This study utilised secondary data from a larger study that looked at individuals that are already infected by HIV which is entitled Implicative personal dilemmas and cognitive conflicts in health decision making in HIV positive adults and adults with AIDS. The primary aim of the larger study was to examine the cognitive construction of the individual and how they utilised their individual resources to construct who they are and how they perceived the difficulties and challenges that they face and the decisions they make regarding their health. HIV and AIDS is a debilitating disease and it affects millions worldwide. South Africa, presently, has the largest burden of this disease with those between the ages of 15 – 49 years of age being most affected. As previously mentioned the decisions that individuals make can impact on their health. Decisions to take necessary precautions such as protected sex during sexual intercourse can decrease the progression of the disease. Decisions made regarding abstinence of risky behaviour as well as being committed to taking medication could also positively impact health. People living with HIV and AIDS find it difficult to adjust to the challenges that this disease presents. Depression is often experienced due to the changes in self image and perception. Studies show that females are twice more likely to experience depression than men. There has however been no conclusive evidence showing the reason for this, however, the perception of stress based on gender could shed some light on this matter and how these perceptions can increase the likelihood of women being more vulnerable to depression. Due to the limitation of this study, it will only look at depression as it relates to HIV and AIDS. Psychological problems such as depression can hamper the adjustment process and the effect of depression is evident in that it can lower the CD 4 + cells. Not only are those living with HIV and AIDS affected by depression, but they also have a lifetime prevalence to depression. It is important to have an effective screening tool for depression so that the detection of this disease can be made and effective treatment can be implemented to enhance health. The sample consisted of 113 adult participants that have already been diagnosed with HIV and AIDS. The primary aim of this study was to compare the Beck’s Depression Inventory II (BDI II) and the Hospital Anxiety and Depression Scale –(the Depression component) (HADS-D) as a screening tool for depression.Exploratory Factor Analysis revealed a 5 factor structure which accounted for 60.14 % of the total variance. The HADS yielded one factor accounting for 14.33% of total variance. The BDI II has proven to be more a reliable measure of depression with 0.89 according to the Cronbach’s Alpha co efficient opposed to 0.375 as per the HADS-D. The secondary aim was to establish the sociodemographic and disease profiles of the participants under study. / Magister Psychologiae - MPsych

Introdução: O comprometimento cognitivo (CC) na Esclerose Múltipla (EM) possui taxas de prevalência de 43% a 70% e pode surgir desde a Síndrome Clinicamente Isolada (CIS) aos estágios iniciais da EM. O CC na EM pode evoluir independentemente dos sinais e sintomas motores, dos resultados do EDSS e ausência de lesões ativas (captantes) na Ressonância Magnética. Neste contexto, o Multiple Sclerosis National Questionaire (MSNQ) e o protocolo Brief International Cognitive Assesment for Multiple Sclerosis (BICAMS) são instrumentos internacionais empregados para a triagem e o monitoramento nos centros de atendimento para os pacientes com EM. Estudos posteriores e reuniões do mesmo comitê concluíram que o MSNQ possui várias limitações por ser uma medida não objetiva e a triagem única pelo Symbol Digit Modalities Test (SDMT) por si só não é capaz de acessar outras áreas que podem estar comprometidas na EM. Com a segunda revisão do MMSE, e na falta de instrumentos de triagem objetivos capazes de triar os pacientes que precisassem ser melhor acompanhados pelo BICAMS, buscou-se no presente estudo criar a partir do BICAMS e do MMSE-2 uma medida rápida para triagem, que tivesse medidas de memória episódica, velocidade de processamento, atenção e memória operacional. Objetivo: Para obter uma ferramenta de triagem para este propósito (MMSE-MS) foram conduzidos estudos de adaptação segundo o estímulo: estudo de protótipos, estudo de adaptação, propriedades psicométricas e normas do MMSE-2 (como a nossa ferramenta experimental) e estudo preliminar de desenvolvimento de uma ferramenta objetiva de triagem para EM, com base no MMSE-3. Métodos: Todos os estudos de tradução e adaptação foram conduzidos seguindo um mesmo método, já amplamente utilizado pela literatura. O primeiro estudo consistiu no estudo convencional e de protótipos para verificar qual possuía melhor estimativa de equivalência entre as culturas. O segundo estudo consistiu em adaptar, verificar as propriedades psicométricas e estabelecer normas para o MMSE-2. Similarmente ao estudo anterior, um juiz internacional discutiu os resultados do estudo de adaptação para estabelecimento dos parâmetros de transculturalidade. O último estudo foi realizado com o objetivo de obter uma ferramenta com estimativas de sensibilidade e especificidade similares ao BICAMS, mas que fosse designada à triagem dos pacientes que são