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PubMed2005

Validation of a parent outcome questionnaire from pediatric cochlear implantation.

This paper analyzes the reliability and validity of a questionnaire designed by Archbold, Lutman, Gregory, O'Neil, and Nikolpoulos (2002) for the assessment of pediatric cochlear implantation. Parents of 61 youngsters (age range 5 to 16 years), who had the implant for at least 3 years, responded to the questionnaire and to an interview. The alpha reliability of the 11 questionnaire scales varied between .41 and .74. Content validity was assessed by comparison with parents' responses to an interview. In general, there was agreement between parents' concerns and views expressed in the interview and as assessed by the questionnaire. However, extra issues were identified in the interview, which suggest the need for increasing the breadth of the questionnaire. Criterion validity was assessed by identifying contrasting cases, with very low or very high scores in each scale, and analyzing the descriptions obtained in the interviews. For nine scales this analysis provided support for the validity of the questionnaire; two scales did not produce positive results. Correlations with interview scores were calculated for only four scales: two were positive and significant whereas two were not significant. A factor analysis of the questionnaire scales identified four components, interpreted as the child's functioning in social situations, attitudes to the process of implantation, support required in the long term, and effective use of the implant. Suggestions for further research and descriptive comments provided by parents are included.

Adolescent↗

PubMed1992

Self-care assessment tool for spinal cord injured persons.

The purpose of this study was to develop a reliable and valid tool that assesses the cognitive and functional skills needed for self-care in persons with spinal cord injury (SCI). The Self-Care Assessment Tool (SCAT) assesses cognitive and functional skills in eight self-care areas: bathing/grooming, nutritional management, taking medications, mobility/transfers/safety, skin management, bladder management, bowel management and dressing. The tool was carefully developed and has demonstrated content validity. Interrater reliabilities for the cognitive, functional and total scores ranged from .69 to .94 (n = 10). Test-retest reliabilities for the cognitive, functional and total scores ranged from -.06 to .86 (n = 14, 16). Regarding predictive validity, R2 ranged from .61 to .90 for the cognitive, functional and total scores (n = 18). Although continued reliability and validity studies are needed, the SCAT has potential to measure patient rehabilitation outcomes, to evaluate nursing care approaches and to serve as a quality assurance indicator for nursing care.

Activities of Daily Living↗

PubMed1998

Patient assessment: validation of a nursing instrument.

The aim of this study is to evaluate the reliability and validity of the Byron Physical Assessment Framework (BPAF). The BPAF is a systems based checklist of physiological measurements, signs, and symptoms designed to structure and document the assessment of a patients physical condition by nursing staff. Initially the BPAF was refined using extensive literature review and expert opinion to improve the comprehensiveness and clarity for its intended purpose. As a result the content validity of the BPAF was supported. Inter-rater reliability between both expert-expert and novice-expert pairings was assessed. A total of 68 assessments were conducted by pairs of qualified nurses with patients on general medical and surgical wards and a nursing-led unit in one London Hospital. Reliability of the dichotomous data items of the BPAF was found to be generally good (kappa > 0.6) with only one item showing a poor reliability (kappa < 0.20). Reliability for continuous items such as pulse and respiratory rate was surprisingly low with evidence of large variation between raters in addition to systematic bias. With relatively little teaching, novice assessors were able to use the BPAF and achieve good inter-rater reliability with expert assessors although this was lower than the reliability of the expert diads. The utilisation of the BPAF to fulfil intended purpose was assessed by examining completed assessments and the outcome in terms of nurses' actions in light of new abnormal findings. Both were found to be fair, showing that the BPAF does affect the actions of nurses although it could be utilised more.

Confounding Factors, Epidemiologic↗

PubMed1980

Reliability and validity characteristics of the Western Aphasia Battery (WAB).

The reliability and validity characteristics of the Western Aphasia Battery (WAB) are described. High internal consistency measures and high test-retest reliability argue for stability of the test both because its parts contribute to the composite index and because of its temporal reliability. Inter- and intrajudge reliability are both very high, suggesting consistent scoring within and between scorers. The WAB satisfies face- and content-validity criteria. Results from the WAB and the Neurosensory Center Comprehensive Examination for Aphasia (NCCEA) highly correlate, indicating good construct validity. WAB AQ scores and Raven's Coloured Progressive Matrices scores significantly correlate, suggesting that the language portions of the WAB are not totally independent from nonverbal functioning. WAB AQ scores reliably differentiate between aphasic and control groups, with only a small overlap for high functioning anomic aphasic subjects.

