Publications by authors named "Serena Petrocchi"

28 Publications

  • Page 1 of 1

Opportunities and Challenges of Web-Based and Remotely Administered Surveys for Patient Preference Studies in a Vulnerable Population.

Patient Prefer Adherence 2021 15;15:2509-2517. Epub 2021 Nov 15.

Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.

The application of web-based and remotely administered surveys is becoming increasingly popular due to the fact that it offers numerous advantages over traditional paper-based or computer-based surveys completed in the presence of the researcher. However, it is unclear whether complex preference elicitation tasks administered online in highly vulnerable patient populations are also feasible. This commentary discusses opportunities and challenges of conducting quantitative patient preference studies in lung cancer patients using web-based modes of data collection. We refer to our recent experience in the context of the Patient Preference in Benefit-Risk Assessments during the Drug Life Cycle (PREFER) project. Among the main advantages were the possibility of reaching a wider and geographically distant population in a shorter timeframe while reducing the financial costs of testing, the greater flexibility offered and the reduced burden on the patients. Some limitations were also identified and should be the object of further research, including the potential lack of inclusiveness of the research, the lack of control over who is completing the survey, a poor comprehension of the study material, and ultimately a lower level of engagement with the study. Despite these limitations, experience from the PREFER project suggests that online quantitative methods for data collection may provide a valuable method to explore preferences in vulnerable patient populations beyond the COVID-19 pandemic.
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http://dx.doi.org/10.2147/PPA.S327006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613941PMC
November 2021

"We-Diseases" and Dyadic Decision-Making Processes: A Critical Perspective.

Public Health Genomics 2021 Nov 23:1-5. Epub 2021 Nov 23.

Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy.

This is a critical perspective paper discussing the theoretical bases and methodological issues regarding dyadic decision-making processes in the oncological domain. Decision-making processes are of a central interest when one partner in a couple has cancer, and patients and partners make decisions together under an interactive and dynamic process. Given that, the attention in research is progressively shifting from patient and partner considered as individuals to a more holistic view of patient-partner considered as a dyad. The consideration of the dyadic nature of the decision-making represents a challenge from a theoretical and methodological point of view. The Interdependence Theory and the Dyadic Model of decision-making provide the theoretical bases to consider, respectively, the interdependence of the dyadic decision-making and the mechanisms affecting the couple-based decision-making. Dyadic processes require also an appropriate data analysis strategy that is discussed in the study as well. Conclusions of the present critical review suggest to develop a new line of research on dyadic decision-making in the oncological domain, testing the Dyadic Model presented in the study and considering the interdependence of the data with appropriate levels of analysis.
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http://dx.doi.org/10.1159/000518596DOI Listing
November 2021

Maternal Psychological Distress and Children's Internalizing/Externalizing Problems during the COVID-19 Pandemic: The Moderating Role Played by Hypermentalization.

Int J Environ Res Public Health 2021 Oct 4;18(19). Epub 2021 Oct 4.

Department of Human and Social Sciences, University of Bergamo, Bergamo 24129, Italy.

In order to explore the psychological impact of the COVID-19 outbreak on the caregiver-child relationship, we investigated the interplay among COVID-19 exposure and children's internalizing/externalizing problems during the Italian lockdown, hypothesizing a mediation effect played by maternal distress. Additionally, we included maternal reflective functioning (i.e., hypermentalization) as a moderator factor among this interplay. A total of 305 Italian mothers of children aged 6-13 years ( = 10.3; = 2.4) filled in an online survey. Findings revealed an indirect effect of maternal COVID-19 exposure on children's anxious/depressed ( = 0.46) and attention problems ( = 0.32) via maternal distress. Hypermentalization moderated the impact of maternal COVID-19 exposure on children's anxious/depressed problems (β = -1.08, = 0.04). Hypermentalization moderated both the relation between maternal distress and children's aggressive behaviors (β = 12.226; < 0.001) and between maternal distress and children's attention problems (β = 5.617, < 0.001). We found pivotal significant effects of maternal hypermentalization on children's anxious/depressed and attention problems, indicating that the higher the mother's hypermentalization was, the higher the children's problems were. Our results broaden what we knew on the role of maternal reflective and emotional functioning on children's emotional/behavioral adjustment during stressful situations.
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http://dx.doi.org/10.3390/ijerph181910450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507724PMC
October 2021

Key Determinants of Health-Related Quality of Life Among Advanced Lung Cancer Patients: A Qualitative Study in Belgium and Italy.

Front Pharmacol 2021 23;12:710518. Epub 2021 Sep 23.

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.

The lung cancer (LC) treatment landscape has drastically expanded with the arrival of immunotherapy and targeted therapy. This new variety of treatment options, each with its own characteristics, raises uncertainty regarding the key aspects affecting patients' health-related quality of life (HRQL). The present qualitative study aimed to investigate how LC patients perceive their HRQL and the factors that they consider to be most influential in determining their HRQL. This qualitative research incorporates four focus group discussions, with six LC patients in each group. In total, 24 stage III and IV LC patients were included in the discussions, with Italian ( = 12) and Belgian ( = 12) patients, age range: 42-78, median age = 62 (IQR = 9.3 years), SD = 8.5; 62% men. Using thematic analysis, transcripts and notes from the FGDs were analyzed using NVivo software (edition 12). Three main themes capturing determinants of HRQL were identified. First, patients agreed on the importance of physical aspects (symptoms and side-effects) in determining their HRQL. In particular, skin conditions, nausea, fatigue, risk of infections, sensory abnormalities, pain, and changes in physical appearance were highlighted. Second, patients worried about psychological aspects, negatively impacting their wellbeing such as uncertainties regarding their future health state, and a lower degree of autonomy and independence. Third, patients underlined the importance of social aspects, such as communication with healthcare providers and social interaction with friends, family and peers. This study demonstrates that physical, psychological, and social aspects are key factors driving LC patients' HRQL. Gaining a better understanding of how LC patients perceive their HRQL and how it is affected by their illness and therapy will aid patient-centric decision-making across the drug life cycle, by providing stakeholders (drug developers, regulators, reimbursement bodies, and clinicians) insights about the treatment and disease aspects of importance to LC patients as well as the unmet needs LC patients may have regarding available treatment modalities. Finally, this study underscores a need for individual treatment decision-making that is considerate of uncertainties among LC patients about their future health state, and ways for improving communication between healthcare providers and patients to do so.
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http://dx.doi.org/10.3389/fphar.2021.710518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494945PMC
September 2021