elegíveis para ser acompanhados pelo BICAMS. Para tal participaram do primeiro estudo, 374 voluntários da comunidade e 25 pacientes com EM. No segundo e terceiro estudo, participaram 128 pacientes com EM e 602 voluntários saudáveis. Todos os estudos clínicos e com as amostras da comunidade foram realizados no período de 2013 à 2015 e contaram com a parceria em pesquisa do Instituto Brasileiro de Neuropsicologia (IBNeuro) e do Laboratório de Instrumentação e Avaliação Psicológica (LABIAP). A coleta de pacientes foi realizada no Ambulatório de Neuroimunologia do Hospital das clínicas da Faculdade de Medicina de Ribeirão Perto (FMRP-USP). Resultados: No primeiro estudo, foram mantidas 5 palavras das 15 da versão original. A razão para as modificações na lista Brasileira foram as diferenças entre a divisão silábica, extensão das palavras e presença de protótipos. Verificou-se ainda que até a quarta palavra evocada na nossa cultura em cada categoria semântica foram as mesmas que foram evocadas na língua nativa do instrumento, mas a ordem da frequência variou dentro de cada categoria, mostrando que embora existam palavras que são prototípicas às duas culturas na classificação semântica global, o contexto cultural interfere muito quando partimos para as especificidades dentro de cada classificação e categoria semântica. O MMSE-2 também apresentou estimativas de validade e precisão comum às duas culturas. No quarto estudo, as medidas do MMSE-2 que tiveram melhor relação com o BICAMS e índices de sensibilidade e especificidade parecidos foram as medidas da tarefa de evocação, atenção e cálculo, memória de histórias e codificação dígitos-símbolos. As correlações selecionadas foram aquelas classificadas em moderadas e fortes. Como segundo critério, as medidas do MMSE-2 foram comparadas às medidas do BICAMS pela curva ROC. As medidas do MMSE- 2 que tiveram especificidade e sensibilidade significativas (p<0,001) foram as elegíveis para compor o teste de triagem. Como a tarefa de codificação dígitos-símbolos é susceptível à demanda motora, optou-se pelo uso da forma oral do SDMT em conjunto. Deste modo, no nosso instrumento de triagem, normas para este instrumento foram criadas a partir da soma dos itens do MMSE-MS com o SDMT oral. Conclusão: A integração de dados desses diversos estudos evidencia cautela quanto aos procedimentos de adaptação empregados para adaptação transcultural das tarefas que são de origem verbal e semântica. Há também evidências da necessidade de instrumentos capazes de triar esses pacientes. Para tal, o MMSE-EM mostrou-se válido, preciso, com índices de sensibilidade e especificidade similares ao BICAMS, com normas ajustadas ao contexto Brasileiro. / Background: The cognitive impairment (CI) in Multiple Sclerosis (MS) has the prevalence rate from 43% to 70% and may occur from the Clinically Isolated Syndrome (CIS) to the early stages of MS. The CI in MS can advance independently of motor signs and symptoms, EDSS scores and MRI stable. In this context, the National Multiple Sclerosis Questionnaire (MSNQ) and the International Brief Cognitive Assesment for Multiple Sclerosis (BICAMS) are international tools used to screening and monitoring MS patients in care centers. Further studies and meetings provided by same committee alluded that MSNQ has several limitations for being a non-objective measure and the screening using the Symbol Digit Modalities Test (SDMT) alone is not effective because other areas that may be impaired in MS is not screened. With the second revision of the MMSE, and the lack of objective screening tools to quikly screening MS patients that needed to be monitored by BICAMS, we aimed in the presente study to create a fast measurement to screening the episodic memory, processing speed, attention and working memory from BICAMS and MMSE-2. Objective: To obtain brief a screening tool for MS (MMSE-MS) were conducted four studies using different tools: first the prototype study to development of CVLT-2 lists, adaptation, psychometric properties and normative data of BICAMS to the Braziliam context (as our gold standard), Cross cultural adaptation, psychometric properties, and normative data of MMSE-2 (the experimental tool) and the preliminary study of development of MMSE-MS. Methods: All translation and adaptation studies were conducted following the same method, as widely used in the literature. The first study consisted of conventional adaptation and prototypical norms, aiming to see which had the best estimates of equivalence between the cultures. The second study with BICAMS protocol show that MS scored significantly lower on all BICAMS tests. At the end of the study, the results were discussed with a member of the international committee to confirm the evidences of transculturality between the original and Brazilian versions. The third study consisted of Adapt, to investigate the psychometric properties and stablish normative data to the MMSE-2. Similarly to the previous study, an international judge discussed the results of the study of adaptation to identify the estimatives of transculturality. The fourth and last study was conducted in order to obtain a tool with sensitivity and similar specificity estimates BICAMS, but it was designed to screen patients who are eligible to be accompanied by BICAMS. Participated of the first study, 374 healthy volunteers and 25 