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PubMed2000

Problem of item overlap between the psychopathy screening device and attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder rating scales.

Content validity requires a clear definition of the construct of interest and the delineation of the construct from similar constructs. Content validity also requires that the items be representative of the construct as well as specific to the construct. An examination of the items on the Psychopathy Screening Device (PSD), a parent- and teacher-rating scale of childhood psychopathy, indicates significant overlap with the symptoms and associated features of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). The failure of the PSD to have unique items results in poor discriminant validity with ADHD, ODD, and CD rating scales. More careful attention to content validation guidelines is required to develop a more useful measure of childhood psychopathy.

Antisocial Personality Disorder↗

PubMed2004

Psychometric assessment of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of HIV-infected women.

Since the late 1980s, several HIV-specific quality of life instruments have been developed; however, little testing has been done in terms of their validity and reliability for HIV-infected women. The purpose of this study was to test the content validity, concurrent validity, internal consistency, and test-retest reliability of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of 85 HIV-infected women. The MQOL-HIV is a 40-item scale comprised of 10 dimensions. Most of the items and all of the domains were determined content valid but revision of some of the items and domains is recommended. Concurrent validity was measured between the MQOL-HIV and the MOS-HIV and ranged from 0.51-0.81 between similar domains. Of the 10 domains and the entire instrument, 7 had a Cronbach's alpha over 0.70 (range 0.43-0.92). Eight domains and the entire instrument achieved test-retest correlation coefficients over 0.70 (range 0.60-0.96). Although some revision may make the scale more content-valid for HIV-infected women, given due care in the interpretation of results, the MQOL-HIV can be used with female populations in its current form.

Adult↗

PubMed1998

The Schwartz Cancer Fatigue Scale: testing reliability and validity.

PURPOSE/OBJECTIVES: To describe the psychometric development of the Schwartz Cancer Fatigue Scale (SCFS). DESIGN: A multiphase instrumentation study describing construct and operational definitions, informal and formal content validity, reliability, and validity analysis. SAMPLE: Content validity established with 20 subjects. Reliability and validity evaluated with 166 subjects residing in diverse parts of the United States. FINDINGS: Eleven items that failed to show variance, had high interitem correlations, or failed to discriminate were eliminated. Factor analysis resulted in a four-factor solution that accounted for 70% of the variance. Cronbach's alpha for the total scale was estimated to be 0.96 and to be between 0.82 and 0.93 for the subscales. CONCLUSIONS: The 28-item SCFS has demonstrated reliability and content and construct validity. Factor analysis supports the four subscales (physical, emotional, cognitive, and temporal). Preliminary construct validity has been demonstrated by differences in fatigue between those people who are currently receiving treatment and those who have completed treatment and by scores on a visual analogue scale of fatigue. IMPLICATIONS FOR NURSING PRACTICE: The SCFS may prove to be clinically relevant in assessing the effect of interventions to treat and manage cancer-related fatigue.

Adult↗

PubMed2005

Psychological screening procedures for deploying U.S. Forces.

This study examined the validity of psychological measures used in screening for the U.S. Army with 885 soldiers before a 6-month peacekeeping rotation in Kosovo. Content validity and construct validity were assessed by evaluating the clinical domains, comparing clinician assessments of functioning, and assessing risk factors for screening positive. Construct validity and content validity were demonstrated. Risks, benefits, and future directions of the Army's psychological screening research program are discussed.

Humans↗

PubMed2006

Development and validation of the self-administration of medication tool.

