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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↗
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↗
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↗
PubMedDate not supplied

The Neurobehavioural Rating Scale: replication in an acute, inpatient rehabilitation setting.

The Neurobehavioural Rating Scale (NRS) was developed to allow quantification of clinical observations of the behaviour of individuals following traumatic head injury. Initial validation of this instrument reported satisfactory interobserver reliability, as well as preliminary support for its validity in differentiating both severity and chronicity of head injury. In the present study, reliability and content validity of the NRS were replicated using a population of severe head injury patients undergoing inpatient rehabilitation. Concurrent, independent assessment using the NRS was conducted weekly by two members of an inpatient, traumatic head injury team. Acceptable levels of interobserver reliability were found, despite less control over observed behaviour in the naturalistic setting used. Content validity was also supported in this replication, although recommendations for 'tightening' the NRS included better definition of the seven-point severity rating for each item, as well as potential deletion of two items that contributed little to differential variance in the total NRS score. The NRS appears to be a promising clinical and research tool for assessing the neurobehavioural sequelae of traumatic head injury. Its strengths include efficiency of administration and the flexibility to administer through brief, structured interviews or observations in a naturalistic setting. Continued research on the NRS in different settings and with different populations is required to establish its validity.

Adolescent↗
PubMed1990

Development and testing of the Stressor Scale for Pediatric Oncology Nurses.

Pediatric oncology nursing has been identified as a stressful specialty, but the exact sources of the stress have not been comprehensively specified nor put into measurable form. Effective interventions can best be developed when the stressors are known and measured. The purpose of this study was to develop and test an instrument that could accurately and sensitively measure the job-related stressors for pediatric oncology nurses. A 61-item, visual analogue instrument, the Stressor Scale for Pediatric Oncology Nurses (SSPON), was inductively developed from interviews with 30 pediatric oncology nurses. Subsequently, the SSPON was tested in three geographically separated samples of pediatric oncology nurses (n = 78). After an item analysis, 11 items were deleted from the scale. Reliability of the SSPON was estimated using both stability and internal consistency methods. The test-retest correlation coefficient was 0.88, and the total scale alpha coefficient was 0.94. Content validity was estimated using a two-stage process of developmental and judgment quantification with a panel of three specialty nurses. Construct validity was estimated through testing of theoretically derived hypotheses and a cluster analysis. Findings indicated the SSPON is content valid. Six meaningful clusters that represented sources of job-related stress were identified and defined. The revised SSPON appears to have adequate psychometric properties for a new instrument.

Evaluation Studies as Topic↗
PubMed1992

The use of goal attainment scaling in a geriatric care setting.

OBJECTIVE: Goal attainment scaling (GAS) is a measurement approach used extensively in mental health. It accommodates multiple individual patient goals, yet retains mathematical properties allowing comparisons between patients. This study was carried out to investigate the feasibility and measurement properties of GAS in a geriatric care setting. DESIGN: Prospective descriptive study. SETTING: The geriatric restorative care service and geriatric assessment unit at Camp Hill Hospital, a 350-bed tertiary care facility in Halifax, Canada. PATIENTS: Fifteen patients aged 65 to 94 who were consecutively admitted to the two geriatric services (mean age 79 years, mean length of stay 37 days, 9 females). INTERVENTION: Goal Attainment follow-up guides were developed independently for each patient by two geriatricians after a comprehensive assessment of the patient. These guides were later compared to assess level of agreement in goal setting and scale development. A single goal attainment follow-up guide was then developed for each patient by consensus of the two geriatricians. At the end of the follow-up, the guides were scored independently for each patient by one of the geriatricians and by the patient's primary care nurse. MAIN OUTCOME MEASURES: GAS scores were determined on admission and discharge. Each patient also received admission and discharge ratings on the Barthel Index as well as a global rating of outcome (on a subjective 10-point scale) by a geriatrician who was blinded to the Goal Attainment follow-up score. RESULTS: GAS proved feasible, requiring 15-20 minutes to scale an average of six goals per patient. GAS also appears reliable. Of 87 goals, 71 (82%) were identified independently by two geriatricians, and the remainder were determined by consensus. This is also a measure of content validity. The physician-nurse inter-rater reliability was 0.87 (intraclass correlation). Concurrent validity was assessed by correlation with the Barthel Index (r = 0.86) and the global clinical outcome rating (r = 0.82). Content validity was also assessed by comparing our goal areas with those identified in recent consensus reports on geriatric assessment. Of these 13 assessment areas, 12 appeared to be reasonably well covered while one assessment area (sexual problems) was not identified for any of the 15 patients. CONCLUSIONS: GAS appears to be a feasible method of goal setting and outcome evaluation in geriatric care settings, with promising reliability and validity.

