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PubMed2004

Professional and patient perspectives on nutritional needs of patients with cancer.

PURPOSE/OBJECTIVES: To identify and compare perceptions of RNs, registered dietitians (RDs), and patients regarding the best format and key nutrition information components that should be provided to patients during cancer treatment. DESIGN: Cross-sectional study using an opinion-based questionnaire. SETTING: Outpatient cancer centers. SAMPLE: 506 RNs and 367 RDs, as well as 653 patients undergoing cancer treatment. METHODS: Two similar self-administered questionnaires were developed, one for patients and one for healthcare professionals. Face and content validity were assessed by a panel of experts. Data were analyzed using descriptive statistics, chi-square statistic, and a Spearman Correlation Coefficient to compare responses. MAIN RESEARCH VARIABLES: Patient nutrition concerns as well as format and content of printed educational materials. FINDINGS: Significant differences existed among groups regarding the most common nutrition concerns, the perception of importance of information frequently provided to patients with cancer, and rank order of importance for eight items typically provided to patients. The dietary information format preferred by all groups was an all-inclusive booklet; RNs (75%) were more likely than RDs (43%) or patients (50%) to prefer this format. Data also revealed that almost half of the patients (47%) received no dietary counseling, including 18% who experienced significant weight loss. CONCLUSIONS: RNs and RDs who provide nutrition education to patients with cancer should consider the need to develop and use a variety of printed materials to meet individual needs. Because major concerns of patients and healthcare professionals were related to patients ability to consume adequate amounts of food, this should be the primary focus of any nutrition education materials. IMPLICATIONS FOR NURSING: These findings provide information that can be applied to the development of informational materials and counseling practices.

Adult↗

PubMed2004

Development and validation of the medication regimen complexity index.

BACKGROUND: Medication regimen attributes, such as the number of drugs, dosage frequency, administration instructions, and the prescribed dosage forms, have been shown to influence patient outcomes. No single tool for quantifying the complexity of general medication regimens has been published in the medical literature. OBJECTIVE: To develop and validate a tool to quantify the complexity of prescribed medication regimens. METHODS: Literature findings and the expertise of the authors were used for developing the tool. Eight pharmacy researchers helped in establishing the tool's face and content validity. The new tool was tested on 134 medication regimens from patients with moderate to severe chronic obstructive pulmonary disease. Six regimens with a spread of scores on the tool were presented to a 5-member expert panel that subjectively ranked these regimens to confirm the tool's criterion-related validity. The relationships between scores on the tool and various independent variables were tested to judge the tool's construct validity. Two raters scored 25 regimens using the tool to test its inter-rater and test-retest reliabilities. RESULTS: A 65-item Medication Regimen Complexity Index (MRCI) was developed. The expert panel had strong agreement (Kendall's W = 0.8; p = 0.001) on their individual rankings of the 6 regimens. The panel's consensus ranking had perfect correlation with the MRCI ranking. The total MRCI score had significant correlation with the number of drugs in the regimen (Spearman's Rho = 0.9; p < 0.0001), but not with the age and gender of the patients. Inter-rater and test-retest reliabilities for the total score and scores for individual sections on the MRCI were > or = 0.9. CONCLUSIONS: The MRCI is a reliable and valid tool for quantifying drug regimen complexity with potential applications in both practice and research.

Clinical Protocols↗

PubMed2004

Validation of a symptom measure suitable for use among palliative care patients in the community: CAMPAS-R.

The purpose of the study was to investigate psychometric properties of CAMPAS-R, an instrument for prospectively monitoring patients' symptoms and needs during palliative care at home. CAMPAS-R was piloted for face and content validity and then administered alongside criterion measures to a home care sample. Cronbach's alpha was used to test internal consistency and criterion-related validity was tested by non-parametric correlation with Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and EORTC QLQ-C30. Predictive validity was assessed by relating CAMPAS-R scores to survival. One hundred and nine patients were recruited to the study. Good reliability and high correlations between CAMPAS-R and criterion measures were found. Predictive validity was demonstrated by significant differences in symptom scores between groups differing in length of survival. CAMPAS-R is acceptable to patients, families and primary care professionals and is a valid, reliable instrument, which has the benefit of being easy to score.

