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PubMed2006

Reconsidering the Caregiving Stress Appraisal scale: validation and examination of its association with items used for assessing long-term care insurance in Japan.

The Caregiving Stress Appraisal (CSA) scale is a simple scale for measuring family caregiver stress. However, information on its validity and association with new social welfare systems in Japan is inadequate. The purpose of the present study is to examine the criterion validity of the CSA and to explore its association with the variables used for assessing long-term care insurance in Japan. In the present study, 219 family caregivers completed a self-administered questionnaire. Of these, 50 and 202 caregivers were used for the analysis of the criterion validity and construct validity, respectively. The CSA, the Japanese version of the Zarit Burden Interview (J-ZBI), the Center for Epidemiological Studies-Depression (CES-D), and the items used for assessing long-term care insurance in Japan were used for the analyses. The results revealed that the CSA had significant correlations with the J-ZBI and the CES-D. Despite the small sample size, the CSA had significant correlations with the items used for assessing long-term care insurance in Japan. These results suggest sufficient criterion and construct validity of the CSA for the future study.

Aged↗

PubMed2004

Development of a scale to measure adolescents' beliefs and attitudes about postponing sexual initiation.

PURPOSE: To develop a scale to measure adolescent beliefs and attitudes about postponing sexual initiation (PSI). METHODS: A theory-based, 12-item scale measuring beliefs about PSI was developed and administered via a mailed questionnaire to those participants in an ongoing longitudinal cohort study of adolescents who had not yet initiated sexual intercourse. Internal consistency reliability, content validity, factorial validity, and construct validity were assessed using cross-sectional data. RESULTS: Mean age for boys was 14.4 (+/- 1.6) years and for girls 14.3 (+/-1.6) years (range 11 to 19 years), and 93% of respondents were white. The beliefs about PSI rated as most important by both girls and boys were concern about pregnancy and sexually transmitted infection. Cronbach alpha for the scale was 0.83 for girls and 0.88 for boys. Exploratory factor analysis demonstrated that the items loaded on four factors consistent with the theoretical basis of the model and confirmatory factor analysis demonstrated good fit of the overall model. The PSI scale score was associated with hypothesized sociodemographic, psychological, and behavioral variables, supporting construct validity of the scale. A higher score was associated with female gender; age < or = 14 years; higher global and social self-esteem; more frequent attendance at religious services; less peer pressure to have sexual intercourse; nonuse of alcohol, illicit drugs, and cigarettes; and no intention to initiate sexual intercourse in the next year. CONCLUSIONS: The PSI scale demonstrated satisfactory psychometric properties. Future research is needed to evaluate the utility of this scale in predicting sexual initiation and in interventions aimed at postponing sexual initiation.

Adolescent↗

PubMed1991

More on MTMM: the role of confirmatory factor analysis.

This article is the second of two on the use of confirmatory factor analysis (CFA) as a method to assess construct validity. The construct validation criteria required by the conventional MTMM approach are satisfied only by certain ideal data sets, such as those in which the method variance of measures is very low. The CFA approach to multitrait-multimethod (MTMM) data is more general, in that violations of those stringent criteria can be managed. Another limitation of the conventional MTMM approach is that only a relatively small number of indicators can be examined by bivariate analysis. The economy of the CFA approach permits the analysis of a much larger number of indicators. In this article, a data set is analyzed using the CFA approach. Results are presented that illustrate the application of this statistical method.

Electromyography↗

PubMed2006

Development of competency inventory for registered nurses in the People's Republic of China: scale development.

BACKGROUND: Literature review indicated there is no existing nursing competency framework or instrument for Chinese registered nurses. By virtue of its global leadership role in nursing, the International Council of Nurses (ICN) developed an ICN Framework of Competencies for the Generalist Nurses in 2003. On the basis of the ICN's framework, a qualitative study was conducted to explore the expectations of Chinese nurse professionals on nursing competency in the previous study. A competency framework for Chinese registered nurses was formed. This paper describes the development and testing of the Competency Inventory for Registered Nurses (CIRN). METHODS: A methodological study design was used, consisting of two phases with six steps. A review of literature generated 112 items, which were evaluated by six experts followed by field testing in a purposive sample of 815 Chinese clinical registered nurses. Factor analysis and item analysis were applied to establish the scale's construct validity and reliability. RESULTS: The final scale consists of seven dimensions with 58 items. The overall scale reliability had a Cronbach's alpha of 0.89; the dimensions Cronbach's alpha ranged from 0.79 to 0.86. In addition, evidence for two other kinds of validity was obtained, which included criterion-related validity (r=0.44, p=0.04) and contrasted-group validity (p<0.001). CONCLUSION: The CIRN has demonstrated evidence of internal consistency reliability, content validity, and construct validity, and it provides an objective tool for assessing registered nurse competencies in the various areas of clinical practice.

