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Development and psychometric properties of appraisals of post traumatic spinal cord injury health scale in Iran

Spinal Cord Series and Cases volume 10, Article number: 26 (2024) Cite this article

Subjects

Abstract

Study design

Development and psychometrics study

Objective

To evaluate the reliability and validity of a new version of Appraisals of Post-Traumatic Spinal Cord Injury Health Scale (APTSCIHS) in the Persian language for persons with spinal cord injury (SCI).

Setting

The persons were selected from National Spinal Cord Injury Registry of Iran (NSCIR-IR) and Brain and Spinal Cord Injury Research center (BASIR).

Method

This was a mixed sequential exploratory study that performed in two phases. In the qualitative phase, a systematic scoping review and 12 interviews with the participants were done. Finally, items were generated. In the quantitative phase, face, content, construct and convergent validity were assessed to evaluate validity. To evaluate construct validity, a cross-sectional study was conducted on 305 persons with TSCI along with internal consistency and stability assessments. All quantitative data analyses were conducted using SPSS 22 software.

Results

The content validity and reliability were indicated by Scale’s Content Validity Ratio (S-CVR) = 0.73 and Scale’s Content Validity Index (S-CVI) = 0.86, Cronbach’s α = 0.9 and the Test re-test reliability using intra-class correlations were (ICC) = 0.97 to 0.98. Exploratory factor analysis determined eight factors which showed more than 52% of the variance. APTSCIHS had a significant and strong correlation with Appraisals of DisAbility Primary and Secondary Scale (ADAPSS) (r = 0.475, P < 0.001).

Conclusion

Results showed the 36 items APTSCIHS tool had an acceptable validity and reliability in Iran, and it can help health care providers or even administrators improve the quality of the rehabilitation services and quality of life.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request, with Ethics Committee approval.

References

  1. Wyndaele M, Wyndaele J-J. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord. 2006;44:523–9.

    Article  CAS  PubMed  Google Scholar 

  2. Groves C, Poudel M, Baniya M, Rana C, House D. Descriptive study of earthquake-related spinal cord injury in Nepal. Spinal Cord. 2017;55:705–10.

    Article  CAS  PubMed  Google Scholar 

  3. Derakhshanrad N, Yekaninejad M, Vosoughi F, Fazel FS, Saberi H. Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran. Spinal Cord. 2016;54:901–7.

    Article  CAS  PubMed  Google Scholar 

  4. Van der Meer P, Post M, van Leeuwen CM, van Kuppevelt H, Smit C, Van Asbeck F, et al. Impact of health problems secondary to SCI one and five years after first inpatient rehabilitation. Spinal Cord. 2017;55:98–104.

    Article  PubMed  Google Scholar 

  5. Mahmoodi N, Ai J, Ebrahimi‐Barough S, Hassannejad Z, Hasanzadeh E, Basiri A, et al. Microtubule stabilizer epothilone B as a motor neuron differentiation agent for human endometrial stem cells. Cell Biol Int. 2020;44:1168–83.

    Article  CAS  PubMed  Google Scholar 

  6. Woolrich RA, Kennedy P, Tasiemski T. A preliminary psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people livingwith a spinal cord injury. Psychol Health Med. 2006;11:80–90.

    Article  PubMed  Google Scholar 

  7. Kyutoku Y, Tada R, Umeyama T, Harada K, Kikuchi S, Watanabe E, et al. Cognitive and psychological reactions of the general population three months after the 2011 Tohoku earthquake and tsunami. PloS One. 2012;7:e31014.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Dean R, Kennedy P. Measuring appraisals following acquired spinal cord injury: A preliminary psychometric analysis of the appraisals of disability. Rehabilit Psychol. 2009;54:222.

    Article  CAS  Google Scholar 

  9. Lazarus RS, DeLongis A, Folkman S, Gruen R. Stress and adaptational outcomes: The problem of confounded measures. Am Psychol. 1985;40:770–85.

  10. King KR. Why is discrimination stressful? The mediating role of cognitive appraisal. Cultural Divers Ethnic Minority Psychol. 2005;11:202.

    Article  Google Scholar 

  11. McDonald SD, Goldberg-Looney LD, Mickens MN, Ellwood MS, Mutchler BJ, Perrin PB. Appraisals of DisAbility Primary and Secondary Scale—Short Form (ADAPSS− sf): Psychometrics and association with mental health among US military veterans with spinal cord injury. Rehabilit Psychol. 2018;63:372.

    Article  Google Scholar 

  12. Rahnama P, Javidan A, Saberi H, Montazeri A, Tavakkoli S, Pakpour A, et al. Does religious coping and spirituality have a moderating role on depression and anxiety in patients with spinal cord injury? A study from Iran. Spinal Cord. 2015;53:870–4.

    Article  CAS  PubMed  Google Scholar 

  13. Ahmad MM. Psychometric evaluation of the Cognitive Appraisal of Health Scale with patients with prostate cancer. J Adv Nurs. 2005;49:78–86.

    Article  PubMed  Google Scholar 

  14. Arafat SY, Chowdhury HR, Qusar M, Hafez M. Cross cultural adaptation & psychometric validation of research instruments: A methodological review. J Behav Health. 2016;5:129–36.

    Article  Google Scholar 

  15. Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications; 2017.