Adult↗

PubMed2005

The Reynolds Adolescent Depression Scale in New Zealand adolescents.

OBJECTIVE: To examine aspects of the reliability and validity of the Reynolds Adolescent Depression Scale (RADS) in measuring depression in New Zealand adolescents of all major ethnic groups. METHOD: A sample of 9699 randomly selected New Zealand secondary school students participated in the Youth2000 Health and Wellbeing Survey which included the RADS. Data from this survey have been used to assess some aspects of the reliability and validity of the RADS in the New Zealand context across different ethnic groups. Cronbach's alpha, item-total score correlations, correlation to other questions and a factor analysis were done in order to examine the internal reliability, content validity, convergent validity and construct validity of the data and compare to the original Reynolds validation study. RESULTS: Tests of the scale resulted in scores over 0.90 on Cronbach's alpha and high item-total score correlations, with a median correlation of 0.62 and 25 of the 30 correlations measuring more than 0.5. The scores were found to have similar factor structure to the original scale and the correlations to other depression related questions indicate acceptable concurrent validity. CONCLUSIONS: On all of the tests conducted, the RADS was found to have acceptable reliability and validity for New Zealand adolescents across the major different ethnic groups, indicating that it is a valid and appropriate instrument to use with New Zealand adolescents.

Adolescent↗

PubMed2001

The construction and evaluation of the reliability and validity of a life attitude scale for elderly with chronic disease.

The elderly with chronic diseases face numerous impacts which influence their life attitudes. The purpose of this study was to construct, and evaluate the reliability and validity of a life attitude scale for elderly with chronic disease. Initially, the 27 items of the Life Attitude Scale were constructed by in depth interview of 48 elderly with chronic diseases. Then, the construct validity was established by factor analysis with 663 samples. Six factors: Congeniality of Family Life, Life Meaning, Dignity of Life, Struggle with Adversities, Hollow Existence, and Destiny to Life, which included 20 items, explained 59.7% of total variances. Content validity was found to be well established by 6 experts. Correlation of inter-rater reliability among 6 data collectors was 0.96. Cronbach's alpha of internal consistency was above 0.89 for 148 samples. Correlation of test-retest reliability was above 0.87 for 37 samples with 2-week interval. This study presents what the Taiwan elderly with chronic diseases are undergoing and their views on life and its value. There are highly culture-based and philosophy-based knowing about life attitude of elderly with chronic disease in Taiwan, and it is imperative to inspire nurses to promote the quality of spiritual care for elderly with chronic disease.

Aged↗

PubMedDate not supplied

Psychiatric nurses' satisfaction with a patient classification system for staffing.

The nursing literature is replete with patient classification (PC) tools that are reported to be valid and reliable. Most of our knowledge about these tools is derived from studies conducted in general hospitals. Little is known about the few psychiatric PC tools that exist or how satisfied nurses are with them. The purpose of this study was to survey nurses' satisfaction with the validity, reliability, and general use of a PC tool for psychiatric patients. A convenience sample of nurses at one mental health hospital participated in the study. After selecting a PC system, all subjects received an extensive PC inservice. Content validity was confirmed by a panel of experts. The nurses surveyed indicated they were satisfied with the tool as a valid and reliable assessment of patient staffing needs. Furthermore, they were satisfied with its ease and overall adequacy. The alpha coefficient for the survey questionnaire was high, indicating reliability.

Attitude of Health Personnel↗

PubMed2005

Perceived competence of rural South-African and rural African-American families: a cross-cultural assessment of structural validity.

The present study explores psychometric differences in baseline data from rural African-American (AA) and rural South-African (SA) adolescents to establish the cross-cultural validity of the Harter Perceived Competence Scale (PCSC). Two versions of the PCSC (one English and one Sepedi) were collected from 223 rural AA families and 157 rural SA families. A multinational research team was assembled to establish content validity of the translated versions of the PCSC. Principle components analysis and multiple group confirmatory factor analysis were used to investigate structural validity. The results have implications for intercontinental research and the theoretical construct of perceived competence.

Adolescent↗

PubMed1992

Validity and reliability of the infant behavioral summarized evaluation (IBSE): a rating scale for the assessment of young children with autism and developmental disorders.