Adult↗

PubMed2004

The sense of belonging to a neighbourhood: can it be measured and is it related to health and well being in older women?

This study investigates the sense of belonging to a neighbourhood among 9445 women aged 73-78 years participating in the Australian Longitudinal Study on Women's Health. Thirteen items designed to measure sense of neighbourhood were included in the survey of the older women in 1999. Survey data provided a range of measures of demographic, social and health-related factors to assess scale construct validity. Factor analysis showed that seven of the items loaded on one factor that had good face validity and construct validity as a measure of the sense of neighbourhood. Two of the remaining items related to neighbourhood safety and comprised a factor. A better sense of neighbourhood was associated with better physical and mental health, lower stress, better social support and being physically active. Women who had lived longer at their present address had a better sense of belonging to their neighbourhood, as did women living in non-urban areas and who were better able to manage on their income. Feeling safe in the neighbourhood was least likely in urban areas, increased in rural townships, and was most likely in rural and remote areas. Older women living alone felt less safe, as did women who were less able to manage on their income. This study has identified two sets of items that form valid measures of aspects of the social environment of older women, namely the sense of neighbourhood and feelings of safety. These findings make a contribution to our understanding of the relationship between feelings of belonging to a neighbourhood and health in older women.

Aged↗

PubMed2000

A taxonomy for classification of stroke rehabilitation services.

OBJECTIVE: To develop a taxonomy for use in measuring stroke rehabilitation services. DESIGN: A cross-sectional study using facility-level survey data and extant data files. SETTING: Veterans Administration medical centers (VAMCs). VARIABLES: (1) A list of rehabilitation characteristics, including personnel, physical facilities, coordination of care, and hospital characteristics; and (2) a classification or typology of VAMCs according to the type of postacute stroke care on-site. MAIN OUTCOME MEASURES: Data sources included extant Veterans Administration (VA) computerized databases, VA central office administrative files, and 2 mailed surveys to VA rehabilitation medicine services and stroke acute care services. The rehabilitation taxonomy was derived using 2 methods that assess face and construct validity, respectively: (1) an expert panel rating, using a modified Delphi process, of the clinical importance of each of the rehabilitation characteristics; and (2) a comparison of rehabilitation characteristics across the different types of VAMCs. Variables were included in the final taxonomy if the expert panel reached consensus that the variable was clinically important, or if there were statistically significant differences in these characteristics across the different types of medical centers. RESULTS: Of 67 possible rehabilitation characteristics, a multidisciplinary expert panel reached consensus about the likely clinical importance of 21 rehabilitation characteristics, 11 of which showed statistically significant differences across different types of VAMCs. An additional 9 variables that lacked expert panel consensus differed significantly among the different medical centers. These 30 variables represent a preliminary taxonomy of key rehabilitation characteristics. Among the 20 variables that varied significantly across the different types of medical centers, 18 showed a pattern with the greatest amount of resources and organizational sophistication being found in VAMCs with rehabilitation units, followed by medical centers with geriatric units, and the least amount of resources and organizational sophistication was seen in medical centers whose postacute care services were limited to nursing home or intermediate care. CONCLUSION: Thirty rehabilitation characteristics had face validity and/or construct validity, and can be considered to represent a preliminary taxonomy for measuring stroke rehabilitation services. This study also shows that there are significant differences among hospitals in resources and organization of care deemed to be important for stroke patients.

Aged↗

PubMed1992

Assessing the consequences of traumatic brain injury.

Research concerned with assessing the rehabilitation outcome for the survivor of traumatic brain injury has suffered from both conceptual and procedural difficulties. The purpose of this paper is twofold: to assess the psychometric features in instruments used in assessing outcome; and to describe a test development framework based on the principles of construct validity. A construct validation approach is viewed as a means of avoiding common measurement difficulties, as well as integrating perspectives important to this population. Emphasis has been given to the cognitive/social dimensions of recovery, as it is this area which has the greatest impact for rehabilitation success.

