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PubMed1997

Instrument development: the Mental Health-Related Self-Care Agency Scale.

This article addresses the development and initial testing of an instrument to measure individual's capabilities to perform mental health related self-care. A two-step process of development and judgment (Lynn, 1986) was used to develop and evaluate this instrument's content validity. The development phase included explication of the content domains, item generation, and instrument formation. Evaluation of the content validity was addressed by an expert panel for theoretical and clinical relevance. These processes resulted in a 35 item, self-report questionnaire. A pilot study supported the Mental Health Self-Care Agency Scale as a reliable and valid instrument appropriate for theory-testing research.

Adolescent↗

PubMed1995

Development of the perceptions of racism scale.

Racism may be a factor in low-birth-weight (LBW) and preterm delivery in African American childbearing women. Because no satisfactory measure of racism existed, the Perception of Racism Scale (PRS) was developed. The PRS was pilot tested on 109 participants from churches and community organizations. The scale was then used in a study of 136 childbearing women to investigate LBW and preterm delivery. Twenty items rated on a 4-point Likert-type scale were scored with 1 as the lowest and 4 as the highest perception of racism. Alpha reliabilities were .88 for the pilot and .91 for the study. Content validity was strengthened by expert panel critique. Reliability, content validity, and construct validity were demonstrated and no undue participant burden was observed. The scale is an effective instrument to measure perceptions of racism by African American women.

Adolescent↗

PubMed2004

Visual and visuo-tactile detection of dental caries.

The objective of this review is to describe and discuss the content validity of a sample of caries detection criteria reported in the literature between January 1, 1966, and May 1, 2000. Using filters to locate randomized or controlled clinical trials on dental caries, fluorides, sealants, and "restorative" care, I identified a total of 171 documents from MEDLINE and the Cochrane Collaboration's Oral Health Group (CC-OHG) special register. These articles met the following inclusion criteria: (1) Data had been collected from samples of patients or populations; and (2) dental caries was assessed clinically, and criteria were either published or described in the paper. From the selected articles, evidence tables were prepared describing each caries detection criterion. Analysis of the content validity of the criteria systems was based on evaluation of the disease process, exclusion of non-caries lesions, subjectivity, use of explorers, and drying of teeth prior to examination. This review included 29 unique criteria systems. Of those, 13 originated from the UK, 3 from the USA, 4 from Denmark, and others from the World Health Organization (WHO), Sweden, Switzerland, Norway, Netherlands, and Canada. Thirteen of the criteria systems either measured active and inactive early and cavitated lesions or defined separate criteria for smooth and occlusal tooth surfaces. Nine systems measured early as well as cavitated stages of the caries process, and 7 measured cavitation only. Eleven of the criteria systems provided explicit descriptions of the disease process measured or information on how to exclude non-caries from caries lesions. The use of explorers and drying and cleaning of teeth varied widely among the criteria. The majority of the newly developed criteria systems originated from Europe. In conclusion, this review of the content validity of the 29 criteria systems found substantial variability in disease processes measured, inclusion and exclusion criteria, and examination conditions.

Controlled Clinical Trials as Topic↗

PubMed2006

Psychometric properties of the Arabic version of Quality of Life Index.

AIM: This paper reports a study to translate the English language version of the Quality of Life Index into Arabic and estimate its reliability and content validity. BACKGROUND: Quality of life has become an important concern in health care and social policy. It is a difficult construct to define and measure, as it is determined by cultural, ethical, personal and religious values. The generic Ferrans and Powers Quality of Life Index was developed to measure quality of life of healthy individuals. Specific versions of the index were developed for particular diseases, such as diabetes, cancer and end-stage kidney disease. The instruments were initially developed for English-speaking clients and were later translated into several languages and used within a variety of cultures. However, there were no Arabic versions of the tool available to measure the quality of life of general populations or of people with particular diseases. METHOD: The Quality of Life Index was translated into Arabic using two of the techniques suggested in the literature for translation - back translation and bilingual technique. The same process was followed in the translation of the original scale and various disease-specific versions of the instrument. The work took place between 1995 and 2004. FINDINGS: The translated Arabic Quality of Life Index demonstrated a high degree of accuracy of translation and estimates of content validity. Subsequent to the translation of the original scale into Arabic, 13 disease-related versions of the instrument were translated and are ready for use with clients who speak Arabic. Four of the versions have been used to collect data from clients. The results revealed high estimates of reliability for the generic, diabetes, cancer and dialysis versions. CONCLUSION: The Arabic version of the Quality of Life Index is highly reliable and has sufficient content validity for measuring quality of life of Arabic-speaking clients.