The Infant Behavioral Summarized Evaluation (IBSE) is a rating scale adapted from the Behavioral Summarized Evaluation (BSE) and specifically related to the assessment of behaviors of young children having autistic disorders. Content validity and reliability studies described in the paper were made from behavior ratings of videotapes for 89 children aged from 6 to 48 months. Results show a significant group of 19 items including some characteristic early autistic behaviors (communicative and social abnormalities) and some that are less commonly described in the syndrome (attentional, perceptive, and adaptive disorders). The value of the use of this scale for clinicians and professionals involved in behavioral evaluations and treatment of young children with developmental disorders and the necessity for further psychometric investigations are discussed.

Autistic Disorder↗

PubMed2000

Development and validation of a questionnaire to evaluate patient satisfaction with diabetes disease management.

OBJECTIVE: To develop a reliable and valid questionnaire to measure patient satisfaction with diabetes disease management programs. RESEARCH DESIGN AND METHODS: Questions related to structure, process, and outcomes were categorized into 14 domains defining the essential elements of diabetes disease management. Health professionals confirmed the content validity. Face validity was established by a patient focus group. The questionnaire was mailed to 711 patients with diabetes who participated in a disease management program. To reduce the number of questionnaire items, a principal components analysis was performed using a varimax rotation. The Scree test was used to select significant components. To further assess reliability and validity; Cronbach's alpha and product-moment correlations were calculated for components having > or =3 items with loadings >0.50. RESULTS: The validated 73-item mailed satisfaction survey had a 34.1% response rate. Principal components analysis yielded 13 components with eigenvalues > 1.0. The Scree test proposed a 6-component solution (39 items), which explained 59% of the total variation. Internal consistency reliabilities computed for the first 6 components (alpha = 0.79-0.95) were acceptable. CONCLUSIONS: The final questionnaire, the Diabetes Management Evaluation Tool (DMET), was designed to assess patient satisfaction with diabetes disease management programs. Although more extensive testing of the questionnaire is appropriate, preliminary reliability and validity of the DMET has been demonstrated.

Adolescent↗

PubMed1978

Assessing achievement for minimal academic competency. II. Validity and reliability.

Research was undertaken to develop, administer, and evaluate two forms of a criterion-referenced test instrument for measuring the competency status of students graduating from undergraduate programs in general dietetics. Involved in the evaluation of the final forms were 186 students graduating from fourteen college or university programs. Results are reported on the content validity, concurrent validity, reliability, and summary and individual test-item statistics. It is concluded that the test forms need further refinement and development and that the use of criterion-referenced evaluation tools to measure academic competency of students graduating in dietetics is needed.

Dietetics↗

PubMed2004

Assessing coughing and wheezing in lung cancer: a pilot study.

PURPOSE/OBJECTIVES: To establish reliability and validity of two self-report questionnaires, the Lung Cancer Cough Questionnaire and the Lung Cancer Wheezing Questionnaire. DESIGN: Prospective, exploratory pilot study. SETTING: Clinical oncology settings in the southern United States. SAMPLE: 31 adult women with lung cancer. METHODS: Content validity of both questionnaires was assessed through a comprehensive literature review and an expert judge panel. Concurrent validity was established by Spearman rank correlation coefficients and Wil-coxon Rank Sum tests with items from other valid tools. Test-retest reliability was assessed by percent agreement, kappa, paired t tests, and correlations. Internal consistency was determined by Cronbach's alpha. MAIN RESEARCH VARIABLES: Cough, wheeze. FINDINGS: Cronbach's alpha showed excellent internal consistency and percent agreement, and kappa showed similarity of item responses across test-retest administrations. Nonsignificant paired t tests indicated similar mean scores, and significant test-retest correlations supported test-retest reliability. CONCLUSIONS: Preliminary testing indicates good reliability and validity for both questionnaires. Both instruments can identify people with problems of coughing and wheezing and have the potential for monitoring these symptoms over time and determining effectiveness of interventions. IMPLICATIONS FOR NURSING: Assessment of coughing and wheezing is an important component of monitoring respiratory symptoms of lung cancer. Both of these symptoms can be amenable to interventions. Further research is needed to confirm psychometrics and sensitivity of these tools.

Cough↗

PubMed1997

Development, reliability, and validity testing of the Ethical Behavior Test: a measure for nurses' ethical behavior.

