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PubMed2006

mini-PAT (Peer Assessment Tool): a valid component of a national assessment programme in the UK?

PURPOSE: To design, implement and evaluate a multisource feedback instrument to assess Foundation trainees across the UK. METHODS: mini-PAT (Peer Assessment Tool) was modified from SPRAT (Sheffield Peer Review Assessment Tool), an established multisource feedback (360 degrees ) instrument to assess more senior doctors, as part of a blueprinting exercise of instruments suitable for assessment in Foundation programmes (first 2 years postgraduation). mini-PAT's content validity was assured by a mapping exercise against the Foundation Curriculum. Trainees' clinical performance was then assessed using 16 questions rated against a six-point scale on two occasions in the pilot period. Responses were analysed to determine internal structure, potential sources of bias and measurement characteristics. RESULTS: Six hundred and ninety-three mini-PAT assessments were undertaken for 553 trainees across 12 Deaneries in England, Wales and Northern Ireland. Two hundred and nineteen trainees were F1s or PRHOs and 334 were F2s. Trainees identified 5544 assessors of whom 67% responded. The mean score for F2 trainees was 4.61 (SD = 0.43) and for F1s was 4.44 (SD = 0.56). An independent t test showed that the mean scores of these 2 groups were significantly different (t = -4.59, df 390, p < 0.001). 43 F1s (19.6%) and 19 F2s (5.6%) were assessed as being below expectations for F2 completion. The factor analysis produced 2 main factors, one concerned clinical performance, the other humanistic qualities. Seventy-four percent of F2 trainees could have been assessed by as few as 8 assessors (95% CI +/-0.6) as they either scored an overall mean of 4.4 or above or 3.6 and below. Fifty-three percent of F1 trainees could have been assessed by as few as 8 assessors (95% CI +/-0.5) as they scored an overall mean of 4.5 or above or 3.5 and below. The hierarchical regression when controlling for the grade of trainee showed that bias related to the length of the working relationship, occupation of the assessor and the working environment explained 7% of the variation in mean scores when controlling for the year of the Foundation Programme (R squared change = 0.06, F change = 8.5, significant F change <0.001). CONCLUSIONS: As part of an assessment programme, mini-PAT appears to provide a valid way of collating colleague opinions to help reliably assess Foundation trainees.

Clinical Competence↗

PubMed1994

Validation of cutaneous stimulation interventions for pain management.

The purpose of this study was to identify and validate specific activities considered important in the implementation of selected cutaneous stimulation pain management interventions including heat and cold application, massage and Transcutaneous Electrical Nerve Stimulation (TENS). A two-round Delphi survey was completed by nurses selected for their expertise in pain management. Data were analyzed using a modification of Fehring's diagnostic content validity method. Consistently high scores were obtained by the raters for each intervention and activity, with most activities perceived as critical to the intervention. From this process, a list of activities for each cutaneous stimulation intervention evolved that are applicable to education, clinical practice and clinical nursing research.

Cryotherapy↗

PubMed2004

Reliability and validity of the Beck depression inventory--II with adolescent psychiatric inpatients.

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.

Adolescent↗

PubMed2005

[Validity and reliability of an instrument for predictive nursing intention for SARS patient care].

PURPOSE: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. METHOD: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. RESULT: Principal component analysis verified the hypothesized 6-factor solution, explaining 68.2% of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. CONCLUSION: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.

Adult↗

PubMed1991

Objective structured clinical examination in a pediatric residency program.

This report describes and evaluates a 42-station objective structured clinical examination (OSCE) administered to 29 pediatric residents and six medical students. In half of the stations, residents spent 5 minutes performing a clearly defined clinical task while being rated by an observer. In the other half of the stations, they answered questions based on the data just gathered. There were six interviews with real or simulated patients, four physical examinations, six laboratory tests or procedures, and one chart review. Eight rest stops were provided. The results of the OSCE were compared with those of resident performance ratings and the Pediatric Board's in-training examination. The OSCE scores could clearly separate the students from the residents and each class of residents from all others (construct validity). The in-training examination could not separate first-year post-graduate level and second-year postgraduate level residents. Resident performance ratings could distinguish only first-year postgraduate level from third-year postgraduate level residents. Residents uniformly agreed that the OSCE measured important clinical objectives attesting to its content validity. Reliability for the OSCE was calculated at the 0.8 to 0.83 range. It is concluded that valid and reliable clinical examinations in pediatrics are feasible, practical, and highly desirable.

