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PubMed1998

Development and validation of the avoidance of environmental tobacco smoke scale.

The Avoidance of Environmental Tobacco Smoke (ETS) scale is a self-report measure of the avoidance of ETS by young adults. Initial use of the scale with 30 undergraduate students showed an internal consistency of .84 across 40 items and .90 in a refined 28-item instrument. In a sample of 241 students, a 20-item scale had an internal consistency reliability of .94 and a refined 10-item scale had an internal consistency of .86. In a sample of 95 mothers with a mean age of 36, the 10-item scale had an internal consistency of .81. In three distinct samples, significant known groups' discrimination was found between smokers and nonsmokers. Psychometric analysis indicates that the scale merits further testing using a more heterogeneous sample from community and clinical populations to ensure its usefulness by clinicians and researchers interested in explaining, predicting, and preventing exposure to ETS.

Adult↗

PubMed1998

Measuring the information needs of husbands of women with breast cancer: validity and reliability of the Family Inventory of Needs--husbands.

PURPOSE/OBJECTIVES: A two-phase study was undertaken to test the Family Inventory of Needs--Husbands (FIN-H), a tool designed to measure the information needs of husbands of women with breast cancer and the extent to which these needs are met. DESIGN: Methodologic survey. SAMPLES: Phase I: a panel of 6 husbands; phase II: 84 husbands of women with breast cancer. METHODS: Panel of expert ratings followed by pilot test of the two-part survey. FINDINGS: In phase I, husbands assessed the FIN-H for clarity, internal consistency, and content validity. All preset criteria were met. In phase II, internal consistency, test-retest reliability, and internal validity were assessed. Internal consistency estimates as measured by Cronbach's standardized alpha coefficients were 0.91 and 0.93. Test-retest correlations were 0.82 and 0.76 (p = 0.0001). Exploratory factor analysis suggested that the FIN-H consists of five factors. CONCLUSIONS: Initial results suggest that the FIN-H is reliable and valid. Further testing is needed to confirm these results. IMPLICATIONS FOR NURSING PRACTICE: Before nurses can address the information needs of husbands of women with breast cancer, use of a reliable and valid assessment tool is recommended.

Adult↗

PubMed2004

High-fidelity patient simulation: validation of performance checklists.

BACKGROUND: Standardized scenarios can be used for performance assessments geared to the level of the learner. The purpose of this study was to validate checklists used for the assessments of medical students' performance using high-fidelity patient simulation. METHODS: Our undergraduate committee designed 10 scenarios based on curriculum objectives. Fifteen faculty members with undergraduate educational experience identified items considered appropriate for medical students' performance level and identified items that, if omitted, would negatively affect grades. Items endorsed by less than 20% of faculty were omitted. For remaining items, weighting was calculated according to faculty responses. Students managed at least one scenario during which their performance was videotaped. Two raters independently completed the checklists for three consecutive sessions to determine inter-rater reliability. Validity was determined using Cronbach's alpha with an alpha>or=0.6 and <or=0.9 considered acceptable internal consistency. Item analysis was performed by recalculating Cronbach's alpha with each item deleted to determine if that item contributed to a low internal consistency. RESULTS: 135 students participated in the study. Inter-rater reliability of the two raters determined on the third session was 0.97 and therefore one rater completed the remaining performance assessments. Cronbach's alpha for the 10 scenarios ranged from 0.16 to 0.93 with two scenarios demonstrating acceptable internal consistency with all items. Three scenarios demonstrated acceptable internal consistency with one item deleted. CONCLUSIONS: Five scenarios developed for this study were shown to be valid when using the faculty criteria for expected performance level.

Algorithms↗

PubMed2005

A psychometric analysis of the Geriatric Hopelessness Scale (GHS): towards improving assessment of the construct.

