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PubMed2006

Translation, cross-cultural adaptation, reliability, and validity of the German version of the Coping Strategies Questionnaire (CSQ-D).

UNLABELLED: The aim of this study was to translate and cross-culturally adapt the American version of the Coping Strategies Questionnaire (CSQ) and to test the reliability and validity of the German version (CSQ-D). The CSQ was translated and cross-culturally adapted following international guidelines. Reliability and validity were tested in 62 individuals with chronic musculoskeletal pain syndromes. For the concurrent criterion-related validity the CSQ-D scales were compared with the German Pain Coping Questionnaire (FESV-BW), and for the construct validity with the German Short Form 36 (SF-36). The translation process proceeded without major difficulties. In testing for reliability, the CSQ-D as a whole had a Cronbach's alpha of .94 and an intraclass correlation coefficient of .89 (95% CI .86-.98). The total CSQ-D score was correlated to the FESV-BW scales with scores of r = 0.32-0.55 and with the SF-36 Mental Component Summary with scores of r = 0.32-0.53. The CSQ-D is a precisely translated and highly reliable instrument in the assessment of chronic pain coping strategies. Its concurrent criterion-related validity and construct validity are low. The main reason for the low level of agreement between the CSQ-D and the FESV-BW was revealed by factor analysis. PERSPECTIVE: This paper presents the German version of the Coping Strategies Questionnaire (CSQ-D) together with the results of clinimetric testing. The CSQ-D is a feasible and reliable outcome measure to be used in trials with German-speaking patients or large multicenter multinational trials to assess pain coping strategies in patients with chronic musculoskeletal pain.

Adaptation, Psychological↗

PubMed2004

The NOAR Damaged Joint Count (NOAR-DJC): a clinical measure for assessing articular damage in patients with early inflammatory polyarthritis including rheumatoid arthritis.

OBJECTIVES: To evaluate the reliability and validity of the Norfolk Arthritis Register Damaged Joint Count (NOAR-DJC) in patients with early inflammatory polyarthritis (IP). METHODS: The NOAR-DJC examines deformity in 51 joints. Deformity is defined as inability to adopt the anatomical position, reduction in range of movement by at least one-third, and/or surgical alteration of the joint. Reliability was investigated by assessing intra- and inter-observer agreement in 40 and 32 patients, respectively. Validity was assessed by correlating the NOAR-DJC with the eroded joint count (criterion validity), the Health Assessment Questionnaire (HAQ) (convergent construct validity) and tender and swollen joint counts (divergent construct validity) and by discriminating between those who did and did not satisfy criteria for rheumatoid arthritis (discriminant validity). RESULTS: The intraclass correlation coefficient for the intra- and inter-rater studies were 0.88 [95% confidence interval (CI) 0.79, 0.94, P<0.00001] and 0.74 (95% CI 0.53, 0.86, P<0.00001), respectively. Correlations with eroded joint counts and HAQ scores after 5 yr follow-up were r(s) = 0.42 (95% CI 0.35, 0.49, P<0.01) and r(s) = 0.45 (95% CI 0.4, 0.5, P<0.01), respectively. Correlations with tender and swollen joint counts were weak (r(s) = 0.28 and r(s) = 0.33). CONCLUSION: The NOAR-DJC is a quick, reliable and valid tool for assessing articular damage in patients with early IP.

Adolescent↗

PubMed2005

Health related quality of life of adolescents in Vietnam: cross-cultural adaptation and validation of the Adolescent Duke Health Profile.

Quality of life (QOL) of adolescents has been scarcely documented in a general population sample. The study was aimed at translating and adapting the Adolescent Duke Health Profile to Vietnamese, validating the questionnaire, determining reference value, and identifying determinants of poor QOL. Following a cross-cultural methodology, the Adolescent Duke Health Profile (ADHP) had content adapted to Vietnamese by alteration of 2 out of 17 items. Test-retest validity was checked in 408 adolescents. Construct validity and internal consistency were assessed in a 1408 probability sample of adolescents in Vietnam, and determinants were analysed by multiple linear regression. The ADHP showed satisfactory internal consistency (Cronbach's alpha=0.87-0.92) and satisfactory construct validity in relation with drug abuse or not, or with parent situation living in couple or alone. Test-retest reliability was acceptable (ICC=0.7-0.8) and major determinants were age, sex, education, chronic disease, alcohol and drug use. This works provide a validated, simple health related QOL scale suited to adolescent population with reference values. Taking into account determinants identified will help program prevention and intervention health policy and to evaluate the effect of these actions.