Analysis of Variance↗

PubMed2002

Validity and reliability of the Perineal Assessment Tool.

This study was conducted to evaluate the validity and reliability of an instrument designed to measure risk of perineal skin injury in hospitalized individuals. Interrater reliability of the Perineal Assessment Tool was examined by correlating the scores calculated by a wound, ostomy and continence nurse compared to those calculated by staff RNs and LPNs using the same tool with the same patient. Content validity was assessed by obtaining level of agreement ratings from 102 wound, ostomy, and continence nurses. Good correlation between the expert and staff nurse scores was found (r = .970, confidence intervals = 95%, P = .923 to .988 or P < .0001). Average perineal assessment tool subscale level of agreement scores ranged from 7.66 to 8.4 (range 1 = strongly disagree to 10 = strongly agree) and the median score for all subscales was 9. The results obtained are encouraging and justify additional reliability and validity studies.

Attitude of Health Personnel↗

PubMed2006

Development and validation of the Chinese version of the Diabetes Management Self-efficacy Scale.

OBJECTIVE: The purpose of this study was to translate the Diabetes Management Self-Efficacy Scale (DMSES) into Chinese and test the validity and reliability of the instrument within a Taiwanese population. RESEARCH DESIGN AND METHODS: A two-stage design was used for this study. Stage I consisted of a multi-stepped process of forward and backward translation, using focus groups and consensus meetings to translate the 20-item Australia/English version DMSES to Chinese and test content validity. Stage II established the psychometric properties of the Chinese version DMSES (C-DMSES) by examining the criterion, convergent and construct validity, internal consistency and stability testing. The sample for Stage II comprised 230 patients with type 2 diabetes aged 30 years or more from a diabetes outpatient clinic in Taiwan. RESULTS: Three items were modified to better reflect Chinese practice. The C-DMSES obtained a total average CVI score of .86. The convergent validity of the C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale in measuring self-efficacy (r=.55; p<.01). Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities scores (Beta=.58; t=10.75, p<.01). Factor analysis supported the C-DMSES being composed of four subscales. Good internal consistency (Cronbach's alpha=.77 to .93) and test-retest reliability (Pearson correlation coefficient r=.86, p<.01) were found. CONCLUSIONS: The C-DMSES is a brief and psychometrically sound measure for evaluation of self-efficacy towards management of diabetes by persons with type 2 diabetes in Chinese populations.

Analysis of Variance↗

PubMed1987

Development and validation of the occupational identity scale.

Ego-identity research utilizing Marcia's (1966) identity statuses has been prolific during the past 15 years. The four types of statuses--achievement, moratorium, foreclosure, diffusion--have become part of the ego-identity development theory. The development of a research tool to study further one of the dimensions of ego-identity development (occupational dimension) was perceived as a need. Therefore, items were created utilizing the criteria established by previous research and content validated by a group of experts. These statements were validated by 417 students from six high schools and colleges. Responses were analyzed and measures of construct and concurrent validity were obtained. Also indexes of internal consistency and item discrimination were estimated. Through factor analysis techniques, four factors were identified for the occupational identity statuses. They accounted for 49 per cent of the total variance. Reliability coefficients ranged between 0.70 and 0.87. Concurrent validity coefficients ranged between 0.38 and 0.79, when correlated with a similar instrument. After deletion of those items that did not contribute significantly to the validity of the instrument, a 28-item Occupational Identity Scale was established.

Adolescent↗

PubMedDate not supplied

Development and exploratory analysis of the Neurorehabilitation Program Styles Survey.