BACKGROUND: Hopelessness increases vulnerability to late-life depression and risk for suicide. The present study examined the psychometric properties of the Geriatric Hopelessness Scale (GHS; Fry, 1984) among a heterogeneous sample of older adults and its association with depression and suicide ideation. METHODS: Seventy-eight adults 65 years or older recruited from psychiatric, medical, residential, and community were administered the study measures. We examined the item-response characteristics, factor structure, and reliability of the GHS, its construct validity by way of associations with depression, hopelessness, and suicide ideation, and criterion validity in terms of differentiating psychiatric patients from non-psychiatric participants. RESULTS: The GHS had poor item-response characteristics but acceptable internal consistency and construct validity. A factor analysis yielded three internally consistent factors assessing Fatalistic, Interpersonal, and Spiritual Hopelessness. An 11-item GHS-Suicide Risk subscale was identified with acceptable internal consistency, significant association with measures of hopelessness, depression, and suicide ideation, and that differentiated psychiatric patients from non-psychiatric participants. LIMITATIONS: This study had a relatively small sample size, included a high proportion of female respondents (79%), and a relatively low proportion of patients in mental health care (17%). CONCLUSIONS: The GHS had acceptable reliability and construct validity, but poor item-response characteristics and criterion validity with respect to differentiating psychiatric patients from non-psychiatric participants. Use of shortened GHS measures may improve upon the limitations of the full scale, and may be preferable when seeking to identify older adults at risk for suicide.

Aged↗

PubMed2005

A subjective rating scale for evaluating the appearance outcome of autologous breast reconstruction.

BACKGROUND: Subjective evaluations of the appearance outcome of autologous breast reconstruction are usually performed by surgeons and not by patients. Such surgeon-based evaluations are rarely reproducible and show little interobserver agreement. Among existing patient-based subjective scales, none has been tested for reliability, and no study to date has evaluated the reliability when both surgeons and patients use the same scale. METHODS: The authors developed a new instrument for assessing the appearance of autologous breast reconstruction. The instrument's use by four plastic surgeons and 36 transverse rectus musculocutaneous flap patients was assessed for test-retest reliability, internal consistency, surgeon-patient and surgeon-surgeon interobserver agreement, and interitem correlation. RESULTS: The instrument demonstrated high overall internal consistency when used by patients (Cronbach alpha = 0.92). Test-retest reliability on each aesthetic subitem in the scale was higher among patients than among surgeons (weighted kappa range, 0.57 to 0.88 versus 0.25 to 0.66). Interrater agreement was poor among both patients and surgeons (weighted kappa, 0.0 to 0.39). Poor correlation was found between surgeons' evaluations of aesthetic subitems and patients' overall appearance and overall satisfaction scores. CONCLUSIONS: The instrument both demonstrates better internal consistency and is more reliable when used by patients to evaluate their own reconstructions. By contrast, the instrument's use by surgeons is not as internally consistent and reproducible. The poor interobserver agreement among surgeons and the weak correlation between surgeon and patient evaluations suggest that patient input regarding item-specific criteria should be included in evaluations of breast reconstructions.

Esthetics↗

PubMed2006

Cross-cultural validation of the hill-bone compliance to high blood pressure therapy scale in a South African, primary healthcare setting.

OBJECTIVES: Hypertension is prevalent, under-diagnosed, and inadequately treated in Black South Africans. However, few studies have addressed barriers to hypertension care and control in this community. The aim of this study was to validate the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HB Comp Scale) for use in a South African primary healthcare setting. This instrument consists of three subscales, medications-compliance, appointment making, and salt intake. METHODS: A demographic questionnaire and the HB scale were translated into the first language of the subjects and then back-translated into English. Hypertensive patients (N=98) were recruited from primary healthcare clinics in Cape Town. Blood pressure was measured with an Omron electronic blood pressure manometer, after 5 min of seated rest. Item-analysis was conducted to determine internal consistency of the HB Comp Scale; Spearman rank order correlations were used to assess the relationship between compliance scores and blood pressure. RESULTS: A modified scale consisting of only 10 items demonstrated reasonable internal consistency (item-total correlations all >.31, and a standardized Cronbach alpha of 0.79), with an average interitem correlation of .26. In addition, the modified scale had significant predictive validity in that noncompliance predicted higher diastolic blood pressures (p=.21, P<.05) and medication noncompliance tended to predict higher systolic blood pressures (p=.20, P<.06). Appointment-making and dietary salt-intake subscales were not internally consistent. CONCLUSIONS: We demonstrated criterion validity and internal consistency for a modified Hill-Bone Compliance Scale, in Black, urban, hypertensive, South African patients. Results compare favorably with those from an urban African-American setting (standardized Cronbach alpha was .74-.84).

