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PubMed2004

The Ophthalmic Clinical Evaluation Exercise (OCEX).

PURPOSE: New concise tools must be developed to assess reliably and validly the core residency competencies identified by the Accreditation Council for Graduate Medical Education. PARTICIPANTS: Eighteen content experts (residency program directors). METHODS: A 1-page Ophthalmic Clinical Exercise Examination (OCEX) checklist, for use during observed resident-patient interactions, was developed by an American Board of Ophthalmology taskforce. The OCEX checklist was sent to 18 content experts for their review and constructive comments. RESULTS: Experts' comments were incorporated, establishing face and content validity. CONCLUSIONS: The OCEX has face and content validity. It can be used to assess a resident's patient care skills, medical knowledge, and interpersonal skills. Reliability and predictive validity still need to be determined.

Accreditation↗

PubMedDate not supplied

The staff nurse decisional involvement scale: report of psychometric assessments.

BACKGROUND: For decades, enhancing staff nurse decisional involvement in matters of nursing practice and patient care has been identified as a long-term strategy to improve the quality of the nursing work environment and the safety and quality of patient care. OBJECTIVE: To describe psychometric assessments of the Decisional Involvement Scale (DIS), a diagnostic and evaluative measure of nurse decisional involvement. METHODS: A series of assessments were conducted to evaluate the psychometric performance of the scale. Content validity was assessed by experts in the field. Descriptive statistics were used to examine the use and performance of the scale. The contrasted groups approach was used to assess construct validity. Item analysis was used to explore evidence of the internal consistency of items and subscales across multiple samples. Structural modeling was used to conduct a confirmatory factor analysis using data from two independent samples of staff registered nurses (RNs; n = 849 and 650). RESULTS: Acceptable content validity indexes (CVIs) were independently generated by three content experts. Construct validity was supported, as hypothesized; nurses working on professional practice units scored significantly higher for all items when compared to nurses working on units without professional practice models in place. Internal consistency (coefficient alpha) was high and nearly identical for the total measure and all subscales across the two independent nurse samples. Six subscales were identified using factor analysis, and these were confirmed by structural modeling. CONCLUSION: Psychometric findings support that the DIS is a valid and reliable measure of staff nurse decisional involvement.

Cooperative Behavior↗

PubMed2005

[Study on predicting sugar content and valid acidity of apples by near infrared diffuse reflectance technique].

The nondestructive method for quantifying sugar content (SC) and available acid (VA) of intact apples using diffuse near infrared reflectance and optical fiber sensing techniques were explored in the present research. The standard sample sets and prediction models were established by partial least squares analysis (PLS). A total of 120 Shandong Fuji apples were tested in the wave number of 12,500 - 4000 cm(-1) using Fourier transform near infrared spectroscopy. The results of the research indicated that the nondestructive quantification of SC and VA, gave a high correlation coefficient 0.970 and 0.906, a low root mean square error of prediction (RMSEP) 0.272 and 0.056 2, a low root mean square error of calibration (RMSEC) 0.261 and 0.0677, and a small difference between RMSEP and RMSEC 0.011 a nd 0.0115. It was suggested that the diffuse nearinfrared reflectance technique be feasible for nondestructive determination of apple sugar content in the wave number range of 10,341 - 5461 cm(-1) and for available acid in the wave number range of 10,341 - 3818 cm(-1).

Acids↗

PubMed2001

A measure of critical care nurses' post-code stress.

AIM: The purpose of this research was to develop an instrument to measure critical care nurses' post-code stress and then to examine the psychometric properties. BACKGROUND: Critical care nurses experience stress from multiple sources. One source of stress may arise from participation in resuscitation attempts and this has been labelled post-code stress; however, no means exist for measuring this source of stress. DESIGN/METHOD: In phase 1, 47 items were developed and submitted to a panel of experts for content validity. Based on content experts' ratings, 20 items were retained for phase 2 instrument testing. To test the instrument, a convenience sample of critical care nurses was obtained from four institutions in north-eastern United States. Each nurse received the Post-Code Stress Scale and completed it anonymously. A subsample completed the Post-Code Stress Scale a second time to assess stability reliability. The Nursing Stress Scale was also administered to assess construct validity. RESULTS/FINDINGS: An exploratory principal components factor analysis with varimax rotation suggested five dimensions to post-code stress. These five dimensions accounted for 66% of the variance and indicated that stress arose from feeling discomposed, oppressed, uncertain, burdened and morally conflicted. The Pearson product moment correlation between the Post-Code Stress Scale and the Nursing Stress Scale was 0.46, providing preliminary evidence of construct validity. Internal consistency reliability estimates for the five-factor subscales ranged from 0.57 to 0.77 with only one factor being <0.70. The internal consistency reliability estimate for the final 14 items on the scale was 0.79. CONCLUSIONS: The instrument shows promise as a measure of post-code stress based on the evidence obtained in this study; however, further psychometric testing is warranted.

