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PubMed2001

Nursing in Colorectal Cancer Initiative: the audit phase. Part 2. Content validity of the audit tool and implications of the standards set for clinical practice.

This paper gives an account of the process of refining the content validity of an audit tool, which defines and measures best practice in colorectal cancer nursing and identifies areas for development. The European Oncology Nursing Society (EONS) and AstraZeneca collaborated to develop the Nursing in Colorectal Cancer Initiative (NICCI). The initiative was funded through educational grants from AstraZeneca and led by EONS. It is a project with two components, education and audit. The education component culminated in a manual that provides a core set of materials concerning fundamental aspects of colorectal cancer, to foster a common understanding amongst nurses at national and international levels. An audit tool was developed to measure standards of nursing care in relation to the delivery of cytotoxic chemotherapy to patients with advanced colorectal cancer. The content validity of the audit tool was established in three stages by expert panel review with revisions made to the content and organisation of the audit measures at each stage. The standards set by the NICCI Audit Project have key implications for multi-professional practice in colorectal cancer care.

Journal Article↗

PubMedDate not supplied

Using the Delphi technique to examine the content validity of nursing diagnoses.

Official labeling of phenomena that nurses diagnose and treat requires that researchers validate the existence of proposed diagnoses. One part of the validation process is the examination of content validity. The Delphi technique is a useful methodologic technique for such an examination. This article describes the characteristics, background, advantages, and disadvantages of the Delphi technique, as well as suggested strategies for using it to validate nursing diagnoses. In discussing strategies for using the Delphi technique to validate nursing diagnoses, the format, essential components, and steps of each round of the traditional and modified Delphi procedure are addressed. Round I of the traditional Delphi technique involves selection of a panel of content experts, developing and mailing questionnaires and content analysis, and generating a list of defining characteristics and operational definitions for a nursing diagnosis. Round II involves developing and mailing questionnaires, determining percentage of agreement, and providing statistical analysis. Round III includes developing and mailing questionnaires and providing statistical analysis of data. Round IV consists of developing and mailing the final report, which includes a statistical summary of individual and grouped responses in round III, as well as a minority report. The format and statistical analysis of the modified Delphi procedure is similar to rounds II, III, and IV of the traditional Delphi technique, except the modified technique usually will require only three rounds.

Delphi Technique↗

PubMed1995

Measuring workaholism: content validity of the Work Addiction Risk Test.

A total of 20 psychotherapists, randomly selected from a state list, critically examined the 25 items on the Work Addiction Risk Test for content validity. Subjects were asked to identify 25 items from a list of 35 which most accurately measured work addiction. Selected test items have generally high content validity for the domain of work addiction.

Adult↗

PubMed1993

The measurement of instrumental ADL: content validity and construct validity.

A new measure of Instrumental Activities of Daily Living (IADL), which is able to discriminate among the large group of elderly who do not depend on help, was tested for content validity and construct validity. Most assessments of functional ability include Physical ADL (PADL) and Instrumental ADL (IADL). PADL-scales assess the basic capacity of persons to care for themselves. IADL-scales are used to assess somewhat higher levels of performance, such as the ability to perform household chores or go shopping. Data were collected from 734 70-year-old people in Denmark in the county of Copenhagen. The measure of Instrumental ADL included 30 activities in relation to tiredness and reduced speed. Construct validity was tested by the Rasch model for item analysis; internal validity was specifically addressed by assessing the homogeneity of items under different conditions. The Rasch item analysis of IADL showed that 14 items could be combined into two qualitatively different additive scales. The IADL-measure complies with demands for content validity, distinguishes between what the elderly actually do, and what they are capable of doing, and is a good discriminator among the group of elderly persons who do not depend on help. It is also possible to add the items in a valid way. However, to obtain valid IADL-scales, we omitted items that were highly relevant to especially elderly women, such as house-work items. We conclude that the criteria employed for this IADL-measure are somewhat contradictory.

Activities of Daily Living↗

PubMed2003

Content validity of manual spinal palpatory exams - A systematic review.

BACKGROUND: Many health care professionals use spinal palpatory exams as a primary and well-accepted part of the evaluation of spinal pathology. However, few studies have explored the validity of spinal palpatory exams. To evaluate the status of the current scientific evidence, we conducted a systematic review to assess the content validity of spinal palpatory tests used to identify spinal neuro-musculoskeletal dysfunction. METHODS: Review of eleven databases and a hand search of peer-reviewed literature, published between 1965-2002, was undertaken. Two blinded reviewers abstracted pertinent data from the retrieved papers, using a specially developed quality-scoring instrument. Five papers met the inclusion/exclusion criteria. RESULTS: Three of the five papers included in the review explored the content validity of motion tests. Two of these papers focused on identifying the level of fixation (decreased mobility) and one focused on range of motion. All three studies used a mechanical model as a reference standard. Two of the five papers included in the review explored the validity of pain assessment using the visual analogue scale or the subjects' own report as reference standards. Overall the sensitivity of studies looking at range of motion tests and pain varied greatly. Poor sensitivity was reported for range of motion studies regardless of the examiner's experience. A slightly better sensitivity (82%) was reported in one study that examined cervical pain. CONCLUSIONS: The lack of acceptable reference standards may have contributed to the weak sensitivity findings. Given the importance of spinal palpatory tests as part of the spinal evaluation and treatment plan, effort is required by all involved disciplines to create well-designed and implemented studies in this area.