Adolescent↗

PubMed1996

The development and validation of a measure of parent-reported child health and morbidity: the Warwick Child Health and Morbidity Profile.

OBJECTIVE: to validate a simple instrument for the measurement of parent-reported health and morbidity in infancy and childhood suitable for research and service planning purposes and capable of measuring both cross-sectional and longitudinal health and morbidity experience in a child population. SETTING: child health clinic (CHC), child development unit (CDU) and paediatric outpatient department (OPD) in Coventry. DESIGN: 3-phase field testing to establish test-retest reliability, validity and inter-observer variation of the instrument. Field testing samples: phases 1 and 2; 188 parents of pre-school children attending one of the three health service settings-CHC, CDU or paediatric OPD; phase 3; 40 parents of pre-school children attending CHCs. METHODS: test-retest reliability of each domain of the WCHMP was estimated using weighted Kappa; criterion validity was estimated for selected domains against health records; construct validity against medically plausible constructs was tested by comparing responses between domains; Inter-observer variation was estimated using weighted Kappa. RESULTS: the test-retest reliability of the WCHMP varied from 'moderate' for behaviour, functional health and life quality status to 'very good' for acute significant illness and hospital admission status; criterion and construct validity were high; weighted Kappas for all domains for inter-observer variation between the researcher and family health visitor were in the 'good' to 'very good' range and inter-observer variation remained unaffected by change in the order of administration of the WCHMP. CONCLUSIONS: the WCHMP is a simple measure of parent-reported health and illness which, on field-testing, has been shown to be reliable and valid with low inter-observer variation. After further development and validation including incorporation into the parent-held record, it should be suitable for use in infancy and early childhood to collect cross-sectional and longitudinal health and morbidity data for research and service planning purposes.

Chi-Square Distribution↗

PubMedDate not supplied

[Validity of a job stressors measurement scale in nursing staff: the nursing stress scale].

BACKGROUND: The aim of this work was to determine the reliability and construct validity of a scale intended to measure job stressors to which hospital nursing staff may be exposed. SUBJECTS AND METHODS: The nursing stress scale contains 34 stressors. The scale's trans-cultural adaptation was carried out by means of the translation-back translation method. Validation was conducted on a random sample of 201 health professionals in a public hospital in Valencia. The reliability of the scale was assessed after its readministration on a sub-sample of 30 nursing professionals, with a 15 day interval. The construct validity was obtained through the correlation of the scale with another two scales: The 28 item version of Goldberg's General Health Questionnaire and 7 dimensions of the Health questionnaire SF-36. RESULTS: The scale in Spanish language contains 34 items after eliminating the first item from the original scale (N1: computer failure) and including a new item (E1: Frequent job interruptions). The distribution of scores obtained in the initial administration of the scale and fifteen days later do not differ statistically. The Cronbach's alfa coefficient is 0.92 for the total scale and in each of the sub-scales ranges between 0. 83 and 0.49. The correlation between the scale and the GHQ-28 items questionnaire is 0.34. For each one of the seven dimensions of the SF-36 questionnaire the correlations range between -0.21 and -0.31. CONCLUSION: The nursing stress scale is a useful instrument for measuring possible stressors in this collective. It has high internal consistency and construct validity, as does the original American version, however reliability is moderate.

Data Interpretation, Statistical↗

PubMed1999

How valid and reliable are patient satisfaction data? An analysis of 195 studies.