Activities of Daily Living↗

PubMedDate not supplied

Measurement of safe sex behavior in adolescents and young adults.

The aim of this project was to develop an instrument to measure use of safe sex practices among adolescents and to conduct initial evaluation of the psychometric properties of the instrument. The Safe Sex Behavior Questionnaire (SSBQ) was designed to measure the frequency of use of safe sex practices and was assessed for content validity, reliability, and construct validity through a series of tests. The content validity index computed for the SSBQ was 98%. Initial reliability computed for sums of items of the total scale was .82 among 89 college freshmen. Using a second sample of 531 subjects, the SSBQ was factor-analyzed separately for males and females and five similar factors emerged for each gender. Reliability coefficients for sums of salient items for each factor ranged from .52 to .85. Using a third sample of 174 subjects, construct validity was assessed by correlating the SSBQ with measures of general assertiveness and general risk-taking. The resulting correlations were appreciable and in the predicted directions, thus providing support for the construct validity of the instrument.

Acquired Immunodeficiency Syndrome↗

PubMed1996

A menopause-specific quality of life questionnaire: development and psychometric properties.

OBJECTIVE: To develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. METHODS SUBJECTS: Women 2-7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines'Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. RESULTS: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and -0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 for the vasomotor domain, 0.55 and -0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. CONCLUSIONS: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.

Attitude to Health↗

PubMed1989

[The construction and validation of a questionnaire on the satisfaction of primary health care users].

The questionnaire was developed after establishing the domains that might be measured with it and selecting 16 items. During June and September 1987 it was administered to 163 patients, selected by quota sampling, who belonged to two health centers and two outpatient clinics from the city of Almería. With the obtained data several parts of the questionnaire were validated: stability, homogeneity, distorting variables and constructed validity. There were significant differences (analysis of variance) between the satisfaction of the users of health centers and outpatient clinics (p = 0.042) (higher satisfaction in health centers). There were not marked differences between the users of both health centers (p = 0.144) and between both outpatient clinics (p = 0.66). The measurement of satisfaction is a valuable instrument for the investigation and administration of health services and a good indicator of the quality of care.

Consumer Behavior↗

PubMed2005

Psychometric properties of the Mini-Mental State Examination in patients with acquired brain injury in Turkey.

OBJECTIVE: To evaluate the psychometric properties of Mini-Mental State Examination (MMSE) in patients with acquired brain injury in Turkey. METHODS: A total of 207 patients with acquired brain injury were assessed. Reliability was tested by internal consistency and the person separation index; internal construct validity by Rasch analysis; external construct validity by correlation with cognitive disability; and cross-cultural validity by differential item functioning analysis compared with Italian MMSE data. RESULTS: Reliability was adequate with a Cronbach's alpha of 0.75 and person separation index of 0.76. After collapsing some categories, and adjustment for differential item functioning, internal construct validity was supported by fit of the data to Rasch model. Differential item functioning for culture was found in 2 items and after adjustment, data could be pooled between Turkey and Italy. External construct validity was supported by expected associations. CONCLUSION: The Turkish version of the Mini-Mental State Examination can be used as a cognitive screening tool in acquired brain injury. Cross-cultural validity between Italy and Turkey is supported, given appropriate adjustment for differential item functioning. However, shortfalls in reliability at the individual level, as well as the presence of differential item functioning suggest that a better instrument should be developed to screen for cognitive deficits following acquired brain injury.

Adult↗

PubMed2005

The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation.

BACKGROUND: Clinical practice guidelines are not uniformly successful in influencing clinicians' behaviour toward best practices. Implementability refers to a set of characteristics that predict ease of (and obstacles to) guideline implementation. Our objective is to develop and validate a tool for appraisal of implementability of clinical guidelines. METHODS: Indicators of implementability were identified from the literature and used to create items and dimensions of the GuideLine Implementability Appraisal (GLIA). GLIA consists of 31 items, arranged into 10 dimensions. Questions from 9 of the 10 dimensions are applied individually to each recommendation of the guideline. Decidability and Executability are critical dimensions. Other dimensions are Global, Presentation and Formatting, Measurable Outcomes, Apparent Validity, Flexibility, Effect on Process of Care, Novelty/Innovation, and Computability. We conducted a series of validation activities, including validation of the construct of implementability, expert review of content for clarity, relevance, and comprehensiveness, and assessment of construct validity of the instrument. Finally, GLIA was applied to a draft guideline under development by national professional societies. RESULTS: Evidence of content validity and preliminary support for construct validity were obtained. The GLIA proved to be useful in identifying barriers to implementation in the draft guideline and the guideline was revised accordingly. CONCLUSION: GLIA may be useful to guideline developers who can apply the results to remedy defects in their guidelines. Likewise, guideline implementers may use GLIA to select implementable recommendations and to devise implementation strategies that address identified barriers. By aiding the design and operationalization of highly implementable guidelines, our goal is that application of GLIA may help to improve health outcomes, but further evaluation will be required to support this potential benefit.

