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PubMed2000

An instrument to measure symptom experience. Symptom occurrence and symptom distress.

This article describes the development of an instrument that measures symptom experience (symptom occurrence and symptom distress). The Adapted Symptom Distress Scale-2 (ASDS-2), adapted from the McCorkle and Young Distress Scale, is a 31-item, 5-point, self-report paper-and-pencil instrument that measures patients' perception of the occurrence and distress of 14 symptoms: nausea, vomiting, pain, eating, sleep, fatigue, bowel elimination, breathing, coughing, concentration, lacrimation, changes in body temperature, appearance, and restlessness. Use of the instrument yields a total score for symptom experience, scores for symptom occurrence, scores for symptom distress, and subscale scores for six symptom categories: gastrointestinal, fatigue/restlessness, concentration, pain/discomfort, respiratory, and appearance. Reliability and validity were determined with well adults (n = 97), medical-surgical patients (n = 82), and oncology patients (n = 175). Findings revealed a Cronbach's alpha of 0.91 for symptom experience, 0.90 for symptom occurrence, and 0.76 for symptom distress. Cronbach's alpha for the subscales ranged from 0.38 for appearance symptoms to 0.83 for gastrointestinal symptoms. Inclusion of symptoms reported by patients with cancer strengthened content validity. A contrasted groups approach was used to demonstrate construct validity.

Adolescent↗

PubMed2004

Techniques for measuring clinical competence: objective structured clinical examinations.

The traditional clinical examination has been shown to have serious limitations in terms of its validity and reliability. The OSCE provides some answers to these limitations and has become very popular. Many variants on the original OSCE format now exist and much research has been done on various aspects of their use. Issues to be addressed relate to organization matters and to the quality of the assessment. This paper focuses particularly on the latter with respect to ways of ensuring content validity and achieving acceptable levels of reliability. A particular concern has been the demonstrable need for long examinations if high levels of reliability are to be achieved. Strategies for reducing the practical difficulties this raises are discussed. Standard setting methods for use with OSCEs are described.

Clinical Competence↗

PubMed1995

Measuring sexual functioning in premenopausal women.

OBJECTIVE: To assess the validity and reliability of a measure of sexual function for premenopausal women. DESIGN: A self-administered sexual function questionnaire, derived from the Sabbatsberg Sexual Self-Rating Scale, and other health measures were given to women who were randomly sampled from the community health index. SUBJECTS: One hundred and forty-eight premenopausal women aged between 45 and 49 years. MAIN OUTCOME MEASURES: The content validity, internal consistency and construct validity of the revised sexual rating scale. RESULTS: One hundred and thirty-seven women (92%) responded to the main questionnaire and 89 (60%) completed the sexual rating scale, which possessed a high level of internal consistency; scores on the sexual rating scale, which possessed a high level of internal consistency; scores on the sexual ratings scale had small to moderate correlations with the measures of health, two of which (depression and role limitations attributable to emotional problems) were sufficient to explain 25% of the variation in the sexual functioning scores. CONCLUSION: Questions derived from the Sabbatsberg sexual self-rating scale have been used to construct a simple, acceptable, valid and reliable measure of sexual functioning for women in the 45 to 49 years of age group. Such a measure could be widely used as an adjunct to clinical and more general measures of health in order to assess the impact of interventions on sexual functioning within clinical trials.

Female↗

PubMed1991

Patient satisfaction with hospital services: development and testing of a measuring instrument.

The present study was undertaken with the aim of developing and testing an instrument that could be used to measure patient satisfaction with hospital services in Kuwait. The instrument, which comprised 57 items, and measured satisfaction with 7 specific dimensions of hospital services, was administered to 493 patients using the interview technique. Statistical analysis showed that the instrument yields good response variability. Reliability of the instrument, measured in terms of the internal consistency coefficient alpha, exceeded the acceptable criterion level, the coefficients ranging between 0.73 and 0.86. Evidence of the construct validity of the instrument was found in significant positive correlation between the dimension specific satisfaction scale scores and scores for allegiance scale and for overall rating of quality of hospital services. Construct validity was further supported by convergent discriminant analysis, which showed that correlations between items of all 7 scales and their total scale scores were greater than correlations between scale items and the total scores of scales they do not represent. Analysis of an open-ended question about dissatisfying aspects of hospital services not included on the interview was undertaken to examine the instrument's content validity. Results indicated that patients identified 11 items, 8 of which were identified more than once, and 2 of which were not classifiable to the 7 dimensions assessed by the instrument. It was suggested to add the 8 items that were identified more than once, and to reassess the reliability and validity of the revised instrument. Assessment of the test-retest reliability, by comparing scale scores over time, was also suggested.