Communication Barriers↗

PubMed2003

Psychometric testing of the translated McGill Quality of Life Questionnaire-Taiwan version in patients with terminal cancer.

BACKGROUND AND PURPOSE: Quality of life (QOL) is the paramount goal of end-of-life care. However, there is no Chinese language instrument for measuring QOL that has been shown to have adequate psychometric properties for Taiwanese patients with terminal cancer. The purpose of this study was to examine the psychometric properties of a Chinese language version of the McGill Quality of Life questionnaire (MQOL-Taiwan version) in this population. METHODS: The original English version of the MQOL questionnaire was translated into Chinese, and administered to 64 Taiwanese patients with terminal cancer for psychometric testing (factor structures and various types of reliability and validity). The cultural equivalence of the translation was tested by content validity index. Statistical analysis included exploratory factor analysis, Pearson's product moment correlation coefficient, and the calculation of Cronbach's alpha (alpha). RESULTS: Findings on the validity and reliability of the MQOL-Taiwan version were as follows. The value of content validity was 0.98. The range of the correlations between an item and its domain was 0.59 to 0.96 (all p < 0.05), and for inter-domain was 0.28 to 0.52 (all p < 0.05). The 4 domains of the original MQOL emerged as the 4 dominant factors (64% total variance explained) in the MQOL-Taiwan version, namely the domains of physical symptoms, psychological symptoms, existential well-being, and support. The internal consistency (Cronbach's alpha) coefficient of the whole MQOL-Taiwan version was 0.83, and those for the 4 domains ranged from 0.69 to 0.90. For the convergent and divergent validity, the MQOL-Taiwan version physical domain was moderately and significantly (r = -0.44, p < 0.05) correlated with the performance status rating of the Eastern Cooperative Oncology Group-Performance Status Rating (ECOG-PSR). The MQOL-Taiwan version psychological, existential, and support domains were not significantly correlated to the ECOG-PSR. CONCLUSIONS: The MQOL-Taiwan version demonstrated an acceptable level of reliability, validity and equivalency in the initial cross-cultural validation. These findings indicate the suitability of this QOL measure for clinical and research use in Taiwanese patients with terminal cancer.

Adult↗

PubMed1997

[Development of an instrument to measure self-care agency for the chronic ill in later adulthood--the first step of development].

The purpose of this study was to develop the instrument to measure self-care agency for the Japanese chronic ill in later adulthood and to test reliability and validity of that. First, the Self-Care Agency instrument draft which consists of 56 items rated along a 5-point Likert scale was developed. This draft was based upon the work of Orem (1991) and qualitative data of the Japanese chronic patients. Second, reliability and validity of this instrument was tested. The instrument was reviewed by 5 expert nurses and 16 nursing researchers for content validity. And this instrument was reviewed by 19 Japanese chronic patients for face validity. By result of content validity and face validity, this draft was refined. Next, the internal consistency, stability, and construct validity of this refined instrument was tested. The internal consistency of the instrument, as measured by the Cronbach's alpha, was 0.90 for a sample of 200 Japanese chronic patients. This instrument had a test-retest coefficient of r = 0.86 for a sample of 104 Japanese chronic patients. Using factor analytic techniques, five subscales emerged. These subscales gave some agreement with subscales that had been obtained before factor analysis. Therefore, construct validity of the instrument was established in some degree. And the subscale 'get a valid support' which emerged in this instrument was reflect Japanese cultural factor. Reliability and validity of this instrument were obtained in some degree. Further, it is necessary to refine this instrument, considering this research result.