Benchmarking↗

PubMed2003

Reliability and validity of refractive error-specific quality-of-life instruments.

OBJECTIVE: To evaluate the reliability and validity of the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL-42) and the Refractive Status and Vision Profile survey (RSVP). METHODS: Eighty-one participants with good visual acuity (better than 20/30 best-corrected acuity in each eye) completed the NEI-RQL-42 and RSVP on 2 occasions. Noncycloplegic, subjective refractions and high-contrast visual acuity assessments were also performed. Statistical analyses addressed internal consistency, test-retest reliability, and validity (ie, concurrent and construct validity) of the 2 instruments. OUTCOME MEASURES: The NEI-RQL-42, RSVP survey, subjective refraction, and visual acuity. RESULTS: The internal consistency for the overall NEI-RQL-42 was excellent (Cronbach alpha = 0.91); and for the overall RSVP, good (Cronbach alpha = 0.81). Likewise, the test-retest reliability for the overall NEI-RQL-42 was excellent (intraclass correlation coefficient [ICC], 0.91; 95% limits of agreement, -9.1 to 10.1); and for the RSVP, fair (ICC, 0.76; 95% limits of agreement, -12.1 to 12.5). The NEI-RQL-42 overall score showed good concurrent validity as it correlated significantly with subjective refraction, whereas the RSVP overall score did not. The NEI-RQL-42 and RSVP showed similar construct validity in terms of refractive error discrimination, but the NEI-RQL-42 showed better construct validity when discriminating by the type of refractive correction used by patients. Between-instrument convergent and divergent validity was good. CONCLUSIONS: The NEI-RQL-42 and RSVP generally have good reliability and validity in this sample of patients with refractive error. However, other factors such as content should be considered in choosing 1 of these instruments for studies of refractive error correction.

Adult↗

PubMed2002

[Construction and validation of a respiratory epidemiological questionnaire].

This paper illustrates the principles of construction and validation of an epidemiological questionnaire by using various aspects of the questionnaire prepared for the Epidemiological Study of the Genetic and Environmental Factors in Asthma, Bronchial Hyper-responsiveness and Atopy (EGEA). Standardised international questionnaires (for adults and children) were adapted and augmented for the requirements of the study. New areas in relation to international epidemiological studies are described (detailed descriptions of asthma and allergic rhinitis, trigger factors exposure tovarious environmental factors and family history). Various aspects of validation are discussed: the acceptibility by the study of missing data in the description of asthmatic symptoms, the construct validity for a score for allergic rhinitis, the reliability of a new self-administered questionnaire for perceived hyper responsiveness to various stimuli and the validity of reported family history using information obtained from family members. Some of these elements could be used in the context of other clinical and epidemiological studies. The complete questionnaire, together with the source of the questions, instructions for interviewers and the method of coding are presented in an appendix available on the internet (http://www.splf.org/bbo/revues-articles/RMR/depotElectronique/2001-110_Kauffmann/Kauffmann2002.htm) which supplements the printed paper.

Asthma↗

PubMedDate not supplied

Construction and validation of a body image rating scale: a preliminary study.

PURPOSE: To construct and validate a preliminary version of a scale for use in routine screening of body image disturbances in nursing practice. METHODS: A five-stage procedure consisting of item construction, analysis of content validity, analysis of reliability, analysis of construct validity, and analysis of the discriminant validity of the scale. FINDINGS: At the end of the current stage of development, the preliminary version of the scale consisted of 23 items, demonstrating stability, adequate internal consistency, and discriminant validity between subjects in the upper and lower groups of scores. CONCLUSIONS: Although the psychometric properties of the scale have been delineated, the scale needs further psychometric evaluation and testing in different settings/samples so its clinical validity and reliability can be confirmed. PRACTICE IMPLICATIONS: The preliminary version of the body image rating scale has the potential to provide the nurse with reliable and valid information about a person's mental image of his/her own body. Using it can help nurses to identify possible body image disturbances and to plan individual nursing interventions.