BACKGROUND: Consumer participation in planning and implementing health care is actively encouraged as a means of improving patient outcomes. In assessing the ability of patients to self-medicate, health professionals can identify areas in which patients need assistance, education, and intervention to optimize their health outcomes after discharge. OBJECTIVE: To develop and validate a tool to quantify the ability of patients to administer their regularly scheduled medications while they are hospitalized. METHODS: Past research enabled us to develop the Self-Administration of Medication (SAM) tool. Using a Delphi technique of 3 rounds, a panel of expert health professionals established the content validity of the tool. For determining level of agreement in using the SAM tool, 56 patients were selected; for each patient, 2 randomly selected nurses completed an assessment. Construct validity and internal consistency were examined by testing the tool in 50 patients and comparing with other validated scales. RESULTS: The 29-item SAM tool had high content validity scores for clarity, representation, and comprehensiveness, with content validity index values ranging from 0.95-1.0. In testing the level of agreement between 2 nurses, out of 43 valid cases, 95.3% of nurses overwhelmingly agreed about the patients' competence to self-administer their drugs. The intraclass correlation coefficient was 0.819 (95% CI 0.666 to 0.902). Internal consistency for the SAM tool was high, with a Cronbach's alpha of 0.899. A moderate to strong correlation was obtained when comparing the SAM tool with other validated measures. CONCLUSIONS: The SAM tool is valid and reliable for quantifying patients' ability to manage their regularly scheduled medications in the hospital setting.

Adult↗

PubMed2026

Critical insights on the application of the theory of planned behaviour to food handlers' food safety practices.

Foodborne diseases remain a significant public health concern, often linked to unsafe food-handling practices. The Theory of Planned Behaviour (TPB) is widely used to predict and explain food safety behaviours, yet its application in this field has not been systematically and in-depth evaluated. This review evaluated how the TPB has been applied to study food handlers' behaviour, focusing on methodological approaches, use of the TACT (Target, Action, Context, and Time) framework, validity, elicitation studies, and reliability. Seventeen studies were included following a systematic search of four databases (Scopus, Web of Science, Wiley Online Library, and Taylor & Francis Online). Data were extracted on behaviour definition, aim of study, main findings, use of indirect and direct TPB measures, use of elicitation studies, internal consistency, content validation, analytical methods used, and any extensions to the original TPB framework. Key elements related to adherence to core TPB principles and measurement practices were extracted using a Checklist. Most studies used direct measures of TPB constructs, and only a few reported procedures for content validation. Considerable variability was found in the reporting of key measurement and psychometric practices. Five studies fully applied the TACT framework, while nine incorporated additional factors such as knowledge and moral norms. Elicitation studies were conducted in five cases where indirect measures were employed. Analytical approaches were mainly based on multiple linear regression, with limited use of more advanced techniques such as structural equation modeling. Twelve studies reported internal consistency results. Overall, the review highlights opportunities to strengthen methodological practices in future TPB research on food safety. Greater attention to conducting and reporting content validation, full application of the TACT framework, reporting of internal consistency, and consistent inclusion of elicitation studies when using indirect measures may enhance transparency, reinforcing the credibility and trustworthiness of research findings. A major methodological limitation of this review was that screening and data extraction were conducted by a single reviewer and no formal quality or risk-of-bias assessment of the included studies was performed. Despite these limitations, the findings provide practical guidance for the development and validation of TPB-based questionnaires and may support more robust food safety research, interventions, and policy initiatives aimed at improving food handlers' practices.

Humans↗

PubMed1996

Development of a questionnaire identifying factors responsible for successful self-management of insulin-treated diabetes.

Education and psychosocial factors are widely believed to contribute to diabetes control. However, there is no systematic way of measuring or recording these factors, or for transfer of information to future care-givers. We developed a 41-question questionnaire to measure the skills and contributory factors to self-management in diabetes, and examined the relationship between these factors and glycaemic control. The questionnaire was assessed for construct validity, and for content validity by independent diabetes health professionals, and easily completed by 128 insulin-treated diabetic patients (mean age 42 +/- 13 (SD) yr, diabetes duration 17 +/- 9 yr, HbA, 10.5 +/- 1.8%). Principle Components Factor analysis revealed nine factors explaining 63% of variance (Eigen values 1.2-5.8). Five of these were significantly related to HbA1. These were: practical self-management skills, p < 0.001; emotional adjustment, p < 0.002; perceived goals, p < 0.01; perceived self-efficacy, p < 0.005; and costs-benefit analysis, p < 0.01. Multiple regression revealed that these five predictor variables (factors) explain 21% of variance in HbA1, combined r = 0.46. The questionnaire also distinguished between patients with good and poor control (HbA1 8.2 vs 13.4%, p < 0.001), p for differences in question responses, 0.014-0.001. Four factors (lifestyle, influence of other people, diet concerns, and weight concerns) were unrelated to HbA1. In conclusion, we have developed a single, patient-completed questionnaire of high content and construct validity, which identifies alterable factors (in contrast to fixed demographic variables) which may be specifically targeted in individual patients on the one hand to improve glycaemic control and, on the other, to enable more satisfactory adjustment to life with diabetes. It may be used in day-to-day practice to identify patient needs, and their barriers to effective self-management, and to transfer this information to future care-givers.