Patient Preferences for Lung Cancer Treatments: A Study Protocol for a Preference Survey Using Discrete Choice Experiment and Swing Weighting.

Front Med (Lausanne) 2021 2;8:689114. Epub 2021 Aug 2.

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.

Advanced treatment options for non-small cell lung cancer (NSCLC) consist of immunotherapy, chemotherapy, or a combination of both. Decisions surrounding NSCLC can be considered as preference-sensitive because multiple treatments exist that vary in terms of mode of administration, treatment schedules, and benefit-risk profiles. As part of the IMI PREFER project, we developed a protocol for an online preference survey for NSCLC patients exploring differences in preferences according to patient characteristics (preference heterogeneity). Moreover, this study will evaluate and compare the use of two different preference elicitation methods, the discrete choice experiment (DCE) and the swing weighting (SW) task. Finally, the study explores how demographic (i.e., age, gender, and educational level) and clinical (i.e., cancer stage and line of treatment) information, health literacy, health locus of control, and quality of life may influence or explain patient preferences and the usefulness of a digital interactive tool in providing information on preference elicitation tasks according to patients. An online survey will be implemented with the aim to recruit 510 NSCLC patients in Belgium and Italy. Participants will be randomized 50:50 to first receive either the DCE or the SW. The survey will also collect information on participants' disease-related status, health locus of control, health literacy, quality of life, and perception of the educational tool. This protocol outlines methodological and practical steps to quantitatively elicit and study patient preferences for NSCLC treatment alternatives. Results from this study will increase the understanding of which treatment aspects are most valued by NSCLC patients to inform decision-making in drug development, regulatory approval, and reimbursement. Methodologically, the comparison between the DCE and the SW task will be valuable to gain information on how these preference methods perform against each other in eliciting patient preferences. Overall, this protocol may assist researchers, drug developers, and decision-makers in designing quantitative patient preferences into decision-making along the medical product life cycle.
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http://dx.doi.org/10.3389/fmed.2021.689114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8365300PMC
August 2021

Emotional Expression in Children With ASD: A Pre-Study on a Two-Group Pre-Post-Test Design Comparing Robot-Based and Computer-Based Training.

Front Psychol 2021 21;12:678052. Epub 2021 Jul 21.

Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Several studies have found a delay in the development of facial emotion recognition and expression in children with an autism spectrum condition (ASC). Several interventions have been designed to help children to fill this gap. Most of them adopt technological devices (i.e., robots, computers, and avatars) as social mediators and reported evidence of improvement. Few interventions have aimed at promoting emotion recognition and expression abilities and, among these, most have focused on emotion recognition. Moreover, a crucial point is the generalization of the ability acquired during treatment to naturalistic interactions. This study aimed to evaluate the effectiveness of two technological-based interventions focused on the expression of basic emotions comparing a robot-based type of training with a "hybrid" computer-based one. Furthermore, we explored the engagement of the hybrid technological device introduced in the study as an intermediate step to facilitate the generalization of the acquired competencies in naturalistic settings. A two-group pre-post-test design was applied to a sample of 12 children (M = 9.33; ds = 2.19) with autism. The children were included in one of the two groups: group 1 received a robot-based type of training ( = 6); and group 2 received a computer-based type of training ( = 6). Pre- and post-intervention evaluations (i.e., time) of facial expression and production of four basic emotions (happiness, sadness, fear, and anger) were performed. Non-parametric ANOVAs found significant time effects between pre- and post-interventions on the ability to recognize sadness [ = 7.35, = 0.006; pre: M (ds) = 4.58 (0.51); post: M (ds) = 5], and to express happiness [ = 5.72, = 0.016; pre: M (ds) = 3.25 (1.81); post: M (ds) = 4.25 (1.76)], and sadness [ = 10.89, < 0; pre: M (ds) = 1.5 (1.32); post: M (ds) = 3.42 (1.78)]. The grouptime interactions were significant for fear [ = 1.019, = 0.03] and anger expression [ = 1.039, = 0.03]. However, Mann-Whitney comparisons did not show significant differences between robot-based and computer-based training. Finally, no difference was found in the levels of engagement comparing the two groups in terms of the number of voice prompts given during interventions. Albeit the results are preliminary and should be interpreted with caution, this study suggests that two types of technology-based training, one mediated a humanoid robot and the other a pre-settled video of a peer, perform similarly in promoting facial recognition and expression of basic emotions in children with an ASC. The findings represent the first step to generalize the abilities acquired in a laboratory-trained situation to naturalistic interactions.
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http://dx.doi.org/10.3389/fpsyg.2021.678052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8334177PMC
July 2021

A longitudinal application of the Actor Partner Interdependence Model extended Mediations to the health effects of dyadic support.

PLoS One 2021 19;16(7):e0254716. Epub 2021 Jul 19.

Faculty of Communication, Culture and Society, Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland.