Adult↗

PubMed2003

Tool to classify stool consistency: content validity and use by persons of diverse cultures.

Developing and testing the quality of a research instrument, including its ability to be used by culturally diverse persons, is an important methodological objective. The present study determined the content validity and feasibility of culturally diverse persons to use an instrument to classify stool consistency that has been employed in research on fecal incontinence. Five multidisciplinary clinicians experienced in assessing stool consistency determined the tool to possess content validity. Twenty-four foreign nationals of diverse cultures who spoke English as a second language (ESL) classified the consistency of nine stools using word only or word plus diagram descriptions. The agreement of the ratings of the participants were compared with the those of an experienced investigator. There was no significant difference between the ratings of participants using either type of description. There was good agreement between the classifications of the participants and those of the investigator. The findings of this study contribute to the quality of our instrument and support its use by culturally diverse persons.

Adult↗

PubMed2005

Development of the seating and mobility script concordance test for spinal cord injury: obtaining content validity evidence.

The appropriateness of a consumer's seating and mobility system varies considerably depending on the competence, proficiency, and experience of the professionals assisting the user. At present, there is a scarcity of skilled and knowledgeable therapists to evaluate and recommend seating and mobility devices. There is also a lack of measurement tests available to evaluate the impact of educational experiences or clinical practice on the ability to make specialized clinical decisions about seating and mobility needs. The Seating and Mobility Script Concordance Test (SMSCT) is a new assessment tool, grounded in the hypothetico-deductive and schema theories of clinical reasoning. The test is designed to assess therapists by examining the organization of their knowledge, associations between items of their knowledge, and the adequacy of their clinical decisions as compared to expert consensus. This article describes the interview, test development, and content/item review processes used for the collection of content validity evidence. The iterative process employed and the appraisal of the content validity evidence that resulted in the final version of the SMSCT are presented. The SMSCT appears to be a promising assessment tool representing content within the domain of seating and mobility for individuals with spinal cord injuries. The process utilized to develop the SMSCT in spinal cord injury can be replicated for other diagnoses and domains.

Adult↗

PubMed2003

Measurement practices: methods for developing content-valid student examinations.

Measurement experts generally agree that a systematic approach to test construction will probably result in an instrument with sound psychometric properties. One fundamental method is called the blueprint approach to test construction. A test blueprint is a tool used in the process for generating content-valid exams by linking the subject matter delivered during instruction and the items appearing on the test. Unfortunately, this procedure as well as other educational measurement practices is often overlooked A survey of curriculum administrators at 144 United States and international medical schools was conducted to assess the importance and prevalence of test blueprinting in their school. Although most found test blueprinting to be very important, few require the practice. The purpose of this paper is to review the fundamental principals associated with achieving a high level of content validity when developing tests for students. The short-term efforts necessary to develop and integrate measurement theory into practice will lead to long-term gains for students, faculty and academic institutions.

Administrative Personnel↗

PubMedDate not supplied

Development of the cancer therapy satisfaction questionnaire: item generation and content validity testing.

OBJECTIVES: This study was undertaken to develop a new questionnaire, the Cancer Therapy Satisfaction Questionnaire (CTSQ), to focus on the issues oncology patients consider when evaluating chemotherapy in terms of expectations and satisfaction. METHODS: Items of the CTSQ were generated through the review of responses from interviews with oncology patients, physicians, and nurses. Analysis of the data was stratified by disease stage, disease type, and country to explore potential differences between these groups. Two rounds of face and content validity testing were then conducted. RESULTS: Patients explained their hopes for efficacy and factors related to treatment satisfaction. Content validity testing in 30 patients, followed by additional testing in 10 patients on oral therapy, suggested that patients felt the questionnaire was clear, comprehensive, relevant, and easy to complete. Minor revisions were implemented to improve clarity, resulting in deletion of 12 items, modification of 17 items and the rewording of "chemotherapy" to "cancer therapy" to ensure patients on oral therapy were able to respond. The CTSQ contains 21 items and assesses seven domains: Expectations of cancer therapy, Feelings about side effects, Oral cancer therapy adherence, Convenience, Satisfaction with cancer therapy, Stopping cancer therapy, and Reasons for nonadherence. CONCLUSIONS: The CTSQ was designed for adults with a wide range of cancer types and stages, receiving a variety of cancer treatment formulations. A validation study is currently underway to examine the psychometric properties, further refine the questionnaire and develop scoring methods for the CTSQ.

