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PubMed2004

[Cross-validation of the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8)].

This study was aimed at confirming the cross-validity and construct validity of the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8) developed by Arai and colleagues. A total of 169 family members caring for disabled elderly were assessed by a self-administered questionnaire which included the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI). Cronbach's alpha of the J-ZBI_8 was 0.88, indicating a high reliability of this instrument. A confirmatory factor analysis revealed that the two factor model of J-ZBI_8 fitted the data. Pearson's correlation coefficient between J-ZBI_8 and J-ZBI was 0.92; and the correlation coefficient between J-ZBI_8 and item 22 (a single global burden) was 0.66. These data indicated that J-ZBI_8 had a high concurrent validity. The J-ZBI_8 was found to be significantly correlated with Barthel Index, duration of caring, hours of caregiving/day, physical fatigue and mental fatigue among caregivers, but not with the duration of caring (months). Caregivers of disabled elderly who did not have any behavioral disturbances had a significantly lower J-ZBI_8 score than those who were caring for elderly with such behaviors. Also, caregivers who declared that they did not abuse disabled elderly had a significantly lower J-ZBI_8 score than those who replied they abused them, when compared by t-test. These results indicated that J-ZBI_8 had a high construct validity. It is concluded that the J-ZBI_8 had a high cross-validity and construct validity. This instrument can thus facilitate the assessment of family caregiver burden in clinical settings.

Aged↗

PubMed2003

Validity: on meaningful interpretation of assessment data.

CONTEXT: All assessments in medical education require evidence of validity to be interpreted meaningfully. In contemporary usage, all validity is construct validity, which requires multiple sources of evidence; construct validity is the whole of validity, but has multiple facets. Five sources--content, response process, internal structure, relationship to other variables and consequences--are noted by the Standards for Educational and Psychological Testing as fruitful areas to seek validity evidence. PURPOSE: The purpose of this article is to discuss construct validity in the context of medical education and to summarize, through example, some typical sources of validity evidence for a written and a performance examination. SUMMARY: Assessments are not valid or invalid; rather, the scores or outcomes of assessments have more or less evidence to support (or refute) a specific interpretation (such as passing or failing a course). Validity is approached as hypothesis and uses theory, logic and the scientific method to collect and assemble data to support or fail to support the proposed score interpretations, at a given point in time. Data and logic are assembled into arguments--pro and con--for some specific interpretation of assessment data. Examples of types of validity evidence, data and information from each source are discussed in the context of a high-stakes written and performance examination in medical education. CONCLUSION: All assessments require evidence of the reasonableness of the proposed interpretation, as test data in education have little or no intrinsic meaning. The constructs purported to be measured by our assessments are important to students, faculty, administrators, patients and society and require solid scientific evidence of their meaning.

Data Interpretation, Statistical↗

PubMed1993

The validity of health assessments: resolving some recent differences.

The purpose of this paper is to examine what is meant by a valid measure of health. Guyatt, Kirshner and Jaeschke propose that health tests should be designed so as to have one of several kinds of validity: "longitudinal construct validity" for those which are used for longitudinal research designs, and "cross-sectional construct validity" for those which are used for cross-sectional designs. Williams and Naylor argue that this approach to test classification and validation confuses what a test purports to measure with the purpose for which it is used, and that some tests have multiple uses. A review of the meanings of validity in the psychological test literature shows that both sets of authors use the term validity in an idiosyncratic way. Although the use of a test (evaluated by content validity) should not be conflated with whether the test actually measures a specified construct (evaluated by construct validity), if health is actually made up of several constructs (as suggested in Hyland's interactional model) then there may be an association between types of construct and types of purpose. Evidence is reviewed that people make several, independent judgements about their health: cognitive perceptions of health problems are likely to be more sensitive to change in a longitudinal research design, whereas emotional evaluations of health provide less bias in cross-sectional designs. Thus, a classification of health measures in terms of the purpose of the test may parallel a classification in terms of what tests purport to measure.

Health↗

PubMed2004

Psychometric evaluation of two scales assessing functional status and peripheral neuropathy associated with chemotherapy for ovarian cancer: a gynecologic oncology group study.

