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PubMed1980

Measuring identification with the mothering role.

Three summated rating scales entitled Feelings of Motherliness (FOM), Conception of the Fetus as a Person (CFP), and Appropriateness of Fantasies about the Baby-to be (AFB) were constructed. During instrument development, data were collected from a sample of 169 women selected using the criteria of gravidity, ethnicity, and experience. Thirty-four of these women were used to test the final versions of the scales. Coefficient alphas for FOM, CFP, and AFB were.87, .89, and .67, respectively. Coefficient alphas for the subscales ranged from .88 to 1.0. Content validity was built into the scales. The data supported the concept validity of FOM and CFP, but not AFB. Three subscales of the Parental Attitude Research Instrument were used as criterion measures; criterion validity was not established. Construct validity was assessed using convergent and discriminant measures. Data provided support for convergent validity, but not for discriminant validity. Further modification and testing of the scales are needed.

Adolescent↗

PubMed1986

Development of a patient satisfaction scale.

Three studies to develop and test an instrument to measure hospitalized patients' satisfaction with nursing care are reported. Content validation procedures involved both clinicians and patients (N = 75). An inverse relationship of satisfaction scores to negative mood states demonstrated evidence of construct validity. Factor analytic procedures (N = 664) failed to confirm the existence of the subscales initially conceptualized for this instrument and others in common use. Three new factors were identified: dissatisfaction, interpersonal support, and good impression. The dissatisfaction subscale explained 73.6% of the variance and had a high internal consistency (alpha = .91); the reliability coefficients of the other subscales also were high (alpha = .92 and .89). Reliability coefficients for the total instrument in successive testings were .92 (N = 100) and .95 (N = 533).

Adolescent↗

PubMed1991

Development of a health habits scale.

The present study is based on the assumption that health habits assessment can make a significant contribution to our understanding of physical and psychological well-being. Thus, the purpose of this study was to develop an easily administered, conceptually sound, and psychometrically adequate health habits scale for use in nursing and health research. A self-report scale consisting of 5 positive health items and 5 negative items was administered initially to a sample of more than 1500 American adults. Subsamples of this group were used in various psychometric evaluations of the scale. A second sample of more than 700 college and noncollege adults also completed the new health habits scale and a number of additional inventories thought to be related conceptually to the new scale. In general, the health scale showed high content validity, good agreement between self- and other-ratings, strong test-retest reliability, and consistent evidence of concurrent and divergent validity. The strengths of the scale are its inclusion of both disease-preventive and health-promoting behaviors, its brevity, and its psychometric development.

Adolescent↗

PubMed1992

A community-based Inventory of Current Concerns of impoverished homeless and drug-addicted minority women.

The purpose of this series of studies was to refine and evaluate the psychometric properties of a measure of the concerns of impoverished minority women who were homeless and/or drug addicted. A comprehensive review of the literature and qualitative focus groups conducted with homeless and drug-addicted minority women were used to refine the inventory of Current Concerns (ICC) (Weisman, Worden, & Sobel, 1980). A 31-item revised Community-Based Inventory of Current Concerns (CICC) was critiqued by measurements and content experts, and content validity was established. The CICC was administered to 978 black and Hispanic women who were residents of drug recovery programs or were homeless and residing in shelters, single room occupancy hotels, or with family or friends. Principal components factor analysis with varimax rotation resulted in a five-factor solution explaining 53% of the variance. These factors were labeled Competency, Personal Instability/Despondency, Survival, Drug-Related, and Parenting Concerns. Alpha reliability coefficient was .90 for the total scale and .79 to .93 for the subscales. Construct validity was demonstrated by moderate correlations (r = .54) between the total CICC and the CES-D. The revised CICC can be used for clinical and research purposes to aid in assessing the concerns of minority impoverished women.

Adolescent↗

PubMed1992

Psychometric examination of instruments using aggregated data.

The techniques used to examine the psychometric properties of instruments that measure concepts where individual responses are aggregated to form an index describing a group level phenomenon are reviewed. This examination includes assessing the content validity of items to determine how well they measure group level concepts as well as analyzing reliability and validity at the aggregated rather than individual level. Additional techniques to test for within and between group variability are presented. The latter approaches are useful in determining the consistency and adequacy of individual responses at the group level.

Group Processes↗

PubMed1992

Assessment of discomfort in advanced Alzheimer patients.

