were left intact, except for the linguistics adaptation, which was accomplished by a team of experts in the Spanish language. With an α global of 0.80 and coefficients larger than 0.7 in the multi-item sub scales, which oscillated between 0.750 and 0.860, the questionnaire provides a high reliability. Conclusion: Although the values reported in this study are somewhat lower than previous research, they were comparable the Cronbach’s Alpha coefficients reported by Cabanach, in which the numbers reported are considered high (α > 0.70) which show acceptable confiability of the subscales included in the study and a high degree of consistency and thus can be relied upon in future research. In synthesis, the Academic Stress Questionnaire (CEA) modified and adapted, thoroughly fulfills the established criteria of confiability and validity to evaluate academic stress of Puertorrican nursing students.

Psychometric validation of the Chinese version of the dry eye-related quality-of-life score questionnaire

AIM:To psychometrically validate the Chinese version of the dry eye-related quality-of-life score questionnaire(DEQSCHN)among Chinese patients with dry eye.METHODS:This study involved 231 participants,including 191 with dry eye disease(DED)comprising the dry eye disease group,and 40 healthy participants forming the control group.Participants were required to complete the DEQS-CHN,and Chinese dry eye questionnaire and undergo clinical tests including the fluorescein breakup time(FBUT),corneal fluorescein staining(CFS),and Schirmer I test.To assess the internal consistency and retest reliability,Cronbach’sαand the intraclass correlation coefficient(ICC)were employed.Content validity was assessed by item-level content validity index(ICV)and an average scale-level content validity index(S-CVI/Ave).Construct validity was assessed by confirmatory factor analysis.The concurrent validity was assessed by calculating correlations between DEQS-CHN and Chinese dry eye questionnaire.Discriminative validity was evaluated through nonparametric tests,with receiver operating characteristic(ROC)curve serving as conclusive indicators of the questionnaire’s distinguishing capability.RESULTS:The Cronbach’sαcoefficients for frequency and degree of ocular symptoms,impact on daily life,and summary score were 0.736,0.704,0.811,0.818,0.861,and 0.860,respectively,and the ICC were 0.611,0.677,0.715,0.769,0.711,and 0.779,respectively.All I-CVI scores ranged from 0.833 to 1.000,with an S-CVI/Ave of 0.956.Confirmatory factor analysis results exhibited a wellfitting model consistent with the original questionnaire[χ^(2)/df=2.653,incremental fit index(IFI)=0.924,comparative fit index(CFI)=0.924,Tucker-Lewis index(TLI)=0.909,and root mean square error of approximation(RMSEA)=0.065].There was a moderate positive correlation between the DEQS-CHN and the Chinese dry eye questionnaire(r^(2)=0.588).The dry eye group demonstrated significantly higher scores compared to the control group,and the area under the curve(AUC)value was 0.8092.CONCLUSION:The DEQS-CHN has been demonstrated as a valid and reliable instrument for assessing the impact of dry eye disease on the quality of life among Chinese individuals with DED.

Development and validation of a novel questionnaire regarding vision screening among preschool teachers in Malaysia

AIM:To develop and evaluate the validity and reliability of a knowledge,attitude,and practice questionnaire related to vision screening(KAP-VST)among preschool teachers in Malaysia.METHODS:The questionnaire was developed through a literature review and discussions with experts.Content and face validation were conducted by a panel of experts(n=10)and preschool teachers(n=10),respectively.A pilot study was conducted for construct validation(n=161)and test-retest reliability(n=60)of the newly developed questionnaire.RESULTS:Based on the content and face validation,71 items were generated,and 68 items were selected after exploratory factor analysis.The content validity index for items(I-CVI)score ranged from 0.8-1.0,and the content validity index for scale(S-CVI)/Ave was 0.99.Internal consistency was KR^(2)0=0.93 for knowledge,Cronbach’s alpha=0.758 for attitude,and Cronbach’s alpha=0.856 for practice.CONCLUSION:The KAP-VST is a valid and reliable instrument for assessing knowledge,attitude,and practice in relation to vision screening among preschool teachers in Malaysia.