Evaluation Studies as Topic↗

PubMed1993

The comprehensive Breast Cancer Knowledge Test: validity and reliability.

Two subscales for a breast cancer knowledge test were developed and tested to be used (a) in determining a woman's general knowledge of breast cancer (i.e. risk factors and epidemiology) and her knowledge of breast cancer curability, and (b) in exploring the relationship between knowledge of breast cancer and utilization of screening practices. These subscales were designed to be used in conjunction with the Breast Cancer Knowledge Test (BCKT), which assesses screening and detection knowledge. The instrument was submitted to four experts in the field of oncology to establish content validity. Reliability testing was conducted on a random sample of 182 women. Internal consistency reliability for the post-tested general knowledge subscale was 0.60, and for the curability subscale was 0.62. The overall alpha coefficient was 0.71. In combination with the BCKT, these subscales can be used to describe a woman's knowledge of breast cancer.

Aged↗

PubMed2004

Validity and internal consistency of a whiplash-specific disability measure.

STUDY DESIGN: Cross-sectional study of patients with whiplash-associated disorders investigating the internal consistency, factor structure, response rates, and presence of floor and ceiling effects of the Whiplash Disability Questionnaire (WDQ). OBJECTIVES: The aim of this study was to confirm the appropriateness of the proposed WDQ items. SUMMARY OF BACKGROUND DATA: Whiplash injuries are a common cause of pain and disability after motor vehicle accidents. Neck disability questionnaires are often used in whiplash studies to assess neck pain but lack content validity for patients with whiplash-associated disorders. The newly developed WDQ measures functional limitations associated with whiplash injury and was designed after interviews with 83 patients with whiplash in a previous study. METHODS: Researchers sought expert opinion on items of the WDQ, and items were then tested on a clinical whiplash population. Data were inspected to determine floor and ceiling effects, response rates, factor structure, and internal consistency. Packages of questionnaires were distributed to 55 clinicians, whose patients with whiplash completed and returned 101 questionnaires to researchers. RESULTS: No substantial floor or ceiling effects were identified on inspection of data. The overall floor effect was 12%, and the overall ceiling effect was 4%. Principal component analysis identified one broad factor that accounted for 65% of the variance in responses. Internal consistency was high; Cronbach's alpha = 0.96. CONCLUSIONS: Results of the study supported the retention of the 13 proposed items in a whiplash-specific disability questionnaire. Dependent on the results of further psychometric testing, the WDQ is likely to be an appropriate outcome measure for patients with whiplash.

Adult↗

PubMed2000

The development and validation of a Greek version of the short-form McGill Pain Questionnaire.

BACKGROUND: The short form of the McGill Pain Questionnaire (SFMPQ) is a widely used instrument for assessing the quality of pain where use of the full form is not possible. To date however, this instrument has not been translated into the Greek language. AIMS: It is the aim of this study to validate an adopted Greek version of the short form of the McGill Pain Questionnaire. METHODS: A systematic translation procedure was followed before development of the final version. Sixty spinal and osteoarthritis chronic musculoskeletal pain patients completed the questionnaire. A large percentage of the subjects (43%) was of elementary educational level. RESULTS: The analysis of the results indicated that an internally consistent (Cronbach's alpha = 0.71) and content valid (all 15 descriptors were used at least by the 33% of the subjects) instrument has been developed. It has been shown to be suitable, easy to understand and administer for this sample of chronic musculoskeletal patients. CONCLUSIONS: A Greek version of the SFMPQ (the GR-SFMPQ) has been constructed which has the properties of internal validity and consistency. It is easy to administer, easy to understand even for an elementary educational level and it is capable of describing multidimensionally the pain experience of chronic musculoskeletal pain patients.

Adult↗

PubMedDate not supplied

Validation of the defining characteristics of body image disturbance in Japan.

PURPOSE: To examine the validity of the nursing diagnosis body image disturbance and to specify its major and minor defining characteristics in Japanese culture. METHODS: A qualified sample of 149 RNs with an average of 10 years of clinical experience and knowledge of nursing diagnosis was given a questionnaire consisting of 21 defining characteristics from NANDA, 8 additional items from the literature, and 2 distracting characteristics. FINDINGS: Four major diagnostic content validation (DCV) scores of 0.75 and higher and 15 minor defining characteristics with DCV scores from 0.60 to 0.74 were identified. CONCLUSIONS: This study provides a foundation for further study of culturally appropriate defining characteristics for use in Japan.

