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PubMed2002

[Development of the behavioral inhibition system/behavioral approach system scales].

The purpose of present studies was to create brief self-report scales to assess individual differences in the sensitivity of two neurological self-regulatory systems; one is the behavioral inhibition system (BIS) which bears on aversive motivation, and the other is the behavioral approach system (BAS) which bears on appetitive motivation. Scale development was reported in study 1, and convergent and discriminant validation using alternative measures of similar constructs was reported in study 2. In study 3, positive and negative affect was manipulated in a controlled setting. Results were consistent with the hypothesis that participants with higher BIS sensitivity would show heightened emotional reactivity to negative mood induction, whereas higher BAS sensitivity would show heightened reactivity to positive mood induction. Furthermore, results indicated that higher BAS sensitivity not only inhibited negative affect in response to negative mood induction but also facilitated recovery from negative mood states. These results suggested that abnormal sensitivity of either system may be a vulnerability factor of psychopathology, when specific situational cues are present.

Adult↗
PubMed1979

The family therapist behavior scale (FTBS): development and evaluation of a coding system.

This study evaluated the validity and reliability of a new coding system--The Family Therapist Behavior Scale (FTBS)--that was designed to identify and study clinically relevant verbal behaviors of short-term, problem-oriented family therapists. Validity was assessed by testing the scale's ability to discriminate significant, predicted differences between the in-therapy behaviors of eight beginning family therapists conducting observed interviews and eight advanced family therapists conducting supervisory interviews. All of the sessions, which were initial interviews, were videotaped. Two coders rated three five-minute samples from each of the 16 tapes with the FTBS. The validity results supported over 50 per cent of the 16 research hypotheses. The reliability analysis, based on the actual study data, indicated that the interrater reliability of the 19 category FTBS differed from chance at less than the .001 level of significance. The implications of these findings are examined and future research directions are identified.

Adult↗
PubMed2005

Developing a scale for measuring professional equity among Canadian physicians.

This paper reports on progress made in defining and measuring the concept of professional equity through the development of a summative measure of professional equity and three of its components: financial, intrinsic and recognition equity. The study sample consisted of a stratified sample of 8375 Canadian physicians with usable responses from 2749 (32.8%). Following preliminary components analysis, items were grouped into constructs. Reliability of the constructs was then determined using Cronbach's alpha and total inter-item correlations followed by confirmatory factor analysis. A summary scale using all 15 equity items yielded a reliability: Cronbach's alpha=0.86. The sub-scales reliabilities were: financial equity (Cronbach's alpha=0.91); intrinsic equity (Cronbach's alpha=0.86); and recognition equity (Cronbach's alpha=0.70). The professional equity measures reported are therefore capable of assessing different aspects of equity and represent an advance over more general effort-reward scales or those that only measure the range of rewards.

Canada↗
PubMed2003

The breathlessness, cough, and sputum scale: the development of empirically based guidelines for interpretation.

BACKGROUND: A patient report of respiratory symptoms in COPD is essential to successfully monitoring disease, adjusting treatment, and evaluating outcomes. OBJECTIVE: To develop empirically based guidelines for interpreting mean changes in symptom scores using the Breathlessness, Cough, and Sputum Scale (BCSS). METHODS: Analyses were performed on data from three multinational trials (n = 2,971). Mean changes in BCSS score with treatment were examined by physician and patient ratings of treatment efficacy, juxtaposed with percentage change in symptoms, statistical effect size (ES), DeltaFEV(1), and change in St. George Respiratory Questionnaire (SGRQ) score. BCSS scores during an exacerbation were examined relative to changes in peak expiratory flow and rescue medication use. RESULTS: Mean baseline BCSS total score was 5.2 +/- 2 (+/- SD); 90% of scores were between 2 and 9. Highly efficacious treatment (n = 257; physician rating) was associated with a DeltaBCSS total score of - 1.3 +/- 1.8, representing a 24% improvement (ES = 0.7), and corresponding to a 10% improvement in FEV(1) and DeltaSGRQ score total of - 10.3 +/- 13.8. Similar changes in BCSS score were observed during recovery from an exacerbation (n = 713; - 1.3 +/- 1.8). Mean change with moderately efficacious treatment (n = 965) was - 0.7 +/- 1.8, a 13% improvement (ES = 0.3) corresponding to DeltaSGRQ total score of - 6.8 +/- 12.6. Mildly efficacious treatment (n = 891) was associated with a change of - 0.35, a 7% improvement (ES = 0.18), with a DeltaFEV(1) <1% and DeltaSGRQ total score of - 2.6 +/- 11.7. CONCLUSIONS: Patient-reported daily symptom data are sensitive to change and useful for both observational studies and controlled clinical trials of patients with COPD. A mean DeltaBCSS total score > 1.0 represents substantial symptomatic improvement, changes of approximately 0.6 can be interpreted as moderate, and changes of 0.3 can be considered small.