patients with MS. In the second and third study participated 128 MS patients and 602 healthy volunteers. All clinical studies and community samples were carried out from 2013 to 2015 and had the partnership of the Brazilian Institute of Neuropsychology (IBNeuro) and the Laboratory of Instrumentation and Psychological Assessment (LABIAP). The collection of patients was performed at the Neuroimmunology Outpatient Clinic from Ribeirão Preto Medical School (FMRP-USP). Results: In the first study, were kept 5 words of 15 from the original American version. The reason for these changes in the Brazilian list were the differences between the syllabic division, extension of the words and the presence of prototypicall words. Was also found that until the fourth word evoked in our culture, in each semantic category were the same as those mentioned in the native language, but the order of the frequency varied within each category, indicating that although there are words that are prototypically commom between the two cultures in the overall semantic classification, the cultural context changes when we analyse the specifics prototipically words inside of each classification and semantic categories. To the second study, the BICAMS showed similar estimates of reliability and validity for current use as monitoring tool for MS in the Brazilian contexto, supporting the diagnostic validity of the Brazilian-Portuguese adaptation The normative data were satisfactory (p <0.001) in relation to the vocational status. The third study, with MMSE-2 also provided good estimates of validity and precision to the both cultures. To the fourth study, the MMSE-2 was compared to the BICAMS. The MMSE-2 tasks which had similar sensitivity and specificity to the BICAMS protocol was the recalling, attention and calculation, history memory and processing speed (Symbol Digit-coding). The selected tasks were those classified as moderate and Strong correlations. The second procedure consisted on comparisions among the MMSE-2 measurements and BICAMS using ROC curve. So, the MMSE-2 measures that had significant (p <0.001) specificity and sensitivity and similar area under the curve (ROC) were eligible to composse the screening tool. As the digit-symbol coding task is susceptible to motor demand, we decided to include the oral SDMT to the task. Thus, to get our screening tool, normative data for this instrument were created from the sum of the MMSE-MS items with oral SDMT. Conclusion: The overall of the data from these studies calls attention to the necessity of the caution to the adaptation procedures used in cross-cultural adaptation of the tasks that has verbal and semantic stimuli. There is also the need of tools abel to screening MS patients. For this, these preliminar data for MMSE-MS showed evidences of validation, similar sensitivity and and specificity, with normative data culturally adjusted to the Brazilian context.

This thesis focuses on the concept of self-compassion - a healthy attitude toward oneself which could be more easily attainable than unconditional self-acceptance and have less downsides than self-esteem. The first part of the thesis offers the most widely used conceptualisation of self-compassion, a comparison between self-compassion, self-esteem and unconditional self-acceptance, a summary of application areas of self-compassion, a list of relevant psychometric tools and a description of the Czech translation of the Self-Compassion Scale (SCS-CZ). The second part of the thesis consists of a quantitative study designed to further assess the construct validity of the SCS-CZ using the Beck Depression Inventory (BDI-II), the trait form of the State-Trait Anxiety Inventory (STAI X2) and the Unconditional Positive Self-Regard Scale (UPSRS) and to explore the connection between self-compassion and unconditional positive self-regard. A battery of web-based inventories was administered to a non-clinical sample (n = 415). The SCS-CZ shows a strong negative correlation with the BDI-II and the STAI X2, and a strong positive correlation with the UPSRS. The SCS-CZ is a valid measure of self-compasssion, suitable for comparing groups and population samples. For drawing conclusions about individuals, it is...

Esta investigación tuvo como objetivo analizar las propiedades psicométricas de la Escala Personalidad Resistente (EPR) en estudiantes pertenecientes a universidades privadas de Lima. La muestra quedó compuesta por 300 alumnos (52% mujeres y 48% hombres) con edades entre 18 y 28 años. Se aplicaron los instrumentos EPR, para medir la personalidad resistente, y la Escala de Percepción Global del Estrés (EPGE), que mide la percepción ante situaciones estresantes, con el fin de realizar un análisis convergente y divergente. Se realizó un análisis factorial confirmatorio, que demostró que la escala puede ser explicada como tres factores relacionados y como un factor con tres dimensiones. En cuanto a la confiabilidad, el EPR muestra una alta consistencia interna al identificarse un Coeficiente de Omega mayor a .90. Así, en base a los resultados, se concluye que el EPR evidencia propiedades psicométricas adecuadas para ser aplicado a estudiantes de universidades privadas de Lima. / This research aimed to analyze the psychometric properties of the Hardy Personality Scale (HPS) in students belonging to private universities in Lima. The sample is made up of 300 students (52% women and 48% men) with ages between 18 and 28 years. The HPS, to measure hardy personality, and Global Stress Perception Scale (GSPS), that measures the perception of stressful situations, in order perform a convergent and divergent analysis, were the instruments applied. A confirmatory factor analysis was performed as part of the internal structure analysis, which showed that the scale can be explained as a three related factors and as a factor with three dimensions. Regarding reliability, the HPS shows high internal consistency since it has an Omega Coefficient greater than .90. Thus, based on the results, it is concluded that the HPS evidences adequate psychometric properties to be applied to students of private universities in Lima. / Tesis