Adult↗

PubMedDate not supplied

[Clinical assessment of schizophrenic syndrome (CASS): validity evaluation of the new diagnostic tool].

AIM: The aim of the study was an evaluation of validity measures of the CASS (Clinical Assessment of Schizophrenic Syndromes)--a new multi-purpose and multi-level clinical diagnostic instrument consisting of a diagnostic questionnaire (CASS-D) allowing to analyze a diagnosis of schizophrenia according to DSM-IV and ICD-10 criteria as well as of three rating scales designed for description and intensity evaluation of schizophrenic syndromes on the global (CASS-G), dimensional (CASS-P, a profile of 13 basic dimensions) or symptomatological (CASS-S, a set of 31 symptoms) level. SUBJECTS: 194 inpatients consecutively admitted to the Department within approximately 6 months were assessed twice (at the start and end of their hospitalization) by 12 trained diagnosticians. METHOD: Several measures of validity were analyzed. Results obtained by means of CASS were compared with results of the SANS/SAPS, BPRS, and PANSS as reference rating scales (diagnostic validity). Characteristics of frequency, intensity, dynamics and specificity of scale items were used to analyze content validity. Factorial structure of CASS scales was applied as a measure of construct validity. FINDINGS: Diagnostic validity of the new instrument seems to be confirmed by its very high correlation coefficients with rating scales recognized as international standards: BPRS, PANSS, and SANS/SAPS. Reasonable characteristics of frequency, intensity, dynamics and specificity of individual items (dimensions, symptoms) and sum scores of CASS scales and relationships between their values strongly suggest their content validity. Both sum (CASS-P, CASS-S) and global (CASS-G) scores of scales under study revealed some specificity--they had significantly higher values in patients with schizophrenia than in patients with other diagnoses. It allows to distinguish in a schizophrenic syndrome described by CASS components which are specific and not specific for this disorder. The latter have been left also in the final version for their practical and clinical importance. Construct validity of the CASS was studied separately for different scales (CASS-P, CASS-S) and different groups (all or only schizophrenic patients) by means of several factor analyses, and performed along identical statistical procedure (principal component method of extraction with criterion eigenvalue > 1, followed by Equamax rotation). Resulting solutions could be interpreted reasonably and consistently with contemporary attempts to find adequate factorial models of intrinsic structure of schizophrenic syndrome. Thus they support confidence for constructive aspect of the CASS validity. CONCLUSIONS: Ultimately, results obtained in the study suggest that the CASS may be considered as an instrument with some promising indices of diagnostic, content and construct validity, which may be potentially useful for clinical and research purposes.

Humans↗

PubMed2003

Evaluation of a novel electronic fetal monitor simulator.

The purpose of this study was to evaluate the content validity and construct validity of a novel electronic fetal monitor (EFM) simulator. Fourteen residents in Gynecology and Obstetrics (OB/GYN) and 7 medical students in their OB/GYN clerkship interpreted 10 fetal heart rate (FHR) tracings and 4 clinical scenarios generated by the EFM simulator. Their responses were scored by experts in maternal-fetal medicine. Construct validity was determined by comparing subjects' scores to their level of experience. Subjects assessed content validity of the EFM simulator by rating the realism of its various elements on a 4-point Likert scale. Residents achieved statistically significant higher mean scores in the description of FHR tracings generated by the simulator than medical students and statistically significant higher mean scores in the correct interpretation of and interventions in 2 of 4 clinical scenarios. Two-thirds of the residents rated the simulator-generated FHR tracings and clinical scenarios as "real" or "very real." The EFM simulator exhibited both content and construct validity, supporting its use in an educational setting.

Adult↗

PubMed1994

Domains, constructs and the development of the breathing problems questionnaire.