OBJECTIVE: To assess the properties of validity and reliability of instruments used to assess satisfaction in a broad sample of health service user satisfaction studies, and to assess the level of awareness of these issues among study authors. DESIGN: Examination and analysis of 195 papers published in 1994 in 139 journals. The following databases were searched: British Nursing Index, CINAHL, EMBASE, MedLine, Popline, and PsycLIT. MAIN MEASURES: Number and types of strategies used for content, criterion, and construct validity, and for stability and internal consistency. Associations between validity/reliability and other study characteristics. RESULTS: Eighty-nine (46%) of the 195 studies reported some validity or reliability data; 76 reported some element of content validity; 14 reported criterion validity, with patient's intent to return the most commonly used criterion; four reported construct validity. Thirty-four studies reported internal consistency reliability, 31 of which used Cronbach's coefficient alpha; eight studies reported test-retest reliability. Only 11 studies (6% of the 181 quantitative studies) reported content validity and criterion or construct validity and reliability. 'New' instruments designed specifically for the reported study demonstrated significantly less evidence for reliability/validity than did 'old' instruments. CONCLUSION: With few exceptions, the study instruments in this sample demonstrated little evidence of reliability or validity. Moreover, study authors exhibited a poor understanding of the importance of these properties in the assessment of satisfaction. Researchers must be aware that this is poor research practice, and that lack of a reliable and valid assessment instrument casts doubt on the credibility of satisfaction findings.

Data Collection↗

PubMed1984

Convergent validity of type A behavior pattern scales and their ability to predict physiological responsiveness in a sample of female public employees.

The purpose of this study was to assess the construct validity of the structured interview (SI), Jenkins Activity Survey (JAS), Thurstone Activity Scale, and Bortner Type A Scale in a sample of female employees from a government service agency. Criteria for validity assessment were physiological reactance to a mental stressor, psychological strains experienced at work, physical symptoms associated with work, and urinary catecholamine production at work. A continuous Type A SI scale demonstrated better convergent and construct validity than did the SI category scores. All of the SI Type A scales were reliable. Among the questionnaire measures only the Thurstone Activity Scale was reliable and showed the strongest construct validity. The SI measures of Type A tended to correlate with physiological responsiveness (changes in heart rate, skin temperature, and skin conductance), while the questionnaire measures correlated with self-reports of job strains (satisfaction, irritation, depression, physical symptoms), thus indicating the operation of measurement artifacts in validity assessment. No significant correlations were obtained between Type A and catecholamines. Comparison of correlation analysis with subgroup analysis revealed the former to be a more powerful test of the relationships that may exist between Type A behavior pattern and relevant criteria.

Adult↗

PubMed2000

Factor analysis of the Neuropsychological Screening Battery for Hispanics (NeSBHIS).

The Neuropsychological Screening Battery for Hispanics (NeSBHIS; Pontón et al., 1996) was developed to provide clinicians and researchers with appropriate tests and norms to assess the Latino population. However, the construct validity of the NeSBHIS is unclear, and its clinical utility is untested. This study provides data on the construct validity of this battery via factor analytic methodology. Five factors were identified: (a) a language factor, which included the Controlled Oral Word Association Test, the Pontón-Satz Boston Naming Test, and the Escala de Inteligencia Wechsler para Adultos (EIWA; Wechsler, Green, & Martinez, 1968) Digit Span; (b) a verbal learning factor, which included all the World Health Organization--University of California, Los Angeles Auditory Verbal Learning Test scores (Trials V, VII, and VIII); (c) an attentional-mental control factor, which included the EIWA Digit Symbol, Color Trails 1 and 2, and the EIWA Block Design; (d) a visuospatial factor, made up of the Rey-Osterrieth Complex Figure Test Copy and Memory and the Raven's Standard Progressive Matrices total score; and (e) a psychomotor factor, the Pin Test. This was a stable factor structure, suggesting that the NeSBHIS has a robust construct validity.

Adolescent↗

PubMed1999

Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group.