Supportive communicative experiences within close relationships, such as dyadic support, have a protective effect on individuals' health and emotional well-being. However, little is known about how partners interact in determining their own and others' health or the mechanisms through which dyadic support influences physical health. We addressed those gaps by studying 1088 romantic couples from three consecutive years (T1, T2, T3; Swiss Household Panel). The study applied a data analysis strategy called Actor Partner Interdependence Model extended Mediation, which allows for mediation processes while considering the interdependence, or non-independence, of data coming from partners. Results showed that dyadic support was positively associated with perceived health over two years through the mediation of optimistic attitudes and depressive mood, both for person and partner effects. The present study demonstrates the interplay between the dyadic process and personality dispositions in maintaining good health.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254716PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289016PMC
November 2021

Psychological Impact of COVID-19 Outbreak on Families of Children with Autism Spectrum Disorder and Typically Developing Peers: An Online Survey.

Brain Sci 2021 Jun 18;11(6). Epub 2021 Jun 18.

Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy.

Background: When COVID-19 was declared as a pandemic, many countries imposed severe lockdowns that changed families' routines and negatively impacted on parents' and children's mental health. Several studies on families with children with autism spectrum disorder (ASD) revealed that lockdown increased the difficulties faced by individuals with ASD, as well as parental distress. No studies have analyzed the interplay between parental distress, children's emotional responses, and adaptive behaviors in children with ASD considering the period of the mandatory lockdown. Furthermore, we compared families with children on the spectrum and families with typically developing (TD) children in terms of their distress, children's emotional responses, and behavioral adaptation.

Methods: In this study, 120 parents of children aged 5-10 years (53 with ASD) participated.

Results: In the four tested models, children's positive and negative emotional responses mediated the impact of parental distress on children's playing activities. In the ASD group, parents reported that their children expressed more positive emotions, but fewer playing activities, than TD children. Families with children on the spectrum reported greater behavioral problems during the lockdown and more parental distress.

Conclusions: Our findings inform the interventions designed for parents to reduce distress and to develop coping strategies to better manage the caregiver-child relationship.
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http://dx.doi.org/10.3390/brainsci11060808DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235600PMC
June 2021

Affective empathy predicts self-isolation behaviour acceptance during coronavirus risk exposure.

Sci Rep 2021 05 12;11(1):10153. Epub 2021 May 12.

Cantonal Sociopsychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino, Mendrisio, Switzerland.

Health risk exposure during the global COVID-19 pandemic has required people to adopt self-isolation. Public authorities have therefore had the difficult task of sustaining such protective but stressful behaviour. Evidence shows that besides egoistic drives, the motivation for self-isolation behaviour could be altruistic. However, the type and role of prosocial motivation in the current pandemic is underestimated and its interaction with risk exposure and psychological distress is largely unknown. Here we show that affective empathy for the most vulnerable predicts acceptance of lockdown measures. In two retrospective studies, one with a general population and one with COVID-19 positive patients, we found that (1) along with health risk exposure, affective empathy is a predictor of acceptance of lockdown measures (2) social covariates and psychological distress have no significant impact. Our results support the need to focus on altruistic behaviours while informing the public instead of on fear-inducing messages.
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http://dx.doi.org/10.1038/s41598-021-89504-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115029PMC
May 2021

A Breast Cancer Smartphone App to Navigate the Breast Cancer Journey: Mixed Methods Study.

JMIR Form Res 2021 May 10;5(5):e28668. Epub 2021 May 10.

Department of Obstetrics and Gynecology, Centro di Senologia della Svizzera Italiana, Ente Ospedaliero Cantonale, Viganello, Switzerland.

Background: Several mobile apps have been designed for patients with a diagnosis of cancer. Unfortunately, despite the promising potential and impressive spread, their effectiveness often remains unclear. Most mobile apps are developed without any medical professional involvement and quality evidence-based assessment. Furthermore, they are often implemented in clinical care before any research is performed to confirm usability, appreciation, and clinical benefits for patients.

Objective: We aimed to develop a new smartphone app (Centro di Senologia della Svizzera Italiana [CSSI]) specifically designed by breast care specialists and patients together to help breast cancer patients better understand and organize their journey through the diagnosis and treatment of cancer. We describe the development of the app and present assessments to evaluate its feasibility, usefulness, and capability to improve patient empowerment.

Methods: A mixed method study with brief longitudinal quantitative data collection and subsequent qualitative semistructured interviews was designed. Twenty breast cancer patients participated in the study (mean age 51 years, SD 10 years). The usability of the app, the user experience, and empowerment were measured after 1 month. The semistructured interviews measured the utility of the app and the necessary improvements.

Results: The app received good responses from the patients in terms of positive perception of the purpose of the app (7/20, 35%), organizing the cure path and being aware of the steps in cancer management (5/20, 25%), facilitating doctor-patient communication (4/20, 20%), and having detailed information about the resources offered by the hospital (2/20, 10%). Correlation and regression analyses showed that user experience increased the level of empowerment of patients (B=0.31, 95% CI 0.22-0.69; P=.009). The interviews suggested the need to constantly keep the app updated and to synchronize it with the hospital's electronic agenda, and carefully selecting the best time to offer the tool to final users was considered crucial.

Conclusions: Despite the very small number of participants in this study, the findings demonstrate the potential of the app and support a fully powered trial to evaluate the empowering effect of the mobile health app. More data will be gathered with an improved version of the app in the second phase involving a larger study sample.
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http://dx.doi.org/10.2196/28668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145088PMC
May 2021

The Relationship between Social Anxiety, Smartphone Use, Dispositional Trust, and Problematic Smartphone Use: A Moderated Mediation Model.