Activities of Daily Living↗
PubMed1992

Evolving a blueprint for certification: the responsibilities and knowledge comprising American professional oncology nursing practice.

Ensuring adequate content validity of a certification examination is a major concern in the development and administration of a test. To establish content validity of the Oncology Nursing Certification Corporation (ONCC) certification exam, a job analysis study was conducted to provide empirical data about the responsibilities and knowledge areas required for practice at the level of the newly certified oncology nurse. The study involved The Profession of Oncology Nursing: An Inventory of Responsibilities and Knowledge (IRKPON), a questionnaire that was developed based on a review of the literature, professional practice information, interviews with oncology nurses, the original ONCC certification exam table of specifications, and evaluations undertaken by two advisory committees. The IRKPON consisted of three parts: 56 responsibilities clustered into eight job dimensions, 217 knowledge areas grouped into seven knowledge dimensions, and demographic information. The IRKPON was sent to a stratified random sample of 3,000 oncology nurses in the United States, who were asked to rate both the responsibilities and knowledge areas by level of importance. The 1,297 (43%) responding nurses rated 45 of 56 responsibilities (80.4%) as "very important" and 8 of 56 responsibilities (14.3%) as "extremely important"; they also rated 163 of 217 knowledge areas (75.1%) as "very important" and 41 of 217 knowledge areas (18.9%) as "extremely important." These findings identified the specific responsibilities most important to the oncology nurse role at the level of the newly certified nurse, as well as the knowledge areas necessary for competent performance. Subsequent ONCC certification examinations were modified; the test blueprint that guides the construction of the examination was revised, and the passing score was adjusted.

Adult↗
PubMedDate not supplied

Faculty and student perceptions of effective classroom teaching in nursing.

The purpose of this three-stage study was to identify and validate constructs which students use in differentiating among teachers. In stage I, six theoretical constructs thought to be involved in teaching effectiveness were identified; these were revised through a faculty content validity study. In stage II, a known-groups validity study, all items and constructs were found to be used by students in differentiating between good and poor teachers. In stage III, students' ratings of current teachers were collected and factor analyzed. Two factors, individualized prescriptive approach and systematic theoretical presentation, were identified. An analogy was drawn between these factors and elements of nursing process. The category structure which had been derived through the faculty content validity study was not supported.

Connecticut↗
PubMed1991

Development of the inventory of functional status-cancer.

The purpose of this article is to report the development and psychometric testing of the Inventory of Functional Status-Cancer (IFS-CA). The IFS-CA was developed to measure functional status in women with cancer. The questionnaire includes four subscales measuring the extent to which the woman continues her usual household and family, social and community, personal care, and occupational activities. Content validity was established at 98.5%. Internal consistency reliability testing used a sample of 100 women receiving treatment for cancer. Internal consistency reliability using average correlations for the subscale item to subscale total scores ranged from 0.56 to 0.82. Subscale to total IFS-CA score correlations ranged from 0.73 to 0.92. Test-retest reliability used a sample of 17 women who had completed treatment for cancer. The coefficients ranged from 0.43 to 0.96 for the four subscales. Initial construct validity testing was accomplished by examination of subscale correlations and by comparing the functional status of women in active treatment for cancer with those who had completed treatment. The study's findings reveal content validity, internal consistency, test-retest reliability, and beginning construct validity; thus, they demonstrate strong evidence for further development and testing of the IFS-CA's construct validity.

Activities of Daily Living↗
PubMed1991

An evaluation of validity, reliability, and readability of the Critical Care Family Needs Inventory.

The benefits of caring for the family as well as the patient are well supported in the literature. The Critical Care Family Needs Inventory (CCFNI) has been used by several researchers to identify the needs of family members when a relative is admitted to a critical care setting. However, no research to date has comprehensively evaluated the instrument's content validity, test--retest reliability, or readability. The CCFNI, after review by a panel of 16 experts, was given on two separate occasions to a random sample of 51 family members of adult patients in both medical and surgical intensive care units. Overall content validity was established, but the panel found numerous redundancies among the need statements, suggesting that several items might need to be eliminated or combined. Among family members, a percentage of exact agreement of 70% or greater was calculated for 86.7% of the need statements demonstrating acceptable test--retest reliability. The Gunning Fog Index, used to evaluate readability, was calculated at 9.0, indicating that the CCFNI could be read and understood by those with a ninth grade reading level. Suggestions are made for additional studies to establish the reliability and validity of this widely used instrument.