Adult↗

PubMed2005

Psychometric properties of the Stirling Eating Disorder Scales with bulimia nervosa patients.

BACKGROUND: The Stirling Eating Disorder Scales (SEDS) are described as a well-validated measure of anorexic and bulimic cognitions and behaviors. However, there is little published research that demonstrates or tests the psychometric properties of the SEDS. The aim of this study was to assess the internal consistency of the SEDS with a clinical population at a specialist eating disorders service. METHOD: This study was a cross-sectional component of a larger study (evaluating cognitive behavioural group treatment for bulimia nervosa). At assessment at a specialist eating disorders service, the SEDS was administered to a clinical sample of women with a diagnosis of bulimia nervosa (N=40). Cronbach's alpha coefficients were used to determine the internal consistency of the scales. RESULTS: While the internal consistency of the overall SEDS was good, the existing SEDS subscales lacked internal consistency. Only one of the eight subscales (perceived external control) had an acceptable alpha (>.700). By removing up to three questionnaire items for each subscale that most impaired the alpha, only two further subscales were raised to an acceptable alpha. The sample's scores did not closely reflect the reported norms. DISCUSSION: More studies are needed to determine the clinical and psychometric validity of the SEDS. However, the present findings indicate that the preliminary psychometric findings do not generalize to other adult clinical populations. Therefore, caution should be used when interpreting the results of the SEDS when working with adults with eating disorders.

Adult↗

PubMed1997

HOME inventory and NCATS: relation to mother and child behaviors during naturalistic observations. Home Observation for Measurement of the Environment. Nursing Child Assessment Teaching Scale.

The purpose of this study was to determine the relationships among the Nursing Child Assessment Teaching Scale (NCATS), the Home Observation for Measurement of the Environment (HOME) inventory, and interactive behaviors observed in the home for fifty-three 3-year-old, prematurely born children and their mothers. The total HOME score showed high internal consistency, with moderate subscale levels. NCATS total score showed high internal consistency, but low to moderate subscale consistency. Combining NCATS subscales into a mother subscale and child subscale improved internal consistency. The HOME and the NCATS mother subscale correlated with observed maternal behaviors, but the NCATS child subscale was unrelated to child behaviors. Relationships between observed behaviors and HOME scores did not differ for high- and low-education mothers or for Caucasians and African Americans, but only low-education mothers and African Americans exhibited correlations between NCATS scores and observed behaviors. These results show the HOME, NCATS, and naturalistic observations measure related, but not overlapping, aspects of the mother's contribution to her relationship with her child, but the NCATS child subscale should be used with caution with 3-year-olds.

Adult↗

PubMed2001

[The factors that influence the consistency of international normalized ratio of prothrombin time].

OBJECTIVE: To investigate the factors that influence the consistency of international normalized ratio (INR) of prothrombin time. METHODS: Using the same automated blood coagulation analyzer and INR calibration plasma with two different types of prothrombin time (PT) reagent to assay the INR values of 19 controls (group 1), 12 patients who took long-term anticoagulant orally (group 2), 12 patients who took it at the first time (group 3) and 8 patients who took long-term anticoagulant together with cephalosporin N (group 4). RESULTS: The two kinds of reagents gave quite different INR values in all four groups (P < 0.01). The INR difference in group 3 (0.23 +/- 0.07, n = 12) was larger than that in group 2 (0.51 +/- 0.20, n = 12) (P < 0.01). The difference in group 4 (0.61 +/- 0.21, n = 8) was larger than that in group 2 (P < 0.01). CONCLUSIONS: The factors that may influence INR consistency are the source and sensitivity of the reagents, as well as the period of the anti coagulant been taken and the other drugs taken at the same time.

Administration, Oral↗

PubMed2005

Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements.