PURPOSE/OBJECTIVES: To evaluate the psychometric properties of two adapted scales, one for functional status and one for peripheral neuropathy secondary to neurotoxic chemotherapy. DESIGN: Repeated measures methodologic design conducted within a Gynecologic Oncology Group (GOG) phase III clinical trial that randomly assigned patients with advanced epithelial ovarian cancer to cisplatin and cyclophosphamide or cisplatin and paclitaxel. SETTING: 8 GOG institutions participating in the GOG clinical trial. SAMPLE: 88 evaluable outpatients enrolled in the GOG clinical trial. Sample size at time 1 (T1) was 88 patients and at time 2 (T2) was 67 patients. METHODS: All scales were administered at T1 (prior to initiation of chemotherapy) and T2 (after six cycles of chemotherapy but prior to second-look laparotomy). Internal consistency reliability, criterion validity, and construct validity were evaluated, and clinical application was explored. MAIN RESEARCH VARIABLES: Self-reported peripheral neuropathy and functional status (comprised of physical function and role function subscales), the GOG performance status scale, and the GOG toxicity criteria. FINDINGS: Reliability coefficients at T1 were physical function = 0.83, role function = 0.96, and peripheral neuropathy = 0.91; at T2, they were physical function = 0.83, role function = 0.92, and peripheral neuropathy = 0.89. At T1, physical function and role function correlated positively with performance status. Peripheral neuropathy correlated positively with GOG toxicity criteria used at T2. Principal component factor analysis suggested that the functional status scale had a two-factor structure with factors representing general and specific mobility and that the peripheral neuropathy scale also had a two-factor structure with factors representing foot and hand neuropathy. CONCLUSIONS: The physical function, role function, and peripheral neuropathy scales have internal consistency, reliability, criterion validity, and construct validity. However, revision of the scales should address modification of specific questions and consider increasing the Likert scale from a four-point to a five- or seven-point scale to enhance clinical sensitivity and application. IMPLICATIONS FOR NURSING: With minor modifications, these scales should be useful in assessing physical function, role function, and peripheral neuropathy in patients who receive agents that may cause peripheral neuropathy.

Adult↗

PubMed2003

Evaluation of a novel electronic fetal monitor simulator.

The purpose of this study was to evaluate the content validity and construct validity of a novel electronic fetal monitor (EFM) simulator. Fourteen residents in Gynecology and Obstetrics (OB/GYN) and 7 medical students in their OB/GYN clerkship interpreted 10 fetal heart rate (FHR) tracings and 4 clinical scenarios generated by the EFM simulator. Their responses were scored by experts in maternal-fetal medicine. Construct validity was determined by comparing subjects' scores to their level of experience. Subjects assessed content validity of the EFM simulator by rating the realism of its various elements on a 4-point Likert scale. Residents achieved statistically significant higher mean scores in the description of FHR tracings generated by the simulator than medical students and statistically significant higher mean scores in the correct interpretation of and interventions in 2 of 4 clinical scenarios. Two-thirds of the residents rated the simulator-generated FHR tracings and clinical scenarios as "real" or "very real." The EFM simulator exhibited both content and construct validity, supporting its use in an educational setting.

Adult↗

PubMedDate not supplied

[The Knee Injury and Osteoarthritis Outcome Score--a multifunctional questionnaire to measure outcome in knee arthroplasty].

AIM: It was the purpose of this investigation to create a German version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) and to test its appropriateness in patients with advanced gonarthritis. METHOD: Reliability (test-retest reliability, internal consistency), validity (convergent construct validity and divergent construct validity), sensitivity to change as well as practicability and acceptance of this questionnaire were tested in 90 patients. RESULTS: The test-retest reliability was acceptably high for all subscales, it ranged between r = 0.65 and 0.78 and the questionnaire showed a high internal consistency in almost all of the subscales. The comparison to the results of the questionnaire "Short Form-12" (SF-12) as well as to the patients self-assessment of health status showed high concordance in nearly all subscales, however it was only moderate for the symptom scale. Furthermore the KOOS was able to show significant differences between patients and healthy controls. When testing the sensitivity to change, the KOOS could demonstrate significant improvements within 3 months and the instrument has shown to be practicable with a high acceptance by the patients. CONCLUSION: With the German version of the Knee Injury and Osteoarthritis Outcome Score a multidimensional instrument is available now to measure health status as well as therapeutic effects in patients with knee problems. Modifying the subscale "symptoms" could further optimize this questionnaire in patients with advanced gonarthritis.