OBJECTIVES: To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions. To validate the measure in various specialist and non-specialist palliative care settings throughout the UK. DESIGN: A systematic literature review of measures appropriate for use in palliative care settings was conducted. In conjunction with a multidisciplinary project advisory group, questions were chosen for inclusion into the scale based on whether they measured aspects of physical, psychological, or spiritual domains pertinent to palliative care, and whether similar items had shown to be valid as part of another measure. A staff completed version was developed to facilitate data collection on all patients throughout their care, and a patient completed version was designed to enable the patient to contribute to the assessment of their outcomes when possible. A full validation study was conducted to evaluate construct validity, internal consistency, responsiveness to change over time, and test-retest reliability. Assessments were timed. SETTING: Eight centres in England and Scotland providing palliative care, including inpatient care, outpatient care, day care, home care, and primary care. PATIENTS: A total of 450 patients entered care during the study period. Staff collected data routinely on patients in care long enough to be assessed (n = 337). Of these, 262 were eligible for patient participation; 148 (33%) went on to complete a questionnaire. MAIN MEASURES: The Palliative Care Outcome Scale (POS), the European Organisation for Research on Cancer Treatment, and the Support Team Assessment Schedule. RESULTS: The POS consists of two almost identical measures, one of which is completed by staff, the other by patients. Agreement between staff and patient ratings was found to be acceptable for eight out of 10 items at the first assessment. The measure demonstrated construct validity (Spearman rho = 0.43 to 0.80). Test/re-test reliability was acceptable for seven items. Internal consistency was good (Cronbach's alpha = 0.65 (patients), 0.70 (staff)). Change over time was shown, but did not reach statistical significance. The questionnaire did not take more than 10 minutes to complete by staff or patients. CONCLUSION: The POS has acceptable validity and reliability. It can be used to assess prospectively palliative care for patients with advanced cancer.

England↗

PubMed2002

Development of a new seizure severity questionnaire: initial reliability and validity testing.

PURPOSE: This report describes the initial steps for development of a new scale to assess seizure severity as a treatment response. METHODS: Standard methodology was used to develop the test instrument. Item generation was performed by selecting items from other questionnaires, and asking patients and epileptologists about seizure components. Face and content validity were assessed in a pilot study with patients and observers. The questionnaire was formatted as a structured interview for a reliability study. Construct validity was assessed with three existing questionnaires. Inter-rater reliability and test-retest reliability were performed as two independent ratings on one day, and one re-interview. RESULTS: Based on item generation and pilot testing (33 patients, 28 observers), the Seizure Severity Questionnaire (SSQ) was organized into warning, activity-movement, and recovery (cognitive, emotional, and physical aspects) stages of seizures. Questions reviewed duration, severity, bothersomeness and overall ratings, and the most bothersome aspect of seizures. The mean SSQ Summary Score was 5.78+/-3.24, inter-rater reliability was 0.76 (N=91), and test-retest reliability was 0.74 (N=63). Construct validity showed statistically significant correlations with other scales. CONCLUSION: This study has explored the psychometric properties of the SSQ for face and content validity, inter-rater and test-retest reliability, and construct validity. The Summary Score reliably represents the major components of seizures.

Adult↗

PubMed1999

Validation of the premature infant pain profile in the clinical setting.

OBJECTIVE: The Premature Infant Pain Profile (PIPP) is a 7-indicator composite measure developed to assess acute pain in preterm and term neonates. It has been validated in studies using synchronized videotaping of infants undergoing procedures. The purpose of this study was to establish (a) construct validity of the PIPP and (b) inter- and intrarater reliability of the PIPP prospectively in the clinical environment. DESIGN: A randomized, crossover design was used. SETTING: The study was conducted in a Level III outborn neonatal intensive care unit. PARTICIPANTS: A convenience sample of 43 neonates, stratified by gestational age, was studied. INTERVENTIONS: Each infant experienced three separate, randomly ordered events: baseline, a painful event, and a nonpain event. Infants were videotaped and scored at the bedside using the PIPP by the nurse caring for the infant and the clinical nurse specialist who bad expertise in infant pain. The videotapes were later reviewed by two additional experts; one in real time and one using a second-to-second stop frame technique. RESULTS: Repeated-measures analysis of the main effects and interactions yielded a statistically significant main effect for event (pain, nonpain, baseline), thus differentiating pain from nonpain and baseline events (F = 48, p = 0.0001) and establishing construct validity. Interrater reliability analysis of individual event scores of the PIPP yielded reliability coefficients of 0.93-0.96. Intrarater reliability coefficients analysis for individual events were equally high at 0.94-0.98. CONCLUSIONS: This study demonstrates that the PIPP is a pain measure with good construct validity and excellent inter- and intrarater reliability for the assessment of procedural pain of preterm and term infants in clinical settings.