Adult↗

PubMed2005

Development and psychometric testing of the EverCare Nurse Practitioner Role and Activity Scale (ENPRAS).

PURPOSE: To develop and test an instrument measuring the frequency of the performance of role activities by EverCare nurse practitioners (NPs), who provide primary care to nursing home residents. DATA SOURCES: One hundred thirty-one EverCare Nurse Practitioner Role and Activity Scale (ENPRAS) activities were identified through telephone interviews (n= 11), participant observation (n= 5), and a focus group (n= 4). CONCLUSIONS: Two content validity tests (n= 11; n= 15) (Content Validity Index > or = .78 for all retained items) and internal consistency reliability testing (n= 127; Cronbach's alpha = .78-.96) yielded 99 activities arranged in six role subscales-Collaborator, Clinician, Care Manager/Coordinator, Counselor, Communicator/Cheerleader, and Coach/Educator. IMPLICATIONS FOR PRACTICE: The ENPRAS can be used to measure similarities and differences in NP practice activities performed by EverCare NPs working at different EverCare program sites and to compare practice activities performed by EverCare NPs and other NPs. The EverCare program is sponsored by United Health Care, which leads the field in collaborative NP/MD primary care in nursing homes. Future studies should be directed toward testing the generalizability of the ENPRAS with NPs working in other collaborative models, as well as NPs in noncollaborative models of care delivery in the long-term care setting.

Adult↗

PubMed2002

Developing and testing methods for improving patient-oriented mental health care.

There is a trend in nursing policy and practice towards allowing patients to participate actively in their treatment and the services they use. The author concludes, based on an earlier qualitative study, that psychiatric patients in a hospital environment want a more active role in their treatment and that psychiatric nurses also aim at more active patient participation. In mental health care, professionals often define the needs of patients in terms of their own expertise and tend to overlook the variety of the service users' needs. The need to improve and empower psychiatric patients is a considerable challenge to present-day nursing. The purpose of this paper is to describe the theoretical background of tools used to assess patients' involvement in mental health care and the process by which credibility can be determined in rating the panel phase of instrument construction. The instruments, based on a qualitative study using grounded theory, produced a model of patient initiatives in psychiatric nursing. Content validity refers to the determination of the substantive representativeness or relevance of the items of an instrument. Face validity has been defined as validity conferred by a lay persons' acceptance that a procedure, statement or instrument appears to be sound or relevant. In the panel rating, the raters were experts. They evaluated the readability, consistency and content validity of the instruments' items. In the instrument for nurses, the content validity was 0.84 and consistency 0.91; this corresponds to 0.91 and 0.95, respectively, in the instrument for patients.

Humans↗

PubMed2003

Development of instruments to assess assaultive behavior in nursing homes.

The use of psychometric techniques is not usually considered in the development of non-scale tools. In the development of these tools, both content validation and inter-rater reliability were assessed in an effort to produce better quality tools than would have occurred otherwise. The procedure employing content experts for content validation followed the usual protocol for both of the tools. In each case, valuable information about the tools was obtained, in addition to data supporting the content validity of the tools. The development of vignettes for the inter-rater assessment would probably not have occurred if the authors were not familiar with the different techniques for assessing inter-rater reliability. The only way data concerning inter-rater reliability could be obtained was by having each respondent view the same stimuli. Creating vignettes was the best way to accomplish this goal in a cost-effective manner. The additional data obtained from the respondents also provided invaluable information for the development of the tools. This pilot study was conducted to assess all aspects of the tools in the nursing home setting. Clarity of items and usability of the tools were major considerations. Because NAs were involved in the pilot study, both readability by most NAs and clarity of the items in the revised tool were assured. Considerable time was spent assessing these tools, but the completed tools are evidence that the time was well spent. The use of psychometric techniques resulted in objective evidence that led to quality improvement decisions. The revised tools have the potential for use in obtaining quality data for research projects, in policy development by an agency, and for training agency personnel.