Int J Environ Res Public Health 2021 03 2;18(5). Epub 2021 Mar 2.

Faculty of Communication, Culture and Society, Università della Svizzera italiana, 6900 Lugano, Switzerland.

Background: The pervasiveness of smartphones has raised concerns about an increase in the prevalence of problematic smartphone use (PSU), which depends on a set of psychological and behavioral risk factors. Previous research has yielded mixed results on factors predicting PSU, including social anxiety and trust. In particular, the role of trust remained largely unexplored. In the present study, we aimed to investigate the relationship between social anxiety and PSU, via the mediating role of time spent on the phone, and to explore the moderating role of dispositional trust toward others, by using a moderated mediation model with PSU as the outcome.

Methods: A total of 240 young adults (M = 23.33, SD = 3.90, 50% male) answered an online questionnaire, which included the 12-item Social Anxiety Scale, a question on the daily duration of smartphone use, a single-item measure of dispositional trust, and the 10-item Smartphone Addiction Scale Short Version. Gender and occupational status were included as covariates.

Results: Social anxiety was significantly and positively related to PSU; however, smartphone use did not mediate this relationship. Although the relationship between smartphone use and PSU was significant and positive, the link between social anxiety and smartphone use was not. Dispositional trust moderated and strengthened the direct relationships between social anxiety and PSU as well as smartphone use and PSU.

Conclusions: Heavy smartphone users as well as socially anxious individuals, with the tendency of trusting others, are more at risk of PSU, which can be explained by their preference and search for online connections.
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http://dx.doi.org/10.3390/ijerph18052452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967585PMC
March 2021

What Matters Most to Lung Cancer Patients? A Qualitative Study in Italy and Belgium to Investigate Patient Preferences.

Front Pharmacol 2021 4;12:602112. Epub 2021 Mar 4.

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.

The potential value of patient preference studies has been recognized in clinical individual treatment decision-making between clinicians and patients, as well as in upstream drug decision-making. Drug developers, regulators, reimbursement and Health Technology Assessment (HTA) bodies are exploring how the use of patient preference studies could inform drug development, regulatory benefit risk-assessment and reimbursement decisions respectively. Understanding patient preferences may be especially valuable in decisions regarding Non-Small Cell Lung Cancer (NSCLC) treatment options, where a variety of treatment options with different characteristics raise uncertainty about which features are most important to NSCLC patients. As part of the Innovative Medicines Initiative PREFER project, this qualitative study aimed to identify patient-relevant lung cancer treatment characteristics. This study consisted of a scoping literature review and four focus group discussions, 2 in Italy and 2 in Belgium, with a total of 24 NSCLC patients (Stages III-IV). The focus group discussions sought to identify which treatment characteristics patients find most relevant. The discussions were analyzed thematically using a thematic inductive analysis. Patients highlighted themes reflecting: 1) positive effects or expected gains from treatment such as greater life expectancy and maintenance of daily functioning, 2) negative effects or adverse events related to therapy that negatively impact patients' daily functioning such as fatigue and 3) uncertainty regarding the duration and type of treatment effects. These overarching themes were consistent among patients from Belgium and Italy, suggesting that treatment aspects related to efficacy and safety as well as the psychological impact of lung cancer treatment are common areas of concern for patients, regardless of cultural background or country. Our findings illustrate the value of using qualitative methods with patients to identify preferred treatment characteristics for advanced lung cancer. These could inform a subsequent quantitative preference survey that assesses patient trade-offs regarding treatment options.
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http://dx.doi.org/10.3389/fphar.2021.602112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970036PMC
March 2021

Influence of Empathy Disposition and Risk Perception on the Psychological Impact of Lockdown During the Coronavirus Disease Pandemic Outbreak.

Front Public Health 2020 20;8:567337. Epub 2021 Jan 20.

Department of Internal Medicine and Nephrology, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

During the current COVID-19 pandemic, and especially in the absence of availability of an effective treatment or a vaccine, the main health measure is neither chemical nor biological, but behavioral. To reduce the exponential growth of infections due to the new coronavirus (SARS-CoV-2) and the resulting overburdening of the healthcare system, many European Countries, parts of the US and Switzerland gradually implemented measures of quarantine and isolation defined as lockdown. This consideration leads to the need to understand how individuals are motivated to protect themselves and others. Recent research suggested that prosocial mental dispositions, such as empathy, might promote adherence to social norms of distancing. Other research conducted during the COVID-19 outbreak indicates, however, that empathy levels might fluctuate according to anxiety linked to the risk of death, and this negatively predicted prosocial willingness. The present protocol proposes a study on whether people's empathic dispositions, interacting with the levels of risk, influence the psychological impact of lockdown. The rationale is that emphatic dispositions, encouraging the acceptance of the lockdown, determine a better psychological adaptation and less distress. One retrospective study will be developed in Switzerland and, if the pandemic conditions force a new wave of lockdown on the population, one prospective study as well. A total of 120 participants will be involved, distinguished by their level of objective risk: (1) high objective risk (COVID-19 positive patients, hospitalized in isolation in post-acute phase); (2) moderate objective risk (COVID-19 positive patients, isolated at home); (3) minimum objective risk (non-positive adults, in lockdown). Measures of perceived risk of being contagious for third parties, empathic dispositions and acceptance of lockdown will be collected. The expected results provide important answers related to the immediate impact of empathic dispositions, effective risk and risk perception on the psychological impact of lockdown during a pandemic outbreak. Data gathered from this study could inform policy makers and public health managers about the best communication strategies that will take into account the various stages of health risk and, in particular, to modulate messages to the population aimed at inducing self-isolation behaviors.
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http://dx.doi.org/10.3389/fpubh.2020.567337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855966PMC
February 2021

Effects of Objective and Subjective Health Literacy on Patients' Accurate Judgment of Health Information and Decision-Making Ability: Survey Study.