Cross-Over Studies↗

PubMedDate not supplied

[Construction and validation of a severity of illness index of patients hospitalized in clinical areas].

Severity of illness indexes for hospitalized patients are frequently used for the assessment of hospital performance. The purpose here was to develop and validate a quantitative index for clinical areas which could measure severity of illness during hospitalization period and would be easy to obtain from the information contained in a regular clinical chart. The construction included item selection and search for items weights. Experts and literature were consulted and 74 clinical records provided empirical information. The result was the proposal of an index with two alternatives: one quantitative and the other ordinal with four levels of severity. Validation included four aspects of validity, general reliability, interrater agreement and internal consistency. Sixteen specialized physicians assessed content and face validity. One hundred clinical records of discharged patients were used to assess criterion, construct validity and reliability. Results show satisfactory validity in almost all aspects. The reliability coefficient was 0.95, Kappa coefficient was 0.4 for the ordinal index and correlation coefficients over 0.93 for the quantitative one. The index is ready for current applications in this context although some suggestions for future improvements were also included.

Adolescent↗

PubMed2005

Development and validation of an objective instrument to measure surgical performance at tonsillectomy.

OBJECTIVES: The goals of this project were 1) to develop and validate an objective instrument to measure surgical performance at tonsillectomy, 2) to assess its interobserver and interobservation reliability and construct validity, and 3) to select those items with best reliability and most independent information to design a simplified form suitable for routine use in otolaryngology surgical evaluation. DESIGN: Prospective, observational data collection for an educational quality improvement project. METHODS: The evaluation instrument was based on previous instruments developed in general surgery with input from attending otolaryngologic surgeons and experts in medical education. It was pilot tested and subjected to iterative improvements. After the instrument was finalized, a total of 55 tonsillectomies were observed and scored during academic year 2002 to 2003: 45 cases by residents at different points during their rotation, 5 by fellows, and 5 by faculty. Results were assessed for interobserver reliability, interobservation reliability, and construct validity. Factor analysis was used to identify items with independent information. RESULTS: Interobserver and interobservation reliability was high. On technical items, faculty substantially outperformed fellows, who in turn outperformed residents (P < .0001 for both comparisons). On the "global" scale (overall assessment), residents improved an average of 1 full point (on a 5 point scale) during a 3 month rotation (P = .01). In the subscale of "patient care," results were less clear cut: fellows outperformed residents, who in turn outperformed faculty, but only the fellows to faculty comparison was statistically significant (P = .04), and residents did not clearly improve over time (P = .36). Factor analysis demonstrated that technical items and patient care items factor separately and thus represent separate skill domains in surgery. CONCLUSIONS: It is possible to objectively measure surgical skill at tonsillectomy with high reliability and good construct validity. Factor analysis demonstrated that patient care is a distinct domain in surgical skill. Although the interobserver reliability for some patient care items reached statistical significance, it was not high enough for "high stakes testing" purposes. Using reliability and factor analysis results, we propose a simplified instrument for use in evaluating trainees in otolaryngologic surgery.