Adult↗

PubMed2004

Focus groups in psychological assessment: enhancing content validity by consulting members of the target population.

A review of articles in Psychological Assessment reveals that many researchers develop instruments without the benefit of consultation with members of the target population. To the extent that researchers do consult the target population, most fail to bring consultation in early enough to inform the identification and specification of key constructs. Moreover, this consultation typically takes the form of one-to-one interviews. The authors' goal in this article was to elaborate on the importance of population consultation as part of content validation and to critically evaluate the potential of one method of consultation, focus groups, to inform multiple stages of instrument development. The authors suggest that this method holds promise for enhancing the content validity of instruments and, ultimately, the validity of research findings.

Combat Disorders↗

PubMed2006

Establishing content validity of the oral assessment guide in children and young people.

There is a need for accurate and consistent oral assessment to measure mucosal changes and oral complications associated with cancer therapies. Mucositis is an important and common side effect of cancer therapies that merits the identification of improved health-care interventions. Developing appropriate and reliable oral assessment instruments for use with children is relevant to the evaluation of these interventions. The purpose of this study was to determine the content validity of the oral assessment guide (OAG) in children: an instrument that was designed to objectively assess the physiological changes of the oral cavity following administration of chemotherapy and radiotherapy to adults. This process is considered to be most effective when undertaken systematically. A judgement quantification process was used with health care professionals in paediatric oncology to establish content validity of items (n=9) and instrument (n=10). A revised OAG more pertinent to children and young people was produced in the light of this process.

Antineoplastic Agents↗

PubMed2026

Teaching Engagement and Caregiving Help in the Intensive Care Unit (TEACH-ICU) Scale: Content Validity.

BACKGROUND: Having family members provide care to their loved ones in the intensive care unit (ICU) is a beneficial yet seldom implemented approach. For family members to perform caregiving, nurses must be willing to teach, and such willingness is a developing area of research. OBJECTIVES: To adapt an instrument validated in family members, the Family Willingness for Caregiving Scale, to address nurses' willingness to teach family members caregiving skills. METHODS: Purposive and snowball sampling were used to recruit 10 expert ICU nurses through the American Association of Critical-Care Nurses' research website and social media platforms. The researchers conducted cognitive interviews with the nurses to address the instrument's content validity. RESULTS: The scale was refined based on the participants' feedback. Items were deleted, added, and revised. Furthermore, scale instructions were adjusted to emphasize the willingness to teach families of patients receiving mechanical ventilation. Qualitative themes emerged related to barriers to family engagement, including time constraints, patient acuity, and nurse and family characteristics. CONCLUSIONS: Content validity of the scale was assessed, with future research aimed at pilot testing and evaluating construct validity before using the scale as a research instrument. Practical implications include using the scale as an evaluation tool to determine nurses' willingness to teach family members about caregiving. After evaluation, various strategies could be incorporated to enhance family engagement in adult ICUs.

Humans↗

PubMed1997

Different approximations of the McGill Pain Questionnaire in the Norwegian language: a discussion of content validity.

The McGill Pain Questionnaire (MPQ) is a well recognized measuring instrument for pain in English-speaking countries. Several efforts have been made to develop equivalent pain-measuring instruments in other languages. However, the method of translating the English words contained in the MPQ into another language implies that questions about validity may be posed. In Norway three different pain questionnaires have been developed which are inspired by the MPQ. A primary focus for developing the Norwegian Pain Questionnaire (NPQ) was the semantics of pain; the focus of the adapted MPQ was to include commonly used somatosensory Norwegian descriptors of pain in the population of patients with low back pain; the Norwegian McGill Pain Questionnaire (NMPQ) was literally translated into Norwegian to provide a equivalent pain questionnaire to the MPQ for cross-cultural comparisons of pain. Examination of content validity of the adapted MPQ and the translated version of the MPQ is examined by comparing the words in those questionnaires with words collected among Norwegians in the process of developing the NPQ. The findings support the content validity of the adapted MPQ. The NMPQ, however, should be further refined to better fit the semantics of pain in Norway.

Cross-Cultural Comparison↗

PubMedDate not supplied

Content validity and reliability testing of the FIN-PED II: A tool to measure care needs of parents of children with cancer.