Aged↗

PubMed2001

Evaluation of a home health patient classification instrument.

The purpose of this study was to assess reliability and validity of the Revised Easley-Storfjell Patient Classification Instrument (R-ESPCI). Content validity was assessed by expert home health nurses. Interrater reliability was assessed by staff nurse ratings of patients on home visits (N = 34) and by chart review by the investigators (N = 30). Concurrent validity was also assessed. Percentage agreement for staff nurses was 36% (kappa = -.15) and 52% (kappa = .04) in two phases and for investigators 90% (kappa = .63) and 50% (kappa = .02) in two phases. Minimal support for concurrent validity was found. Content validity was established, but revised reimbursement policy eliminated less acutely ill patients, narrowing the acuity range. More discrete rating criteria or scoring changes may be needed, followed by further assessment of the R-ESPCI. Agency stability and adequate resources for staff training are required for additional testing of the instrument.

Community Health Nursing↗

PubMed2004

Midwifery care: development of an instrument to measure quality based on the World Health Organization's classification of care in normal birth.

AIMS AND OBJECTIVES: The aim of the study was to develop an instrument to measure midwifery care in relation to World Health Organization's classification of care in normal birth and to test the instrument for content validity and inter-rater reliability. METHODS: The Delphi method was used for development of the instrument and to elicit evidence of content validity. Six experts from three different geographical regions in Sweden, representing clinically working midwives, lecturers in midwifery and obstetricians, participated in the first part of the study. The instrument was tested for inter-rater reliability in an exploratory study by two midwives and one of the authors. Data were analysed using percentage of agreement level and the Kappa coefficient. RESULTS: Five expert rounds were needed to reach consensus for content validity. The inter-rater reliability test showed high agreement levels (95.9, 94.2 and 95.7%) and good to very good Kappa coefficients (0.74-1.0). The final instrument consisted of 78 items divided into five sections: background (five items); practices which are demonstrably useful and should be encouraged (55 items); practices which are clearly harmful or ineffective and should be eliminated (five items); practices for which insufficient evidence exists to support a clear recommendation and which should be used with caution while further research clarifies the issue (four items); and finally practices which are frequently used inappropriately (nine items). CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: The instrument can be used at a labour ward to measure documented care and quality of midwifery care. The results can be used to identify areas for improvements, to develop guidelines towards evidence-based care and to improve documentation. However, the present study should be regarded as an exploratory study and the feasibility of the instrument remains to be tested in empirical studies.

Attitude of Health Personnel↗

PubMed1997

Development of two instruments examining stress and adjustment in children with cancer.

The childhood cancer literature provides limited understanding of the school-age child's perception of cancer stressors and factors that contribute to adjustment in the midst of these stressors. This study evaluated the reliability and validity of two questionnaires: the Childhood Cancer Stressors Inventory (CCSI) and the Children's Adjustment to Cancer Index (CACI). The following steps were involved in the instrument development process: item development, face and content validation, internal consistency reliability, and construct validity. Questions for both instruments were developed from the literature and experience of the principal investigator. A panel of five expert pediatric oncology nurses was asked to evaluate the content validity of both instruments. All the experts rated every item a 4-5 using the content validity index, indicating that each item measured the concept addressed by the scale. Seventy-five children with cancer were asked to complete the two questionnaires and parents completed a demographic data sheet that included eight questions about the child's school attendance, performance, number of friends, and activities. Children were 7 to 13 years of age; 64% were diagnosed with a leukemia/ lymphoma, and 36% had a solid tumor. Internal coefficient reliability for the total CCSI was .82, and .91 for the CACI. The CCSI correlated negatively with the adjustment scale (r = -.63, P = 000). The number of days missed from school correlated positively with the CCSI and negatively with the CACI. Children who missed more school perceived more cancer stressors and had a lower adjustment rating. Children with lower adjustment ratings on the CACI also had fewer friends (t = 3.4(72), P = .001). Scores on both instruments demonstrated expected relationships with measures hypothesized to covary with the dimensions assessed by the new instruments. Adjustment issues for children with cancer have been difficult to assess because of the lack of appropriate instruments. These study findings indicate that the two new instruments can help to measure the child's perceptions of the cancer experience.