Clinical Competence↗

PubMed1996

Constructing and Validating Motive Bridging Inferences

Understanding Jane left early for the birthday party, She spent an hour shopping at the mall requires detecting that the first statement motivates the second. The validation model states that before accepting this bridging inference, the reader validates it with reference to relevant knowledge. In particular, a mediating idea is first derived from the text outcome and its candidate motive. If the mediating idea is supported by general knowledge, then the inference has been validated. In tests of this anaylsis, experimental subjects read motive or control sequences and then answered questions probing the knowledge hypothesized to validate the motive inferences, such as Do birthday parties involve presents? Five experiments confirmed that understanding motive sequences facilitates validating knowledge. A control procedure also refuted a priming counterexplanation of these effects (Experiment 1). Validation processing obtained for motive-outcome statements separated by two to four sentences in coherent sequences (Experiments 2 to 4). Inferred and explicit validating knowledge had a similar representational status (Experiment 3). Whereas proofreading abolished the validation effect, a reading strategy promoting causal processing did not enhance it (Experiment 4). A delayed priming procedure indicated that validating knowledge is integrated with the text representation (Experiment 5). The implications of these findings for the constructionist and minimal inference analyses were explored. The validation effects were simulated using construction-integration model.

Journal Article↗

PubMed1996

Measurement of pain: the psychometric properties of the Pain-O-Meter, a simple, inexpensive pain assessment tool that could change health care practices.

A self-administered pain assessment tool called the Pain-O-Meter (POM) was developed for the purposes of improving assessment and management of pain in acute and chronic pain patients. The POM is a hard, white, plastic tool that measures 8-in. long by 2-in. wide and 1-in. thick. Two methods for assessing pain are located on the POM. The first is a 10-cm visual analogue scale (POM-VAS) with a moveable marker that patients use to rate their pain. The second is a list of 15 sensory and 11 affective word descriptors (WDS). Each WDS is assigned an intensity value that can be as low as 1 or as high as 5. A pain intensity score is provided for the sensory and the affective WDSs. This psychometric study, which employed correlational and comparative designs, investigated the test-retest reliability and the concurrent and construct validity of the POM-VAS and the POM-WDS in 279 patients with acute or chronic pain. High correlations were found between initial and repeat pain intensity ratings on the POM-VAS (r = 0.88, P < 0.001) and POM-WDS (r + 0.84, P < 0.001) (test-retest reliability). Correlations between the POM-WDS and the McGill Pain Questionnaire (MPQ) (r = 0.69, P < 0.001) and POM-VAS (r = 0.85, P < 0.001) supported the concurrent validity of the POM-WDS. Construct validity was also supported for the Pain-O-Meter by showing that pain scores decreased significantly for POM-WDS (t + 5.53, P < 0.001), and POM-VAS (t = 6.18, P < 0.001) after the patients were treated with pain medication. The use of a pain tool, such as the POM, could improve patient care by facilitating the documentation of pain and evaluation of pain relief measures.

Cost Control↗

PubMed1999

Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?

The main goal of current pain management approaches is to increase the patients' quality of life by improving pain coping skills and by reducing the levels of disability in daily life, often despite persistent pain. Direct measurement of quality of life is of crucial importance in economic evaluation research, in which not only is the estimation of financial costs and benefits included, but so is the evaluation of costs and benefits in terms of changes in health states. The purpose of this study is to compare the psychometric qualities of two instruments for assessing patients' utilities, the rating scale (RS) and the standard gamble (SG). Such instruments are designed for their application in economic evaluation research, but have seldomly been used in chronic pain trials. Both methods provide a single measure between 0 and 1. The relationship between these utility measures and descriptive and domain-specific quality of life measures was examined in 133 fibromyalgia patients and 148 patients with chronic non-specific low back pain. Mean utility score at baseline was 0.43 with the RS and 0.78 for the SG. The correlation between both methods was found to be poor (r = 0.21). Both measures appeared to be fairly stable in a 2-week test-retest period (intra class correlation coefficient (ICC) = 0.74 and 0.77). Scores on the description of patient's own health on six domains, global assessment of change and domain specific measures correlated moderately with the RS scores and low with the SG. Multiple regression analyses demonstrated that 32% of the variance in RS values and only 13% of the variance in SG utilities could be explained by domain-specific measures. These results suggest an acceptable construct validity for the RS but insufficient construct validity for the SG. Valuations of ones own health appear only partially to be related to the assessment of the pain-specific measures and measures of distress. It can be concluded that the RS and domain-specific measures assess partly different, but nevertheless complementary aspects of health-related quality of life. It is therefore recommended to include in economic evaluation studies both domain-specific measures and valuation measures. Finally, in chronic musculoskeletal pain patients, RS scores were found to be more responsive in detecting significant changes in preferences than SG scores. For use in patients with chronic musculoskeletal pain, the RS is preferred to the SG for establishing accurate decisions about the impact of new interventions on their health outcomes.