An objective scale for measuring discomfort in noncommunicative patients with advanced Alzheimer's disease was empirically generated from the perspectives of nursing staff practicing on special care Alzheimer units and was judged to have content validity. On the basis of a pilot test, the discomfort scale was reduced to nine items. Quantifiable scoring procedures and a rater training program were developed. The scale (DS-DAT) was tested longitudinally for 6 months with 82 subjects at two sites. Psychometric properties, measurement issues, and recommendations for use in practice and research are discussed.

Alzheimer Disease↗

PubMed1993

Everyday indicators of impaired cognition: development of a new screening scale.

Development of the Everyday Indicators of Impaired Cognition (EIIC) Scale to assess nursing home residents for performance errors in four domains of cognitive functioning is reported. The EIIC had strong content validity, with indices ranging from .7 to 1.0. Factor analyses of data from two independent samples (N = 198, N = 107) confirmed four factors: abstract thinking, judgement, language, and spatial skills. Cronbach's alpha for subscales ranged from .67 to .92; test-retest reliabilities ranged from .49 to .80 with higher reliabilities occurring when time of retest matched time of original testing. Overall EIIC scores correlated to the short Memory-Orientation-Concentration (MOC) test and the Mini-Mental Status Examination (MMSE) at values supporting convergent validity (r = .67 and -.74, respectively). Evidence for divergent validity is a small, negative, nonsignificant correlations (r = -.15, -.18) of the EIIC at Times 1 and 2 to the Bradburn Affect Balance Scale.

Aged↗

PubMed1993

Nursing intervention studies require outcome measures that are sensitive to change: Part Two.

Ohis article is the second and concluding part of a discussion of the importance of sensitivity to change in selecting an outcome measure for a study evaluating a nursing intervention. In Part One of the discussion, (Stewart & Archbold, 1992) the relative lack of attention to measurement sensitivity in the nursing and measurement literature was described. Three factors to consider in selecting an outcome measure for an intervention study were reviewed: the conceptual link between the intervention and the outcome variable, the extent to which the outcome variable is amenable to change, and content validity. In Part Two, four additional factors are discussed: construct validity, distribution of scores on the outcome measure, reliability, and correlational stability over time.

Humans↗

PubMed1994

Psychometric properties of two instruments to measure quality decision making.

The results of testing two instruments for consequential decision making are reported: a screening instrument, the Decision Making Quality Scale (DMQS), which assesses the degree to which a person adheres to seven quality criteria of decision making; and a diagnostic measure, the Decision Making Quality Inventory (DMQI), which assesses an individual's dominant decision-making style through six sequential stages of the process. The instruments are conceptually linked through the same theoretical framework, the Janis and Mann (1977) conflict model of decision making, as well as operationally linked as counterpart instruments. Feasibility of the instruments was demonstrated with low readability indexes, reasonable administration times, and respondent acceptability by six samples (N = 766). Content validity was supported by panels of experts in decision theory. Reliability coefficients were consistently high ( > .70) for all samples. Support for construct validity was obtained using the contrasted groups approach and relationship testing. The instruments are ready for research and clinical use with healthy adolescents and their parents, as well as with adolescents and young adults who have experienced a chronic illness such as cancer and with their parents.

Adolescent↗

PubMed1995

Data aggregation: criteria for psychometric evaluation.

Criteria for the examination of data collected at the individual level and aggregated to the group are proposed. These four empirical criteria relate to content validity, representativeness, reliability, and validity of the aggregated scores as indicators of group phenomena. An example of the use of the criteria is provided using data from a large research project on the implementation of a professional practice model on nine nursing units. The use of the criteria proposed provide a systematic approach to the evaluation of individual data for use at the group level.

Data Collection↗

PubMed1999

A physiotherapy test package for assessing back and neck dysfunction--discriminative ability for patients versus healthy control subjects.

BACKGROUND AND PURPOSE: A physiotherapy test package of 10 tests designed for assessing dysfunction due to back or neck pain was tested for its ability to discriminate between back- or neck-pain sufferers and healthy control subjects. Twenty-seven patients and 26 healthy control subjects participated in the study. METHOD: Fifteen patients suffering from back or neck pain and 15 matched healthy control subjects were assessed using the package to compare the results between the groups. The results from a further 12 back- or neck-pain sufferers and 11 unmatched healthy control subjects were analysed with respect to sensitivity and specificity, cluster formation and correlation with ratings of pain and perceived exertion. RESULTS: The differences in the test results for the patients and the matched healthy control subjects were highly significant in all variables but one. High sensitivity for cut-off points of clinical relevance was found in all variables but one, whereas specificity was moderate in most variables. CONCLUSIONS: Despite the small sample size, the significant differences between patients and healthy control subjects, with the sensitivity and specificity figures, suggest that the content validity of the test package is satisfactory.

