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PubMedDate not supplied

Validation study for impaired personal boundaries, proposed nursing diagnosis.

The authors propose a new nursing diagnosis of impaired personal boundaries based on their experience in psychiatric nursing, a concept analysis of the literature and diagnostic content validation by a panel of experts. Impaired personal boundaries are common in a number of mental disorders including, schizophrenia, borderline personality, substance abuse and enabling. Recognition of this patient problem has implications for further research and nursing interventions.

Codependency, Psychological↗

PubMedDate not supplied

Public health preparedness and response capacity inventory validity study.

The Centers for Disease Control and Prevention's Public Health Practice Program Office has issued a Public Health Preparedness and Response Capacity Inventory to help state and local public health systems assess their progress towards achievement of the critical capacities and benchmarks specified in the federal Supplemental Funds for Public Health Preparedness and Response for Bioterrorism. The criterion validity of the capacity inventory was assessed by comparing selected state and local agency responses with documentation provided by the agencies to corroborate their answers. Content validity assessment took the form of a mailed survey that also identified the most important questions from the perspective of a separate set of state and local officials. Responses generally upheld the validity of the capacity inventory, although circumstantial threats to validity were identified in the testing process. The instrument's use has been reported to the Centers for Disease Control and Prevention by approximately half the states and over 800 local public health entities. An interactive electronic version includes a scoring mechanism that allows agencies to judge progress towards the critical capacities and benchmarks over time.

Bioterrorism↗

PubMedDate not supplied

Validation of the defining characteristics of potential for violence.

A high incidence of violence occurs in contemporary society, which is reflected in the violence exhibited by psychiatric patients. To validate the defining characteristics of potential for violence, 125 registered nurses were asked to rate the relevance of defining characteristics of the diagnosis. A diagnostic content validity index was used to ascertain which defining characteristics the nurses believed to be the most critical in the identification of violence potential. Nine major and 20 minor characteristics were identified by these nurses.

Adult↗

PubMed2006

Development and validation of an instrument to determine patient knowledge: the oral anticoagulation knowledge test.

BACKGROUND: Studies examining the relationship between patient knowledge regarding warfarin therapy and its safe and effective use are limited by the lack of validated knowledge assessment tools. OBJECTIVE: To develop and validate an instrument to assess patient knowledge regarding oral anticoagulation therapy. METHODS: Four nationally recognized anticoagulation experts participated in the instrument development process to ensure content validity. The Oral Anticoagulation Knowledge (OAK) test was administered to subjects on warfarin and a group of age-matched subjects not on warfarin to assess construct validity. A subgroup of warfarin subjects were retested approximately 2-3 months after initial testing to assess test-retest reliability. Internal consistency reliability was assessed by calculating a Kuder-Richardson 20 value. Item analysis was used to assess performance of individual questions. RESULTS: An initial 23 item instrument was pilot tested for readability and comprehension. The OAK test was administered to 74 subjects taking warfarin and 27 age-matched subjects not on warfarin. Thirty-two subjects on warfarin repeated the OAK test an average of 75 days following initial administration. Subjects taking warfarin scored significantly higher than those not on warfarin (72% vs 52%, respectively; p < 0.001), supporting the construct validity of the instrument. Test-retest reliability was acceptable, with a Pearson's correlation coefficient of 0.81. Internal consistency reliability was confirmed by a calculated Kuder-Richardson 20 value of 0.76. CONCLUSIONS: The OAK test is a brief, valid, and reliable knowledge assessment instrument that may be a useful tool for research and clinical practice to augment patient education programs.

Adult↗

PubMedDate not supplied

Development and evaluation of a sickle cell assessment instrument.