Adolescent↗

PubMed2002

Development and validation of two new sensory tests of the hand for patients with stroke.

OBJECTIVE: To establish validity and reliability of two new sensory tests evaluating moving (MTP) and sustained (STP) touch-pressure and their relationship to hand function for patients with stroke. The STP had four components in which a light or heavy ball was applied passively or held actively. PARTICIPANTS: Twenty-eight participants with hemiparesis (1-109 months) from rehabilitation hospitals or outpatient programmes. DESIGN: Content validity was established. Then reliability and concurrent and construct validity were determined. Sensation was compared with hand functional ability using the Modified Moberg recognition task, the Box and Block test and one task of the TEMPA test. RESULTS: Reliability: Both types of reliability were significant for MTP (ICC = 0.92) and all components of STP (ICC = 0.62 to 0.92). Concurrent validity: MTP and STP correlated significantly (r = -0.39 to -0.83) with the Semmes-Weinstein Monofilament test used as a 'gold standard' comparison. Construct validity: MTP was significantly related to Moberg (r = 0.49). Three of four components of STP correlated with TEMPA (r = 0.49-0.53) and Moberg (0.45-0.71). Only STP (heavy ball) correlated with Box and Block (0.42-0.48). Of the four components of STP, only the passive STP (light ball) was not related to hand function. CONCLUSION: The new sensory tests of moving, and three components of sustained touch-pressure were reliable. The passive STP (light ball) was discarded. All but this test were relevant to the two functional roles of sensation: exploration for MTP and dexterity during holding for STP.

Adult↗

PubMedDate not supplied

The IPR inventory: development and psychometric characteristics.

The purpose of this study was to develop, validate, and norm a measure of dimensions of interpersonal relationships that are salient to nursing: social support, reciprocity, and conflict. The selection of these concepts was guided by social exchange and equity theories. In the first phase of the study, 44 respondents were interviewed to provide narrative data from which to develop items so that items would be grounded in lived experience. Content validity of items was judged by a panel of 11 experts. The revised 39-item instrument was tested in successive steps with a total of 340 students, patients, and community residents for reliability and validity, including internal consistency reliability, test-retest reliability, factor analysis, and three forms of validity assessment (theory testing, contrasted groups, and multitrait-multimethod comparison). The three subscales of social support, reciprocity, and conflict demonstrated repeated internal consistency and test-retest reliability. Strong evidence of construct validity was demonstrated for the social support and the conflict subscales; validity of the reciprocity subscale was equivocal.

Adult↗

PubMed1981

The Learning Preference Inventory.

The development, validity, and reliability of the Learning Preference Inventory (LPI) and its use with health professions' students and practitioners are described in this paper. The LPI yields six scores to register preferences for the following kinds of learning: Abstract, Concrete, Individual, Interpersonal, Student-structured, and Teacher-structured. The six scales of the LPI have been supported by factor analysis, thereby establishing content validity. Construct validity is demonstrated in studies with allied health and pharmacy students. Internal consistency reliabilities for the six scales range from .72 to .88. While the majority of allied health and pharmacy students tested prefer teacher-structured and concrete learning tasks and situations, many individuals differ from this pattern. Use of the LPI permits identification of individual learning preferences with a fair degree of accuracy. Ways to improve motivation for learning by adjusting teaching methods and assignments to learning preferences are suggested.

Female↗

PubMed2005

OAKHQOL: a new instrument to measure quality of life in knee and hip osteoarthritis.

OBJECTIVE: To develop a questionnaire with which to measure quality of life (QoL) in patients with knee and hip osteoarthritis (OA). STUDY DESIGN AND SETTING: Thirty-two caregivers and 96 OA patients were interviewed individually (using cognitive and face-to-face techniques) and in focus groups. A group of experts working independently at first and then consensually used the interview transcripts to generate a 46-item questionnaire. RESULTS: Analysis of questionnaires completed by 263 patients with hip or knee OA resulted in the exclusion of three items (two because of low reliability and one because of a low response rate). Principal component analysis revealed four factors: physical activity, mental health, social functioning, and social support. A pain dimension was individualized. Preliminary testing showed the reliability of the five dimensions to be satisfactory (intraclass correlation coefficients: 0.70-0.85), construct validity was adequate when correlated with the SF36 (Spearman correlation coefficients: 0.43-0.75), and discrimination was satisfactory. The osteoarthritis knee and hip quality of life questionnaire (OAKHQOL) consists of 43 items in five dimensions and three independent items. CONCLUSION: The OAKHQOL is the first specific knee and hip OA quality of life instrument. Its development followed an a priori structured strategy to ensure content validity. It meets psychometric requirements for validity and reliability.