Adult↗

PubMed1997

Short Form 36 in the intensive care unit: assessment of acceptability, reliability and validity of the questionnaire.

The aim of this study was to assess the acceptability, validity and reliability of the Short Form 36 quality of life questionnaire in 166 adult patients following discharge from a general intensive care unit. Reliability was quantified by measuring internal consistency using correlation among items and Cronbach's alpha coefficient. Reliability coefficients were calculated from two-way analysis of variance. Construct validity was tested by examining differences in scores between sex and age groups. Content validity was reflected by the spread of dimension scores. Acceptability to patients appeared reasonable, although considerable nursing time was required to administer the questionnaire. The measures of reliability exceeded recognised statistical standards in all but two instances. Construct validity was confirmed by lower scores being reported by women and older age groups. The scores of six of the eight dimensions were spread throughout the entire range of possible scores suggesting acceptable content validity.

Adolescent↗

PubMed2006

Supraesophageal reflux: validation of a symptom questionnaire.

OBJECTIVE: To develop and validate a questionnaire for supraesophageal manifestations of reflux (SER) that will facilitate its study in clinical and research settings. STUDY DESIGN: The Supraesophageal Reflux Questionnaire (SERQ) and previously validated Reflux Symptom Index (RSI) were subjected to multiple types of validity testing, including content validity, concurrent validity, reproducibility, and predictive validity. RESULTS: The concurrent validity and reproducibility of both instruments was good to excellent for most items tested. The predictive validity of the SERQ was superior to the RSI when it included the covariates of history of sinusitis, use of over-the-counter antacid medications, age, gender, and body mass index. CONCLUSIONS: The SERQ will serve as both a useful clinical and research tool by offering not only SER symptom information, like the RSI, but also information about the patient's medical history and medication usage that will facilitate use of the SERQ in research protocols. EBM RATING: B-2b.

Antacids↗

PubMed2005

Design, format, validity and reliability of multiple choice questions for use in nursing research and education.

Multiple choice questions are used extensively in nursing research and education and play a fundamental role in the design of research studies or educational programs. Despite their widespread use, there is a lack of evidence-based guidelines relating to design and use of multiple choice questions. Little is written about their format, structure, validity and reliability of in the context of nursing research and/or education and most of the current literature in this area is based on opinion or consensus. Systematic multiple choice question design and use of valid and reliable multiple choice questions are vital if the results of research or educational testing are to be considered valid. Content and face validity should be established by expert panel review and construct validity should be established using 'key check', item discrimination and item difficulty analyses. Reliability measures include internal consistency and equivalence. Internal consistency should be established by determination of internal consistency using reliability coefficients while equivalence should be established using alternate form correlation. This paper reviews literature related to the use of multiple choice questions, current design recommendations and processes to establish reliability and validity, and discusses implications for their use in nursing research and education.

Education, Nursing↗

PubMedDate not supplied

Reporting of instrument validity and reliability in selected clinical nursing journals, 1989.

Before research findings are applied to practice, the quality of the research must be assessed so that flawed research does not lead inadvertently to flawed practice. Two critical indicators of research quality are the validity and reliability of the data collection instruments. This article summarizes the principles of instrument validity and reliability and identifies deviations from these principles in a random sample of 55 research studies published in 1989 in five refereed nursing journals targeted toward practicing clinicians. Using a valid and reliable instrument, the investigators found that even with a policy of giving authors "the benefit of the doubt," 47% of the research studies contained no evidence of validity for any data collection instruments and 36% had no evidence of reliability; 29% had no evidence of either validity or reliability. Content validity, a basic requirement for all research instruments, was addressed in only 27% of the studies. This article provides documentation, justification, and suggestions for nursing educators, journal editors, and researchers to take action to improve the reporting of instrument validity and reliability to help ensure the quality of the research on which nursing practice is based.