Health-related quality of life (QoL) questionnaires are commonly developed as content valid instruments with conventionally defined domain subscales. We contrasted content valid domain subscales with construct valid construct subscales and developed a 13-domain QoL questionnaire, the Breathing Problems Questionnaire (BPQ), for patients with chronic bronchitis. In a series of studies, we examined the constructs relevant to COPD patients' experience of health. First, we provided psychometric evidence that items in the BPQ form two distinct groups: functional problems and negative evaluations. Second, we showed that problems were significantly more correlated with morbidity whereas negative evaluations were significantly more correlated with neuroticism. Third, we showed that negative evaluations correlated with neuroticism whereas positive evaluations (measured by the Satisfaction with Illness Scale) correlated with extraversion. Patients are more likely to make positive evaluations of their illness when they recognize that they are seriously ill. Most of the BPQ domains are subcategories of the construct of problems: both domains and construct classifications provide useful information.

Aged↗

PubMedDate not supplied

Construct validity of the Chinese version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong Version).

With increasing economic globalization, including health care, it is important to use standardized outcome measures applicable to a broad spectrum of patients in a wide array of countries. The purpose of this study was to verify construct and content validity and reliability of the Chinese version of the Patient-rated Wrist Evaluation Questionnaire (PRWE-Hong Kong version). The PRWE was translated into Chinese, and face validity was established by inviting experts and patients to participate in the panel review of the questionnaire. A correlation field study was performed using a convenience sample of 47 patients with wrist injuries. Patients were assessed at baseline and six weeks after the initial measurement. The following measures were taken: the Chinese version of the PRWE and the Medical Outcome Short Form (36) Health Survey (SF-36), Visual Analogue Scale (VAS) for pain, active wrist range of motion, grip strength, and the Jebsen Hand Function Test. Statistical analysis consisted of Pearson correlation coefficients (convergent validity), factor analysis (content validity), paired t-test (convergent validity), and the Cronbach alpha (internal consistency). Clinically relevant correlations existed between "Pain at rest" and the VAS "resting pain" (r=0.785, p<0.0001) as well as between "Pain on repeated wrist movement" and the VAS "exertion pain" (r=0.872, p<0.0001). The "Physical Component Summary" of the SF-36 was found significantly correlated with the PRWE function subset total score (r=-0.618, p<0.0001), and the PRWE total score (r=-0.645, p<0.0001). The specific function subset score also correlated with the wrist flexion range (r=-0.308, p<0.0001) and the grip strength (r=-0.488, p=0.035). Two factors were found that accounted for 61% of the variance. The Cronbach alpha coefficients ranged from 0.7805 to 0.9502, indicating that the internal consistency of the questionnaire items was sound and reliable. Positive correlations between the wrist ranges of motion (ROM) and the specific function subset score showed that the function subset measured dimensions related to wrist-specific performance in activities of daily living. Factor analysis results supported the construct validity of the PRWE-Hong Kong version in wrist-injured patients. Internal consistency testing results suggested that item consistency within subset items was good and persisted over time. In conclusion, the Chinese version of the PRWE is a reliable and valid self-rated tool in measuring treatment outcome. It supplements traditional objective clinical measures and is potentially applicable in Hong Kong clinical settings.

Activities of Daily Living↗

PubMed1998

Revised Taiwanese Elderly Stressor Inventory.

The purpose of this study was to revise the 73-item Taiwanese Elderly Stressor Inventory (TESI) so as to shorten the time needed by professionals and researchers to assess the stress experience of elderly persons. The research included two phases: Phase I consisted of revising the original form by combining similar items and deleting some TESI items which were found not to effectively test the concept of stress; and Phase II analyzed the reliability and validity of the revised form. The revised instrument consists of sixty stressor items. Two doctorally prepared nurses were used to determine TESI item content validity, resulting in a Content Validity Index of 0.97. Three hundred and one subjects from one district in Metropolitan Taipei area were used in determining the psychometric properties of the revised form. A Cronbach alpha of 0.74 was found. The coefficient for test-retest reliability was 0.89. As to construct validity, correlations of -0.327 with health perception, 0.520 with depression and -0.433 with life satisfaction were found. In the multiple regression analysis, health perception, depression, stressfulness and social support were predictors, while life satisfaction was a criterion variable. Total explanation variance was 41.42%. These results reveal the predicted pattern of relationship among variables, which reflected the modest validity of the revised TESI. The revised TESI possesses a sound psychometric properties, which suggests that it can be readily used in practice settings.