Clinical Trials as Topic↗
PubMed2003

Psychometrically matched measures of global cognition, memory, and executive function for assessment of cognitive decline in older persons.

Item response theory methods were used to derive psychometrically sophisticated measures of global cognition, memory, and executive function. Goals were that these measures (a) could be derived from commonly used neuropsychological tests, (b) would have linear measurement properties, and (c) would be psychometrically matched. Scale development was based on a sample of 400 older individuals with cognitive function ranging from normal to demented. Scales were reasonably matched with linear measurement over an ability range relevant to many important clinical applications. Cognitively normal, mild impairment, and dementia participant groups differed on baseline measures and rate of decline. Association of measures with quantitative structural magnetic resonance imaging variables followed expected patterns. This approach to scale development may have applications for other neuropsychological assessment problems.

Aged↗
PubMed2004

Influence of breast-feeding and parental intelligence on cognitive development in the 24-month-old child.

This study was designed to analyze the relationship between breast-feeding and mental development at 24 months of age, independently of the influence of other factors. A total of 238 babies born between October 1995 and February 1998 were enrolled in an observational prospective cohort study. Cognitive development was assessed using the Bayley Infant Development Scale. The results of multiple linear regression analysis showed that infants breast-fed for longer than 4 months scored 4.3 points higher on the mental development scale than those breast-fed for less time. No differences were found in psychomotor development as a function of feeding regimen or duration. The positive linear correlation observed between parental IQ and mental development scores at 24 months was also statistically significant (mother: r = 0.39; p < 0.001; father: r = 0.43; p < 0.001). It may be concluded that breast-feeding for longer than 4 months has a positive effect on the child's mental development at 24 months of age. Parental intelligence also appears to influence cognitive development.

Bottle Feeding↗
PubMed1986

Relationship between the "cognitive triad" from the personality inventory for children and an extended Halstead-Reitan neuropsychological battery.

The relationships between the Achievement, Intellectual Screening, and Development scales from the Personality Inventory for Children (PIC) and a comprehensive neuropsychological battery were examined in a sample of 49 children with histories of behavioral problems, learning problems, or both but without known neurological impairments or pervasive developmental disorders. Using stepwise multiple regression, the PIC scales predicted global neuropsychological functions moderately well, particularly verbal IQ and achievement. More specific neuropsychological functions were not significantly predicted. The Developmental scale from the PIC consistently outperformed the other two PIC "cognitive-triad" scales, and the latter made no statistically significant additional contribution in predicting neuropsychological functions after the contribution of the Development scale was taken into account.

Journal Article↗
PubMed2005

The composite abuse scale: further development and assessment of reliability and validity of a multidimensional partner abuse measure in clinical settings.

Absence of a well-validated comprehensive partner abuse questionnaire has been a major methodological issue in domestic violence research. A new multidimensional measure of partner abuse, the Composite Abuse Scale (CAS), has four dimensions: Severe Combined Abuse, Emotional Abuse, Physical Abuse, and Harassment. A general practice patient sample (N = 1,836) has been used in the development and testing of CAS. Factor analyses in this current study confirmed the four dimensions from a preliminary nurses sample study and resulted in a final scale of 30 items consisting of acts of physical, emotional, and sexual abuse. These four factors exhibited good internal reliability (Cronbach's alpha > 0.85) and the corrected item-total correlations were high (> 0.5). Evidence of criterion and construct validity is presented.

Adolescent↗
PubMed2002

Development of a scale to measure patients' trust in health insurers.

OBJECTIVE: To develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and other psychometric properties. DATA SOURCES/STUDY SETTING: The scale was developed and validated on a random national sample (n = 410) of subjects with any type of insurance and further validated and used in a regional random sample of members of an HMO in North Carolina (n = 1152). STUDY DESIGN: Factor analysis was used to uncover the underlying dimensions of the scale. Internal consistency was assessed by Cronbach's alpha. Construct validity was established by Pearson or Spearman correlations and t tests. DATA COLLECTION: Data were collected via telephone interviews. PRINCIPAL FINDINGS: The 11-item scale has good internal consistency (alpha = 0.92/ 0.89) and response variability (range = 11-55, M = 36.5/37.0, SD = 7.8/7.0). Insurer trust is a unidimensional construct and is related to trust in physicians, satisfaction with care and with insurer, having enough choice in selecting health insurer, no prior disputes with health insurer, type of insurer, and desire to remain with insurer. CONCLUSIONS: Trust in health insurers can be validly and reliably measured. Additional studies are required to learn more about what factors affect insurer trust and whether differences and changes in insurer trust affect actual behaviors and other outcomes of interest.