Clinical Nursing Research↗

PubMed1998

Psychometric properties of the Health Utilities Index Mark 2 system in paediatric oncology patients.

This study examined the reliability and validity of the Health Utilities Index (HUI) Mark 2 system, a health-related quality of life (QoL) instrument, in children with cancer. The sample consisted of 61 mothers of paediatric oncology patients, aged 4.1-17.3 years, who were either on treatment (n = 20) or off treatment (n = 41). The test-retest reliability was very good for the HUI Mark 2 system global score and all of its dimensions except pain. The HUI Mark 2 dimensions of emotion, pain and self-care as well as its overall score showed moderate convergent validity with other measures. In addition, the HUI Mark 2 system demonstrated good discriminant validity. However, the content validity of the HUI Mark 2 system when considered as a multiattribute descriptive health profile is questionable because it falls to assess domains such as neuropsychological and psychosocial functioning. Overall, the results indicate that the HUI Mark 2 system is reliable and valid as a measure of health-related QoL for paediatric oncology patients.

Adaptation, Psychological↗

PubMed1991

DSM-IV: empirical guidelines from psychometrics.

This commentary addresses the use of psychometric theory and methodology in the development of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Reliability issues include interdiagnostician reliability, temporally consistent diagnoses, and the relations of diagnostic criteria within categories. Validity issues include content validity of the diagnostic criteria, criterion-related validity (the relation between different criterion sets or their algorithms and alternative diagnostic criteria), and construct validity (the relation between diagnostic categories and external validators). Specific questions and methodology to investigate its utility vary with the different uses proposed for the diagnostic system. Specific psychometric methodologies that may be useful in developing the DSM-IV are noted, as are the limitations of psychometrics and their applicability to DSM-IV.

Humans↗

PubMed2005

Positive psychological measure: constructing and evaluating the reliability and validity of a Chinese Humor Scale applicable to professional nursing.

The nursing profession has generally accepted humor as beneficial to health care. As nursing has always emphasized holistic care and the importance of individual needs, the profession values the ability of humor to positively affect all aspects of a patient's well being. The purposes of this study were to develop a "Chinese Humor Scale (CHS)" for the nursing profession and then test its reliability and validity. The 405 individuals selected for participation in this study included nursing on-the-job students from a medical university and professional nurses practicing at four hospitals in north Taiwan. Researchers developed a list of 57 key humor measures which were filled out and returned by study participants. An evaluation of results using Cronbach's alpha coefficients demonstrated good consistency (alpha=.93) for the developed CHS. Intercorrelations amongst the four sub-scales were generally quite low, indicating each sub-scale measures dimensions relatively distinct from one another (r=.24 approximately .48, both p's<.001). The CHS was tested using item analysis. The scale was constructed in accordance with exploratory factor analysis (EFA) (K.M.O.=.92). Thirty CHS items, categorized under the four indices of "humorous creativity", "tendency to laugh", "perceptivity to humor", and "humorous attitude", were found to explain 55.42% of total variances. The CHS was found to provide good validity using a content validity index (CVI) developed by five experts. The results of this study provide encouraging evidence for the construct validity and reliability of the proposed humor scale and support its application by nursing educators and clinicians to further test and assess concepts related to humor. Further research is needed to explore more fully the implications of humor in nursing.

Adolescent↗

PubMed1992

The Canberra Interview for the Elderly: a new field instrument for the diagnosis of dementia and depression by ICD-10 and DSM-III-R.

The Canberra Interview for the Elderly (CIE) has been developed as a field instrument for identifying cases of dementia and depression, doing so strictly according to the diagnostic criteria in both the draft ICD-10 and DSM-III-R. It has been designed to be administered by lay interviewers. Information is gathered from the subject and an informant, and is then processed by computer algorithm to generate diagnoses. In a sample of 76 elderly patients attending a hospital clinic, test-retest reliability was found to be high at the level of individual items. For the diagnoses made on two occasions, agreement was comparable with other standardized psychiatric interviews designed for lay administration in the community. Validity, other than content validity, remains to be assessed. The CIE and its diagnostic algorithms are an efficient tool for clinical and epidemiological research on dementia and depression among elderly people, where close adherence to international criteria is required.

Aged↗

PubMedDate not supplied

Multinational validation of anxiety, hopelessness, and ineffective airway clearance.

