Desarrollo y validación de contenido del Cuestionario de Exposición al Conflicto Armado (CECA)

Abstract

RESUMEN: La caracterización del conflicto armado es un tema de interés mundial por el alto costo humano y material que implica. Para determinar el nivel de exposición a eventos de conflicto, se ha reconocido una limitación de herramientas psicométricamente válidas. En los conflictos armados de larga duración y baja intensidad, como el colombiano, se aplican criterios espacio-temporales para generar tipologías o medias ecológicas de los niveles de exposición al conflicto sin estudiar a priori la exposición de cada individuo. El Cuestionario de Exposición al Conflicto Armado (CECA) fue desarrollado para caracterizar la exposición a eventos directos e indirectos del conflicto y sus efectos, desde la experiencia de sus actores. El instrumento CECA se sometió a una evaluación de validez de contenido por parte de un panel de ocho expertos que evaluaron esta propuesta con relación a la claridad, la relevancia, la suficiencia y la coherencia, mediante un método Delphi. Se calculó el Índice de Validez de Contenido (IVC) de los ítems y el Kappa modificado para evaluar el consenso y el acuerdo de los expertos. Se estableció como punto de corte un IVC mayor a .7 y Kappa mayor a .6. De los 38 ítems propuestos, seis fueron eliminados. Se obtuvo una versión válida de 33 ítems con tres dimensiones: experiencias directas (11 ítems); experiencias indirectas (14 ítems), y desenlaces (8 ítems). En conclusión, se ha desarrollado y establecido la validez de contenido de CECA, lo que será de utilidad para los investigadores y profesionales interesados en realizar investigación e intervención con población expuesta o con antecedentes de exposición a los eventos de conflicto armado.

ABSTRACT: In the field of mental health and armed conflict, its characterization using reliable psychometric instruments has become a key strategy to assess its exposure. In long-time and low-intensity armed conflicts such as Colombian, evaluation of these events through reliable and validated questionnaires is less frequent. Some approaches have explored exposure to the conflict based on ecological measures, for example, scores assigned according to geographic location and according to the history of the presence of armed groups. However, current implies a difficulty in determining the level of exposure. For that, the same authors applied spatial and temporary criteria to generate typologies based on the level of exposure of armed conflict. The use of valid tools, scales, or instruments in the field of armed conflict is recent. The Questionnaire of Exposure or Armed Conflict (CECA in Spanish) has been developed in this study as a useful alternative to assess exposure to armed conflict from exposes individuals. This Questionnaire characterizes direct and indirect exposure to events related to armed conflict and the effects of this experience in their actors. Based on previous approaches such as the Extreme Experiences Scale (EX2) were developed CECA questionnaire, for that, a panel of experts was convened to evaluate each item in terms of clarity, relevance, sufficiency, coherence, based on the Delphi method. Using this method, several successive rounds were carried out with the experts, with the experts, guaranteeing the blinding of the participants. The strategy involved sending each expert the proposed instrument and an excel template where they would rate each item according to the criteria set out. The whole process was online and blind. In the event of disagreement between experts, the following Delphi round was carried out until the best agreement was found against the proposed items. For each item, the Content Validity Index (CVI) > .70 and modified Kappa coefficient > .60 were calculated to evaluate the agreement of the experts. Six items were eliminated from the original questionnaire of 38 items. The final version of CECA contained 33 items classified in 3 dimensions: direct experiences (11 items), indirect experiences (14 items), and outcomes in mental health (8 items). The content validation of CECA provides valuable information for researchers and specialized professionals in the area to make interventions in populations exposed to armed conflict events. This type of tool is an important and necessary advance for the area of mental health and the study of the impact of the armed conflict. Future research should address another type of validation of the CECA instrument. Among these, inquire about structural validity, criterion validity, internal consistency.