Adult↗
PubMed1996

[Development of scales of relationships between grandchildren in adolescence and grandparents].

The purposes of this study are (1) to make scales of relationships between grandchildren in adolescence and grandparents, and (2) to clarify functions of grandparents perceived by grandchildren and functions of grandchildren perceived by grandparents. Subjects were 517 students in junior high schools, high schools and universities (mean of age: 17 years old), and 107 elderly persons at home (mean of age: 73 years old). As a result, factorial validity and reliability of the scales were confirmed. We found the functions of "daily emotional support", "acceptance of existence", "time perspectives", and "succession of generations" in both the grandchildren scale and the grandparents scale. Additionally we identified the function of "instrumental informational support" in the grandparents scale. The fact that the functions of "time perspectives", and "succession of generations" were found in two groups suggested the facilitation of mutual development between the generations. In addition, the function of "acceptance of existence" suggested possibilities of genuinely supportive relationships.

Adolescent↗
PubMed2005

The effects of a randomised multi-centre trial and international accreditation on availability and quality of clinical guidelines.

PURPOSE: To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation. DESIGN/METHODOLOGY/APPROACH: Interventional "before-after" study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation. FINDINGS: The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non-accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p < 0.001) and in non-accredited units (both p < 0.02). The improvement of the systematic development scale was significantly higher in accredited than in non-accredited units (p < 0.01). ORIGINALITY/VALUE: The combination of conducting both the DIPOM Trial and international accreditation led to a significant improvement of both dissemination and quality of guidelines on perioperative diabetic care.

Accreditation↗
PubMed2003

Psychosocial consequences of dental fear and anxiety.

OBJECTIVES: The aim of this study was to examine the negative psychosocial impacts of dental anxiety in a sample of dentally fearful and anxious individuals recruited from the general population. The associations between psychosocial impacts, dental anxiety scale (DAS) scores and other severe fears were explored. METHODS: One hundred and thirty-five subjects who were anxious or fearful about dental treatment were divided into low and high general fear groups based on the number of other severe fears they reported. Negative psychosocial impacts were assessed using a modified form of the scale developed by Kent et al. (1996). This consisted of three dimensions: psychological reactions, social relationships and avoidance/inhibition. Other measures included self-ratings of oral, general and emotional health and scales to assess self-esteem and morale. RESULTS: Overall, 93.1% of subjects reported one or more impacts. Those in the high-fear group had higher psychosocial impact scores than those in the low-fear group (means of 4.19 vs. 2.85; P < 0.05). Differences were most marked with respect to psychological consequences and avoidance/inhibition. The high-fear group had scores indicative of lower self-esteem and lower morale. Forward stepwise linear and logistic regression analyses indicated that both dental anxiety and general fearfulness contributed to these negative outcomes. However, the latter was a more consistent predictor in that it entered six of seven models generated while the former entered only four. CONCLUSION: The study indicated that dental fear and anxiety have pervasive psychosocial consequences, and that these are more marked among subjects with high levels of general fearfulness. It also provided evidence of the validity of a modified form of the psychosocial impact scale developed by Kent et al. (1996).

Adult↗
PubMed2004

A cross-validation of safety climate scale using confirmatory factor analytic approach.

PROBLEM: Given the lack of a consistent factor structure of safety climate, this study tested the stability of a factor structure of a safety climate scale developed through an extensive literature review using confirmatory factor analytic approach and cross-validation. METHODS: A cross-sectional sample of 722 U.S. grain industry workers participated in the questionnaire survey. RESULTS: The safety climate scale developed through the generation of an item pool based on a table of specifications, subsequent scientific item reduction procedures, reviews from experts, and pilot test yielded adequate reliabilities for each dimension. Each item showed proper discriminative power based on both internal and external criteria. Criterion validity was manifested by the significant positive correlation of the scale with five criteria. Evidence of construct validity was provided by both exploratory and confirmatory factor analyses. Both calibration and validation samples supported a consistent factor structure. Management commitment and supervisor support were found to influence other dimensions of safety climate. DISCUSSION: This study provides an insight into the primary reason why previous attempts have failed to find a consistent factor structure of safety climate: No specification of the influence of management commitment and supervisor support on other dimensions of safety in their models. IMPACT ON INDUSTRY: The findings of this study provide a framework upon which accident prevention efforts can be effectively organized and underscore the importance of management commitment and supervisor support as they affect employee safety perceptions.

Adult↗
PubMed1991

The development of scales to measure knowledge and preference for diet and physical activity behavior in 4- to 8-year-old children.