The effective use of nursing diagnosis internationally depends in part on incorporating language and cultural difference into the common language of nursing. International validation studies can provide a basis for this effort. This study tested three diagnoses--anxiety, hopelessness, and ineffective airway clearance--through multinational validation. The Diagnostic Content Validity (DCV) model was used to collect data from critical care nurses in six countries. Defining characteristics rated as critical (greater than .80) by the total sample were dyspnea for ineffective airway clearance and panic and nervousness for anxiety. No critical defining characteristics for hopelessness were identified. DCV ratios for all defining characteristics are compared by country.

Airway Obstruction↗

PubMed2006

The impact of fixed orthodontic appliances on daily life.

OBJECTIVE: i) To develop a measure of the impact of fixed orthodontic appliances on daily life. ii) To assess the impact of fixed appliances over time after initial appliance placement. iii) To investigate factors that may influence the impact of fixed appliances (age, gender and socioeconomic status). RESEARCH DESIGN: Questionnaire. CLINICAL SETTING: University Dental Hospital and Hope Hospital, Manchester. SAMPLE: Sixty-six patients, whose orthodontic appliances had just been placed. Twenty-eight patients whose orthodontic appliances were in place for at least six months were used for the reliability study. METHOD: The Impact of Fixed Appliances Questionnaire was developed using standard qualitative methods and pre-tested on 10 patients. This resulted in a questionnaire with nine conceptual impact sub-scales: aesthetic, functional limitation, dietary, oral hygiene, maintenance, physical, social, time constraints and travel/cost. The questionnaire was piloted on 66 patients, at the first, second and third visits after their fixed appliance had been placed, to assess the impact of fixed appliances over time. Questionnaire reliability, over a one-month time interval, was assessed on 40 patients who had been in treatment for at least six months. MAIN OUTCOME MEASURE: Impact of fixed appliances on daily life. RESULTS: The internal reliability of the questionnaire ranged from moderate to very good (Cronbach's alpha 0.56-0.89). Test-retest reliability was stable for most subscales (intra-class correlation coefficient 0.26-0.65). The questionnaire was said to have face validity and also content validity because of the method of questionnaire development through interviewing children with fixed appliances. None of the subscales scores reduced over time except aesthetic impact (p< 0.05) but this was probably not a clinically significant change. Age was the predominant variable to influence the impact of fixed appliances with younger children being less affected during their daily life (p<0.05). CONCLUSIONS: The questionnaire developed in this study is a reliable tool for assessing the impact of fixed appliances on the daily life of children. It is unlikely that the impact of fixed appliances on daily life reduces as the patient progresses through treatment. Younger patients are probably more adaptable to treatment with fixed appliances, in terms of reduced impact on daily life, so arguably treatment should be started as early as possible. This information could also be used to educate, reassure and motivate patients at the start of treatment.

Adolescent↗

PubMed2004

Assessment of fecal output in patients receiving enteral tube feeding: validation of a novel chart.

OBJECTIVE: To develop a practical, valid and reliable chart to assist in the accurate visual characterization of fecal output in patients receiving enteral tube feeding (ETF). DESIGN: A chart incorporating verbal and pictorial descriptors of fecal output was developed. Validity and reliability were assessed by a questionnaire survey of health professionals and a clinical study of patients commencing ETF. Content validity was assessed from the results of the questionnaire, construct validity by contrasting groups analysis, concurrent validity by comparison of the chart with actual fecal weight and inter-rater reliability by independent characterization of the same fecal sample by two nurses. SETTING: St George's Hospital, London, UK. SUBJECTS: In all, 35 health professionals completed a questionnaire with respect to the chart. The chart was then used to monitor fecal output in 36 patients commencing ETF for a total of 171 patient-days, during which time nurses used the chart to characterize 269 fecal samples, of which 59 were subsequently weighed. RESULTS: The results of the questionnaire suggested good content validity. The chart demonstrated statistically significant differences in fecal frequency, fecal consistency, fecal score and incidence of diarrhea for contrasting patient groups expected to have different fecal output (P < 0.05). The inter-rater reliability was almost perfect for fecal consistency (95% agreement, kappa = 0.91) and substantial for fecal weight (83%, kappa = 0.75). In all, 83% of fecal samples were assigned to the correct weight category (kappa = 0.75). CONCLUSION: The chart has good content, construct and concurrent validity and inter-rater reliability, and is suitable for both research and clinical use. SPONSORSHIP: This research was jointly supported by King's College London and Nestlé, UK.