Diagnostic values of questionnaires of Convergence Insufficiency Symptom Survey and College of Optometrists Vision Development Quality of Life in the screening of convergence insufficiency

AIM:To compare and analyse the diagnostic efficacy of the College of Optometrists Vision Development Quality of Life Questionnaire(COVD-QOL)and the Convergence Insufficiency Symptom Survey(CISS)in detecting convergence insufficiency and to compare their diagnostic value in clinical applications.METHODS:Using the diagnostic test method,62 adult patients with convergence insufficiency(age:24.74±3.75y)and 62 normal participants(age:23.61±3.13y)who visited the Optometry Clinic of West China Hospital of Sichuan University from April 2021 to January 2023 were included.All subjects completed the CISS and COVD-QOL.Statistical analysis of the sensitivity and specificity of the CISS and COVD-QOL and comparison and joint experimental analysis of their diagnostic efficacy were performed.RESULTS:The sensitivity of the CISS and COVD-QOL for convergence insufficiency was 64.5%and 71.0%,respectively,while the specificity was 96.8%and 67.7%,respectively.Compared to the CISS alone,the combination of the CISS and COVD-QOL demonstrated lower sensitivity and specificity.The areas under the receiver operating characteristic curve of CISS,COVD-QOL and CISS combined with COVD-QOL were 0.806,0.694 and 0.782,respectively.CONCLUSION:Considering the low sensitivity of the CISS and the low specificity of the COVD-QOL,it is recommended to supplement these questionnaires with other screening tests for the detection of convergence insufficiency.

Translation and cross-cultural adaptation of the Kidney Transplant Questionnaire 25 to Greek

BACKGROUND Kidney transplantation leads to continuous improvement in the survival rates of kidney transplant recipients(KTRs)and has been established as the treatment of choice for patients with end-stage kidney disease.Health-related quality of life(HRQoL)has become an important outcome measure.It is highly important to develop reliable methods to evaluate HRQoL with disease-specific questionnaires.AIM To translate the disease-specific instrument Kidney Transplant Questionnaire 25(KTQ-25)to the Greek language and perform a cross-cultural adaptation.METHODS The translation and adaptation of the original English version of the KTQ-25 to the Greek language were performed based on the International Quality of Life RESULTS Eighty-four KTRs(59 males;mean age 53.5±10.7 years;mean estimated glomerular filtration rate 47.7±15.1 mL/min/1.73 m2;mean transplant vintage 100.5±83.2 months)completed the Greek version of the KTQ-25 and the 36-item Short-Form Health Survey,and the results were used to evaluate the reliability of the Greek KTQ-25.The Cronbach alpha coefficients for all the KTQ-25 dimensions were satisfactory(physical symptoms=0.639,fatigue=0.856,uncertainty/fear=0.661,appearance=0.593,emotions=0.718,total score=0.708).The statistically significant correlation coefficients among the KTQ-25 dimensions ranged from 0.226 to 0.644.The correlation coeffi-cients of the KTQ-25 dimensions with the SF-36 physical component summary(PCS)ranged from 0.196 to 0.550;the correlation coefficients of the KTQ-25 with the SF-36 mental component summary(MCS)ranged from 0.260 to 0.655;and the correlation coefficients of the KTQ-25 with the total scores with the SF-36 PCS and MCS were 0.455 and 0.613,respectively.CONCLUSION According to the findings,the Greek version of the KTQ-25 is valid and reliable for administration among kidney transplant patients in Greece.

Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic

Background Obstructive sleep apnea hypopnea syndrome （OSAHS） is the most common sleep-disordered breathing and is still underdiagnosed.This study was designed to evaluate the value of the STOP-Bang questionnaire （SBQ） in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.Methods Two hundred and twelve patients undergoing overnight polysomnography （PSG） in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ.A score of 3 or more of the SBQ indicated a high risk of OSAHS.We analyzed the sensitivities and specificities of SBQ in screening OSAHS.Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index （AHI）.Results The patients at high risk of OSAHS had higher AHI,higher oxygen desaturation index （ODI）,lower pulse oxygen saturation （LSpO2） during sleep time and less sleep time in stage N3.SBQ scores were positively correlated with AHI,ODI and the ratio of SpO2 lower than 90％,and negatively correlated with LSpO2 during sleep.The sensitivities of the SBQ with AHI ≥5/h,AHI ≥15/h,AHI ≥30/h as cut-offs were 94.9％,96.5％,and 97.7％,respectively,and the specificities were 50.0％,28.6％,and 17.9％,respectively.The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.Conclusions The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS.More studies will be required to determine the value of SBQ in the general Chinese population.

STOP-Bang questionnaire is superior to Epworth sleepiness scales,Berlin questionnaire, and STOP questionnaire in screening obstructive sleep apnea hypopnea syndrome patients

Background Obstructive sleep apnea hypopnea syndrome （OSAHS） is underdiagnosed.Screening patients at high risk of OSAHS is extremely important.Using the standard questionnaire to screen OSAHS is a practical method.This study aimed to evaluate the value of the STOP-Bang questionnaire （SBQ） in screening OSAHS in sleep-disordered breathing clinic by comparing it with the Epworth sleepiness scales （ESS）,Berlin questionnaire,and STOP questionnaire.Methods In this study,212 patients at the sleep-disordered breathing clinic of the Peking Union Medical College Hospital between May 2011 and January 2012 were prospectively included.They were asked to fill in the SBQ,ESS,Berlin questionnaire,and STOP questionnaire before overnight polysomnography （PSG）.Using PSG as gold standard,the sensitivities and specificities of SBQ were compared with those of ESS,Berlin questionnaire,and STOP questionnaire.Results There was no significance in applying ESS score ≥11 to screen OSAHS and detect moderate and severe OSAHS （P ＞0.05）.SBQ was superior to Berlin questionnaire and STOP questionnaire in screening OSAHS and detecting the severity of OSAHS patients.The sensitivities of SBQ score ≥3 with apnea hypopnea index （AHI） ≥5/h,AHI ≥15/h,and AHI ≥30/h as gold standards were 94.9％,96.5％,and 97.7％,respectively.The specificities were 50.0％,28.6％,and 17.9％,respectively.The area upper curves were 0.815 （0.706-0.925,P ＜0.01）,0.746 （0.665-0.828,P ＜0.01）,and 0.751 （0.686-0.817,P ＜0.01）,respectively.According to SBQ,the population was classified into high-risk group and low-risk group.The gender,BMI,neck circumference,AHI,LSpO2,and number of subjects ofAHI ≥5/h,AHI ≥15/h,and AHI ≥30/h of these two groups were significantly different.Conclusions The SBQ has superior predictive value compared with ESS,Berlin questionnaire,and STOP questionnaire.It should be used further in screening for OSAHS in the general population.

改良STOP-BANG问卷对无痛胃镜检查低氧血症的预测价值

目的 探讨改良STOP-BANG问卷(modified STOP-BANG questionnaire,MSBQ)对无痛胃镜检查低氧血症的预测价值。方法 选取2021年10月至12月于浙江省肿瘤医院行无痛胃镜检查的300例患者为研究对象,检查前以MSBQ和STOP-BANG问卷(STOP-BANG questionnaire,SBQ)进行评估,根据评分将患者分为高风险组(总分≥3分)和低风险组(总分<3分)。观察两个量表高风险组和低风险组患者的低氧血症发生率,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估MSBQ和SBQ对无痛胃镜检查低氧血症风险的预测价值。结果 两个量表高风险组患者的低氧血症发生率均显著高于低风险组(P<0.05);MSBQ和SBQ预测无痛胃镜检查发生低氧血症的敏感度分别为81.01%、83.54%,特异性分别为78.28%、66.06%,曲线下面积分别为0.81、0.79,MSBQ的预测效能更好。结论 MSBQ对无痛胃镜检查低氧血症风险有较高的预测价值。