Activities of Daily Living↗

PubMedDate not supplied

Short form of the Dizziness Handicap Inventory: construction and validation through Rasch analysis.

A new item response scale is presented, which measures the severity of self-reported balance deficits. The scale, DHIsf, is a short form of the Dizziness Handicap Inventory. The scale was constructed and validated by Rasch analysis. Rasch analysis was applied to rescore or remove any items misfitting, redundant, or off-target, until an optimal instrument was obtained. The 25-item, 3-level Dizziness Handicap Inventory was, thus, reduced to the 13-item, 2-level DHIsf. The retained items explore the domains of eye/head movements, full body activities, and mood alterations. Data were collected from 55 outpatients (63 +/- 13 yr; 43 females) attending otoneurological rehabilitation referral at a general hospital because of complaints of dizziness or imbalance. They were fully independent in ambulation and showed no evidence of major neurological or orthopedic diseases. Objective tests included brain computed tomography, sovraaorctic Doppler sonography, craniocorpography, static posturography, and nystagmography. The findings were categorized as pathologic, borderline, or normal. At least one examination was borderline or abnormal in 42 patients. The DHIsf was well targeted on this sample, with a mean score of 5.7/13 (standard deviation, 2.8; median, 5; range, 1-13). The Rasch statistics showed that the 13 items evenly fitted a hierarchy of difficulty within a homogeneous construct. A moderate but significant variance explanation of DHIsf measures was provided by a two-way analysis of variance model, with craniocorpography and nystagmography as independent categorical variables (r2 = 0.15; P = 0.018). When the clinical tests were individually taken into account, their outcome (dichotomized as abnormal v borderline or normal) could not be predicted by either of the DHIsf measures or raw scores (logistic regression). The DHIsf compares favorably with the original Dizziness Handicap Inventory, shows some consistency with the instrumental findings, and provides original information on the severity of imbalance syndromes, as it is seen from the patient's perspective.

Activities of Daily Living↗

PubMed2005

Oral health-related quality of life for 8-10-year-old children: an assessment of a new measure.

OBJECTIVES: The aim of the study was to assess the reliability and construct validity of the Child Oral Health-Related Quality of Life for 8-10-year-olds (COHRQoL [8-10]) using confirmatory factor analysis (CFA) and to test the measurement properties of latent variables believed to define the multidimensional construct of OHRQoL. METHODS: A convenience sample of 270, year 4 children from six schools was obtained. The administered questionnaire included the 25-item COHRQoL [8-10] and the Coopersmith Self-Esteem Inventory-School Form. The analytical method was based upon CFA using maximum likelihood estimation. A second-order factoring approach was applied to determine the extent that the latent variables tapped a single over-arching domain of quality of life. RESULTS: Seven items were withdrawn for low endorsement and poor association with resultant factors. The COHRQoL [8-10] was confirmed to measure a single construct of three latent variables invariant to gender. Internal consistency of the three scales derived comprising a total of 18 retained items was acceptable. Associations with self-esteem and with a single question on the extent that the mouth was a problem were confirmed and strengthened the construct validity of the COHRQoL [8-10] measure. CONCLUSIONS: Reliability and construct validity were demonstrated for COHRQoL [8-10] and supported the scale for adoption as an epidemiological and scientific tool for group comparisons. CFA showed that the three constructs or latent variables underlying the overall COHRQoL ratings were discrete measures that can be reliably assessed in children. Further model testing with additional data will increase generalization of these findings.

Age Factors↗