J Med Internet Res 2021 01 21;23(1):e20457. Epub 2021 Jan 21.

Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland.

Background: Interpreting health information and acquiring health knowledge have become more important with the accumulation of scientific medical knowledge and ideals of patient autonomy. Health literacy and its tremendous success as a concept can be considered an admission that not all is well in the distribution of health knowledge. The internet makes health information much more easily accessible than ever, but it introduces its own problems, of which health disinformation is a major one.

Objective: The objective of this study was to determine whether objective and subjective health literacy are independent concepts and to test which of the two was associated more strongly with accurate judgments of the quality of a medical website and with behavioral intentions beneficial to health.

Methods: A survey on depression and its treatments was conducted online (n=362). The Newest Vital Sign was employed to measure objective, performance-based health literacy, and the eHealth Literacy Scale was used to measure subjective, perception-based health literacy. Correlations, comparisons of means, linear and binary logistic regression, and mediation models were used to determine the associations.

Results: Objective and subjective health literacy were weakly associated with one another (r=0.06, P=.24). High objective health literacy levels were associated with an inclination to behave in ways that are beneficial to one's own or others' health (Exp[B]=2.068, P=.004) and an ability to recognize low-quality online sources of health information (β=-.4698, P=.005). The recognition also improved participants' choice of treatment (β=-.3345, P<.001). Objective health literacy helped people to recognize misinformation on health websites and improved their judgment on their treatment for depression.

Conclusions: Self-reported, perception-based health literacy should be treated as a separate concept from objective, performance-based health literacy. Only objective health literacy appears to have the potential to prevent people from becoming victims of health disinformation.
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http://dx.doi.org/10.2196/20457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861996PMC
January 2021

Maternal Distress/Coping and Children's Adaptive Behaviors During the COVID-19 Lockdown: Mediation Through Children's Emotional Experience.

Front Public Health 2020;8:587833. Epub 2020 Nov 19.

Department of History, Society, and Human Studies, University of Salento, Lecce, Italy.

The present study focused on the psychological impact that the lockdown due to coronavirus disease-19 (COVID-19) had on families in Italy. During the COVID-19 pandemic, the Italian government imposed a strict lockdown for all citizens. People were forced to stay at home, and the length of the lockdown was uncertain. Previous studies analyzed the impact of social distance measures on individuals' mental health, whereas few studies have examined the interplay between the adults' functioning, as parents, during this period and the association with the child's adjustment. The present study tested if maternal distress/coping predicts children's behaviors during the COVID-19 lockdown, hypothesizing a mediation effect children's emotional experience. Participants were 144 mothers ( = 39.3, 25-52, = 5.6) with children aged 5-10 years ( = 7.54, = 1.6, 82 boys); mothers answered to an online survey. Results indicated that mothers with higher exposure to COVID-19 showed higher levels of distress and higher display of coping attitudes, even if in the structural equation modeling model, the COVID-19 exposure was not a predictor of mothers' distress. Compared with mothers with good coping skills, mothers with higher stress levels were more likely to attribute negative emotions to their children at the expense of their positive emotions. Moreover, children's emotions acted as mediators between maternal distress/coping and children's adaptive/maladaptive behaviors. In conclusion, it is important to support parents during pandemic emergence, by providing them with adequate information to manage the relationship with their children, to reduce their level of distress and to enhance their coping abilities.
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http://dx.doi.org/10.3389/fpubh.2020.587833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711130PMC
January 2021

Effects of Self-Mastery on Adolescent and Parental Mental Health through the Mediation of Coping Ability Applying Dyadic Analysis.

Behav Sci (Basel) 2020 Nov 27;10(12). Epub 2020 Nov 27.

Faculty of Communication, Culture and Society, Institute of Communication and Health, Università della Svizzera italiana, Lab Building, Via Buffi 13, 6900 Lugano, Switzerland.

Evidence demonstrated that self-mastery and coping ability predict mental health in adults and children. However, there is a lack of research analyzing the relationships between those constructs in parents and children. Self-report data from 89 dyads (adolescents' mean of age = 14.47, SD = 0.50; parents' mean of age = 47.24, SD = 4.54) who participated in waves 17, 18, and 19 (following T1, T2, and T3) of a nineteen-wave longitudinal study were analyzed using the Actor-Partner Interdependence Model's extended Mediation. Results showed significant actor effects of parents' and adolescents' self-mastery (T1) on mental health (T3) and the mediator effect of their coping abilities in managing stress (T2). Both a higher parental education level and being a mother positively influenced adolescents' coping ability. The mutually beneficial relationships between parents' and adolescents' self-mastery, coping ability, and mental health were not demonstrated. Self-mastery is a significant predictor of adolescents' and parents' mental health, and coping ability serves as a good mediator between them. Qualitative research may clarify reasons why partner effects in the model were found to be non-significant. Further research should re-test this model with a larger sample size during childhood, when parents provide significant behavioral models for their children-as well as in adolescence, considering the peer group-to develop guidelines for behavioral interventions.
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http://dx.doi.org/10.3390/bs10120182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761085PMC
November 2020

Bullying and Substance Use in Early Adolescence: Investigating the Longitudinal and Reciprocal Effects Over 3 Years Using the Random Intercept Cross-Lagged Panel Model.

Front Psychol 2020 5;11:571943. Epub 2020 Nov 5.

Faculty of Communication, Culture and Society, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland.