The need for reliable and valid measures for ethical behavior of nurses has encouraged the authors to develop a new instrument to measure students' ethical behavior in daily nursing dilemmas. Characteristic of the instrument presented is the inclusion of two fundamental components of ethical behavior: (1) ethical reasoning (and the resulting decision), and (2) the actual implementation of the ethical decision. As for many instruments, Kohlberg's theory of moral development has been used as the conceptual framework. However, Kohlberg's abstract justice orientation was refined by a care perspective and representative nursing dilemmas were used to make the instrument conceptually more appropriate for measuring nurses' ethical behavior. The analysis of the psychometric properties of the instrument has provided several relevant indications for the reliability and validity of the ethical reasoning and implementation scores. The revealed inconsistencies in the Ethical Behavior Test could be satisfactorily interpreted in terms of Kohlberg's theory and related empirical research findings, supporting the reliability of the ethical behavior scores. The content validity rests upon the careful development of the instrument resulting in an optimal mix of dilemmas, arguments and care situations to reveal nurses' ethical behavior and in a substantial degree of correspondence between the concept and operationalization. The congruency between the patterns of ethical behavior and Kohlberg's theoretical insights about ethical reasoning and practice support the construct validity of the instrument.

Adult↗

PubMed2005

The development and validation of a dementia behavior disturbance inventory.

OBJECTIVE: To develop an instrument that measures observable problematic behaviors in patients with dementia. METHODOLOGY: We used focus group interviews to identify the problematic behaviors of patients with dementia. Eighty-two behaviors grouped into 12 domains were generated from the data collected from five different focus groups. After conducting a content validation process, a 72-item Dementia Behavior Disturbance Inventory (DBDI) rated by a frequency and a disturbance scale was formed. The DBDI was administered to 200 institutionalized elderly patients with dementia by formal caregivers for psychometric evaluation. RESULTS: Inter-item correlation of items in each domain was performed for item reduction. Forty-eight items remained after this procedure. Exploratory factor analysis obtained nine factors that explained 59.2% and 59.6% of the total variance in the frequency and disturbance scales, respectively. Cronbach's alpha of the entire 48-item frequency and disturbance scales was 0.88 and 0.91, respectively. Most of the factors had acceptable internal consistency reliability. Test-re-test reliability coefficients of the frequency and disturbance scales were 0.78 and 0.64, respectively. The DBDI was weakly but positively related to functions of daily activities and ambulation. CONCLUSION: The DBDI demonstrates promising psychometrical properties as an instrument to assess problematic behaviors in elderly people with dementia.

Adult↗

PubMed1992

[French-language adaptation of an evaluation test of knowledge meant for insulin-dependent children: methodology and value for research in clinical practice].

A measure of knowledge level of diabetic patients is useful in evaluating their educational needs as well as the impact of the educational programs specifically designed for them. The lack of such scales in French, led us to translate and validate an existing knowledge scale for diabetic children, the Test of Diabetes Knowledge (TDK) (Johnson et al.). After several translations and back translations, the 33 item scale was submitted to the staff members of a pediatric diabetology unit, to establish its content validity. An assessment the questionnaire was performed in a group of 49 children, aged 7.9 to 12.8 years. The mean duration of diabetes was 4.6 +/- 2.9 years and their scholastic level varied from 1st to 6th grades. Time spent in filling out the questionnaires was 12 to 25 minutes. Few missing values were noted. The reliability of the scale was excellent as shown by Cronbach's alpha coefficient: 0.83 for the overall scale, 0.72 for the general knowledge subscale (20 items) and 0.70 for the problem solving subscale (13 items). The level of correct responses was correlated with age and scholastic level (p < 0.0001), but not with sex, duration of diabetes, or HbA1c levels. This study shows that the French version of the TDK is a valid and reliable tool for measuring the level of knowledge in children and adolescents with diabetes. This scale provides the researcher and clinician with a tool that facilitates the performance of an educational diagnosis and the evaluation of educational programs based on the transmission knowledge.

Adolescent↗

PubMed2000

The objective structured clinical examination: a step in the direction of competency-based evaluation.