Adult↗

PubMed1995

Measuring health-related quality of life in persons with genital herpes.

A disease-specific measure was needed for use in an international clinical trial to evaluate an investigational drug for genital herpes. A new measure was developed initially in the UK and translated and adapted for use in France, Italy, Germany, Denmark, Spain and the USA. This paper describes the translation and adaptation of the USA measure. It also describes the assessment of internal consistency, reproducibility, content validity, and construct validity (convergent and discriminant) of the measure. Two outcome measures of the final genital herpes-specific measure were developed: (1) a 21-item symptoms subscale; and (2) a 20-item HRQOL subscale. Each measure was scored and analyzed separately; the psychometric testing discussed in this paper refers to the HRQOL subscale only. The internal consistency of the HRQOL subscale is high (r = 0.93), as is the reproducibility measured with a two week interval (r = 0.85). Convergent validity is moderate to high. (Fleming Self-Regard subscale, r = 0.48; SF-36 Social Functioning dimension r = 0.59; SF-36 Mental Health dimension r = 0.50). The number of herpes outbreaks in the past year was a significant predictor of scores on the HRQOL subscale (0-1 outbreaks, mean = 82.1; 2+ outbreaks, mean = 72.1, p = 0.058) suggesting discriminant validity. The measure is currently in a phase III clinical trial including anti-viral therapy where the question of responsiveness can be addressed.

Adult↗

PubMed1990

Effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women.

The purpose of this study was to test the effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women. A pretest-posttest nonequivalent control group design was used with a 2-3 month retest of the experimental group. The sample consisted of 506 experimental and 206 control group women who were clients of the Public Health Foundation's Nutrition Program for Women, Infants and Children in Los Angeles County. The program included a slide-tape presentation, and educational and resource brochures in English and Spanish. Knowledge, attitudes, and sexual and drug use practices were measured using a structured questionnaire that was developed in English and Spanish. Content validity and reliability of the questionnaire were established. A 2-way repeated measures ANOVA examined differences in pretest-posttest knowledge, attitudes, and practices for experimental and control groups and for both racial/ethnic groups. The experimental group made significant gains over the control group on pretest-posttest measures of knowledge and attitudes. Both experimental and control groups made significant changes in practice. Changes in knowledge were retained on retest; changes in practices came close to significance on retest. Blacks and Latinas differed on pretest knowledge and attitudes but not practices. Blacks had more knowledge and positive attitudes on pretest. However, posttest improvements for both knowledge and attitudes were greater in Latinas than in blacks. A multiple regression analysis revealed that the best predictors of knowledge, attitudes and practices were racial/ethnic group, education, and religion. It is concluded that a didactic audio visual program can positively affect the knowledge and possibly the practices of participants and that these are retained over time but that changes in attitudes will take further efforts.

Acquired Immunodeficiency Syndrome↗

PubMed1994

The Children's Headache Assessment Scale (CHAS): factor structure and psychometric properties.

This study investigated the content validity, factor structure, and psychometric properties of the Children's Headache Assessment Scale (CHAS), a parent rating scale for identifying environmental variables associated with pediatric headache. In Study 1, input from physicians and psychologists was obtained to develop a revised set of 44 items receiving high endorsement. In Study 2, the questionnaire was administered to parents of 92 child headache sufferers, ages 6-16, and readministered 2 weeks later. An exploratory factor analysis revealed five factors (Disruptive Impact, Social Consequences, Stress Antecedents, Physical Antecedents and Quiet Coping, and Prescription Medication Use) that reflect distinct environmental concomitants of childhood headache. Scale reliabilities (alpha, .64-.82) indicate acceptable internal consistency, and test-retest reliabilities indicate relatively stable factors and items. High scores on the Disruptive Impact factor were associated with more severe, lengthy, and infrequent headache occurrence, lending initial support for the validity of this factor. Overall, the findings support the clinical and research utility of the CHAS in behavioral treatment of childhood headache.

Adolescent↗

PubMed1993

The ethics objective structured clinical examination.