La presente investigación tiene como objetivo determinar las propiedades psicométricas de la Escala Recursos experiencias/emociones y demandas tecnológicas de información y comunicación (RED-TIC) en una muestra de 204 docentes de educación superior de Lima con una edad promedio de 45.75(DE=10.45). Se utilizó la escala de RED-TIC y la Prueba de Estrés Laboral de la OIT/OMS. Se realizo una validez de contenido con 10 jueces y se realizó un AFE con el método de ejes principales y una rotación promax dando como resultado que la estructura de cuatro factores de la RED-TIC cuenta con cargas factoriales entre .319 y .902 y una alta consistencia interna con valores mayores a .70 según el coeficiente omega. Por otro lado, los factores del RED-TIC mostraron correlaciones con los factores Superiores y Recursos y Organización y Equipo de Trabajo. Se concluye que el RED-TIC es un instrumento con suficiente evidencia de validez y confiabilidad para medir el tecnoestrés en docentes de educación superior en Lima. / The present investigation has as an objective to determine the psychometric properties of the Resource’s experiences/emotions and demands of information and communication technologies (RED-ICT) scale in a sample of 204 college teachers of higher education in Lima with an average age of 45.75 (DE=10.45). To this end, the RED-ICT and The Labor Stress scale by the WHO/ILO was administered to the participants. A content validity with 10 judges and a EFA with a principal axis method and a promax rotation gave as a result that the structure of the four factors present in the RED-ICT had factorial charges between 3.19 and 9.02 and a high internal consistency with Omega values higher than .70. On the other hand, the investigation showed correlations with the factor “Superior” and “Resources and Organizing in Group Work”. It is concluded that the RED-ICT is an instrument with the sufficient evidence for validity and reliability to measure the technostress of college teachers in higher education in Lima. / Tesis

El objetivo del presente estudio fue evidenciar propiedades psicométricas del cuestionario de Autocontrol Breve (BSCS) en adultos de la provincia de Lima y Arequipa, Perú. La muestra estuvo compuesta por 280 adultos jóvenes entre las edades de 20 a 40 años de los cuales fueron de Lima (58%) de Arequipa (42%) de forma no probabilística del tipo intencional. Se aplicó el Cuestionario de Autocontrol breve (Tangney, Baumeister y Luzio, 2004) y el cuestionario de Agresividad (Matalinares, Yaringaño, Uceda, Fernández, Huari, Campos y Villavicencio, 2012). Se realizó un AFC, el cual dio como resultado 4 dimensiones con χ²/gl = 3.16(< 3), p < .001 el CFI = .95 (>.95), SRMR = .05, la RMSEA = 0.088 (0.068, 0.109) (<.08) y el TLI = .93 (>.95). Se calculó la consistencia interna omega que oscila entre .49 y 73. Se utilizó la prueba no paramétrica de Spearman para el análisis de validez discriminante. El análisis de correlaciones entre BSCS y el cuestionario de Agresividad dio como resultado que todas son negativas y significativas (p < .05), con magnitud entre moderada (rs > .62) y baja (rs >.18). Concluyen que el BSCS brinda evidencias suficientes para seguir siendo estudiado en la población. / The objective of this study was to demonstrate psychometric properties of the Brief Self-Control Questionnaire (BSCS) in adults from the province of Lima and Arequipa, Peru. The sample consisted of 280 young adults between the ages of 20 to 40 years of which were from Lima (58%) of Arequipa (42%) in a non-probabilistic way of the intentional type. The brief Self-Control Questionnaire (Tangney, Baumeister and Luzio, 2004) and the Aggression questionnaire (Matalinares, Yaringaño, Uceda, Fernández, Huari, Campos and Villavicencio, 2012) were applied. An AFC was performed, which resulted in 4 dimensions with χ² / gl = 3.16 (<3), p <.001 the CFI = .95 (> .95), SRMR = .05, the RMSEA = 0.088 (0.068, 0.109) (<.08) and the TLI = .93 (> .95). The omega internal consistency ranging between .49 and 73 was calculated. Spearman's non-parametric test was used for the discriminant validity analysis. The correlation analysis between BSCS and the Aggression questionnaire showed that all of them are negative and significant (p <.05), with a magnitude between moderate (rs> .62) and low (rs> .18). They conclude that the BSCS provides sufficient evidence to continue being studied in the population. / Tesis