OBJECTIVE: We developed a questionnaire to evaluate dietitians' knowledge and practices about the use of dietary supplements in light of new draft regulations in South Africa that will allow dietitians to prescribe supplements for the management of nutrition-related diseases. METHODS: A cross-sectional validation study was carried out in two phases: 1) questionnaire planning and development and 2) determination of reliability (internal consistency). The study sample comprised 48 nurses, 105 dietetic interns, and 367 registered dietitians. An expert academic group comprising nine dietitians with research and teaching experience rated the academic relevance and importance of knowledge questions in an item pool of 355 questions to ensure face and content validity. Criterion validity was measured by testing the knowledge questions (KQs) on 48 nurses and 105 dietetic interns. Thereafter questions were deleted based on their difficulty, discrimination, and Cronbach's alpha values. The final questionnaire, which at this point included a test of 50 KQs, was mailed to registered dietitians (n = 1450) in South Africa to determine internal consistency of the final KQs. RESULTS: Criterion validity of the KQs was indicated by a significant difference (P = 0.000) in the mean test scores between nurses (36.9, 95% confidence interval 24.2 to 39.6) and dietetic interns (40.2, 95% confidence interval 38.8 to 41.7). Item discrimination was attained by the deletion of NQs having a minimum correlation of 0.20 with overall test score. Further, item difficulty was controlled for by removal of questions correctly answered by more than 80% (too easy) or fewer than 20% (too difficult). Internal consistency of the KQs, after completion by 367 dietitians, was 0.87 (Cronbach's alpha). The mean knowledge score of dietitians ranged from 56.5% to 62.5%, with the oldest group (> or =40 y) having the highest score (P = 0.018). Thirty-eight percent of dietitians recommended dietary supplements at least 3 times a week; 51% consumed dietary supplements themselves; and 17% sold them to clients. CONCLUSIONS: A valid and reliable questionnaire that tests knowledge and practices of dietary supplements was developed for dietitians. This tool can be used by academic institutions to evaluate the knowledge and practices of final-year students. It can also be used on a representative sample of dietitians in South Africa and possibly elsewhere within the profession.

Adult↗

PubMed2001

Beck Depression Inventory (BDI): a reliability and validity test in the Malaysian urological population.

This study aimed to validate the Beck Depression Inventory (BDI) in the Malaysian urological population. Reliability and internal consistency were evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Responsiveness was expressed as the effect size. Internal consistency was high (Cronbach's alpha value = 0.56 to 0.87). Test-retest correlation coefficient and intraclass correlation coefficient were significant (ICC = 0.56 to 0.87) and a high degree of sensitivity and specificity. The BDI is thus a reliable and a valid instrument to be used in Malaysia.

Depressive Disorder↗

PubMed2000

Psychometric development of a multidimensional measure of weight-related attitudes and behaviors.

Most weight control programs facilitate weight loss by encouraging participants to adopt healthy eating patterns and increase physical activity. There is a need for a relatively brief measure of eating habits and physical activity that could be used to evaluate changes in behavior during weight loss treatment. The purpose of this series of four studies was to develop and validate such a measure, which was subsequently named the Weight Loss Behavior Scale (WLBS). Study 1 (n = 533) included item and scale development and examination of the WLBS's factor structure and internal consistency. Study 2 (n = 226) evaluated the test-retest reliability and convergent validity of its subscales. Study 3 examined their reliability and internal consistency scales in a predominantly overweight sample (n = 36). Study 4 evaluated the WLBS as a treatment outcome measure in a weight loss intervention (n = 50). Study 1 found that the WLBS contained five internally consistent and stable factors: 1) Concern with Dieting and Weight, 2) Exercise, 3) Overeating, 4) Avoidance of Fattening Foods and Sweets, and 5) Emotional Eating. Study 2 found convergent validity for the WLBS by assessing the correlation of its factors/scales with established inventories of comparable constructs, e.g., dietary restraint, disinhibited eating, and physical activity. Test-retest reliability of the five scales was also supported in this second study. In Study 3, support for the internal consistency and test-retest reliability of the WLBS among overweight individuals was found. Study 4 found that all scales significantly changed in the expected directions after a 5-month behavioral weight loss treatment. The findings from this series of studies suggest that the WLBS is a reliable and valid self-report inventory of cognitive and behavioral scales associated with weight control that can be utilized as an outcome measure for weight loss interventions.

Adult↗

PubMed2007

Reliability and validity testing of the Patient and Observer Scar Assessment Scale in evaluating linear scars after breast cancer surgery.