The current ability to predict very young children with sickle cell disease who are likely to have severe complications later in life permits accurate tailoring of therapy to match disease-related risks. A valid and reliable instrument is essential to accurately assess these children prior to referring them to therapies that are not without risk. This study was designed to develop a Sickle Cell Disease Assessment Instrument with two domains-high-risk identification and disease severity classification-and to evaluate instrument validity and reliability. Instrument development involved identification and definition of critical attributes, assignment of numerical values to critical attributes, and development of a scoring system. Content validity was measured using a panel of five experts in the field of sickle cell disease. Registered nurses using the equivalence approach determined interrater reliability and using test-retest design determined stability. Nurses are often the first persons to identify sickle cell patients that need additional intervention. This instrument will allow them to accurately and objectively assess their patients for high-risk indicators and disease severity classification.

Age Factors↗

PubMed2004

Face, content and construct validity of the University of Washington virtual reality transurethral prostate resection trainer.

PURPOSE: We examined the face, content and construct validity of version 1.0 of the University of Washington transurethral prostate resection (TURP) trainer. MATERIALS AND METHODS: Version 1.0 of a virtual reality based simulator for transurethral skills was developed at our laboratory by integrating TURP hardware with our virtual 3-dimensional anatomy, irrigation control, cutting, bleeding and haptics force feedback. A total of 72 board certified urologists and 19 novices completed a pre-task questionnaire, viewed an introductory training video and performed a pre-compiled 5-minute resection task. The simulator logged operative errors, gm resected, blood loss, irrigant volume, foot pedal use and differential time spent with orientation, cutting or coagulation. Trainees and experts evaluated the simulator on a modified likert scale. The 2-tailed Levene t test was used to compare means between experts and novices. RESULTS: Overall version 1.0 content was between slightly and moderately acceptable. Experts spent less time with orientation (p < 0.0001), resected more total tissue (p < 0.0001), had more gm resected per cut (p = 0.002) and less blood loss per gm resected (p = 0.032), used less irrigant per gm resected (p = 0.02) and performed fewer errors (p < 0.0001) than novices. CONCLUSIONS: We established the face, content and construct validity for version 1.0 of the University of Washington TURP trainer to simulate the skills necessary to perform TURP. A predictive validity study showing a translation of skills from the virtual environment to the operating room will complete the validation of this model.

Adult↗

PubMed2005

Sentence completion test for depression (SCD): an idiographic measure of depressive thinking.

OBJECTIVES: This study set out to investigate the reliability and validity of the Sentence Completion Test for Depression (SCD) as a clinical measure. In contrast to questionnaire measures of depressive thinking, respondents finish incomplete sentences using their own words. This elicits idiographic information concurrent with measuring depressive thinking. METHOD: In Study 1, measures of negative thinking were tested between a depressed group and a non-depressed control group. A preliminary item analysis was conducted and replicated on separate samples in Study 2. Psychometric properties of the test were investigated. In Study 3, idiographic validity and sensitivity to change were explored in a sample of clinical cases with reference to cognitive-behavioural case-formulation. RESULTS: In Study 1, the depressed group produced more negatives and fewer positives, and the SCD demonstrated good content validity, internal consistency and inter-rater reliability. The preliminary short-form had comparable psychometric properties, and these were replicated on new samples in Study 2. Sensitivity and specificity values were above 90% in both studies. In Study 3, idiographic content generated hypotheses about target problems and dysfunctional beliefs within cognitive-behavioural case-formulation, and SCD scores were sensitive to clinical change. CONCLUSIONS: The SCD demonstrates good construct validity, internal consistency, inter-rater reliability, sensitivity, and specificity. It offers an idiographic assessment of depression that is complementary to questionnaire measures, particularly by generating hypotheses about target problems and dysfunctional beliefs within a cognitive-behavioural case-formulation. This is achieved without loss to reliability and validity at the nomothetic level.

Adult↗

PubMed1988

Measuring the quality of life of cancer patients: psychometric properties of instruments.