Adult↗

PubMed2004

Developing and testing instruments for improving cooperation and patient's participation in mental health care.

The main purpose of the project was to develop computerized instruments that could be used by nurses and patients to assess their cooperation and mutual contributions to care. This paper presents a part of the project: the reliability and validity testing phase of a process of instrument development. To test the validity and reliability of the instruments, data were collected with questionnaires from nurses (n = 146) and patients (n = 286). The validity evaluated as construct validity and the reliability evaluated as internal consistency of the instruments were quite good. Construct validity was tested by factor analysis, and internal consistency was tested by Cronbach's alpha coefficient, which varied from 0.69 to 0.79. The instruments, which consisted of a software application that can be operated in a www environment, were meant to be used as tools in the psychiatric nursing context for assessing the cooperation between the nurses and patients and the patient's participation in his/her care. Furthermore, the computer programme can be used as a tool for developing and assessing the patient orientation in nursing.

Adolescent↗

PubMed1993

The validity and reproducibility of a work productivity and activity impairment instrument.

The construct validity of a quantitative work productivity and activity impairment (WPAI) measure of health outcomes was tested for use in clinical trials, along with its reproducibility when administered by 2 different methods. 106 employed individuals affected by a health problem were randomised to receive either 2 self-administered questionnaires (self administration) or one self-administered questionnaire followed by a telephone interview (interviewer administration). Construct validity of the WPAI measures of time missed from work, impairment of work and regular activities due to overall health and symptoms, were assessed relative to measures of general health perceptions, role (physical), role (emotional), pain, symptom severity and global measures of work and interference with regular activity. Multivariate linear regression models were used to explain the variance in work productivity and regular activity by validation measures. Data generated by interviewer-administration of the WPAI had higher construct validity and fewer omissions than that obtained by self-administration of the instrument. All measures of work productivity and activity impairment were positively correlated with measures which had proven construct validity. These validation measures explained 54 to 64% of variance (p less than 0.0001) in productivity and activity impairment variables of the WPAI. Overall work productivity (health and symptom) was significantly related to general health perceptions and the global measures of interference with regular activity. The self-administered questionnaire had adequate reproducibility but less construct validity than interviewer administration. Both administration methods of the WPAI warrant further evaluation as a measure of morbidity.

Absenteeism↗

PubMed2001

Adaptation and validation of the rheumatoid arthritis quality of life scale for use in Canada.

OBJECTIVE: The Rheumatoid Arthritis Quality of Life questionnaire (RAQoL) was developed simultaneously in the UK and the Netherlands to measure quality of life in patients with RA. We adapted and validated the RAQoL for the English-Canadian and French-Canadian languages and culture. METHODS: The UK RAQoL was translated into French-Canadian by a bilingual translation panel. Separate lay panels were then used to ensure that this and the English-Canadian instruments were appropriate for use with Canadian patients. Interviews were conducted with 15 French-Canadian and 15 English-Canadian patients with RA to determine the content validity. Reliability and construct validity were established by means of test-retest mail surveys conducted with 92 French-Canadian and 87 English-Canadian RA patients. The survey consisted of the adapted RAQoL, the Health Assessment Questionnaire (HAQ), and a demographic questionnaire. RESULTS: The RAQoL was successfully adapted for both the French and English-Canadian cultures. Field testing showed both versions to be well received by respondents. Of the French-Canadian patients included in the postal survey, 52 responded at Time 1 and 50 at Time 2. For the English-Canadian sample, 54 responded at both time points. Missing data rates for the RAQoL were low and floor and ceiling effects were minimal. Test-retest reliability was good for both versions: 0.87 for the French-Canadian and 0.95 for the English-Canadian. Alpha coefficients (0.92 for the French-Canadian, 0.93 for the English-Canadian) showed the items to be adequately interrelated and scores on the measure showed moderate to high correlations with the HAQ, confirming construct validity. Both versions of the RAQoL were also able to distinguish patient groups that differed according to perceived health status and perceived severity of RA. In addition, the French-Canadian version was able to distinguish patients who rated today as bad or very bad from those who rated today as good or very good. CONCLUSION: The new versions of the RAQoL were well received by both French and English speaking Canadians. The psychometric quality of the adapted questionnaires means they are suitable for inclusion in clinical trials involving patients with RA.

Adult↗