BACKGROUND: The Patient and Observer Scar Assessment Scale is a promising new method incorporating observer and patient ratings in evaluating burn scars. The authors compared this tool to the Vancouver Scar Scale in a cohort of women with linear scars from breast cancer surgery. METHODS: Twenty women with newly diagnosed breast cancer were prospectively accrued. Thirty-one scars were evaluated. The median time from surgery to scar assessment was 8 weeks (range, 3 to 25 weeks). Observer assessment was performed by three independent raters using the Vancouver scale and the observer component of the new tool. Patient self-assessment was performed using the patient component of the tool. Internal consistency, interobserver reliability, and convergent validity were examined. RESULTS: Internal consistency was acceptable for the Vancouver scale and both components of the new tool (Cronbach's alpha, 0.71, 0.74, and 0.77, respectively). Interobserver reliability was substantial with both the Vancouver scale and the observer tool (average measure intraclass coefficient correlation, 0.78 and 0.60, respectively). The observer tool and Vancouver scale correlated significantly with each other (p < 0.001), but only the observer tool correlated well with patients' ratings (p = 0.04). CONCLUSIONS: In surgical scar assessment, the new Patient and Observer Scar Assessment Scale and Vancouver Scar Scale were both associated with acceptable internal consistency and interobserver reliability. The new tool is more comprehensive and has higher correlation with patients' ratings. These findings support the use of the new tool as a reliable, valid, and comprehensive approach to assess linear surgical scars.

Breast Neoplasms↗

PubMed2004

Development of an instrument to measure beliefs and attitudes from heart valve disease patients.

The objective of this study was to verify content validity and reliability of "CAV-Instrument" -- an instrument to measure beliefs and attitudes of heart valve disease patients concerning their illness and treatment. The instrument was analyzed by three judges (using predetermined criteria) and submitted to the pretest (n = 17 subjects). The majority of the items were evaluated as adequate regarding their pertinence, clearness and significance regarding the analyzed questions. The pretest showed the necessity for small changes in some statements, which optimized instrument comprehension by the patients. The restructured instrument was applied to 46 patients to verify internal consistency. The whole instrument and most of its scales presented satisfactory internal consistency. It is concluded that the instrument has content validity and is internally consistent, ratifying the adequacy of its application to measure the strength of association among the researched variables.

Attitude↗

PubMed1997

[Quality of life in patients with chronic obstructive lung diseases: psychometric criteria of the German version of the Sickness Impact Profile and initial results of its application].

BACKGROUND: Quality of life has become an important criterion for assessing disease impact and treatment outcome. The Sickness Impact Profile (SIP) is an internationally widely used generic instrument for the measurement of health related quality of life. Furthermore, it has been frequently employed for research in patients suffering from airway diseases. Therefore, we developed a German version of the SIP and investigated its psychometric properties in patients with chronic obstructive lung disease (COPD). PATIENTS AND METHODS: After translation of the SIP into German, the results of a pilot study suggested several changes. Some items had to be reformulated and the SIP subscales "Emotional and affective behavior", "Alertness" and "Body care and movement" had to be discarded because of insufficient psychometric properties. The reliability, validity and sensitivity of the resulting German SIP version were investigated in a sample of 58 O2-dependent patients with COPD. RESULTS: Internal consistency (Cronbach Alpha) was 0.93 for the entire instrument, while it was 0.85 for the SIP psycho-social scale and 0.89 for the SIP physical scale. The internal consistency ranged from 0.55 to 0.86 for the subscales of the German SIP version. The nutrition subscale was discarded because it showed an insufficient internal consistency (0.40). Indices of respiratory function (FEV1, FVC, Pa, O2, Sa, O2) and severity of dyspnea as assessed by the Baseline Dyspnea Index (BDI) were associated with the total SIP, psycho-social and physical score reaching from r = -0.19 to r = -0.48. Patients who improved after introduction of liquid oxygen therapy (LOX) showed a better total SIP score (p = 0.023) and less impairment in the SIP physical scale (p = 0.009). In order to evaluate the prognostic validity of the German SIP, a discriminance analysis between those patients who were alive 14 months later and those who had died of their illness was performed. A single discriminant function with an Eigenvalue of 0.59 (canonical correlation r = 0.61; CU2 = 21.213; df = 3; p < 0.001) was found. By means of the FVC, the severity of dyspnea (BDI), the SIP total score and the FEV1 85% of the survivors and 91 % of the fatalities could be predicted correctly. CONCLUSIONS: The present results demonstrate sufficient psychometric properties of the German SIP version for the use in patients with COPD and hypoxemia. However, the internal consistencies of the subscales "Work" and "Leisure pastimes and recreation" remain to be improved. Furthermore, the results of factor and cluster analyses suggest some changes in the internal structure of the German SIP.