Adult↗

PubMed2003

Detecting psychosocial problems among 5-6-year-old children in preventive Child Health Care: the validity of a short questionnaire used in an assessment procedure for detecting psychosocial problems among children.

BACKGROUND: An extended re-assessment of the psychometric properties of the LSPPK, an instrument aimed at identifying children with emotional and behavioural problems. METHODS: Data came from a national sample in The Netherlands of parents of 1248 children (aged 5-6 years) interviewed by child health professionals (CHP). Data were obtained regarding psychosocial problems, treatment status and scores on the LSPPK (Parent and CHP Index), and on the Child Behavior Checklist (CBCL). The scale structure, reliability, criterion and content validity and added value of the LSPPK were assessed using the CBCL and treatment status as criteria. RESULTS: The scale structure corresponded with that found originally; the LSPPK improved the prediction of problems according to the CBCL, compared to predictions using readily available risk indicators alone. Reliability varied between 0.55 and 0.69. For the LSPPK Parent Index, sensitivity varied between 0.42 and 0.50. For the CHP Index sensitivity varied between 0.60 and 0.96, but specificity varied between 0.76 and 0.79. Both indices were very sensitive for attention and social problems, but less so for other problems. CONCLUSION: The LSPPK Parent Index cannot distinguish sufficiently between children with or without serious problems. Either too many children with problems remain unnoticed or too many children without problems are labelled as a case. The LSPPK CHP Index, reflecting the CHP's interpretation of the Parent Index after interviewing the parents does not compensate adequately for the weaknesses of the Parent Index. Better assessment procedures and strategies need to be developed.

Child↗

PubMed2006

The Turkish version of the Omaha System: its use in practice-based family nursing education.

The aims of this manuscript are to examine the validity and reliability of the Turkish version of the Omaha System, and to demonstrate its effectiveness as a tool for nursing education. In this methodological and descriptive study, seventy students attending a training program used the Omaha System in clinical practice settings for assessing health problems of 157 clients and for nursing interventions during 378 home visits. After the system's adaptation to the Turkish language, its content validity was reconfirmed through feedback from the students and interrater reliability was tested on six independent students with kappa statistics. The reliability scores were at a statistically significant level when coding the records using the Omaha System. Clinical practice was explained with 332 problems and 1783 nursing intervention terms. Study findings indicate several strengths, including high reliability - except in target terms, coding of problems and interventions, improved understanding of the course, as well as some limitations: the need for new terms and more time required for manual documentation. The findings of the study supported the usefulness of the Omaha System in describing the practice of community health nursing.

Attitude of Health Personnel↗

PubMed1999

A new questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and social consequences of the disorder: reliability and validity.

This paper describes the development and the validation of a questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and the social consequences of the disorder. The final version of the questionnaire includes 28 items, grouped in four sub-scales (social restrictions, social distance, utility of treatments, biopsychosocial causes of schizophrenia), whose intra-rater reliability ranges from 0.36 to 0.84. Cronbach's alpha coefficient, which tests the content validity of the sub-scales, ranges from 0.56 to 0.66. Factor analysis identifies two factors (opinions on social consequences and the utility of treatments, and the beliefs on the causes of schizophrenia), which account for the 73% of the total variance. This questionnaire may be particularly useful to assess relatives'beliefs about schizophrenia and to target psychosocial interventions in the families of patients with schizophrenia.

Adaptation, Psychological↗

PubMed2003

Validation of a functional evaluation system in patients with musculoskeletal tumors.

The validity and reliability of the Musculoskeletal Tumor Society functional evaluation system were evaluated using the Nottingham Health Profile, the Short Form-36, and the EuroQol protocol to measure the quality of life of patients with malignant musculoskeletal tumors. Forty-nine patients were assessed and osteosarcoma around the knee was the most common type of tumor. Prosthetic reconstructions had been done in 55.1% of patients. In a content validity analysis, neither social nor psychologic domain was identified in the Musculoskeletal Tumor Society system. All items of the lower extremity were related to the same function-walking ability. The Musculoskeletal Tumor Society system had a strong correlation with other quality of life measures in the construct validity and the reliability, but each domain of the system was so comprehensive that it could not represent the quality of life properly. Furthermore, the preoperative and postoperative status of patients could not be compared using this system. The overall validity and reliability of the Musculoskeletal Tumor Society system seemed to be acceptable. However, this system may require additional development of the appropriate domains for evaluating the quality of life in patients with musculoskeletal tumors.