Aged↗

PubMed1987

Prototypicality ratings of DSM-III criteria for personality disorders.

Although DSM-III personality disorder criteria have demonstrated acceptable reliability, the question of validity has not been adequately addressed. A first step in establishing the validity of diagnoses is to establish the validity of the criteria used to assess each diagnosis. The content validity of diagnostic criteria was investigated in relation to the larger set of potential criteria culled from the psychiatric literature. For each DSM-III axis II diagnosis, a panel of clinicians rated how prototypical each potential criterion was of the diagnosis in question. The results reveal problems with the organization and content of the criteria for most diagnoses. Many DSM-III criteria are composed of several statements linked by conjunctions or disjunctions. These component statements often received markedly different ratings, suggesting that criteria should be single statements. For most diagnoses, traits not included in DSM-III received higher ratings than did some DSM-III criteria. Suggestions are made to improve the distinctiveness and content validity of paranoid, schizoid, antisocial, borderline, avoidant, dependent, and compulsive personality disorders. The results for schizotypal personality disorder suggest that many clinicians are uncertain about this diagnosis. These findings provide a systematic way to modify definitions that contrasts with the more arbitrary ways in which diagnoses have previously been defined and redefined.

Diagnosis, Differential↗

PubMed2001

The nurse specialist role in Hong Kong: perceptions of nurse specialists, doctors and staff nurses.

AIM: The purpose of this study is to review and delineate the impact in terms of the perceived importance as well as the role components of nurse specialists in Hong Kong. RATIONALE: The Nurse Specialist Scheme was launched in 1994 in Hong Kong. Studies in the West showed that there were impacts on the roles of other members among the health care team. However, minimal local published work has been carried out in reviewing the scheme. DESIGN: The design of the study was nonexperimental. Data were collected by self-administered questionnaires. The questionnaire adopted was developed by O'Mullan (1995), and the five roles studied were administration, clinical practice, consultation, education and research. To ensure the contextual relevancy and consistency of the questionnaire, content validity and test-retest reliability tests were performed. The content validity index was 0.85 and the test-retest reliability (Spearman's rho coefficient) ranged from 0.57 to 0.97. Subjects were obtained by stratified convenience sampling technique. The ratios for subject selection among the doctors, ward managers, nursing officers and registered nurses were 3:1:3:10, respectively. Because of the small numbers for nurse specialists, they were all included in the study. The final sample consisted of 11 nurse specialists, 47 ward managers, 56 nursing officers, 110 registered nurses and 15 doctors (n=239). RESULTS: The results showed that there were significant differences in the perceptions of importance of the administration, clinical practice, education and research roles, and the frequency of occurrence of the clinical practice and research roles. This was further verified by the Fisher's Least Significant Differences (LSD) test. CONCLUSIONS: A regulatory system of the nurse specialist was recommended to monitor the development of the nurse specialist role and practice and to ensure the safety of the public with regard to the emerging role. Both the implications and limitations are discussed.

Attitude of Health Personnel↗

PubMed2003

Directory of clinical databases: improving and promoting their use.