OBJECTIVE: To develop a survey instrument that assesses implementation of key components of outpatient neurorehabilitation programs and test the capacity of this instrument to differentiate between rehabilitation approaches. DESIGN: The Neurorehabilitation Program Styles Survey (NPSS) was administered to 18 outpatient facilities: 10 specialized and 8 discipline-specific outpatient neurorehabilitation programs. Scores were compared between types of programs using independent samples t tests. RESULTS: The NPSS showed good reliability and contrasted groups validity, significantly differentiating between types of programs. CONCLUSIONS: The NPSS holds considerable promise as a tool for distinguishing among different types of brain injury programs, and for assessing the differential effectiveness of specialized versus discipline-specific outpatient brain rehabilitation programs. Future research on the NPSS will assess the stability of the instrument over time, its content validity, and capacity to differentiate the full continuum of neurorehabilitation programs.

Ambulatory Care Facilities↗

PubMed1985

Quality of life index: development and psychometric properties.

The purpose of the study on which this article is based was to assess the validity and reliability of an instrument designed to measure quality of life. Sixty-four items applicable to both healthy subjects and dialysis patients were tested with graduate students (n = 88); six items relative to dialysis were added, and the instrument was administered to dialysis patients (n = 37). Items were based on literature review, which supported content validity. Correlations between the instrument and an overall satisfaction with life question of 0.75 (graduate students) and 0.65 (dialysis patients) supported criterion-related validity. Support for reliability was provided by test-retest correlations of 0.87 (graduate students) and 0.81 (dialysis patients) and Cronbach's alphas of 0.93 (graduate students) and 0.90 (dialysis patients).

Adult↗

PubMed1988

Retaining qualitative validity while gaining quantitative reliability and validity: development of the Transition to Parenthood Concerns Scale.

This article raises issues about the retention of qualitative validity while establishing psychometric estimates of reliability and validity for a scale that was developed from inductively generated concepts to assess and evaluate the learning needs and concerns of expectant parents in the trimester before their baby's birth. A set of practical procedures for pilot testing qualitatively based scales is described. The three procedures, which provide estimates of clarity, apparent internal consistency, and content validity, preserve the assumptions underlying qualitative methods. The ratings from these procedures have provided a base for item and scale revisions and formal quantitative testing.

Adult↗

PubMed1997

A new questionnaire to assess the quality of life of urinary incontinent women.

OBJECTIVES: To design and validate a condition-specific quality of life questionnaire for the assessment of women with urinary incontinence, and to use the questionnaire to assess the quality of life of women with specific urodynamic diagnoses. SETTING: A tertiary referral urogynaecology unit at King's College Hospital, London. DESIGN: The questionnaire was designed following six different pilot studies; in this study it was tested for validity and reliability using standard psychometric techniques. The questionnaire was used in 293 consecutive women referred for investigation of urinary incontinence. RESULTS: The questionnaire was shown to be reliable both by test-retest analysis and by measurement of its internal consistency. The construct of the questionnaire and the answers by respondents confirmed its face and content validity. Criterion validity was measured by correlation with scores obtained on a validated generic measure of quality of life, the Short Form 36. Women with detrusor instability had greater quality of life impairment than women with other urodynamic diagnoses. CONCLUSION: The questionnaire was easy for the women to use and was a valid and reliable instrument for the assessment of quality of life in women with urinary incontinence. It will be useful for the rapid appraisal and follow up of women with urinary incontinence in many different clinical settings, including the evaluation of new treatments of urinary incontinence in controlled clinical trials.

Adult↗

PubMed1994

Reliability and validity of the chronic respiratory questionnaire (CRQ).