This study tested the reliability and validity of the refined Family Inventory of Needs-Pediatrics (FIN-PED), the FIN-PED II, a 17-item instrument structured to measure care needs of parents of children with cancer. The instrument comprises three rating scales. The first rating scale measures the importance-of-care needs, the second measures the extent to which needs are met, and the third measures the need for further information. The revised instrument was first pilot tested with an expert panel of three mothers and three fathers of children with cancer who rated the tool for clarity, apparent internal consistency, and content validity. All items met preset criteria for these assessments. The instrument was then mailed to 85 parents of Australian children with cancer and tested for internal consistency reliability and test-retest reliability. Thirty-four parents returned the instrument. All three rating scales achieved high estimates of internal consistency. Evidence of the instrument's stability over time was also achieved. This study provided support for the reliability and content validity of the FIN-PED II.

Adolescent↗

PubMedDate not supplied

[Diagnoses of fear and anxiety: content validation for a burned patient].

This study aimed at identifying and performing content validation of the defining characteristics of the diagnoses of fear and anxiety for a burned patient. An instrument made up of manifestations of both diagnoses presented by Taxionomy I of the North American Nursing Diagnoses Association was elaborated, as well as others that were found in the literature. Sixteen nurses were interviewed. Out of the 97 characteristics presented in the instrument, 31 were excluded for the diagnoses "fear", and 27 for "anxiety". Eight characteristics had a score average above 0.70 for "fear" and 18 for "anxiety". The characteristics with the highest score were "expressed concern due to changes in life events" for anxiety and "insomnia referred or perceived" for fear.

Anxiety↗

PubMed1996

Content validity of the Harris Infant Neuromotor Test.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the content validity of the Harris Infant Neuromotor Test (HINT), a new screening tool designed to detect early signs of cognitive and neuromotor delays in infants with known risk factors. SUBJECTS: A multidisciplinary panel of 26 international experts, including researchers and clinicians in physical therapy, occupational therapy, developmental pediatrics, child neurology, and psychology, was selected to assess, review, and suggest modifications to the HINT. METHODS: A validity questionnaire that was keyed to the three parts of the HINT (background information, parent questionnaire, and infant assessment) and to individual items within each part was mailed to the selected content experts. Data were analyzed using descriptive statistics. RESULTS: Twenty experts completed the validity questionnaires, and the remaining 6 experts provided written comments. The experts generally agreed that the items on the initial development edition of the HINT were clearly worded and free of cultural bias. Based on written feedback, additional background information items were added, a fifth question was added to the parent questionnaire portion, and 20 of the 22 infant assessment items were modified. CONCLUSION AND DISCUSSION: After receiving questionnaire responses and written comments from a panel of 26 experts, the original version of the HINT was modified and printed as development edition 2 in November 1993. This revised edition is currently being used to examine the reliability and validity of the HINT in assessing infants at risk.

Adult↗

PubMed2002

[Content validity of an information system used for head injury rehabilitation based on an analysis of medical records].

OBJECTIVE: This study examines the content validity of the TCC-Québec Information System based on an analysis of rehabilitation medical records. The goal was to determine the agreement between the variables of the TCC-Québec Information System identified by experts and based on an extensive literature review and those found in medical records. METHOD: The medical records of 82 adults with a head injury were reviewed. The individuals had been hospitalized from 1997 to 1998 at three different acute care facilities or three rehabilitation centers. The abstractor determined if the information pertaining to a variable (e.g. personal history, impairments, or disabilities relating to sensori-motor function) was present in the record. A standardized and reliable procedure was used to ensure the quality of data extraction. The percentage of variables found in the medical records and the number of records in which each variable was documented were calculated for each clinical setting (acute care or rehabilitation) and for the different geographical regions. RESULTS: The results suggest that a large discrepancy exists between what experts desired to be included in the information system and what is really documented clinically. No discrepancy exists between the different regions. Only 23% of variables were found in more than 70% of records. CONCLUSION: This study provides recommendations about the most relevant variables to be included in an information system based on clinicians'information needs and the clinical reality. As such, these results should facilitate the use and implementation of the information system under study.

Adolescent↗

PubMed2002

Symptomatology of cancer patients in palliative care: content validation of self-assessment questionnaires against medical records.

To elucidate which symptoms or problems to measure when evaluating palliative care, we assessed the content validity of selected patient self-assessment questionnaires used to evaluate palliative care: the European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 (EORTC QLQ-C30), the Edmonton Symptom Assessment System (ESAS), the Palliative Care Outcome Scale (POS), the McGill Quality of Life Questionnaire (MQOL) and the Memorial Symptom Assessment Scale (MSAS). The content of the questionnaires was compared against the symptoms and problems noted in the medical records of 171 consecutive cancer patients on their first admission to a department of palliative medicine. From the records, 63 different symptoms were listed. Two questionnaires covered almost all of the prevalent symptoms/problems: the EORTC QLQ-C30 covered 10 and the MSAS 11 of the 12 most frequent problems. Researchers selecting instruments for evaluating palliative care may use the present study and other reviews to examine to what degree a given selection of instruments cover the symptoms/problems targeted by palliative care physicians.

Adult↗