Voice Response Questionnaire System for Speaker Recognition Using Biometric Authentication Interface

The use of voice to perform biometric authentication is an importanttechnological development,because it is a non-invasive identification methodand does not require special hardware,so it is less likely to arouse user disgust.This study tries to apply the voice recognition technology to the speech-driveninteractive voice response questionnaire system aiming to upgrade the traditionalspeech system to an intelligent voice response questionnaire network so that thenew device may offer enterprises more precise data for customer relationshipmanagement(CRM).The intelligence-type voice response gadget is becominga new mobile channel at the current time,with functions of the questionnaireto be built in for the convenience of collecting information on local preferencesthat can be used for localized promotion and publicity.Authors of this study propose a framework using voice recognition and intelligent analysis models to identify target customers through voice messages gathered in the voice response questionnaire system;that is,transforming the traditional speech system to anintelligent voice complex.The speaker recognition system discussed hereemploys volume as the acoustic feature in endpoint detection as the computationload is usually low in this method.To correct two types of errors found in the endpoint detection practice because of ambient noise,this study suggests ways toimprove the situation.First,to reach high accuracy,this study follows a dynamictime warping(DTW)based method to gain speaker identification.Second,it isdevoted to avoiding any errors in endpoint detection by filtering noise from voicesignals before getting recognition and deleting any test utterances that might negatively affect the results of recognition.It is hoped that by so doing the recognitionrate is improved.According to the experimental results,the method proposed inthis research has a high recognition rate,whether it is on personal-level or industrial-level computers,and can reach the practical application standard.Therefore,the voice management system in this research can be regarded as Virtual customerservice staff to use.

Validation of the Chinese Version of the Affective Exercise Experiences Questionnaire (AFFEXX-C)

Despite the well-established benefits of regular physical activity(PA)on health,a large proportion of the world population does not achieve the recommended level of regular PA.Although affective experiences toward PA may play a key role to foster a sustained engagement in PA,they have been largely overlooked and crudely measured in the existing studies.To address this shortcoming,the Affective Exercise Experiences(AFFEXX)questionnaire has been developed to measure such experiences.Specifically,this questionnaire was developped to assess the following three domains:antecedent appraisals(e.g.,liking vs.disliking exercise in groups),core affective exercise experiences(i.e.,pleasure vs.displeasure,energy vs.tiredness,and calmness vs.tension),and exercise motivation(i.e.,attraction vs.antipathy toward exercise).The current study aimed to validate a Chinese version of the AFFEXX questionnaire(AFFEXX-C).In study 1,722 Chinese college students provided data for analyses of factorial,convergent,discriminant,criterion validity,and test-retest reliability of the AFFEXX-C.In addition,1,300 college students were recruited in study 2 to further validate its structural model.Results showed that the AFFEXX-C demonstrates a goodfit and reliability.Additionally,results further supported the hypothesized model based on previous research:antecedent appraisals predicted core affective exercise experiences,which in turn predicted attraction-antipathy toward physical exercise.The AFFEXX-C was found to be a reliable and valid measure of affective exercise experiences in a population of Chinese college students.

Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis

AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.

Validation of LittleEARS questionnaire in Hindi language

Background:Subjective measures of auditory development are equally important as objective measures to obtain a realistic image of the hearing status in infants and toddlers.Objectives:The objectives of the current study were to translate and validate the LittleEARS questionnaire into the Hindi language,to calculate its psychometric properties and establish a regression curve of the scores obtained as a function of age,to calculate the inter-test and test retest reliability of the same.The secondary objectives were to compare the scores obtained by the normal hearing children and those with hearing impairment and to plot a regression curve of total scores obtained by the hearing-impaired children as a function of the duration of auditory training attended since their first fit of the device.Materials and methods:The procedures involved conventional translation,reverse translation,and content validation before administering the questionnaire.The translated version was administered to parents of 59 children with normal hearing and 41 children with hearing impairment.Results:The finalized version had good reliability and efficient internal consistency with a Cronbach alpha value of 0.96.The mean scores obtained by the normal hearing children showed a progressive pattern as a function of age.Conclusion:The LittleEARS questionnaire has been successfully translated and validated into the Hindi language with excellent validity and reliability and can be used for screening and early identification of hearing impairment and in evaluating the outcome of audiological treatment approaches.