BACKGROUND: The Chronic Respiratory Questionnaire (CRQ) is frequently applied to assess quality of life in patients with chronic obstructive pulmonary disease (COPD). However, the reliability and validity of this questionnaire have not yet been determined. This study investigates the reliability and validity of the four separate dimensions of the CRQ. METHODS: The CRQ was administered on two consecutive days to 40 patients with COPD (mean FEV1 44% predicted, FEV1/IVC 37% predicted). Internal consistency reliability of each dimension was investigated by Cronbach's alpha reliability coefficient, test retest reliability by the Spearman-Brown reliability coefficient (p), and content validity by Pearson's correlation coefficient between the CRQ and the symptom checklist (SCL-90). RESULTS: Items of the fatigue, emotion, and mastery dimensions showed a high internal consistency reliability (alpha = 0.71-0.88) as well as a high test retest reliability (p above 0.90). These three dimensions correlated with comparable dimensions of the SCL-90. Items of the dyspnoea dimension showed a low internal consistency reliability (alpha = 0.53) and a test retest reliability of p = 0.73. CONCLUSIONS: Items of the dimensions fatigue, emotion, and mastery of the CRQ are reliable and valid and can be used to assess quality of life in patients with severe airways obstruction. Items of the dyspnoea dimension are less reliable and should not be included in the overall score of the CRQ in comparative research. However, by scoring the items of dyspnoea separately they may be useful for the evaluation of the effects of intervention in a specific patient.

Aged↗

PubMed2003

Clinical Evidence: a useful tool for promoting evidence-based practice?

BACKGROUND: Research has shown that many healthcare professionals have problems with guidelines as they would prefer to be given all relevant information relevant to decision-making rather than being told what they should do. This study assesses doctors' judgement of the validity, relevance, clarity and usability of the Italian translation of Clinical Evidence (CE) after its free distribution launched by the Italian Ministry of Health. METHODS: Opinions elicited using a standardised questionnaire delivered either by mail or during educational or professional meetings. RESULTS: Twenty percent (n = 1350) doctors participated the study. Most of them found CE's content valid, useful and relevant for their clinical practice, and said CE can foster communications among clinicians, particularly among GPs and specialists. Hospital doctors (63%) more often than GPs (48%) read the detailed presentation of individual chapters. Twenty-nine percent said CE brought changes in their clinical practice. Doctors appreciated CE's nature of an evidence-based information compendium and would have not preferred a collection of practice guidelines. CONCLUSIONS: Overall, the pilot initiative launched by the Italian Ministry of Health seems to have been well received and to support the subsequent decision to make the Italian edition of Clinical Evidence concise available to all doctors practising in the country. Local implementation initiatives should be warranted to favour doctor's use of CE.

Attitude of Health Personnel↗

PubMedDate not supplied

Validity and reliability of a breast cancer knowledge test.

A study was made to develop and test a tool to measure a subject's knowledge about breast cancer screening in order to implement effective strategies for prevention and early detection. The Breast Cancer Knowledge Test measures a subject's knowledge about detection and screening practices. The instrument is an expansion of Stillman's Knowledge Questionnaire. A 30-item test was designed and pretested. Four nationally recognized experts in cancer control determined content validity. Reliability testing then was done with a sample of 101 women 50 years of age and older. The complete posttested 18-item instrument is reported here. Correlational analyses were done between the total scores on the Breast Cancer Knowledge test and subjects' practice of screening behaviors. Findings indicate that more knowledge of breast cancer screening is associated with use of mammography and obtaining a professional examination, but not with the practice of breast self-examination.

Aged↗

PubMed2006

Melasma in Latina patients: cross-cultural adaptation and validation of a quality-of-life questionnaire in Spanish language.