Adolescent↗

PubMed2004

A Chinese version of the Sleep Apnea Quality of Life Index was evaluated for reliability, validity, and responsiveness.

OBJECTIVE: Obstructive sleep apnea (OSA) is a common disorder in many ethnic populations. Patients with OSA have impaired health-related quality of life (HRQOL). No sleep apnea-specific HRQOL measure has been validated in Chinese patients. STUDY DESIGN AND SETTING: A cross-sectional sample of 106 Chinese OSA patients and a longitudinal sample of 51 patients in Hong Kong completed a Chinese (Cantonese) version of SAQLI for assessment of its acceptability, scaling assumptions, reliability, validity, and responsiveness. RESULTS: The instrument was understood and seen as relevant by 97% of subjects. Internal consistency, test-retest reliability, item-scale convergent validity and discriminatory validity, and construct validity were good to excellent. Construct validity was confirmed by significant correlations with SF-36 subscale scores. However, factor analysis showed that only items of daily functioning and symptom domains all loaded on the hypothesized scales. Longitudinal data showed that SAQLI was more responsive than SF-36 to changes after treatment. CONCLUSION: Hence, this version of SAQLI was an acceptable, psychometrically valid, and responsive HRQOL measure for evaluating impact of illness and treatment effectiveness in Chinese OSA patients.

Adult↗

PubMed2004

Psychometric evaluation of the Chinese version of the State Anxiety Scale for Children.

The assessment of anxiety in children undergoing surgery must be addressed before any intervention can be appropriately planned, provided, and evaluated. The purpose of this study was to evaluate the psychometric properties of the Chinese version of the State Anxiety Scale for Children. Two hundred and thirty-seven children from a primary school and 112 children admitted for day surgery were recruited for this study. The instrument demonstrated adequate internal-consistency reliability, appropriate concurrent validity, and construct validity. Factor analyses further confirmed the construct validity of the scale, with a good fit between the factor structure of the scale and the observed data. Results suggest that the Chinese version of the State Anxiety Scale for Children can be used as a self-report assessment tool in measuring the anxiety level of Chinese children ages 7-12 years.

Ambulatory Surgical Procedures↗

PubMed2003

Development of the overt-covert aggression inventory.

The expression of anger in Japanese people is different from that of other races. We developed a new brief inventory, the Overt-Covert Aggression Inventory, to assess aggressive behavior ofJapanese people by focusing on their uniqueness and examined its reliability and validity. This inventory, the Center for Epidemiological Studies Depression scale, the Japanese version of the Buss-Perry Aggression Questionnaire, and the Picture-Frustration Study were administered to 3,104 men and 316 women in a factory. Internal consistency, test-retest reliability, concurrent validity, and construct validity of the scale were examined. We confirmed that the Overt-Covert Aggression Inventory has adequate reliability and sufficient concurrent validity, however, further studies of the construct validity and discriminant validity are required.

Adult↗

PubMed2001

The community integration measure: development and preliminary validation.

OBJECTIVE: To present a new measure of community integration, the Community Integration Measure (CIM), and to offer preliminary information about its psychometric properties. DESIGN: Validation study. SETTING: Community. PARTICIPANTS: Ninety-two participants placed in 3 subgroups (brain injury survivors, n = 41; significant others, n = 36; college students, n = 15). MAIN OUTCOME MEASURES: The distributional properties, factor structure, internal consistency reliability, content validity, discriminant validity, concurrent validity, and construct validity of the CIM. RESULTS: All items correlated positively with each other and with the total score. Principal components factor analysis confirmed a 1-factor structure, which explained 44.1% of the variance. Internal consistency reliability, using Cronbach's alpha, was.87. Content validity was assured by the development procedure, correspondence with the theoretical model, and direct use of consumer language. Discriminant validity was supported by the CIM's ability to differentiate between subsamples. Criterion validity was supported by using correlations with the Community Integration Questionnaire. Construct validity was supported by correlations with the Interpersonal Support Evaluation List. CONCLUSION: The CIM offers a brief, easily administered measure of community integration that conforms to an empirically derived theoretical model and is psychometrically sound.