Adaptation, Psychological↗

PubMed2004

The Strain of Care for Delirium Index: a new instrument to assess nurses' strain in caring for patients with delirium.

This study evaluated content validity, internal consistency and construct validity of the Strain of Care for Delirium Index (SCDI), a newly constructed instrument to measure the strain nurses experience in caring for patients with delirium. Content validity, evaluated by eight experts, reduced the initial pool of items from 38 to 28. Using a convenience sample of 190 nurses, Cronbach's alpha for the 28-item version was 0.88. Using non-linear principal components analysis another eight items were eliminated and a four-factor structure was identified. The proportion of variance explained by the remaining 20 items was 61.51%. Preliminary psychometric evaluation of the SCDI supported content validity, internal consistency and construct validity; however additional psychometric evaluation is warranted.

Adult↗

PubMed2005

Simultaneous development of the Pediatric GERD Caregiver Impact Questionnaire (PGCIQ) in American English and American Spanish.

BACKGROUND: The objective of this study was to develop simultaneously a new questionnaire, the Pediatric GERD Caregiver Impact Questionnaire (PGCIQ), in American English and American Spanish in order to elucidate the impact of caring for a child with GERD. METHODS: Two focus group discussions were conducted in American English and American Spanish to develop a relevant conceptual model. Focus group participants were the primary caregivers of children with GERD (newborn through 12 years of age). Participant responses were qualitatively analyzed to identify potential differences in caregiver perspectives by the caregiver's language, socio-economic status and demographic profile as well as the child's age and disease severity level. Items in the PGCIQ were generated simultaneously in English and Spanish by reviewing results of qualitative analysis from focus groups in each language. The PGCIQ was finalized in both languages after testing content validity and conducting an in-depth translatability assessment. RESULTS: Analysis of focus group comments resulted in the development of a first draft questionnaire consisting of 58 items in 10 domains. Content validity testing and an in-depth translatability assessment resulted in wording modification of 37 items, deletion of 14 items and the addition of a domain with five items. Feedback from the content validity testing interviews indicated that the instrument is conceptually relevant in both American English and American Spanish, clear, comprehensive and easy to complete within 10 minutes. The final version of the PGCIQ contains 49 items assessing ten domains. An optional module with nine items is available for investigative research purposes and for use only at baseline. CONCLUSION: The PGCIQ was developed using simultaneous item generation, a process that allows for consideration of concept relevance in all stages of development and in all languages being developed. The PGCIQ is the first questionnaire to document the multidimensional impact of caring for an infant or young child with GERD. Linguistic adaptation of the PGCIQ in multiple languages is ongoing. A validation study of the PGCIQ is needed to examine its psychometric properties, further refine the items and develop an appropriate scoring model.

Adult↗

PubMed2000

Testing of the Incontinence Impact Questionnaire (IIQ-7) with men after radical prostatectomy.