BACKGROUND: Melasma has been shown to have a significant emotional and psychologic effect on affected patients. Although this pigmentary disorder is thought to be more prevalent among Latinos, the effect of melasma on quality of life (QOL) in this population is unknown. OBJECTIVES: The goals of this study were to translate and culturally adapt the previously validated Melasma QOL (MELASQOL) scale into Spanish language, to confirm the new scale's reliability and validity, and to administer the scale to characterize melasma's effect on the health-related QOL of Spanish language-speaking Latino patients. METHODS: Cross-cultural adaptation of the original questionnaire was performed using previously established guidelines. After pretesting the questionnaire in a group of 30 patients, it was tested in a group of 112 patients recruited from a community outpatient clinic. A Spanish-language health-related QOL assessment battery was also administered for validation purposes. The degree of melasma was determined on clinical examination by the investigator using the Melasma Area and Severity Index. RESULTS: Cross-cultural adaptation of the questionnaire was successful in producing a working and understandable Spanish-language version of the MELASQOL. The Spanish-language MELASQOL scale was internally reliable and demonstrated construct and content validity. The Spanish-language MELASQOL scores of patients with little to no formal education were significantly higher than those with at least a seventh-grade education. Scores were proportional to the length of time a patient had lived with melasma and were higher in patients who had previously sought treatment. Spanish-language MELASQOL score and Melasma Area and Severity Index were shown to be moderately correlated, but no differences were seen according to patient age, marital status, employment, or coexisting medical or psychiatric conditions. LIMITATIONS: Limitations are a lack of data regarding socioeconomic status and limitation to Mexican and Central American female patients. CONCLUSIONS: We have developed a semantically equivalent translation of MELASQOL in the Spanish language and have begun to characterize the effects of melasma on the QOL in a population that has not been previously studied. Further studies in larger populations of Spanish language-speaking patients from various geographic and socioeconomic groups are warranted.

Adult↗

PubMedDate not supplied

Psychosocial treatment compliance scale for people with psychotic disorders.

OBJECTIVE: Psychosocial treatment compliance is essential for effective treatment outcomes. A psychometrically valid compliance scale is required for identifying possible obstacles causing treatment non-compliance and testing the effectiveness of compliance therapy. This study developed a scale to measure psychosocial treatment compliance of people with psychotic disorders and established its psychometric properties. METHOD: An initial item pool was generated by literature review and contacts with psychiatric professionals. The content validity and cultural relevancy of this scale were examined by experienced researchers, mental health professionals and mental health consumers which resulted in the 17-item Psychosocial Treatment Compliance Scale (PTCS). Some 108 adults with a DSM-IV diagnosis of psychosis verified by certified psychiatrists were recruited from mental hospitals and social service settings in Hong Kong. Self-stigma, self-esteem, self-efficacy, insight and attitudes to medication of the participants were measured by relevant assessment instruments through interviews. Case therapists then filled in the PTCS and recorded their demographic data. SPSS version 11.0 was used for data analysis. RESULTS: Exploratory factor analysis revealed a two-factor solution (participation and attendance) accounting for 70.74% of the variance. Test-retest reliability and internal consistency were 0.90 and 0.96, respectively, for 'participation'; and 0.86 and 0.87, respectively, for 'attendance'. Its convergent validity was supported by the correlational relationships with measures on self-stigma, self-esteem, self-efficacy, insight and attitudes to medication. CONCLUSION: PTCS is a reliable and valid scale which may be used to measure the compliance to psychosocial treatment of people with psychotic disorders.

Adult↗

PubMed2003

Predictive validity of critical thinking skills for initial clinical dental hygiene performance.

This study collected validity evidence on the utility of critical thinking skills and critical thinking disposition in predicting initial clinical performance. The predictive value of critical thinking skills scores and disposition scores was examined to determine their unique contribution beyond that provided by traditional predictors: grade point average, age, and number of college hours. The study involved three phases: establishing content validity of three outcome measures; assessing students' baseline critical thinking skills and disposition using the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Dispositions Inventory (CCTDI); and assessing students' initial clinical competence, clinical reasoning, and clinical knowledge. All baccalaureate-level dental hygiene programs in the United States affiliated with a dental school (N=22) were invited to participate; of those, seven volunteered. A convenience sample of 207 first-year dental hygiene students was obtained. A series of hierarchical multiple regression analyses demonstrated that CCTST scores explained a statistically significant (p<.05) proportion of variance in students' initial clinical reasoning scores, acquired knowledge scores, and faculty ratings, above and beyond that explained by other predictor variables. CCTDI scores were not significant predictors of any outcome measure. It was concluded that CCTST is a good predictor of initial student outcomes and may have utility for student selection and retention.

Clinical Competence↗