Adolescent↗

PubMed2005

Chinese version of the Childbirth Self-efficacy Inventory.

AIM: This paper reports a study to translate the Childbirth Self-efficacy Inventory into Chinese and examine its reliability and validity among pregnant Chinese women in Hong Kong. BACKGROUND: Self-efficacy for childbirth has been emerged as an important psychological construct in childbearing care. A reliable and valid self-efficacy measure for pregnant women is crucial to the understanding of their psychological preparation, as well as the development of an appropriate childbirth education programme. METHODS: Two experienced midwives undertook translation of the Childbirth Self-efficacy Inventory into Chinese, and another two experienced midwives independently conducted back translation. An expert panel of six healthcare professionals and 10 pregnant women examined the face and content validity of the translated instrument. A convenience sample of 148 pregnant Chinese women of not <36 weeks of gestation, and attending a regional teaching hospital in Hong Kong, were invited to complete the translated inventory and a demographic data sheet. RESULTS: The Childbirth Self-efficacy Inventory indicated high internal consistency. Principal components analysis supported the fact that each of the efficacy and outcome expectancy subscales is uni-dimensional. Neither scores in the efficacy nor outcome expectancy subscales suggested any statistically significant relationships with parity, age, education and attendance at childbirth education classes. No statistically significant differences in efficacy and outcome expectancy scores were found between the active phase (when contractions are not more than 5 minutes apart) and second stage (when pushing out the baby) of labour. CONCLUSION: The study provides initial support for the reliability and validity of the Childbirth Self-efficacy Inventory. Although its sensitivity in differentiating between the two stages of labour was not evident, the distinguishing role of its expectancy subscales has been identified.

Adolescent↗

PubMed2006

Modification of the Body Sensations Interpretation Questionnaire (BSIQ-M): validity and reliability.

The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.

Adult↗

PubMed1991

Development and validation of an instrument to measure satisfaction of participants at breast screening programmes.

A reliable and valid questionnaire has been developed to measure the satisfaction of participants with service offered at mammography screening programmes. The questionnaire measures five specific aspects: convenience and accessibility, staffs' interpersonal skills, information transfer between staff and client, physical surroundings and perceived technical competence of staff. A general satisfaction dimension was also included. Systematic procedures were followed to ensure that the initial pool of items met the criteria for satisfactory content validity. These procedures included extensive literature review and interviews with participants and service providers. Discriminant validity was assessed by a modified Q-sort procedure, where eight expert judges sorted items into relevant dimensions. The sample for other validity and reliability testing consisted of 584 women who were participants at a breast X-ray programme in Melbourne, Australia. Concurrent validity was demonstrated by considering the correlation of the sum of the subscale scores for each respondent with their score on the general subscale (r = 0.76; P less than 0.001). Multiple regression was used to provide further evidence for the discriminant validity of the proposed subscales and support for the multidimensional conceptualism of satisfaction. Scores on the general satisfaction subscale were used as an outcome variable and other subscale scores were predictor variables. All subscale scores significantly contributed to the prediction of satisfaction, over and above that of other subscales (R2 = 0.59). This indicates that these subscales are measuring distinct dimensions of satisfaction. Cronbach's alpha of each subscale was over 0.50, indicating that the subscales are reliable. The instrument is a potentially useful tool for assessing the quality of care at mammographic screening services and could be used routinely by such services to monitor satisfaction.

Australia↗

PubMed2003

Applicability, validity, and reliability of the Piper Fatigue Scale in postpolio patients.

OBJECTIVE: To identify a scale that is potentially applicable for measuring the fatigue in postpolio patients and to evaluate its validity and reliability in this population. DESIGN: Interview survey of 64 individuals with postpolio syndrome and 25 healthy controls of similar age range, with retest in a subset of postpolio patients. The sample was recruited from a postpolio support group, a postpolio clinic, and the general community. Subjects completed the Piper Fatigue Scale, the Beck Depression Inventory, and the Chalder Fatigue Questionnaire during the interview. RESULTS: Face and content validity of the Piper Fatigue Scale was established by a team of experts and by a group of postpolio patients. The postpolio subjects had significantly higher Piper Fatigue Scale scores than the healthy control subjects (P < 0.001), demonstrating extreme groups validity. Convergent validity was shown with a strong positive correlation between Piper Fatigue Scale scores and Chalder Fatigue Questionnaire scores (r = 0.80). Reliability was also demonstrated with the Piper Fatigue Scale's high internal consistency (alpha = 0.98) and strong test-retest agreement (intraclass correlation coefficient = 0.98). CONCLUSIONS: The Piper Fatigue Scale is a valid and reliable tool for measuring postpolio fatigue. This scale may be useful in other studies of postpolio fatigue, including those gauging the effectiveness of various treatments for this fatigue.