Activities of Daily Living↗

PubMed1997

Development of a new outcomes instrument for conductive hearing loss.

OBJECTIVE: The objective was to design and validate a disease-specific outcomes instrument for use in conductive hearing loss (CHL). STUDY DESIGN: The study was a retrospective survey of 47 patients recently treated for CHL with either a hearing aid or surgery. Patients were tested with the newly designed instrument (the Hearing Satisfaction Scale [HSS]), previously validated hearing-specific instruments, and a generic quality-of-life instrument. SETTING: The study was performed in an academic tertiary referral center. MAIN OUTCOME MEASURES: These included test-retest reliability, internal consistency reliability, content validity, criterion validity, and construct validity of the HSS. RESULTS: Test-retest reliability (r = 0.72, p < 0.001) and internal consistency reliability were adequate (Cronbach's alpha was 0.83 and 0.74 for the two subscales of the HSS). Criterion validity for individual items was adequate (r = 0.45, p = 0.02) using audiometric data as the criterion standard. Construct validity was also high using results from other instruments; both convergent and divergent validity of the HSS was demonstrated. In addition, the HSS demonstrated the ability to differentially discriminate between subgroups when grouped by level of hearing loss. CONCLUSIONS: The HSS is a valid and reliable instrument for use in outcomes research on conductive hearing loss.

Adult↗

PubMed2005

Psychological screening procedures for deploying U.S. Forces.

This study examined the validity of psychological measures used in screening for the U.S. Army with 885 soldiers before a 6-month peacekeeping rotation in Kosovo. Content validity and construct validity were assessed by evaluating the clinical domains, comparing clinician assessments of functioning, and assessing risk factors for screening positive. Construct validity and content validity were demonstrated. Risks, benefits, and future directions of the Army's psychological screening research program are discussed.

Humans↗

PubMed1994

The Index of Readiness: development and psychometric analysis.

This article describes the development and initial psychometric evaluation of a measure of individual appraisal of readiness to initiate health behavior change. Items were developed from inductively generated data to index dimensions of individual appraisal of readiness. Quantification of Index of Readiness content validity was established through the ratings of 10 experts, following criteria established by Imle and Atwood (1988). The instrument was tested in successive steps with 146 individuals who were participating in an outpatient cardiac rehabilitation program, for reliability and validity, including internal consistency reliability, and three forms of validity assessment (content validity, criterion-related validity, and construct validity). The three subscales of Reevaluation of Lifestyle, Identification of Barriers, and Goal Commitment demonstrated internal consistency. Criterion-related and construct validity were substantiated. With refinement, this measure will provide a basis for nursing interventions designed to enhance individual motivation in relation to specific health behaviors.

Adult↗

PubMed2007

Quality of paediatric rehabilitation from the parent perspective: validation of the short Measure of Processes of Care (MPOC-20) in the Netherlands.

OBJECTIVE: In the present study we aim to assess the reliability and validity of the 20-item version of the Dutch Measure of Processes of Care (MPOC). DESIGN: The reliability, concurrent validity, predictive validity and construct validity of the Dutch MPOC-20 were determined. A subset of MPOC-20 data was extracted from a large Dutch MPOC (56-item version) database. SUBJECTS: Participants were 405 mothers and 22 fathers of children aged 1-18 years recruited through nine paediatric rehabilitation centres in the Netherlands. MAIN MEASURES: The participants filled out the MPOC-20 items, the Client Satisfaction Questionnaire (CSQ), and two additional questions about satisfaction with services and the amount of stress they experienced. RESULTS: The internal consistency analyses (alphas 0.75-0.87) and the test-retest analyses (intraclass correlation coefficients (ICCs) 0.78-0.91) showed that the Dutch MPOC-20 is a reliable tool. The concurrent validity of the Dutch MPOC-20 was confirmed by positive correlations between MPOC-20 scale scores and the CSQ (r 0.39-0.69), and between MPOC-20 scale scores and an overall satisfaction variable (r 0.37-0.66). The predictive validity of the Dutch MPOC-20 was supported by moderately negative correlations between MPOC-20 scores and a stress variable (r -0.27 to -0.44). The construct validity of the Dutch MPOC-20 was confirmed by significant scale intercorrelations (r 0.41-0.84) and a factor analysis. CONCLUSIONS: The 20-item version of the MPOC (Dutch MPOC-20) is a reliable and valid measure of the family-centredness of paediatric rehabilitation.