El objetivo de la investigación fue analizar las propiedades psicométricas del Inventario de Crecimiento Postraumático (PTGI, por sus siglas en inglés) en inmigrantes venezolanos que residen en Lima Metropolitana. La muestra estuvo conformada por 250 personas, cuyas edades estuvieron en el rango de 18 a 70 años (M=29; σ=8.51). Se realizó un Análisis Factorial Exploratorio (AFE), análisis convergente con la Escala de Resiliencia y análisis de fiabilidad. Los resultados del análisis de la estructura interna indican que el PTGI presenta una estructura de 4 factores (Fuerza personal, Relaciones Interpersonales, Cambio espiritual y Nuevas Posibilidades) y 20 ítems. Además, se encontró una relación convergente con la variable resiliencia. También, se reporta una adecuada fiabilidad por consistencia interna para cada factor (ω=.65 a ω=.91). Se concluye que el PTGI es un instrumento que cuenta con evidencias de validez y puntuaciones de fiabilidad. / The objective of the research was to analyze the psychometric properties of the Posttraumatic Growth Inventory (PTGI) in Venezuelan immigrants residing in Metropolitan Lima. The sample consisted of 250 immigrants; whose ages ranged from 18 to 70 years (M=29; σ=8.51). An Exploratory Factor Analysis (EFA), convergent analysis with the Resilience Scale and reliability analysis were performed. The results of the analysis of the internal structure indicate that the PTGI presents a structure of 4 factors (Personal Strength, Interpersonal Relationships, Spiritual Change and New Possibilities) and 20 items. In addition, a convergent relationship was found for the variable resilience. Also, an adequate internal consistency reliability is reportad for each factor (ω=.65 a ω=.91). It is concluded that the PTGI has evidence of validity and reliability scores. / Tesis

INTRODUCTION : Pour mieux comprendre l’impact des différentes conditions bucco-dentaires sur les enfants, de nombreux outils permettant de mesurer la qualité de vie liée à la santé bucco-dentaire (QVLSB) ont été développés. Cependant, il n’existe aucun outil en français pour les enfants québécois. OBJECTIF : Le but de cette étude était d’effectuer la traduction et l’adaptation culturelle de la version abrégée du questionnaire Child Oral Health Impact Profile (COHIP-19) en français et d’évaluer certaines propriétés psychométriques. MÉTHODOLOGIE : La traduction et l’adaptation culturelle de la version originale du COHIP-19 en français ont été effectuées selon la technique inversée parallèle avec un comité de traduction. La version traduite a été complétée à deux reprises à 59 enfants québécois francophones âgés de 8 à 15 ans avec un délai de passation allant de 1 à 3 semaines. Les scores du questionnaire ont été comparés selon le sexe, l’âge et le statut de traitement orthodontique. La validité de convergence, la cohérence interne et la stabilité temporelle sont les propriétés psychométriques du questionnaire qui ont été évaluées. RÉSULTATS : Aucune différence significative n’a été trouvée entre les scores du questionnaire en fonction du sexe, l’âge ou le statut de traitement orthodontique. L’auto-perception de la santé bucco-dentaire était significativement corrélée avec le score total du questionnaire (rs = 0,371; P = 0,004), indiquant que l’instrument possède une bonne validité de convergence. Le version traduite a également révélé une cohérence interne acceptable (alpha de Cronbach = 0,67) et une excellente fiabilité test-retest (ICC = 0,99; P < 0,0001). CONCLUSION : Les données recueillies ont montré que la version traduite du COHIP-19 possède des propriétés psychométriques suffisantes. Toutefois, il faudrait effectuer des études de validation sur un échantillon plus grand et représentatif, ainsi que dans un contexte hors pandémie. / BACKGROUND : For a better understanding of the burden of oral health disorders on children, many different tools are available to measure oral health-related quality of life (OHRQoL). However, none of these tools are available in French for the children of Quebec. AIM : The aim of this study was to translate and culturally adapt the short form of the Child Oral Health Impact Profile (COHIP-19) to French and to assess some of its psychometric properties. METHODS : The original English COHIP-19 was translated into French using a forward and backward translation procedure using a translation committee. The translated version was filled out twice by 59 children between the ages of 8 and 15 with a completion time ranging from 1 to 3 weeks. Questionnaire scores were compared by gender, age, and orthodontic treatment status. The convergent validity, the internal consistency and testretest reliability were the psychometric properties used in the evaluation of this questionnaire. RESULTS : No significant difference was found between questionnaire scores with respect to gender, age and orthodontic treatment status. The self-perceived oral health rating was significantly correlated with the translated version’s total score (rs = 0,37; P = 0,004) indicating that the instrument had sufficient convergent validity. The translated version also revealed good internal consistency (Cronbach’s alpha = 0,67) and an excellent test-retest reliability (ICC = 0,99; P < 0,0001). CONCLUSION : The collected data showed that the French Canadian translation of the COHIP-19 possesses acceptable psychometric properties. However, a validation study should be performed on a larger and more representative sample, as well as in a nonpandemic context.