Although there is a sizable literature on determinants of health-related habits in adults, relatively little attention has been paid to influences on health habits in children. The purpose of this study was to (a) develop practical, reliable, and valid measures of knowledge of and preference for cardiovascular disease-related diet and exercise behaviors in children, and (b) assess parental influences on children's knowledge and preference. Eighty-one 4- to 8-year-old children from diverse ethnic backgrounds and their parent or legal guardian participated. Children were presented with 15 attractive photo-pairs of foods. One photograph was of a "healthful" food or activity, and the other was "unhealthful." They were asked to identify which food/activity of the pair they preferred, and which one they thought was more healthy. Children were retested after 1 week to determine test-retest reliability. Validity of the preference tests was determined by giving the child actual choices of the same activity and food pairs. Validity of knowledge tests was determined by testing children after an educational intervention session. The alpha coefficients, test-retest reliabilities, and validity data generally indicated that food preference and knowledge tests had adequate psychometric properties, but the physical activity scales did not. Very few parental influences on health-related behavior were detected.

Cardiovascular Diseases↗
PubMed2006

Development of a questionnaire to assess dentists' knowledge, opinion, education resources, physician cooperation, and clinical practice regarding obstructive sleep apnea (OSAQ-D).

This report describes the construction of a questionnaire to assess dentists' knowledge, opinion, education resources, clinical practice, and physician cooperation regarding obstructive sleep apnea (OSA) based on the PRECEDE-PROCEED model. The scale development included such steps as generating an item pool, expert review of initial item pool, pilot test, and final test. After the expert review, a total of 78 items made up the pilot test instrument including five demographic (age, year graduated from dental school, gender, years in practice dentistry, and membership of the Academy of Dental Sleep Medicine), 22 knowledge, 15 opinion, 11 education resources, 10 physician cooperation, and 15 clinical practice questions. The pilot test samples were third or fourth year dental school students and dentists from the University of Florida. Nineteen dentists and 26 students returned the survey. Based on the results of item analysis and content review, a total of 70 questions were remained for the final test. The final questionnaire was mailed to 450 dentists who were randomly selected from a list of 10,838 dentists with a Florida license and also delivered to 65 dental school students and postgraduates of the University of Florida. A total of 163 participants including 112 dentists and 51 students and postgraduates responded. The average age was 42.87 years, and most of them are males (77.8%). Only one dentist was a current member of the Academy of Dental Sleep Medicine. The item analysis was performed for five scales. 8 items with poor item difficulty, lower item discrimination, or having big effect on the item consistency were removed from the instrument, and 62 questions were kept for the further evaluation. The reliability coefficient alpha of knowledge, opinion, education resources, physician cooperation, and clinical practice scales was 0.77, 0.86, 0.67, 0.75, and 0.86, respectively. According to the standard from DeVellis (Scale development: theory and applications, Sage, Thousand Oaks, 2003), they were acceptable, or respectable, or even very good.

Adult↗
PubMed2000

The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning.

Anxiety about pain is increasingly recognized as one factor contributing to increased pain perception and pain behavior [McCracken, L. M., Faber S. D., & Janeck A. S. (1998) Pain-related anxiety predicts nonspecific physical complaints in persons with chronic pain. Behavior Research and Therapy, 36, 621-630; McCracken L., & Gross R. (1995). The pain anxiety symptoms scale (PASS) and the assessment of emotional responses to pain. Innovations in clinical practice: a source book, 14, 309-321]. To assess this emotional reaction to pain in chronic pain patients, McCracken, Zayfert and Gross [McCracken, L., Zayfert, C., & Gross, R. (1992). The Pain Anxiety Symptom Scale: development and validation of a scale to measure fear of pain. Pain, 50, 67-73] developed the Pain Anxiety Symptom Scale (PASS) composed of four subscales: Cognitive Anxiety, Fearful Appraisal, Escape Avoidance and Physiological Anxiety. The present study extended previous work by examining the relationship among pain anxiety dimensions, use of active and passive coping strategies and arthritis self-efficacy as predictors of functional status in 154 rheumatoid arthritis (RA) patients. Functional status was assessed using the Five-Factor Model of the Arthritis Impact Scale, 2nd ed., (AIMS2): Physical Functioning, Affective Experience, Symptoms, Social Interaction and Role Function. Hierarchical multiple regression analysis on each of the AIMS2 criterion variables showed that pain anxiety, pain and symptom self-efficacy, health status and coping strategies were able to explain between 9 and 38% of the variance in the five AIMS2 variables. The present results support the hypothesized role of pain anxiety along with previously established contributions of self-efficacy and coping strategies, in affecting physical, social, emotional and role functioning in chronic RA patients.

Activities of Daily Living↗