Activities of Daily Living↗

PubMed1999

Development of a general nutrition knowledge questionnaire for adults.

OBJECTIVE: This paper describes the development of a reliable and valid questionnaire to provide a comprehensive measure of the nutritional knowledge of UK adults. The instrument will help to identify areas of weakness in people's understanding of healthy eating and will also provide useful data for examining the relationship between nutrition knowledge and dietary behaviour which, up until now, has been far from clear. DESIGN: Items were generated paying particular attention to content validity. The initial version of the questionnaire was piloted and assessed on psychometric criteria. Items which did not reach acceptable validity were excluded, and the final 50 item version was administered to two groups differing in nutritional expertise on two occasions to assess the construct validity and test-retest reliability. SETTING: The questionnaire was developed in 1994 in the UK. SUBJECTS: Three hundred and ninety-one members of the general public, recruited via their places of work, completed the questionnaire at the piloting stage. The final version was administered to 168 dietetics and computer science students following a university lecture. RESULTS: The internal consistency of each section was high (Cronbach's alpha = 0.70-0.97) and the test-retest reliability was also well above the minimum requirement of 0.7. Nutrition experts scored significantly better than computer experts [F(1167) = 200.5, P<0.001], suggesting good construct validity. CONCLUSIONS: The findings demonstrate that the instrument meets psychometric criteria for reliability and construct validity. It should provide a useful scale with which to reassess the relationship between knowledge and dietary behaviour.

Adolescent↗

PubMed1981

Validity, reliability and implications of an index of inpatient severity of illness.

We discuss statistical characteristics of AS-SCORE, a recently developed index of illness severity for medical patients. The acronym "AS-SCORE" indicates the five major attributes of the index: age, system involved, stage of the disease, complications and response to therapy. The reliability of both the four-class system (k = .84) and the additive point scoring system (r = .92) was substantiated by two judges who independently classified and scored 105 records. We also tested the content validity of the four-class system and found that as severity increased there was a concomitant increase in hospital charges, laboratory charges, length of stay, number of consultations and mortality rates. In addition, we performed a regression analysis to determine the relative contributions of each of the attributes to the AS-SCORE value. We describe how we used the AS-SCORE severity of illness index to compare physician practice patterns and we suggest several other potential uses. We concluded that the AS-SCORE index is a reliable, valid and useful prototype method to assess differences in severity of illness for medical patients.

Abstracting and Indexing↗

PubMed1996

Disease-specific quality of life: the Gallstone Impact Checklist.

OBJECTIVE: To develop a disease-specific quality-of-life scale for symptomatic cholelithiasis for use in clinical trials, and to evaluate its reliability, construct validity and responsiveness. DESIGN: Questionnaire. PARTICIPANTS: Health care professionals, patients with symptomatic cholelithiasis and their significant others. INTERVENTIONS: A 114-item questionnaire was developed from open-ended questions completed by the participants. Questions dealt with physical symptoms, activities of daily living, job performance, leisure activities, emotional factors, marital and sexual relations, support networks and financial situation. The questionnaire was administered by an interviewer to 50 subjects booked for elective cholecystectomy: frequency-importance products were calculated for each of the 114 items. A final shortened scale (the Gallstone Impact Checklist [GIC]) contained 41 items and was completed by patients with symptomatic cholelithiasis on two occasions, 4 to 6 weeks apart. RESULTS: The checklist requires 10 to 15 minutes to complete. Reliability of the questionnaire and its four subscales was assessed by Cronbach's alpha (overall questionnaire 0.88, pain 0.60, dyspepsia 0.73, emotional impact 0.78 and food and eating 0.84). Construct validity was established by comparison of questionnaire subscales with global ratings of physical and emotional health. Among subjects who reported a difference in their symptoms attributed to gallstones, there was a significant change in total GIC score and in each of the four subscales. Among patients who had undergone cholecystectomy, the absolute value of the effect size was 1.63. CONCLUSIONS: The GIC has content validity and appears to be a reliable, responsive measure of within-person change for subjects with symptomatic cholelithiasis.