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option neuropsychologie clinique (Ph.D) / Le traumatisme craniocérébral (TCC) représente un problème de santé publique, notamment en raison de sa prévalence en hausse. La symptomatologie associée au TCC est largement hétérogène et peut compromettre le fonctionnement à long terme dans de multiples sphères, dont l’engagement aux activités quotidiennes et la participation sociale. Une pauvre réinsertion sociale engendre ensuite de vastes répercussions, tant au niveau individuel que familial, communautaire, sociétal et économique. Pour ces raisons, la participation sociale représente aujourd’hui un objectif principal et valorisé en milieu de réadaptation post-TCC, visant une réinsertion sociale optimale chez l’usager et la reprise des habitudes de vie antérieures. La mesure quantitative du niveau de participation sociale est aussi maintenant reconnue comme étant intégrale à l’évaluation du fonctionnement post-TCC. Un outil recommandé et communément utilisé en milieu de réadaptation est le Mayo-Portland Adaptability Inventory (MPAI-4; Malec & Lezak, 2008), surtout pour son contenu multidimensionnel abordant un large éventail de séquelles post-aigües, sa mesure globale du niveau fonctionnel et de participation sociale, ainsi que pour ses bonnes propriétés psychométriques. Dans le cadre de travaux antérieurs, l’outil MPAI-4 a été traduit en français et adapté au contexte québécois. La version canadienne-francophone (CF-MPAI-4; McKerral et al., 2014a, 2014b) résultante a d’abord été intégrée aux Programmes TCC des établissements de réadaptation dans la région du Grand Montréal et ensuite dans les établissements de réadaptation de toute la province. L’implantation multicentrique du CF-MPAI-4 a enclenché une pratique de prise de mesure commune, systématique et longitudinale en réadaptation, générant ainsi une masse de données quantitatives quant à la récupération post-TCC au Québec. Nombreux auteurs utilisent de telles données pour tenter d’identifier les facteurs associés à la participation sociale post-TCC, dans le but d’établir des trajectoires de récupération et d’améliorer le pronostic de réinsertion sociale. Or, la littérature demeure grandement contradictoire à l’égard des facteurs prédicteurs du niveau de participation sociale post-TCC, entre autres en raison des variations méthodologiques entre les études. Encore plus, la généralisation, l’applicabilité et la validité des résultats entre études, entre populations et entre contextes demeurent incertaines, considérant l’importante influence de l’environnement (ex. : particularités démographiques, économiques, politiques, socioculturelles) sur la conceptualisation, l’interprétation et l’évolution de la participation sociale d’un individu. La littérature disponible traitant de récupération et de participation sociale post-TCC constitue donc de bonnes assises, mais reste non spécifique au contexte particulier de soins retrouvé au Québec, qui se distingue par son organisation universelle, publique et en continuum de services en traumatologie. Le système de santé québécois assure d’ailleurs l’offre de soins appropriés et en continuité selon les besoins propres à chacun, via deux parcours possibles en réadaptation : un cheminement en réadaptation interne-externe ou un cheminement en réadaptation externe seulement. Ce contexte unique appuie le besoin d’études et de données de récupération post-TCC propres au Québec. Dans cette optique, cette thèse visait à établir un premier profil multicentrique et longitudinal de la récupération fonctionnelle et de la participation sociale de la clientèle TCC québécoise et à mieux comprendre les variables associées à la participation sociale post-TCC au sein du continuum québécois de services en réadaptation. La première étude de cette thèse s’est intéressée aux propriétés psychométriques du CF-MPAI-4, ciblant en particulier la validation de la structure factorielle et la cohérence interne du questionnaire. Globalement, les résultats répliquent la structure factorielle de la version originale MPAI-4 et montrent une bonne cohérence interne aux sous-échelles. Des normes de référence québécoises ont aussi été élaborées pour guider l’interprétation clinique des scores CF-MPAI-4. Les résultats de cette étude confirment l’applicabilité, la validité et la pertinence clinique de l’instrument et consolident en parallèle son implantation aux processus cliniques des Programmes TCC au Québec. Le CF-MPAI-4 s’avère donc une mesure quantitative valide, appropriée pour documenter l’évolution fonctionnelle et la participation sociale d’une clientèle TCC en réadaptation au sein du continuum québécois de soins. La deuxième étude de cette thèse visait une meilleure compréhension de la participation sociale post-TCC au Québec et des facteurs qui y sont associés à l’aide de données cliniques et CF-MPAI-4 provenant d’usagers en réadaptation. Les résultats révèlent une amélioration significative du niveau fonctionnel et de la participation sociale en réadaptation. Encore plus, les variables impliquées dans la prédiction du niveau de participation sociale en fin de réadaptation diffèrent selon le cheminement suivi en réadaptation. Pour le parcours en réadaptation interne-externe, le niveau de participation sociale est prédit par 3 variables : le nombre d’années de scolarité, les scores Capacités et Adaptation au CF-MPAI-4 en début de réadaptation. Pour le parcours en réadaptation externe seulement, le niveau de participation sociale est prédit par 5 variables : l’hypertension prémorbide, les antécédents en santé mentale, le nombre d’heures de services indirects reçus, les scores Capacités et Adaptation au CF-MPAI-4 en début de réadaptation. Dès lors, les cliniciens peuvent utiliser ces facteurs prédicteurs pour repérer les usagers à risque d’une moins bonne participation sociale en fin de réadaptation, moduler leur prise en charge et les interventions à privilégier chez ceux-ci. En somme, les études dans cette thèse contribuent à l’avancement des connaissances dans le domaine de la réadaptation post-TCC. Les résultats comblent une lacune de données quantitatives spécifiques au Québec et suscitent une meilleure compréhension des trajectoires d’évolution et de la participation sociale post-TCC au sein du contexte québécois de réadaptation. En retour, ces nouvelles connaissances soutiennent une pratique clinique basée sur des données probantes, guident la prise de décisions quant à la prise en charge des usagers, alimentent les réflexions