The importance of measuring the Quality of Life (QL) has become more and more apparent during the past 10 years. Traditionally, QL studies have investigated functional status and treatment side effects. In recent years more comprehensive instruments have been constructed to assess the QL of cancer patients. Most QL instruments take a certain degree of physical and psychological functioning into account as well as the level of activity and a global evaluation of life. The reliability and validity of these instruments are reviewed in this paper. Reliability has been well documented and seems satisfactory for most instruments. Only a few authors have discussed content validity. Predictive validity has also been established in most instances and the results from various studies are promising, however, the choice of criteria is seldom taken into account. It also seems difficult to draw conclusions about construct validity. In our view, the main problem is the lack of definitions and the absence of a theoretical framework. Therefore, some assumptions underlying QL research in cancer patients have been elucidated.

Humans↗

PubMed2004

The development of a helpline for chronic obstructive pulmonary disease (COPD).

BACKGROUND: The goal of the helpline is to assist individuals with chronic obstructive pulmonary disease (COPD) better manage their disease through improved understanding of COPD, its symptoms and treatment. OBJECTIVES: The purpose of this project was to develop and validate a protocol for a COPD helpline. METHODS: Ten key informants with expertise in helpline development or COPD were interviewed. Fifty individuals with COPD participated in content validation of the protocol. RESULTS: An initial protocol for the helpline aimed to provide: (1) information and education regarding COPD and its management via the telephone and with written materials; (2) guidance regarding course of management; (3) resource links to other support services and programs locally, provincially, and/or nationally; and (4) caring support and reassurance to those with COPD and their families. The majority of the calls from individuals with COPD sought medical information (74%) and required 36.6 +/- 14.5 min (range: 15-85) to complete. Many different topics were discussed, with medication and exercise being the most common. The availability of the call center was identified as one means of replacing information sought from other health care providers, mainly physicians and pulmonary rehabilitation staff. CONCLUSION: A protocol of a helpline for COPD has been developed based on the literature, theoretical knowledge, and input from key informants and individuals with COPD.

Aged↗

PubMed2004

Development of a culturally relevant body image instrument among urban African Americans.

OBJECTIVE: To validate a culturally relevant body image instrument among urban African Americans through three distinct studies. RESEARCH METHODS AND PROCEDURES: In Study 1, 38 medical practitioners performed content validity tests on the instrument. In Study 2, three research staff rated the body image of 283 African-American public housing residents (75% women, mean age = 44 years), with the residents completing body image, BMI, and percentage body fat measures. In Study 3, 35 African Americans (57% men, mean age = 42) completed body image measures and evaluated their cultural relevance. RESULTS: In Study 1, 97% to 100% of practitioners sorted the jumbled figures into the correct ascending order. The correlation between the body image figures and the practitioners' weight classifications of the figures was high (r = 0.91). In Study 2, observers arrived at similar ratings of body size with excellent consistency (alpha = 0.95). Ratings of body image were strongly correlated with participant BMI (r = 0.89 to 0.93 across observers and 0.81 for all participants) and percentage of body fat (r = 0.77 to 0.89 across observers and 0.76 for all participants). In Study 3, body image ratings with the new scale were positively correlated with other validated figural scales. The majority of participants reported that figures in the new body image scale looked most like themselves and other African Americans and were easiest to identify themselves with. DISCUSSION: The instrument displayed strong psychometric performance and cultural relevance, suggesting that the scale is a promising tool for examining body image and obesity among African Americans.

Adult↗

PubMedDate not supplied

The practice of certified community health CNSs.

PURPOSE/OBJECTIVES: This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. METHODS: The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. ANALYSIS: Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. FINDINGS: The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25% for nurses/ nursing practice. CONCLUSIONS: Community Health CNS is a viable specialty practice with long-term career options. The subrole functions-described by ANA-of clinician, educator, administrator/leader, consultant, and to a lesser extent researcher apply to the role. The more intergraded updated model offered by NACNS also fits Community Health CNS practice with more emphasis on patient/client and organization/ network spheres than on nurses/nursing practice sphere. IMPLICATIONS: Schools of nursing should continue to offer the Community Health CNS programs and incorporate both the traditional functions and newer practice model into their curricula, with a greater emphasis on diversity of students to help ensure a more diverse CNS population. Further research is needed to explore the outcomes of Community Health CNS practice and the factors that contribute to role satisfaction.