Adult↗
PubMed1992

Alternate forms of HIV prevention attitude scales for teenagers.

The purpose of this study was to develop valid, alternate-form scales to measure teenagers' attitudes toward prevention of the transmission of human immunodeficiency virus (HIV). Using a three-component attitude model, a two-way table of specifications was constructed as a theoretical framework for generating attitudinal items relevant to HIV and HIV prevention. Thus, a large pool of Likert-type items was generated, reviewed for clarity and content validity, and prepared for the preliminary scale with 50 items. The scale was administered to 210 high school students. As a result of extensive analyses, two alternate forms with 15 items each were developed. The two forms were simultaneously administered to a sample of 600 high school students. The collected data were subjected to item analyses, factor analysis, and reliability estimation. The results of the analyses provided strong evidence of internal consistency, content validity, and comparability of both forms. The alternate reliability across the form was .82. The alpha reliability coefficients for forms A and B was .78 and .77 and the split-half .76 and .69, respectively. It is concluded that these alternate forms produce valid, reliable, and comparable results for measuring teenagers' attitudes toward HIV prevention. These forms are ideal for pretest/posttest designs used for evaluating educational approaches to HIV control.

Adolescent↗
PubMed1990

[A study on the development of standardized nursing care plans for computerized nursing service].

A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalized patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows: 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were "PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE". 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical-surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1991

Dimensions, content and validation of the fear of AIDS schedule in health professionals.

We examined the structure of the Fear of AIDS Schedule (FAIDSS) in a sample of 134 health care workers. Factor analysis indicated that there were five discrete dimension of fear of AIDS: fears of loss of control, of sex, of HIV infection through blood and illness, of death and medical interventions, and of contact with outsiders. These dimensions had low to moderate intercorrelations. The dimensions of fear of HIV infection through blood or illness, was significantly correlated with desired personal social distance from people with AIDS, and this dimension along with fear of death and medical interventions were correlated with desired public social distance. Fear of infection through blood and illness were predictors of both desired personal social distance and public social distance from people with HIV infection. The data suggest greater discrimination of AIDS fears with greater closeness of interaction with people with HIV disease, and that these dimensions of the FAIDSS are both reliable and valid measures of AIDS fears.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Validating the content of pediatric outpatient medical records by means of tape-recording doctor-patient encounters.

Information in 51 tape-recorded physician-patient encounters was compared with information written in the patients' medical records. Diagnoses, chief complaints, scheduled appointments, non-drug therapy, and diagnostic studies were uniformly well-recorded. Medication names were well-recorded but dosages were not. Characteristics of care such as levels of function, probable cause of illness, reason for follow-up, and compliance were recorded poorly. Patients were more likely to known about and understand their diagnosis, and names, dosage, and intended function of their medications when this information was written in the record than when it was not. These findings indicate a relationship between the quality of medical records and the effectiveness of care.

Child↗
PubMed1991

Validity and reliability of a pediatric hematology oncology patient acuity tool.

Appropriate use of nursing resources in the pediatric hematology and oncology inpatient settings demands a patient acuity system that is easy to use and accurate, and that objectively measures nursing care needs of a specialized patient population. Structured survey of 13 comprehensive cancer centers and a review of the literature show no valid and reliable acuity tools for this pediatric population. The purpose of this project was to study the validity and reliability of a newly developed pediatric hematology and oncology acuity system designed to quantify patient care needs. A new acuity tool for this pediatric population was developed based on the patient classification tool used at Johns Hopkins Hospital Oncology Center (JHHOC). The levels of care from the JHHOC tool were adopted, with therapeutic indicators modified to reflect nursing diagnoses relevant to the pediatric inpatient. Nursing care hours required for each level of care were also identified. Validity was studied using a content validity index (CVI). Experts from the pediatric unit where the tool would be used were asked whether each therapeutic indicator was assigned to the correct level of care (1 thru 5) based on patient care hours. CVIs for items ranged from .5 to 1.0; the overall CVI for the tool was .93. Interrater reliability was studied using two raters from the unit. Data were collected for 150 patient observations on a 12-bed pediatric hematology and oncology inpatient and short-stay outpatient unit. The resulting Pearson correlation coefficient was r = .97 (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