en matière d’efficacité, le développement et l’amélioration des services en continuum – optimisant dès lors les pratiques québécoises en réadaptation, puis ultimement les pronostics d’évolution et de réinsertion sociale des usagers post-TCC. Enfin, cette thèse souligne la complexité associée au construit de la participation sociale, eu égard aux multiples défis liés à la conceptualisation, l’opérationnalisation et l’interprétation du fonctionnement post-TCC d’un individu. / Traumatic brain injury (TBI) represents a public health issue, particularly due to its increasing prevalence. TBI sequelae are largely heterogeneous and can impact long-term functioning in multiple spheres, including social participation and involvement in daily activities. Poor social reintegration following TBI has broad individual, familial, community, societal and economic consequences. As such, social participation today represents a key and valued goal in post-acute TBI rehabilitation, aiming for the resumption of previous lifestyle habits and a return to active and purposeful roles in the community. The measurement of social participation outcome is also now recognized as an integral part of TBI outcome assessment. One recommended and commonly used measurement tool in rehabilitation settings is the Mayo-Portland Adaptability Inventory (MPAI-4; Malec & Lezak, 2008), for its multidimensional content addressing a wide range of post-acute sequelae, its global assessment of functional outcome and social participation, as well as its good psychometric properties. As part of previous work, the MPAI-4 was translated into French and adapted to the Quebec context. The resulting French-Canadian version (CF-MPAI-4; McKerral et al., 2014a, 2014b) was first implemented in the clinical practice of TBI rehabilitation programs within the Greater Montreal area and then into rehabilitation facilities across Quebec. The multicenter embedment of the CF-MPAI-4 triggered a common, systematic, and longitudinal measurement practice within rehabilitation settings, thus generating extensive empirical data on TBI recovery in Quebec. Many studies use such data to identify factors associated with social participation outcome, aiming to establish recovery trajectories and improve social reintegration following TBI. However, the literature on predictors of social participation outcome remains without consensus, in part due to methodological variations between studies. More so, the generalizability, applicability, and validity of findings between studies, samples and settings remain uncertain, given important environmental influences (ex.: demographic, economic, political, sociocultural factors) on the conceptualization, interpretation, and evolution of a person’s social participation. The available literature on TBI outcomes and social participation therefore constitute some foundation but remain nonspecific to the healthcare context found in Quebec, characterized by a universally accessible and organized trauma continuum of care. The healthcare system especially provides specialized and continuous rehabilitation care according to individuals’ needs following TBI, through two rehabilitation pathways: an inpatient-outpatient rehabilitation path or an outpatient only rehabilitation path. This brings forth the need for studies and data on post-TBI recovery specific to Quebec’s unique context. As such, this thesis aimed to establish a first multicentric and longitudinal portrait of the functional evolution and social participation of TBI patients in Quebec and to better understand factors related to social participation outcomes within the rehabilitation continuum of care. The first study of this thesis focused on the psychometric properties of the CF-MPAI-4, targeting the validation of the factor structure and the internal consistency of the tool. Overall, the results replicate the original MPAI-4 factor structure and suggest good internal consistency within the subscales. Quebec reference norms were also developed to guide the clinical interpretation of CF-MPAI-4 scores. The study therefore promotes the applicability, validity, and clinical relevance of the instrument and, in parallel, assures its integration within TBI rehabilitation programs in Quebec. The CF-MPAI-4 hence proves to be a valid tool, suitable for measuring functional evolution and social participation of TBI adults receiving rehabilitation services within the Quebec continuum of care. The second study of this thesis aimed to better understand post-TBI social participation outcome in Quebec and its associated factors using clinical and CF-MPAI-4 data from users within the rehabilitation continuum of care. Results reveal significant improvements in functional and social participation levels during rehabilitation. Furthermore, variables involved in predicting social participation outcome differ between rehabilitation care pathways. For the inpatient-outpatient rehabilitation path, social participation outcome is predicted by 3 variables: education years, CF-MPAI-4 Ability and Adjustment scores at rehabilitation intake. For the outpatient rehabilitation path, social participation outcome is predicted by 5 variables: premorbid hypertension and mental health diagnosis, total indirect rehabilitation hours received, CF-MPAI-4 Abilities and Adjustment scores at rehabilitation intake. The predictive value of those variables can help clinicians identify patients who are at risk of showing poorer social participation at discharge from rehabilitation, and influence intervention approaches put forward with these individuals. In sum, the thesis’ findings contribute to the advancement of knowledge in the field of TBI rehabilitation, offer evidence-based rehabilitation data specific to Quebec, and foster a better understanding of post-TBI recovery and social participation within a universally accessible and organized trauma continuum of care. In return, the new knowledge supports evidence-based clinical practices, guides decision-making regarding users’ care, prompts reflections with regards to the efficiency, development, and improvement of rehabilitation services – thereby optimizing rehabilitation practices in Quebec, and ultimately the TBI users’ recovery and social participation outcome. Finally, this thesis highlights the complexity surrounding the construct of social participation, in reference to the many challenges associated with the conceptualization, the operationalization and the interpretation of an individual's post-TBI functioning.