Adolescent↗

PubMed1998

The index of self-regulation: development and psychometric analysis.

This paper describes the development and initial psychometric evaluation of a measure of individual self-regulation in the maintenance of health behavior change. Items were developed from inductively generated data to index dimensions of self-regulation in behavioral change (Fleury, 1991). Quantification of Index of Self-Regulation (ISR) content validity was supported through the ratings of 10 experts, following criteria established by Imle and Atwood (1988). The instrument was tested in successive steps with 146 individuals who were participating in an outpatient cardiac rehabilitation program for reliability and validity, including internal consistency reliability and three forms of validity assessment (content validity, criterion-related validity, and construct validity). The three subscales of Stimulus Control, Reconditioning, and Behavioral Monitoring demonstrated internal consistency ranging from .73-.76. Total scale alpha was .87. Initial estimates of criterion-related and construct validity were documented with correlations between ISR subscales and theoretically related criterion measures (.20-.47). With refinement the ISR will provide a basis for tailoring and evaluating clinical interventions designed to enhance motivation in the maintenance of health behavior change.

Adult↗

PubMedDate not supplied

The development of a nurse stress checklist from English to Chinese version.

Work stress has been identified as a relevant problem in the field of professional nursing. Many instruments measuring nurse work stress have already been developed in the United States. The Nurse Stress Checklist (NSC), a Likert-type questionnaire with 47 items, was selected for adaptation into the Chinese language from among these instruments, following a literature review and a comparison with the author's personal nursing experiences. The processes of developing the validity of an NSC Chinese version--content validity, concurrent validity, and construct validity--were conducted. In this pilot study, 13 Chinese nurses who had previously worked in the United States and who were fluent in both Chinese and English filled out the NSC in both the Chinese and English versions. Pearson's correlation was performed to build up concurrent validity. Next, 138 Chinese nurses were randomly selected from three medical centers in Taiwan to be participants in the major study. They filled out the NSC in the Chinese version, and a factor analysis was used to build up construct validity. Four factors were extracted: nonproductive reactions, satisfactory responses, professional concerns, and falling behind. A comparison was made of these four factors with the five factors of the NSC in the English version.

Adult↗

PubMed1996

[Construction and validation of an attitude scale to primary health care].

OBJECTIVES: To elaborate and validate a scale which can be used as an instrument to find the attitudes towards primary health care of doctors at the first care level. DESIGN: Validation study and questionnaire on attitudes. SETTING: The first care level in the Murcia region. Subjects were 155 doctors (27 family and 128 general doctors) in fixed and provisional posts working in the out-clinics and health centres. MEASUREMENTS AND RESULTS: A Likert-type attitudes scale was designed with five reply options. After the pilot-study on the initial scale and the full item-item correlation, the definitive 46-item survey was elaborated. Selection of subjects was through two-stage stratified randomised sampling, by specialty (general/family medicine) and health district. Reliability was high. Contents validity was reached through various consensus methods. To test validity of construction, a factorial analysis of the main components was performed, with 7 factors isolated: overall patient care, team-work, guidance on health problems, doctor's interest in in-work training, professional role, concern for the psychosocial aspects of the illness and inclusion of second level professionals. CONCLUSIONS: The scale designed is a valid instrument, both a reliable way of identifying PHC doctors' attitudes and the attitudes, which could be improved.

Attitude of Health Personnel↗

PubMedDate not supplied

Relationships between psychological mindedness and personality traits and ego functioning: validity studies.

Two studies further investigated the psychometric properties of the self-report Psychological Mindedness Scale (PMS), which has been shown to have good internal consistency and evidence of predictive and divergent validity. Its construct validity was investigated by assessing (1) whether total scores on the PMS of a group of medical students attending a personnel clinic in a psychiatric outpatient setting would be related in theoretically expected ways to their scores on a personality test; and (2) whether total scores on the PMS of a group of regular clinic patients would have the expected theoretical relationships to scores on a measure of ego functions. The findings of both studies provided support for the construct validity of the PMS.

Adaptation, Psychological↗