Adult↗

PubMed1990

Developing a test of knowledge of surgical options for breast cancer.

Because many women now have a choice regarding the type of surgery they prefer for early stage breast cancer, it is important for clinicians to provide comprehensive information about these options and to determine whether patients have understood this information. The purpose of this study was to develop a short, easily administered, valid and reliable test of women's knowledge of surgical treatment options for early stage breast cancer. Instrument development was carried out in two phases: (a) content domains were established and items were generated and examined for content validity and clarity; and (b) the known-groups technique was used to determine construct validity and to generate data for reliability testing. The test was administered to 44 student nurses, 21 women with breast cancer, and 24 practicing nurses. An 18-item test--the BCIT-R (Breast Cancer Information Test-Revised)--with modest internal consistency and very good construct validity resulted from these steps. Nurses scored significantly better than either students or patients. The instrument is discussed in terms of psychometric issues and clinical use.

Adult↗

PubMedDate not supplied

Validation of increased intracranial pressure and high risk for increased intracranial pressure.

The authors designed this validation study to determine the defining characteristics of increased intracranial pressure and the risk factors for high risk for increased intracranial pressure. Using Fehring's Diagnostic Content Validity Model, a purposive sample of 219 nurses validated 17 major and 16 minor defining characteristics of increased intracranial pressure and nine major and six minor risk factors for high risk for increased intracranial pressure. Ratings were similar among nurses with diverse educational preparation but varied among nurses in different specialty areas, suggesting that practice setting is important in nursing diagnosis validation studies.

Humans↗

PubMed2003

Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis.

BACKGROUND: Although disease-specific health status measures are available for ankylosing spondylitis (AS), no instrument exists for assessing quality of life (QoL) in the condition. OBJECTIVE: To produce an AS-specific QoL measure that would be relevant and acceptable to respondents, valid, and reliable. METHODS: The ASQoL employs the needs-based model of QoL and was developed in parallel in the UK and the Netherlands (NL). Content was derived from interviews with patients in each country. Face and content validity were assessed through patient field test interviews (UK and NL). A postal survey in the UK produced a more efficient version of the ASQoL, which was tested for scaling properties, reliability, internal consistency, and validity in a further postal survey in each country. RESULTS: A 41 item questionnaire was derived from interview transcripts. Field testing interviews confirmed acceptability. Rasch analysis of data from the first survey (n=121) produced a 26 item questionnaire. Rasch analysis of data from the second survey (UK: n=164; NL: n=154) showed some item misfit, but showed that items formed a hierarchical order and were stable over time. Problematic items were removed giving an 18 item scale. Both language versions had excellent internal consistency (alpha=0.89-0.91), test-retest reliability (r(s)=0.92 UK and r(s)=0.91 NL), and validity. CONCLUSIONS: The ASQoL provides a valuable tool for assessing the impact of interventions for AS and for evaluating models of service delivery. It is well accepted by patients, taking about four minutes to complete, and has excellent scaling and psychometric properties.

Adult↗

PubMed1985

The MCMI as a measure of DSM-III.

The Millon Clinical Multiaxial Inventory (MCMI) has been interpreted as a measure of DSM-III disorders. However, the MCMI was constructed and validated primarily as a measure of Millon's (1969, 1981) taxonomy, not DSM-III. Comparison of the two taxonomies and examination of the MCMI's content validity for two of the MCMI scales indicate only a partial congruence between the Millon and DSM-III taxonomies. There has been no published empirical research concerning the relationship between the MCMI and DSM-III, and the derivation and cross-validation research for the MCMI scales employed Millon's taxonomy and not DSM-III. It is suggested that until such data have been presented one should be cautious in one's interpretation of the MCMI as a measure of DSM-III disorders.