OBJECTIVE: The objective of this study was to test the validity and reliability of the Incontinence Impact Questionnaire (IIQ-7), a 7-item self-report instrument designed to assess the impact of urinary incontinence (UI), in men. SUBJECTS: Fifty-eight men with incontinence after radical prostatectomy were the subjects of the study. METHODS: Content validity was assessed by a panel of experts. Construct and criterion validity were examined with 3 groups of men who had UI in a randomized controlled trial comparing pelvic muscle exercises with pelvic muscle exercises plus electrical stimulation. Internal consistency and stability coefficients for the IIQ-7 were determined. RESULTS: The content validity index was 0.88. Four items were below the designated content validity index level. A 2-factor analysis solution (factor I-impact on daily activities; factor II-emotional impact) explained 84.94% of the variance. No significant group differences were recorded on impact of UI (F = 0.37, P =.70), nor were any differences among subjects found over time (F = 0.90, P =.50). A positive relationship was found between grams of urine loss on a 24-hour pad test and IIQ-7 scores (r = 0.34, P =.003 to.51, P =.001). When the IIQ-7 score decreased, self-reported quality of life improved as measured by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Version 2 (r = -0.57, P =.0001 to -.49, P =.001). A strong relationship was found between responses to the question "Does leakage affect your life?" and the IIQ-7 scores. Internal consistency ranged between 0.88 and 0.92. IIQ-7 scores were consistent when urine loss was stabilized between 16 and 24 weeks after entry into the study (r = 0.89, P =.0001). CONCLUSION: The IIQ-7 is a reliable measure of the impact of UI; however, the scale requires additional testing regarding construct validity in men.

Activities of Daily Living↗

PubMed2006

Validation of the Japanese version of the Quality of Life-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA).

OBJECTIVE: To evaluate validity and reliability of the Japanese version of the Quality of Life-Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA). DESIGN: Observational study; cross-sectional, longitudinal. METHODS: Seventy-five adults with growth hormone deficiency completed the SF-36 (a generic health-related QOL scale) and the QoL-AGHDA before growth hormone replacement therapy and approximately 3 weeks later (when the therapy began). A sample (n=1000) of controls from the general population was also studied. We computed rates of missing data, measured reproducibility and internal consistency reliability, and tested for known-groups validity, concurrent validity, unidimensionality (by principle component analysis), and content validity. RESULTS: Rates of missing data were low (0-1.4%). The mean of QoL-AGHDA scores in the patients was 8.2 (SD, 6.4). The scores were reproducible (k=0.41-0.78), and internally consistent (alpha=0.91) and the scale was unidimensional. QoL-AGHDA scores were associated with SF-36 scores as hypothesized. Scores were significantly higher in the patients than in controls (8.1+/-0.7, and 5.6+/-0.2, P<0.001). Discrimination between patients and controls was slightly better using scores on the "General Health" and "Role Physical" subscale of the SF-36 as explanatory variables than using QoL-AGHDA scores. CONCLUSIONS: The QoL-AGHDA's reliability, validity, and rates of missing data were satisfactory, and the scale was confirmed to be unidimensional. However, because some subscales of the SF-36 were better for discriminating patients from controls, the content validity of the QoL-AGHDA may need to be re-evaluated.

Adolescent↗

PubMed2000

Development of two instruments measuring social support for siblings of children with cancer.

The literature on childhood cancer provides a very limited understanding of healthy siblings' perceptions of supportive interventions during the childhood cancer experience. The purpose of this article is to discuss the development of the Nurse-Sibling Social Support Questionnaire (NSSSQ). Instrument methodology for the study involved item development, face and content validation, and internal consistency reliability as described by Hockenberry-Eaton, Manteuffel, and Bottomley (1997). Item development for the research instrument evolved from an extensive review of the literature and clinical experience of the principal investigator. Content validity of the instrument was accomplished by five experienced pediatric oncology nurses according to the methodology described by Lynn (1986). Using the content validity index, each nurse rated each item as either 4 or 5, indicating 100% agreement among experts that these items measured the concept of social support. Readability for the instrument was determined by using a computerized program. Results showed that readability was concordant with the grade school level for all items. Twenty-five school-age siblings of children with cancer and their mothers were asked to complete the questionnaire. Instrument completion was accomplished in less than 1 hour. The NSSSQ showed high internal consistencies (alpha coefficients >.90). Results indicated that siblings' perceptions of social support differed from those of their mothers. Siblings perceive emotional and instrumental support as greater in importance, whereas mothers perceive emotional and informational support as more beneficial to siblings. Support issues for siblings of children with cancer have been difficult to assess because of the lack of appropriate instruments. This study finding provides exploratory evidence to suggest that the new instrument can help measure siblings' perceptions of social support during the childhood cancer experience.

Adolescent↗