Diarrhea↗

PubMed2005

The validity of explicit indicators of prescribing appropriateness.

OBJECTIVE: To assess, from the perspective of UK hospital doctors, the content validity and operational validity of a set of 14 previously developed explicit indicators of the appropriateness of long-term prescribing started during a hospital admission. METHOD: A combination of data extraction from medical records and qualitative interviews with a maximum variability sample of hospital doctors. PARTICIPANTS: The indicators were applied to 132 new prescriptions, intended for long-term use, prescribed for 61 patients; 36 doctors, of various grades, were purposively selected for interview. RESULTS: Appropriate prescribing was viewed as prescribing that was indicated, necessary, evidence based (using a broad meaning of 'evidence') and of acceptable cost and risk-benefit ratio. These concepts applied to individual drugs for individual patients, rather than at a more general, public health level. Where drugs had failed an indicator, rationales were explored. Often, it was missing data in the medical notes that had resulted in the drug failing the indicator. CONCLUSIONS: The 14 indicators were considered to have content validity, reflecting all aspects of appropriate prescribing discussed by the doctors. Their operational validity was less clear-cut, due to the lack of necessary data in the medical notes. This has implications for the use of explicit indicators for assessing prescribing appropriateness, as these hospital doctors did not consider that the data required for objective, systematic assessment of prescribing would ever be recorded in hospital medical notes.

Attitude of Health Personnel↗

PubMed1997

The Juvenile Arthritis Quality of Life Questionnaire--development of a new responsive index for juvenile rheumatoid arthritis and juvenile spondyloarthritides.

OBJECTIVE: To develop a disease specific measure of quality of life for application in children with juvenile rheumatoid arthritis and juvenile spondyloarthritides-the Juvenile Arthritis Quality of Life Questionnaire (JAQQ). METHODS: Patients and their parents were interviewed by a trained interviewer using a questionnaire focusing on physical function, psychosocial function, and general symptoms to determine the most appropriate items to include in the JAQQ. Respondents volunteered items and scored them for frequency of occurrence and importance. Items so generated were scored by a panel of experts for potential responsiveness and categorized into dimensions. Item number was reduced using this scoring system. The product was then pretested to confirm its construct validity and responsiveness. Thereafter, it was distributed to clinical experts to establish face and content validity. RESULTS: 91 patients, mean age 10.35 years (range 1.25-18.0), mean disease duration 3.99 years, and their parents were included in the interview process. 220 items generated were ultimately reduced to 85. Pretesting this version of the instrument in a further 30 patients showed it to have construct validity and responsiveness and led to a further reduction in items to 74, distributed in 4 dimensions: gross motor function (17 items), fine motor function (16 items), psychosocial function (22 items), and general symptoms (19 items). Face and content validity were established in 20 clinicians. Scaling was by 7 point Likert scale to enhance responsiveness. English and French versions were developed. CONCLUSION: The JAQQ measures physical and psychosocial function and an array of general symptoms. Preliminary data suggest it is valid and responsive and thus might have potential in clinical trials.

Adolescent↗

PubMed2006

Measuring troublesomeness of chronic pain by location.

BACKGROUND: Current measures of pain assess the relative contribution of pain in different body regions to the overall impact of pain. We developed a series of questions to measure the relative 'troublesomeness' of pain in different body regions (the "troublesomeness grid"). The study aimed to determine whether the "troublesomeness grid" is an appropriate measure to assess the severity of pain in different body regions, allowing the comparative severity of pain in different body regions to be assessed. METHODS: We used data from a pilot for a population survey of pain (N = 205) and from the population survey itself (N = 2504) to assess the 'troublesomeness grid's performance. Specifically, its face and content validity using overall and item non-completion rates; its criterion related validity by exploring the relationship between troublesomeness and standard measures of pain, disability, distress and health utility for the five body regions most commonly affected by chronic pain; and its reliability and reproducibility in a test/re-test study. RESULTS: The troublesomeness grid appeared to have good face validity as it had good completion rates. It also appeared to have good content validity as the percentage agreement between the grid and the pain manikin was high (over 90%). In terms of criterion related validity, troublesomeness was most strongly correlated with pain intensity and health related quality of life, but less with disability and distress. The test-retest reliability was between 80% and 90% for the majority of body regions examined. CONCLUSION: The troublesomeness grid is well completed and appears to be an appropriate tool to assess the comparative severity of pain in different body regions.

Chronic Disease↗