Bullying and substance use among adolescents have been increasingly studied in the field of developmental psychology, but research to date has primarily investigated the cross-sectional relationship and, to a lesser extent, the long-term impact of bullying on substance use. Grounded in the General Theory of Crime, this study focused on the longitudinal reciprocal relationships between bullying and substance use (i.e., smoking and alcohol consumption) during early to mid-adolescence, which is a critical developmental phase. We aimed to investigate the hypothesis of a reinforcing downward spiral at the within-person level. Moreover, we intended to examine gender differences in the expected longitudinal relationships. Our analyses are based on self-report data for bullying and substance use collected from 1,495 adolescents (746 males; = 12.42, = 0.58) at three waves between 2017 and 2019. We applied the random intercept cross-lagged panel model to separate within-person from between-person effects. At the between-person level, the mutual association between bullying and substance use, previously demonstrated in cross-sectional studies, was confirmed. At the within-person level, results provide evidence of a significant age-dependent change in bullying and substance use from 13 to 14 years old, where the significant increase in bullying could be attributed to females but not to males. We also found a gender-independent significant positive effect of bullying at 12 years old on substance use at 13 years, but not vice versa. Thus, the hypothesis of a reinforcing downward spiral, shown by significant positive reciprocal effects, did not find support. According to the General Theory of Crime, our findings underline that bullying can be considered a context-related factor inasmuch as it pushes adolescents to smoke and drink, which are both expressions of low levels of self-control, which need to be considered in intervention programs to effectively prevent unhealthy and risky behaviors in adolescence.
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http://dx.doi.org/10.3389/fpsyg.2020.571943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674280PMC
November 2020

Differentiating objective and subjective dimensions of social isolation and apprasing their relations with physical and mental health in italian older adults.

BMC Geriatr 2020 11 16;20(1):472. Epub 2020 Nov 16.

Institute of Communication and Health (ICH), Università della Svizzera italiana (USI), Via G. Buffi 13, 6900, Lugano, Switzerland.

Background: International research shows that social isolation is harmful for health, especially for the elderly. Its objective and subjective dimensions are important to distinguish as each stands in a different relation with health. The first aim of the present study is the validation of three scales measuring objective and subjective isolation in an Italian elderly population. The second aim is to analyze subjective and objective social isolation and to appraise their association with health among seniors.

Methods: This cross-sectional survey collected data from 306 over 65 s participants. Questionnaires were administered face-to-face by one author and encompassed: social disconnectedness scale; perceived isolation scale; abbreviated Lubben Social Network Scale; measures of general and mental health, and depression.

Results: The three scales measuring social isolation demonstrated acceptable psychometric properties and validity. Objective and subjective social isolation were not directly associated with physical health, whereas subjective isolation is strongly linked to worse mental health and depression. Higher level of subjective isolation was associated with lower level of physical health through the mediation of mental health. Subjective isolation served as a mediator in the relation between objective isolation and health. Moderation analysis demonstrated that low values of objective isolation predicted high values of mental health but only when subjective isolation was low. None of these relations were moderated by socio-demographic variables.

Conclusion: Subjective and objective isolation are clearly two separate dimensions and the scales validated in this paper showed to be potentially culturally invariant. Researchers should work to find instruments able to depict the complexity of the construct of social isolation.
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http://dx.doi.org/10.1186/s12877-020-01864-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670809PMC
November 2020

Application of the theory of regulatory fit to promote adherence to evidence-based breast cancer screening recommendations: experimental versus longitudinal evidence.

BMJ Open 2020 11 12;10(11):e037748. Epub 2020 Nov 12.

Institute of Communication & Health, Università della Svizzera italiana, Lugano, Switzerland.

Objectives: To reduce overtreatment caused by overuse of screening, it is advisable to reduce the demand for mammography screening outside the recommended guidelines among women who are not yet eligible for inclusion in systematic screening programmes. According to principles of regulatory fit theory, people make decisions motivated by either orientation to achieving and maximising gains or avoiding losses. A study developed in two phases investigated whether video messages, explaining the risks and benefits of mammography screening for those not yet eligible, are perceived as persuasive DESIGN: Phase 1 was an experimental study in which women's motivation orientation was experimentally induced and then they were exposed to a matching video message about mammography screening. A control group received a neutral stimulus. Phase 2 introduced a longitudinal component to study 1, adding a condition in which the messages did not match with the group's motivation orientation. Participants' natural motivation orientation was measured through a validated questionnaire PARTICIPANTS: 360 women participated in phase 1 and another 292 in phase 2. Participants' age ranged from 30 to 45 years, and had no history of breast cancer or known BReast CAncer gene (BRCA) 1/2 mutation.

Results: In phase 1, a match between participants' motivation orientation and message content decreased the intention to seek mammography screening outside the recommended guidelines. Phase 2, however, did not show such an effect. Fear of breast cancer and risk perception were significantly related to intention to seek mammography screening CONCLUSIONS: Public health researchers should consider reducing the impact of negative emotions (ie, fear of breast cancer) and risk perception when promoting adherence to evidence-based breast cancer screening recommendations.
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http://dx.doi.org/10.1136/bmjopen-2020-037748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7662420PMC
November 2020

The Criterion Validity of the First Year Inventory and the Quantitative-CHecklist for Autism in Toddlers: A Longitudinal Study.

Brain Sci 2020 Oct 13;10(10). Epub 2020 Oct 13.

Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy.