BACKGROUND: The Accreditation Council for Graduate Medical Education is embarking on the major task of a paradigm shift in graduate education in the direction of competency-based medical education and evaluation of outcomes. The Objective Structured Clinical Examination (OSCE), a measure of clinical competence that focuses on outcomes via observable behaviors, is gaining national recognition. OBJECTIVE: To review the pediatric literature relevant to the OSCE. METHOD: A MEDLINE search from the date of the original report of the OSCE (1975) to the present was performed. All English-language studies regarding the use of the OSCE in pediatric education published in the United States and Great Britain were reviewed. MAIN OUTCOME MEASURES: Reliability and validity of the OSCE were examined. Use of standardized pediatric patients was discussed. RESULTS: A greater number of stations and similarity between tasks at different stations increased the reliability of the OSCE. A greater number of stations increased sampling of material and content validity. Correlation between the OSCE and precertification examinations ranged between 0.59 and 0.71, with P< or =.01. Correlation between the OSCE and monthly clinical evaluations was much lower (0.39-0.57), but still statistically significant at P< or =.05. Gaps between expected and actual performance were documented. Overall, the experience of being a standardized patient was viewed as positive by children and their parents. CONCLUSIONS: With appropriate attention to design, acceptable reliability and validity can be achieved for the OSCE. Significant correlations between the OSCE and precertification examinations as well as monthly clinical evaluations were found, the former being stronger than the latter. We conclude that the combination of the OSCE, standardized board examinations, and direct observation in the clinical setting has the potential to become the "gold standard" for measuring physician competence.

Accreditation↗

PubMed1987

Measuring overall health: an evaluation of three important approaches.

There is growing recognition that meaningful measures of health-related quality of life must be used to evaluate health care interventions. We examined the practicality and validity of three promising measures of overall health: the General Health Rating Index (GHRI), the Quality of Well-being Scale (QWB), and the Sickness Impact Profile (SIP). Practicality was assessed in terms of interviewer training required, administration time, and respondent burden. Content validity, convergent construct validity, and tests of discriminant validity were also evaluated. Although differing in theory and application, we found that each instrument performed according to the claims of the developers and could provide useful, valid data on overall health. The GHRI may be preferred where brief, self-administered forms are required; the QWB has advantages when health assessments are used to calculate cost-effectiveness; and the SIP is a versatile, easy to understand measure dealing with a wide range of specific dysfunctions. It is worth the required effort to include well-studied measures such as these in any trial intended to provide definitive information on the effectiveness of health care interventions.

Activities of Daily Living↗

PubMed1998

Development and testing of the inventory of functional status--chronic pain.

Gender differences have been identified in daily activities and the importance of specific activities. Functional status instruments do not reflect these differences and may provide a biased measurement. The purpose of this 3-phase study was to develop a reliable and valid instrument for measuring functional status in women with chronic pain. The Inventory of Functional Status--Chronic Pain (IFS-CP) measures activities primarily engaged in by women and omits from scoring those activities in which the individual does not usually participate. Content validity was established at 91.5%. Reliability and further validity testing in a sample of 204 women with chronic pain found that internal consistency ranged from 0.61 to 0.94 for item to subscale, and from 0.71 to 0.89 for subscale to total scores. Test-retest reliability was 0.93. Testing of construct validity resulted in significant correlations between functional status and pain severity, pain interference [Multiphasic Pain Inventory (MPI)], perception of pain disability [Pain and Impairment Relationship Scale (PAIRS)], and quality of life (QOL, Survey). The IFS-CP provides a means of comprehensively assessing the effects of pain on the functional status of women.

Activities of Daily Living↗

PubMed2003

How I feel: a self-report measure of emotional arousal and regulation for children.

This article details the development and preliminary validation of a multidimensional self-report measure of emotion for 8- to 12-year-old children--the How I Feel (HIF). Item generation and selection occurred via 2 pilot administrations (ns = 250 and 378, respectively). Ten experts provided data on content validity. Exploratory factor analysis and subsequent confirmatory factor analysis with samples of 406, 524, 349, and 349 3rd-through 6th-grade children supported a 3-factor model, including the frequency and intensity of (a) positive emotion, (b) negative emotion, and (c) positive and negative emotion control. Results showed moderate longitudinal stability for 120 children over 2 years. Concurrent validity was established. The HIF can be useful in understanding the interplay between arousal and control in social-emotional adjustment in school-age children.

Adaptation, Psychological↗