INTRODUCTION. D’ici 2030, le Québec comptera 180 000 personnes aînées vivant avec un trouble neurocognitif (PATNC). Les TNC entraînent des enjeux d’interaction personne environnement – l’aîné interagissant avec son environnement humain (proche aidant) ou non humain (domicile) – compromettant ainsi le maintien à domicile. Basée sur le Modèle de compétence, l’Évaluation à domicile de l’interaction personne environnement (ÉDIPE) – version cognitive vise à combler le manque d’instruments validés ciblant ces enjeux. Cet instrument comprend trois sections (Exploration des problèmes cognitifs et de leur impact; Évaluation de l’interaction; Validation et interprétation du processus d’évaluation) évaluées lors d’entrevues, d’observations et de mises en situation; deux échelles (ordinale; dichotomique) qualifient l’interaction personne-environnement. Ce Mémoire porte sur l’étude de la fidélité interexaminateurs de l’ÉDIPE–version cognitive. MÉTHODOLOGIE. Basés sur la Théorie classique de la mesure, deux ergothérapeutes indépendants et formés ont administré simultanément l’ÉDIPE–version cognitive à 30 dyades (PATNC-proches aidant), à domicile (3,2h/évaluation). Pour chaque item, le coefficient kappa, le pourcentage d’accord et l’erreur-type ont été calculés. RÉSULTATS. Les coefficients kappa varient entre -0,053 et 1,000 (pourcentages d’accord 50%-100%); la majorité (80%) varie d’Acceptable à Presque parfait. DISCUSSION. La formation et l’application rigoureuse du guide de passation soutiennent la fidélité interexaminateurs de l’instrument. Plusieurs coefficients faibles démontrent un pourcentage d’accord élevé, référant aux paradoxes de Feinstein et Cicchetti. CONCLUSION. Cette étude documente la fidélité interexaminateurs d’un instrument prometteur comblant une lacune dans la compréhension de l’interaction personne environnement des PATNC vivant à domicile. Poursuivre la validation de l’ÉDIPE–version cognitive appuiera davantage son utilisation en clinique et en recherche. / INTRODUCTION. By 2030, Quebec will have 180,000 older people living with a neurocognitive disorder (OPLwNDs). Neurocognitive disorders lead to issues affecting the person-environment interaction – the older adult interacting with his or her human (caregiver) or non-human (home) environment – thereby compromising aging in place. Based on the Model of Competence, the Home Assessment of Person-Environment Interaction (HoPE)-Cognitive Version aims to fill the gap in validated tools targeting these issues. This tool has three sections (Exploration of cognitive problems and their impact; Assessment of interaction; Validation and interpretation of the assessment process) that employ interviews, observations and task performance; two scales (ordinal; dichotomous) qualify the person-environment interaction. This Master’s thesis examines the interrater reliability of the HoPE-Cognitive Version. METHODOLOGY. Based on classical test theory, two independent, trained occupational therapists simultaneously administered the HoPE-Cognitive Version to 30 dyads (OPLwND-caregiver), at home (3.2 h/assessment). For each item, the kappa coefficient, percentage of agreement and standard error were calculated. RESULTS. Kappa coefficients ranged from -0.053 to 1.000 (percentages of agreement 50%–100%); the majority (80%) ranged from Acceptable to Almost Perfect. DISCUSSION. Training and rigorous application of the assessment guide support the tool’s interrater reliability. Several low coefficients demonstrate a high percentage of agreement, referring to Feinstein and Cicchetti’s paradoxes. CONCLUSION. This study documents the interrater reliability of a promising tool that fills a gap in understanding the person-environment interaction of OPLwNDs living at home. Further validation of the HoPE-Cognitive Version will support its use in clinical and research settings.