Pediatric surveillance through screening procedures is needed to detect warning signs of risk for Autism Spectrum Disorder under 24 months of age and to promote early diagnosis and treatment. The main purpose of this study is to extend the literature regarding the psychometric properties of two screening tools, the First Year Inventory (FYI) and the Quantitative-CHecklist for Autism in Toddler (Q-CHAT), testing their criterion validity. They were administered during a three-wave approach involving the general population. At T1, 657 children were tested with the FYI and 36 of them were found to be at risk. At T2, 545 were tested with the Q-CHAT and 29 of them were found to be at risk. At T3, 12 out of the 36 children with a high score on the FYI and 11 out of the 29 children with a high score on the Q-CHAT were compared to 15 typically developing children. The criterion validity was tested considering the severity of the autistic symptoms, emotional/behavioral problems, and limited global functioning as criteria. Accuracy parameters were also calculated. Furthermore, we investigated which dimension of each questionnaire better predicted the aforementioned criterion. The results corroborated the hypotheses and confirmed the criterion validity of FYI and Q-CHAT.
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http://dx.doi.org/10.3390/brainsci10100729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601960PMC
October 2020

"What you say and how you say it" matters: An experimental evidence of the role of synchronicity, modality, and message valence during smartphone-mediated communication.

PLoS One 2020 17;15(9):e0237846. Epub 2020 Sep 17.

Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland.

Nowadays, smartphone-Mediated Communication (SMC) has become a popular form of social interactions. The present experimental study manipulated three aspects of messaging in a WhatsApp chat as a form of SMC: synchronicity (immediate vs. time-lagged response), modality (with or without emojis), and valence (empathic accurate vs. empathic inaccurate response). The aim of this study was to investigate whether these three aspects had an impact on perceived social support, interpersonal trust, and personality attribution of the communication partner. The partial mediation of perceived social presence (the evaluation of the communication partner's accessibility) and subjective social presence (the perception of being concordant with him/her) was also examined. Participants were 160 young adults, balanced in gender. They were randomly assigned to different the experimental conditions where they engaged in a manipulated WhatsApp chat with a fictitious same-gender communication partner. Post-questionnaire data were analyzed using Structural Equation Modeling. Message valence (empathic accurate response) and modality (with emojis) significantly predicted higher levels of both forms of social presence. Synchronicity (immediate response) predicted higher levels of perceived but not subjective social presence. Social presence, in turn, was positively associated with social support, while subjective, but not perceived social presence, was positively associated with personality attribution. Neither perceived nor subjective social presence were related to interpersonal trust. Our results show that both what is said and how it is said impact the experience of interpersonal relations in SMC.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237846PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497981PMC
October 2020

Hereditary Gastric and Breast Cancer Syndromes Related to CDH1 Germline Mutation: A Multidisciplinary Clinical Review.

Cancers (Basel) 2020 Jun 17;12(6). Epub 2020 Jun 17.

Division of Cancer Prevention and Genetics, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20141 Milan, Italy.

E-cadherin (CDH1 gene) germline mutations are associated with the development of diffuse gastric cancer in the context of the so-called hereditary diffuse gastric syndrome, and with an inherited predisposition of lobular breast carcinoma. In 2019, the international gastric cancer linkage consortium revised the clinical criteria and established guidelines for the genetic screening of CDH1 germline syndromes. Nevertheless, the introduction of multigene panel testing in clinical practice has led to an increased identification of E-cadherin mutations in individuals without a positive family history of gastric or breast cancers. This observation motivated us to review and present a novel multidisciplinary clinical approach (nutritional, surgical, and image screening) for single subjects who present germline CDH1 mutations but do not fulfil the classic clinical criteria, namely those identified as-(1) incidental finding and (2) individuals with lobular breast cancer without family history of gastric cancer (GC).
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http://dx.doi.org/10.3390/cancers12061598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352390PMC
June 2020

Theory of Mind as a Mediator Between Emotional Trust Beliefs and Interpersonal Communication Competence in a Group of Young Adults.

Psychol Rep 2021 Apr 4;124(2):555-576. Epub 2020 Apr 4.

Department of History, Society, and Human Studies, University of Salento, Lecce, Italy; Lab of Applied Psychology and Intervention, University of Salento, Lecce, Italy.

Research has provided direct and indirect evidence of associations between trust beliefs and social-perceptual theory of mind (ToM) and between social-perceptual ToM and interpersonal communication competence during childhood and adolescence. This research (a) developed a scale for evaluating trust beliefs in young Italian adults (Study 1) and (b) examined how social-perceptual ToM mediates the relationship between emotional trust beliefs and interpersonal communication competences such as assertiveness and empathy (Study 2). In Study 1, a sample of 168 university students ( = 23.3,  = 3 months) completed the Italian Adults' Generalized Trust Beliefs (AGTB) scale and two second-order false beliefs tasks. In Study 2, 318 Italian university students ( = 22.96 years,  = 2 months) completed the AGTB scale, the Experiences in Close Relationships-Revised questionnaire, the Reading the Mind in the Eyes Test, and items measuring assertiveness and empathy. As expected, the AGTB scale exhibited acceptable internal consistency, structural validity, and construct validity. Furthermore, path analysis confirmed the existence of the hypothesized paths between adults' emotional trust beliefs, social-perceptual ToM, assertiveness, and empathy. This study also identified the effects of gender on the other variables, but sex did not moderate the relationships between variables.
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http://dx.doi.org/10.1177/0033294120913489DOI Listing
April 2021

Systematic Review of Level 1 and Level 2 Screening Tools for Autism Spectrum Disorders in Toddlers.

Brain Sci 2020 Mar 19;10(3). Epub 2020 Mar 19.

Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy.