BACKGROUND: The controversy surrounding the actual and potential use of clinical databases partly reflects the huge variation in their content and quality. In addition, use of existing clinical databases is severely limited by a lack of knowledge of their availability. OBJECTIVES: To develop and test a standardised method for assessing the quality (completeness and accuracy) of clinical databases and to establish a web based directory of databases in the UK. METHODS: An expert group was set up (1). to establish the criteria for inclusion of databases; (2). to develop a quality assessment instrument with high content validity, based on epidemiological theory; (3). to test empirically, modify, and retest the acceptability to database custodians, face validity and floor/ceiling effects; and (4). to design a website. RESULTS: Criteria for inclusion of databases were the provision of individual level data; inclusion in the database defined by a common circumstance (e.g. condition, treatment), an administrative arrangement, or an adverse outcome; and inclusion of data from more than one provider. A quality assessment instrument consisting of 10 items (four on coverage, six on reliability and validity) was developed and shown to have good face and content validity, no floor/ceiling effects, and to be acceptable to database custodians. A website (www.docdat.org) was developed. Indications over the first 18 months (number of visitors to the site) are that it is increasingly popular. By November 2002 there were around 3500 hits a month. CONCLUSIONS: A website now exists where visitors can identify clinical databases in the UK that may be suitable to meet their aims. It is planned both to develop a local version for use within a hospital and to encourage similar national systems in other countries.

Databases, Factual↗

PubMed2001

Self-efficacy in children with diabetes mellitus: testing of a measurement instrument.

The study reported here assessed the psychometric properties of an instrument to measure diabetes management self-efficacy in Dutch children, ages 8 to 12. Content validity of the item list was tested by consulting an expert panel of diabetes nurse specialists and a child-oriented rating scale was developed. A pretest was conducted to assess whether the instrument was clear and comprehensible for children. Then the instrument was tested in children with diabetes at the outpatient diabetes clinics for children at three Dutch hospitals. Reliability and criterion-related validity of the instrument were assessed. The instrument was judged content valid by the expert panel of diabetes nurse specialists, and the language of the instructions, the items and the rating scale was found to be clear and understandable for children of this age group. The study yielded only a moderate internal consistency estimate (Cronbach's = 0.71) and limited support for criterion-related validity. Several useful theoretical and methodological issues were identified.

Child↗

PubMed2004

Knowledge and attitudes in pain management: Hong Kong nurses' perspective.

Effective pain management requires accurate knowledge, attitudes and assessment skills. To determine the current knowledge level and attitudes of nurses in pain management, 1,604 registered nurses working in three different hospitals in Hong Kong were invited to participate in this study. The sample consisted of 601 registered nurses, 63 nursing officers, and 14 nursing specialists (N = 678). The response rate was 43%. The Nurses' Knowledge and Attitudes Survey Instrument questionnaire developed by McCaffery and Ferrell was translated into Chinese and used with permission. To ensure the contextual relevancy and consistency of the questionnaire, content validity and test-retest reliability tests were performed. The content validity index was 0.87 and the test-retest reliability (Spearman's p coefficient) was 0.812. The percentage of correctly answered questions was 44%. There was statistical significant in educational preparation and clinical experiences with correct scores. The findings of our study support the concern of inadequate knowledge and attitudes in relation to pain management. Further intensive continuing education and staff development is highly indicated for nurses in Hong Kong.

Adult↗

PubMed1990

[Research methodology for the formulation of nursing standards].

The purpose of this article is to describe the research methodology to be utilised when formulating nursing standards. Standards guide the practice and should be formulated within the context of the culture of a country, its philosophical and ethical values, and its social, economic and political development. Two approaches of standard formulation were identified, namely a national generic approach and a decentralised, specific approach. A structured two-phase model is recommended, consisting of a developmental and a quantification phase. In the case of national standards, statistical determination of the content validity of the standards is recommended by means of a content validity index determination of each standard.

Humans↗

PubMed1992

Improving the validity of the PSNI in assessing the performance of deaf parents of hearing children.

The content validity of the Parental Strengths and Needs Inventory (PSNI) for evaluating the child-rearing performance of deaf adults was assessed by replicating and extending an earlier cross-sectional descriptive study. Three types of subjects--deaf parents, hearing offspring, and hearing grandparents--provided the research data. The interview responses of 15 parent-child dyads were triangulated with grandparent questionnaire responses to identify parental issues not tapped by the closed-ended PSNI format. The content validity of the PSNI in its present form was found to be inadequate for assessing the strengths and needs of deaf parents. Recommendations for modifying the PSNI for use with deaf parents of hearing children are advanced.

Adolescent↗