Adult↗

PubMedDate not supplied

The Comprehensive Prevention Knowledge and Applications Survey Instrument: its validity and reliability.

Because the instruments used to measure current practices among primary care physicians in a broad range of prevention activities are limited, we developed a study to test a tool that would evaluate current prevention knowledge and applications, including items regarding activities to prevent AIDS and other sexually transmitted diseases. The Comprehensive Prevention Knowledge and Applications Survey Instrument measures knowledge, counseling capabilities, and use of recommended applications in preventive medicine. We designed and tested a 74-item instrument. Four recognized experts in preventive medicine and public health determined its content validity. We then proceeded with reliability testing with a random sample of 315 family physicians and replicated it with an additional 432 physicians for stability reliability. Internal consistency reliability and stability reliability have both been demonstrated for this instrument.

Health Knowledge, Attitudes, Practice↗

PubMed2001

Visual analogue scale, urinary incontinence severity score and 15 D--psychometric testing of three different health-related quality-of-life instruments for urinary incontinent women.

OBJECTIVE: The purpose of this study is psychometric assessment of disease-specific questionnaire, Urinary Incontinence Severity Score (UISS) and Visual Analogue Scale (VAS) in urinary incontinent women. We also investigated functional relationship between UISS, VAS and 15D-valid, generic health-related quality-of-life (HRQoL) instrument. MATERIALS AND METHODS: Eighty-two incontinent female patients were recruited for the study that included baseline investigation and re-evaluation 13 months (range 6-21 months) after treatment. Twenty-nine control women who had urinary incontinence but were not bothered by it completed the HRQoL measurements. RESULTS: Internal consistency and content validity of UISS was good. Both measures UISS and VAS were reproducible, Spearman's rank correlation between test-retest were 0.88 and 0.85 respectively. The control women's UISS, 15D and VAS scores were significantly lower than the patient's scores (p<0.001, Mann-Whitney U test) which proves to be a good discriminant. The changes in pad test correlated moderately well with those in the VAS and UISS. The UISS, VAS and 15D in the improved group had responsiveness (Guyatt's) statistics: 1.48, 1.74 and -0.80 respectively. CONCLUSION: The UISS and VAS proved to be valid, reproducible and responsive to treatment for UI women. The functionality of the 15D was good but it demonstrated less sensitivity to changes after treatment.

Adult↗

PubMed1983

Toward the behavioral assessment of biological aging in the laboratory mouse: concepts, terminology, and objectives.

The thesis is presented that much of the controversy and confusion concerning the measurement of biological aging stems from the lack of agreement on clearly defined objectives, constructs, and methods to validate measures. To alleviate some of the confusion, basic terminology borrowed from psychometrics is offered to provide a conceptual framework within which such issues can be discussed. This psychometric nomenclature is subsequently applied to the development and evaluation of a test battery designed to assess biological aging in laboratory mice at a behavioral level of analysis. Reference is made to the assessment of reliability, content validity, construct validity, and predictive validity of tests of biological aging.

Aging↗

PubMed2005

Pathways to sexual offense recidivism following treatment: an examination of the Ward and Hudson self-regulation model of relapse.

Ward and Hudson (1998, 2000) proposed a self-regulation model of relapse in sexual offenders, which classifies offenders into one of four pathways. This study examined the validity of the model, whether sexual recidivists are characterized by one predominant pathway and offense type, and whether participants would change pathway pre- to posttreatment intervention. Twenty-five sexual offenders who had participated in a comprehensive cognitive-behavioral treatment program during a prison sentence, but committed a further sexual offense on their release from custody, participated in the study. Results supported the content validity of the model. The predominant pathway pre- and posttreatment was approach explicit. The hypothesis that participants would change pathway posttreatment was not supported. These results may have implications for the efficacy of treatment of approach-explicit sexual offenders.

Adult↗

PubMed2005

Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements.