Activities of Daily Living↗

PubMedDate not supplied

Clinical nurse specialists' knowledge specific to Medicare structures and processes.

PURPOSE: The purpose of this study was to describe clinical nurse specialists' (CNSs) knowledge of Medicare structures and processes using a multiple-choice examination. DESIGN: This descriptive study used the survey method with a convenient sample. SETTING: Potential subjects received the research study packet at the address designated by them for membership mailings sent from the National Association of Clinical Nurse Specialists (NACNS). SAMPLE: The population of interest was practicing CNSs. The accessible population was NACNS members drawn from the 2002 mailing list organized by zip code. Every third mailing label was skipped. The remaining list members (N = 950) received a study packet. There was a 14.42% response rate with 137 respondents. Eighty-two percent held a master's degree in nursing. METHODS: A 46 item multiple-choice examination was developed based upon a content map established after a review of the available Medicare-related literature and consultation with Medicare advanced practice nurse providers. Content validity was established. Survey packets with the instrument, Scantron answer key, informational letter, and demographic profile were sent to potential subjects. Returned responses were keyed for correct answers. Relationships between demographic variables, raw score, and self-reported Medicare expertise were analyzed. Qualitative data elicited on the demographic form were thematically analyzed. FINDINGS: The examination had a.67 coefficient. Correlation of examination raw score to self-reported Medicare content expertise was 0.982 (P =.000). One third of the examination questions were incorrectly answered by 30% or more of respondents. Percentage correct scores ranged from 60.9 to 95.7 (M = 62.7%; SD = 10.46). Respondents offered 40 comments. Eleven comments related to a self-recognized Medicare knowledge deficit. Four responses highlighted that graduate studies had not provided them with the knowledge necessary for understanding reimbursement issues. Ten respondents expressed an interest in locating some type of educational resource addressing the Medicare system, reimbursement processes, and opportunities. CONCLUSIONS: Findings suggest that NACNS members have Medicare program knowledge deficits. Respondents recognize their deficiencies and are interested in obtaining more information about Medicare but are uncertain as to available resources or networking opportunities that might support them in this process. Graduate nursing programs may need to evaluate the amount of information provided within curriculums specific to insurance reimbursement and Medicare structures and processes. Study limitations include the low response rate and indeterminate sample representativeness. IMPLICATIONS FOR PRACTICE: Educators should examine CNS curriculums to ensure the adequacy of Medicare program information. Continuing education programs and conference workshops addressing Medicare information should be offered to CNSs interested in increasing their expertise or exploring provider opportunities. There may be entrepreneurial opportunities available to CNSs interested in developing an expertise in Medicare programs. Future research studies should quantify potential benefits to Medicare beneficiaries when CNSs participate as providers.

Health Knowledge, Attitudes, Practice↗

PubMed2000

Quality-of-life of pacemaker patients: a reappraisal of current instruments.

Current clinical practice permits the use of single chamber ventricular or dual chamber pacemakers. However, it is not known which type of pacemaker results in superior clinical and patient outcomes. This is of growing importance because of the higher costs and increased risk of technical failures of dual chamber pacemakers. Patient outcomes can be assessed with quality of life questionnaires, but it is unclear which questionnaires are valid for use in pacemaker patients. This article reappraises studies on quality of life instruments for pacemaker patients. We searched MEDLINE (1985-1998) for studies assessing quality-of-life in general and in pacemaker patients. The SF-36 appeared to be the best among generic questionnaires because of its psychometric characteristics and experience of use. Concerning disease specific instruments, the Karolinska quality of life questionnaire has desirable content validity but lacks more rigorous psychometric validation, which constitutes a serious limitation. Previous studies suggested that implantation of atrioventricular pacemakers improves quality-of-life compared to ventricular pacemakers, but since no well-designed and validated questionnaire exists, these results should be interpreted with caution. The best outcome measure to evaluate quality-of-life in pacemaker patients would be a combination of a generic health profile with established reliability and validity supplemented with a cardiovascular assessment adjusted to suit pacemaker patients. By doing so, individual scores can be compared within a disease cohort and to same-aged, nondiseased persons, as well as other diseased populations. The development and validation of such an instrument is currently needed.

Humans↗