  16. Shabany M, Ghodsi SM, Arejan RH, baigi V, Ghodsi Z, Rakhshani F, et al. Cognitive appraisals of disability in persons with traumatic spinal cord injury: a scoping review. Spinal Cord. 2022;60:954–62.

    Article  PubMed  Google Scholar 

  17. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K, et al. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Mental Health. 2015;42:533–44.

    Article  Google Scholar 

  18. Benoot C, Hannes K, Bilsen J. The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory. BMC Med Res Methodol. 2016;16:1–12.

    Article  Google Scholar 

  19. Lindgren B-M, Lundman B, Graneheim UH. Abstraction and interpretation during the qualitative content analysis process. Int J Nurs Stud. 2020;108:103632.

    Article  PubMed  Google Scholar 

  20. Phillips T, de Wet JP. Towards rigorous practice: A framework for assessing naturalistic evaluations in the development sector. Evaluation. 2017;23:102–20.

    Article  Google Scholar 

  21. Hajizadeh E, Asghari M. Statistical methods and analyses in health and biosciences a research methodological approach. Tehran: Jahade Daneshgahi Publications; 2011, 395.

  22. Ayre C, Scally AJ. Critical values for Lawshe’s content validity ratio: revisiting the original methods of calculation. Measur Eval Counsel Dev. 2014;47:79–86.

    Article  Google Scholar 

  23. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. Springer Publishing Company, New York; 2010.

  24. Plichta SB, Kelvin EA, Munro BH. Munro’s statistical methods for health care research. Canada:Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013.

  25. Munro BH. Statistical methods for health care research. Lippincott Williams & Wilkins. Chestnut Hill; 2005.

  26. Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Measur. 1960;20:141–51.

    Article  Google Scholar 

  27. Watkins MW. Determining parallel analysis criteria. J Modern Appl Stat Methods. 2006;5:344–6.

    Article  Google Scholar 

  28. Alwin DF. How good is survey measurement? Assessing the reliability and validity of survey measures. Handb Surv Res. 2010;2:405–34.

    Google Scholar 

  29. Carpenter R. A review of instruments on cognitive appraisal of stress. Arch Psychiatric Nurs. 2016;30:271–9.

    Article  Google Scholar 

  30. Ahmad MM. Validation of the cognitive appraisal health scale with Jordanian patients. Nurs Health Sci. 2010;12:74–9.

    Article  PubMed  Google Scholar 

  31. Newton AT, McIntosh DN. Specific religious beliefs in a cognitive appraisal model of stress and coping. Int J Psychol Relig. 2010;20:39–58.

    Article  Google Scholar 

  32. Duggan CH, Albright KJ, Lequerica A. Using the ICF to code and analyse women’s disability narratives. Disabil Rehabilit. 2008;30:978–90.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge Dr. Sally Kaiser for sending us helpful information about the ADAPS scale.

Funding

This work was funded by Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences [grant number is 98-02-38-43250].

Author information

Author notes

  1. These authors contributed equally: Vafa Rahimi-Movaghar, Seyed Mohammad Ghodsi.

Authors and Affiliations

  1. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Shabany & Seyed Mohammad Ghodsi

  2. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Shabany, Vafa Rahimi-Movaghar, Roya Habibi Arejan, Parastoo Saberi, Vali Baigi & Zahra Ghodsi

  3. Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Maryam Shabany & Vafa Rahimi-Movaghar

  4. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Vafa Rahimi-Movaghar & Seyed Mohammad Ghodsi

  5. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

    Vafa Rahimi-Movaghar

  6. Visiting Professor, Spine Program, University of Toronto, Toronto, ON, Canada

    Vafa Rahimi-Movaghar

  7. Rehabilitation Office, State Welfare Organization of Iran, Tehran, Iran

    Roya Habibi Arejan

  8. Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran

    Reza Tabrizi

  9. Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran

    Reza Tabrizi

  10. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Vali Baigi

  11. Department of Health Education & Health Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran

    Fatemeh Rakhshani

  12. Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Morteza Gholami

  13. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Morteza Gholami

  14. Department of Orthopedics and Neurosurgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, PA, USA

    Alexander R. Vaccaro

Authors
  1. Maryam Shabany
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  2. Vafa Rahimi-Movaghar
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  7. Zahra Ghodsi
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  8. Fatemeh Rakhshani
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Contributions

VRM, MGh, MSh and VB contributed to designing and writing the method. In addition, FR, RH, VRM, ZGH helped design and corrected questionnaires. MGh help in review, PS and MSH aided with data gathering. RT and MSH analyzed and interpreted the results. All authors wrote the article and help to critically review.

Corresponding authors

Correspondence to Vafa Rahimi-Movaghar or Seyed Mohammad Ghodsi.

Ethics declarations

Competing interests

The authors declare that they have no competing interests except ARV (Supplementary Appendix 2).

Ethics approval

The Ethics Committee of Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, approved the study, and the reference number is98-02-38-374. We certify that all applicable institutional and governmental regulations were followed during the course of this research.

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Shabany, M., Rahimi-Movaghar, V., Habibi Arejan, R. et al. Development and psychometric properties of appraisals of post traumatic spinal cord injury health scale in Iran. Spinal Cord Ser Cases 10, 26 (2024). https://doi.org/10.1038/s41394-024-00638-1

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  • DOI: https://doi.org/10.1038/s41394-024-00638-1

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