OBJECTIVE: We developed a questionnaire to evaluate dietitians' knowledge and practices about the use of dietary supplements in light of new draft regulations in South Africa that will allow dietitians to prescribe supplements for the management of nutrition-related diseases. METHODS: A cross-sectional validation study was carried out in two phases: 1) questionnaire planning and development and 2) determination of reliability (internal consistency). The study sample comprised 48 nurses, 105 dietetic interns, and 367 registered dietitians. An expert academic group comprising nine dietitians with research and teaching experience rated the academic relevance and importance of knowledge questions in an item pool of 355 questions to ensure face and content validity. Criterion validity was measured by testing the knowledge questions (KQs) on 48 nurses and 105 dietetic interns. Thereafter questions were deleted based on their difficulty, discrimination, and Cronbach's alpha values. The final questionnaire, which at this point included a test of 50 KQs, was mailed to registered dietitians (n = 1450) in South Africa to determine internal consistency of the final KQs. RESULTS: Criterion validity of the KQs was indicated by a significant difference (P = 0.000) in the mean test scores between nurses (36.9, 95% confidence interval 24.2 to 39.6) and dietetic interns (40.2, 95% confidence interval 38.8 to 41.7). Item discrimination was attained by the deletion of NQs having a minimum correlation of 0.20 with overall test score. Further, item difficulty was controlled for by removal of questions correctly answered by more than 80% (too easy) or fewer than 20% (too difficult). Internal consistency of the KQs, after completion by 367 dietitians, was 0.87 (Cronbach's alpha). The mean knowledge score of dietitians ranged from 56.5% to 62.5%, with the oldest group (> or =40 y) having the highest score (P = 0.018). Thirty-eight percent of dietitians recommended dietary supplements at least 3 times a week; 51% consumed dietary supplements themselves; and 17% sold them to clients. CONCLUSIONS: A valid and reliable questionnaire that tests knowledge and practices of dietary supplements was developed for dietitians. This tool can be used by academic institutions to evaluate the knowledge and practices of final-year students. It can also be used on a representative sample of dietitians in South Africa and possibly elsewhere within the profession.

Adult↗

PubMed2002

Coping with family-to-work conflict: the role of informal work accommodations to family.

The purposes of this study are to (a) construct and validate a scale measuring informal work accommodations to family (IWAF), (b) test the moderating effect of IWAF on the relationship between family-to-work conflict and work stress, and (c) examine the relationships between IWAF and a set of relevant antecedents and coping constructs. Two survey-based nonexperiments are used to accomplish these goals. Results indicate that (a) the IWAF scale is reliable, content valid, and meaningfully correlated to work-family and coping constructs; (b) more frequent use of IWAF attenuates the positive relationship between family-to-work conflict and stress; and (c) IWAF, along with organizational policies and climates, may be important for workplace stress management. Implications for research and practice are discussed.

Adaptation, Psychological↗

PubMed1998

Analyzing the time and value of housestaff inpatient work.

OBJECTIVE: To determine time allocation and the perceived value to education and patient care of the weekday activities of internal medicine housestaff on inpatient rotations and to compare the work activities of interns and residents. DESIGN: An observational study. We classified activities along five dimensions (association, location, activity, time, and value), developed a computer-assisted self-interview survey, and demonstrated its face and content validity, internal consistency, and interrater reliability. Subjects were assigned survey computers for 5 consecutive weekdays over a 24-week period, into which they entered data when prompted several times a day. SETTING: The medical service of a university-affiliated Veterans Administration Medical Center. PARTICIPANTS: Sixty housestaff (36 interns, 24 residents) rotating on the inpatient wards. MEASUREMENTS AND MAIN RESULTS: We analyzed activities according to content (direct patient care, indirect patient care, education), association, and location. Likert-scale ratings of perceived value to education and patient care were also obtained. Housestaff provided complete responses to 3,812 (95%) of 3,992 prompts by a median of 11 seconds; 93% of responses were logically consistent across the measured dimensions. Housestaff spent more time in indirect patient care (56%) than in direct patient care (14%) or educational activities (45%). Formal educational activities had the highest educational value (66 on 0-100 scale), and direct care had the highest value to patient care (81). Over 30% of time was spent in administrative activities, which had low educational value(40). Compared with residents, interns allocated significantly less time to educational activities (38% vs 57%) and more time to lower-value activities such as documentation (19% vs 12%). CONCLUSIONS: Improved data collection methods demonstrate that housestaff in our program, particularly interns, spend much of their workday in activities that are low in educational and patient care value. Selective elimination or delegation of such activities would preserve higher-value experiences during reductions in overall inpatient training time. Planners can use automated random sampling to guide the rational redesign of housestaff work.

Confidence Intervals↗