Antisocial Personality Disorder↗

PubMed2003

Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders.

The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated disorders (WAD). The aim of this study was to assess the validity of the NDI and NPQ as measures of outcome in WAD by comparing them to a patient preference questionnaire, the problem elicitation technique (PET), which identifies problems that are of most importance to the individual patient. A cross-sectional study of 71 patients with varying severity and duration of WAD were recruited from a private physiotherapy practice. All patients completed a standardized self-administered questionnaire that included demographic and clinical details as well as self-perceived pain and severity of symptoms, NDI and NPQ. A trained interviewer administered the PET. Construct validity of the disability measures was examined by determining their correlation with each other and with pain and severity of symptoms by calculating Pearson's correlation coefficients. Content validity of the NDI and NPQ was assessed by comparing the items of both questionnaires to the problems identified by the PET. Participants' mean age was 40.1 years (SD=14.3) and 59 were women (83.1%). Most patients were in WAD category I (n=23, 32.1%), or II (n=42, 59.2%). Mean NDI, NPQ, and PET scores were 40.7 (SD=17.0), 38.7 (SD=15.8), and 160.2 (SD=92.0, range 6.0-509.5), respectively. Correlations between the NDI and PET, NPQ and PET, and NDI and NPQ were r=0.57, 0.56 and 0.88, respectively. The PET identified an average of 7.7 problems per patient (SD=4.2, range 1-17 problems). Problems most commonly identified were work for wages (52.1%), fatigued during the day (50.7%), participation in sports (47.9%), depression (43.7%), drive a car (43.7%), socialize with friends (33.8%), sleep through the night (31.0%), frustration (31.0%), and anger (28.2%). Only three of these problems are included in the NDI (work, driving, and sleeping) and only four are included in the NPQ (work, driving, sleeping, and social activities). While both the NDI and NPQ include some problems that are common in patients with WAD, frequently identified problems, such as emotional and social items are absent. In contrast to the PET, neither instrument captures the full spectrum of disabilities judged to be important by the patient.

Adult↗

PubMed2002

Psychometric properties of a new metamemory questionnaire for older adults.

Subjective memory ratings provide information that is distinct from objective memory performance, and there is a need for reliable and valid metamemory measures. The Multifactorial Memory Questionnaire (MMQ), developed to assess separate dimensions of memory ratings that are applicable to clinical assessment and intervention, includes scales of Contentment (i.e., affect regarding one's memory), Ability (i.e., self-appraisal of one's memory capabilities), and Strategy (i.e., reported frequency of memory strategy use). Among a group of 115 older adults, analyses revealed excellent content validity, factorial validity, test-retest and intratest reliability, convergent and discriminant construct validity, and independence from demographic variables. The psychometric strengths of the MMQ, together with descriptive statistics provided for healthy older adults, make this questionnaire useful in both clinical and research settings.

Age Factors↗

PubMed1993

Standardized patients: a long-station clinical examination format.

Data from the first 20 periods of a long-station clinical performance examination for a 4-week required clerkship in family medicine were examined in order to assess the reliability and validity of the examination. Data from 304 students were examined for station, case scenario and examiner effects and results compared to short-station formats. A significant examiner effect was found but there were no differences in student performance for station or case scenario. These findings reflect examiner specificity cited in the literature for short station examinations, but not case specificity. The source of variability for this examination appears to be primarily examiner effect. There was a significant correlation between student scores on the two cases, and raters tended to rank order students similarly in spite of variability in mean rater score. Scores on the CPE correlated with other measures of clinical performance as well as other methods of student evaluation for the clerkship providing some evidence for construct and criterion-related validity. CPE cases were developed from clerkship objectives but examination of the test blueprint revealed some gaps in the extent to which the CPE covers the course content. CPE developers are working to increase interrater reliability through examiner training and further standardize case scenarios through check-lists and patient training. Additional cases are being developed to increase the content validity of the examination.

Clinical Clerkship↗