中文简版Spatial Hearing Questionnaire的信效度分析

目的空间听觉指在复杂声环境下,患者能够理解言语和识别不同方位声音的能力,可以采用Spatial Hearing Questionnaire评估。本研究在正常听力受试者及耳聋受试者中进行中文简版Spatial Hearing Questionnaire信效度分析。方法首先对Spatial Hearing Questionnaire进行汉化形成C-SHQ12。纳入50例正常听力受试者及57例耳聋受试者进行研究,采用内部一致性检验评价量表的信度,采用探索性因子分析评价量表的结构效度。采用t检验分析正常听力受试者与耳聋受试者C-SHQ12得分的差别,采用pearson相关分析SHQ量表得分与实验室声源定位测试的相关性。采用配对t检验对人工耳蜗植入术前和术后的C-SHQ12得分进行比较。结果 Cronbach’sα系数为0.98,说明量表具有良好的内部一致性信度。采用探索性因子分析提取了2个公因子,分别是声源定位和噪声环境下言语能力,累计贡献率为94.8%。正常听力受试者C-SHQ12得分为87.74±7.99,耳聋受试者得分为52.80±21.76,P=2.2×10-16<0.01,两者差异有显著统计学意义。C-SHQ12量表得分与实验室声源定位得分有很好的相关性,P=2.858×10-6<0.01。人工耳蜗植入术前和术后的C-SHQ12得分有显著差异。结论 C-SHQ12量表信效度很高,可用于耳聋人群的空间听觉能力评估。

Questionnaire Design and Analysis for the Influences of Prototype Landscape on One's Landscape Perception

Prototype landscape refers to the impressive scenes that one has experienced in his/her living environment before 20 years old.Based on the analysis of the existing literature,the authors compiled a standard scale type questionnaire by means of a field survey,which was about the influences of prototype landscape on one's landscape perception.Taking Likert scale as the main part,this questionnaire analyzed the influence of prototype landscape on landscape perception from perception,attitude,and behavior dimensions.In order to further improve its rationality,the authors tested some other aspects of this questionnaire,including logic validity,construct validity,congeniality reliability,split-half reliability,etc..The results validated that the questionnaire possessed good theoretical structure and validity target,which can evaluate various aspects of prototype landscape on one's landscape perception in an effective and reliable way.Therefore,the questionnaire put forward by this study not only enriched the studies of prototype landscape on landscape designing,but also provided an effective tool for quantitative analysis of "the influences of prototype landscape on one's landscape perception".

On Developing the Questionnaire for Evaluating PBL's Multiple Learning Achievements

How to comprehensively,scientifically,objectively and impartially evaluate the multiple learning achievements of the PBL model should be highlighted when PBL is introduced and applied.A questionnaire of a total of 23 items involving such dimensions of language proficiency,subject contents and 21 st Century skills was designed.Its reliability and validity were tested and well-met with the statistical requirements.