Adolescent↗

PubMedDate not supplied

Psychometric properties of ADHD rating scales among children with mental retardation I: reliability.

The reliability of Attention-Deficit/Hyperactivity Disorder (ADHD) rating scales in children with mental retardation was assessed. Parents, teachers, and teaching assistants completed ADHD rating scales on 48 children aged 5-12 diagnosed with mental retardation. Measures included the Child Behavior Checklist (CBCL), Conners Rating Scales, the Attention-Deficit/Hyperactivity Disorder Test (ADHDT), the Swanson, Nolan, and Pelham (SNAP) Checklist, the Werry-Weiss-Peters Activity Rating Scale (WWPARS), the ADD-H Comprehensive Teacher's Rating Scale (ACTeRS), and the Aberrant Behavior Checklist-Community (ABC-C). The internal consistency, test-retest, and interrater reliability of each scale was examined. Results showed best support for teacher completed scales, followed by ratings made by teaching assistants, and parent-report scales. Strong support for the internal consistency of the teacher-report measures was found, and it was quite similar to previously reported internal consistencies with typically developing children. Test-retest reliabilities of the teacher report measures were also quite good but tended to be lower than those reported for typically developing children. For teaching assistant ratings, test-retest reliabilities were adequate to very good. The internal consistency reliabilities for parent completed measures were adequate to excellent, but test-retest reliabilities were low. Interrater reliability was best for teacher-teaching assistants. The ABC-C was the only measure on which the interrater reliability was adequate for clinical purposes.

Attention Deficit Disorder with Hyperactivity↗

PubMed2003

The nonarthritic hip score: reliable and validated.

The purpose of the current study was to assess the validity, internal consistency, and reproducibility of a short, self-administered hip score designed for use in younger patients with higher demands and expectations than older patients with degenerative joint disease. Validity and internal consistency was studied with 48 consecutive patients with a mean age of 33 years with intractable hip pain and normal plain radiographs. Reproducibility was assessed from data on an additional random sample of 17 patients with hip pain. The Pearson correlation coefficients were 0.82 and 0.59 between the nonarthritic hip score and the Harris hip score and Short Form-12, respectively showing validity. Cronbach's coefficient alpha measuring the internal consistency within each of the score's four domains ranged from 0.69 to 0.92. The test and retest reproducibility ranged from 0.87 to 0.95 for the four subsets and was 0.96 overall. This short, self-administered questionnaire regarding hip pain in young patients with increased activity demands and high treatment expectations is valid compared with previous measures of hip performance, is internally consistent, and is reproducible.

Adolescent↗

PubMed2003

Dimensionality of the Kansas Family Strengths Scale and the Kansas Marital Satisfaction Scale as revised to capture changes in marital satisfaction.

The Kansas Marital Satisfaction Scale was modified to reflect issues of relationship development and administered, along with 19 items from a previously reported Kansas Family Strengths Scale by Schumm, Bollman, Jurich, and Hatch, to 337 married couples from a midwestern urban community. High internal consistency was obtained for the revised version (alpha=.93), and the dimensionality of the Kansas Family Strengths Scale was approximately similar to that reported previously. In both this and the previous study, communication and conflict resolution items factored together while items for enjoying time together and actually spending time together factored separately. Likewise, in both studies, normative and affective commitment factored separately, and the internal consistency of the affective commitment subscale exceeded that for the normative commitment subscale. While the subscales for affective commitment, communication or conflict resolution, positive interaction, and time together yielded fair to adequate internal consistency in both studies, both studies indicated very low internal consistency for the normative commitment subscale, suggesting a need for improvement in that particular subscale.

Adult↗