The present study provides a systematic review of level 1 and level 2 screening tools for the early detection of autism under 24 months of age and an evaluation of the psychometric and measurement properties of their studies. Methods: Seven databases (e.g., Scopus, EBSCOhost Research Database) were screened and experts in the autism spectrum disorders (ASD) field were questioned; Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and Consensus-based Standard for the selection of health Measurement INstruments (COSMIN) checklist were applied. Results: the study included 52 papers and 16 measures; most of them were questionnaires, and the Modified-CHecklist for Autism in Toddler (M-CHAT) was the most extensively tested. The measures' strengths (analytical evaluation of methodological quality according to COSMIN) and limitations (in term of Negative Predictive Value, Positive Predictive Value, sensitivity, and specificity) were described; the quality of the studies, assessed with the application of the COSMIN checklist, highlighted the necessity of further validation studies for all the measures. According to COSMIN results, the M-CHAT, First Years Inventory (FYI), and Quantitative-CHecklist for Autism in Toddler (Q-CHAT) seem to be promising measures that may be applied systematically by health professionals in the future.
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http://dx.doi.org/10.3390/brainsci10030180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139816PMC
March 2020

Early Screening of the Autism Spectrum Disorders: Validity Properties and Cross-Cultural Generalizability of the First Year Inventory in Italy.

Brain Sci 2020 Feb 18;10(2). Epub 2020 Feb 18.

Department of History, Society and Human Studies, Department of History, Society and Human Studies, University of Salento,Via di Valesio, 73100 Lecce, Italy.

This study examined the cross-cultural generalisability of the First Year Inventory (FYI) on an Italian sample, testing its construct validity, consistency, and structural validity. Six hundred ninety-eight parents of children aged 11-13 months completed the questionnaire. Similarities between analyses of Italian and American/Israeli samples were found, as were demonstrations of the instrument's construct validity and internal consistency with both groups. The original factorial structure was not demonstrated; thus, a new factorial structure was tested, and a short version of the FYI was demonstrated via confirmatory factor analysis. The findings supported the generalisability of the Italian version of the FYI and its validity. The FYI may aid in medical decision-making on further steps for referral of the child to an early diagnostic assessment.
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http://dx.doi.org/10.3390/brainsci10020108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071436PMC
February 2020

Computational Assessment of Facial Expression Production in ASD Children.

Sensors (Basel) 2018 Nov 16;18(11). Epub 2018 Nov 16.

Dipartimento di Storia, University of Salento, Società e Studi Sull' Uomo, Studium 2000-Edificio 5-Via di Valesio, 73100 Lecce, Italy.

In this paper, a computational approach is proposed and put into practice to assess the capability of children having had diagnosed Autism Spectrum Disorders (ASD) to produce facial expressions. The proposed approach is based on computer vision components working on sequence of images acquired by an off-the-shelf camera in unconstrained conditions. Action unit intensities are estimated by analyzing local appearance and then both temporal and geometrical relationships, learned by Convolutional Neural Networks, are exploited to regularize gathered estimates. To cope with stereotyped movements and to highlight even subtle voluntary movements of facial muscles, a personalized and contextual statistical modeling of non-emotional face is formulated and used as a reference. Experimental results demonstrate how the proposed pipeline can improve the analysis of facial expressions produced by ASD children. A comparison of system's outputs with the evaluations performed by psychologists, on the same group of ASD children, makes evident how the performed quantitative analysis of children's abilities helps to go beyond the traditional qualitative ASD assessment/diagnosis protocols, whose outcomes are affected by human limitations in observing and understanding multi-cues behaviors such as facial expressions.
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http://dx.doi.org/10.3390/s18113993DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6263710PMC
November 2018

A longitudinal investigation of trust beliefs in physicians by children with asthma and their mothers: Relations with children's adherence to medical regimes and quality of life.

Child Care Health Dev 2018 11 15;44(6):879-884. Epub 2018 Aug 15.

Institute of Communication and Health, Università della Svizzera Italiana, Lugano, Switzerland.

Objective: The study examined the relations between trust beliefs in physicians, adherence to prescribed medical regimes, and quality of life for children with asthma and their mothers.

Methods: One hundred forty-three children with asthma (116 males, M = 12 years-7 months) and their mothers were tested twice (Time 1/T1 and Time 2/T2) across a 1-year period. Standardized measures were administered that assessed the children's and mothers' trust beliefs in physicians, the children's quality of life, and children's adherence to prescribed medical regimes (adherence).

Results: Correlations were found between children's trust beliefs in physicians, mothers' trust beliefs in physicians, adherence, and quality of life. Structural equation modelling analyses confirmed that (a) children's trust beliefs in physicians predicted their adherence and quality of life and (b) there were reciprocal predictive relations between the children's and mothers' trust beliefs in physicians.

Conclusions: The findings yield support for the conclusions that (a) trust beliefs in physicians by children with asthma promote their adherence and quality of life and (b) socialization of trust beliefs in physicians is a mutual mother-child process.
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http://dx.doi.org/10.1111/cch.12604DOI Listing
November 2018

Measurement invariance of the Short Wake Forest Physician Trust Scale and of the Health Empowerment Scale in German and French women.

J Health Psychol 2020 03 10;25(4):558-569. Epub 2017 Aug 10.

Università della Svizzera Italiana, Switzerland.

Measurement invariance is a crucial prerequisite to carry out cross-cultural research and to provide knowledge that enables culturally diverse patients to feel comfortable with their health providers. Although trust in doctors and health empowerment are widely studied, no previous research has examined their measurement invariance. The Short Wake Forest Physician Trust scale and the Health Empowerment scale were administered online. Participants were 217 German-speaking women ( = 39.07, standard deviation = 5.71) and 217 French-speaking women ( = 39.11, standard deviation = 5.82). Demonstration of partial scalar invariance was met and reasons for non-invariant items are discussed. The study was evaluated applying COnsensus-based Standards for the selection of health status Measurement INstruments checklist.
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http://dx.doi.org/10.1177/1359105317719582DOI Listing
March 2020
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