Development of an Arabic version of the National Eye Institute Visual Function Questionnaire as a tool to study eye diseases patients in Egypt

AIM:To develop and test an Arabic version of the National Eye Institute Visual Function Questionnaire-25(NEI-VFQ-25).METHODS:NEI-VFQ-25 was translated into Arabic according to WHO translation guidelines. We enrolled adult consenting patients with bilateral chronic eye diseases who presented to 14 hospitals across Egypt from October to December 2012, and documented their clinical findings. Psychometric properties were then tested using STATA.RESULTS:We recruited 379 patients, whose mean age was(54.5±15)y. Of 46.2% were males, 227 had cataract,31 had glaucoma, 23 had retinal detachment, 37 had diabetic retinopathy, and 61 had miscellaneous visual defects. Non-response rate and the floor and ceiling numbers of the Arabic version(ARB-VFQ-25) were calculated. Internal consistency was high in all subscales(except general health), with Cronbach-α ranging from0.702-0.911. Test-retest reliability was high(intraclass correlation coefficient 0.79).CONCLUSION:RB-VFQ-25 isareliableandvalidtool for assessing visual functions of Arabic speaking patients. However, some questions had high non-response rates and should be substituted by available alternatives. Our results support the importance of including self-reported visual functions as part of routine ophthalmologic examination.

Psychosocial and spiritual needs of patients with chronic diseases: validation of the Chinese version of the Spiritual Needs Questionnaire

OBJECTIVE： Even in secular societies, a small portion of patients find their spirituality to help cope with illness. But for the majority of patients, psychosocial and spiritual needs are neither addressed nor even considered a relevant factor by health care professionals. To measure such specific needs, the Spiritual Needs Questionnaire （SpNQ） was developed. The aim of this study was to validate the Chinese version of the SpNQ （SpNQ-Ch） and thus to measure psychosocial and spiritual needs of Chinese patients. METHODS： This was a cross-sectional study among 168 patients with chronic diseases who were recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China using standardized questionnaires. We performed reliability and factor analyses, as well as analyses of variance, first order correlations and regression analyses. RESULTS： The 17-item SpNQ-Ch had a similar factorial structure as the original version with two main and three minor factors which accounted for 64% of variance, and internal consistency estimates （Cronbach＇s a） ranging from 0.51 to 0.81. Included were the 4-item scale Inner Peace Needs, the 5-item scale Giving/Generativity （with 2 sub-constructs, Praying and Sources）, and a Needs, the 5-item scale Religious Needs 3-item scale Reflection/Release Needs. In Chinese patients with cancer （63%）, pain affections （10%）, or other chronic conditions （23%）, the needs for Giving/Generativity （which refer to categories of Connectedness and Meaning） and Inner Peace Needs scored highest, while Religious Needs and the Reflection/Release Needs scored lower. CONCLUSION： The SpNQ-Ch is congruent with its primary version, and can be used in future studies with the mostly nonreligious patients from China. First findings indicate specific psychosocial and spiritual needs which should be addressed by health care professionals to support patients in their struggle with chronic illness in terms of psycho-emotional stabilization, finding hope and meaning, and thus achieving peaceful states of mind despite chronic illness.

Food Frequency Questionnaire for Chinese Children Aged 12-17 Years: Validity and Reliability

Objective The primary objective of this study was to examine the validity and reliability of a semi-quantitative food frequency questionnaire(FFQ) among Chinese children aged 12-17 years. Methods A semi-quantitative 72-food item FFQ was developed for children aged 12-17 years. The reliability and validity of this FFQ were evaluated against 24-h dietary recalls(24 h DRs) to measure the consumption of foods and nutrients. We administered two FFQs and three DRs to children(N = 160) over a period of 1 month to evaluate the reliability and validity. Reliability was examined by quartile agreement and intraclass correlation coefficients(ICCs), and validity was examined by quartile agreement, Bland-Altman plots and correlation with DRs. Results For reliability, the ICCs between the two FFQs ranged from 0.21 to 0.76 for foods and nutrients, and the quartile agreement ranged from 70.0% to 95.0% in the same or adjacent quartiles. Spearman’s correlation coefficients of foods and nutrients between the second FFQ and the 24 h DRs ranged from-0.04 to 0.59. The Bland-Altman plots demonstrated good agreement across the range of intakes among nutrients. The quartile agreement ranged from 50.0% to 100.0%, with infrequent misclassification. Conclusion The FFQ assessment of dietary intakes demonstrated acceptable relative validity and high reproducibility for Chinese children aged 12-17 years.