OBJECTIVE: To develop objective structured clinical examination (OSCE) stations to assess the ability of physicians to address selected clinical-ethical situations, and to evaluate inter-rater agreement in these stations. DESIGN: Two ten-minute OSCE stations were developed using video-taped encounters between attending physicians and standardized patients. One scenario involved a daughter requesting a do-not-resuscitate (DNR) order for her competent mother without the mother's knowledge; the other involved a competent elderly woman requesting not to be re-intubated if her congestive heart failure worsened. The scenarios were evaluated using foreign medical graduates taking an OSCE. Each candidate was scored on his or her interaction with a standardized patient in the two OSCE stations by two independent observers. PARTICIPANTS: Eight attending physicians from the Division of General Internal Medicine at the Toronto Hospital were used to develop the OSCE stations, and 69 foreign medical graduates taking the University of Toronto Pre-Internship Program OSCE were used to evaluate the stations. RESULTS: The inter-rater reliability coefficients for the DNR and intubation scenarios were 0.79 (95% CI 0.69-0.87) and 0.75 (95% CI 0.62-0.84), respectively. For the DNR station, the scores of the two examiners, on a scale of 0 to 10, agreed exactly for 34 candidates (50%), within one mark for 59 candidates (87%), and within two marks for 65 candidates (96%). For the intubation station, the scores of the two examiners agreed exactly for 27 candidates (40%), within one mark for 56 candidates (84%), and within two marks for 63 candidates (94%). CONCLUSIONS: The authors produced ethics OSCE stations with face and content validity and satisfactory inter-rater agreement. Ethics OSCE stations may be suitable for evaluating the ability of medical students and residents to address selected clinical-ethical situations.

Analysis of Variance↗

PubMed2006

Brief survey: determining brain death in Canadian intensive care units.

PURPOSE: Criteria for brain death were first described in 1968, and Canadian guidelines were published in 1988. However, international inconsistency persists in the process of determining brain death. We sought to determine self-reported practices and processes in the determination of brain death amongst Canadian intensive care unit (ICU) physicians. METHODS: An email survey of members of the Canadian Critical Care Society was undertaken. A survey instrument was developed, then face and content validated prior to distribution. RESULTS: Eighty eight responded (response rate = 49%), including adult and pediatric ICU physicians working in both tertiary referral (academic) and community hospitals. Most respondents admit patients with brain death to their ICUs. However, 9% reported refusing to admit this type of patient for reasons including inappropriate utilization of ICU resources (36%), and lack of either space or staff (32% and 29% of respondents, respectively). Community hospital-based ICU physicians were less likely to report a hospital policy on the determination of brain death (46% vs 78% of physicians in tertiary care hospitals). Nearly all physicians (96%) reported that a revised national standard and checklist for the determination of death would be useful. CONCLUSIONS: Nearly one quarter, and over one half of tertiary care and community hospitals (respectively) in Canada lack an institutional policy on neurological determination of brain death. Canadian ICU physicians are interested in a national standard for the determination of death, and establishment of processes that may improve the clinical determination of death by neurological criteria.

Brain Death↗

PubMedDate not supplied

A comparison of outcome scores in os calcis fractures.

BACKGROUND: Of over 20 different scoring systems to evaluate outcome following calcaneal fracture, the Maryland Foot Score has broad current acceptance. A general health survey, the Short Form 36 (SF 36) has also been used. AIMS: The study compared two scoring systems for assessing the outcome of open reduction and internal fixation of displaced intra-articular calcaneal fractures. METHODS: Over a four-year period, 31 displaced intra-articular calcaneal fractures were categorised by the Sanders classification and treated by open reduction and internal fixation. Outcome was assessed by the Maryland Foot Score and by the Short Form 36 (SF 36) general health questionnaire. RESULTS: Thirty-five per cent of fractures were Sanders class 2, 57% were class 3 and 8% were class 4. The average follow-up was 2.5 years (range 1-4 years). Using the Maryland Foot Score, seven fractures had an excellent result, 13 had a good result, six had a fair result and one was a failure. There was a correlation between pain (coefficient = 0.780, p < 0.001) and physical function (coefficient = 0.638, p < 0.001) with the appropriate sections of the SF 36. CONCLUSION: The Maryland Foot Score measures what it attempts to measure and therefore it has content validity for pain and physical function.

Adult↗

PubMed1999

[A scale for measuring symptoms related to degenerative diseases of the cervical spine. A reference in determining indications and evaluating surgical outcome].

A scale for measuring symptoms related to degenerative diseases of the cervical spine is presented. Twenty typical symptoms are listed, e. g., neck pain, dysesthesia, and reduced mobility. Responses are assessed via a 6-point scaling ("did not have symptom" - "had symptom and suffered very strongly".) The cervical spine scale was tested in three samples: patients having undergone cervical spine surgery (n = 70), patients with other orthopedic diagnoses (n = 104), and healthy students (n = 100). The single items of the scale were aggregated into four scores: total number of symptoms, degree of overall symptom distress, functional disability, and pain/psychological distress. Statistical analyses proved the high reliability (Cronbach's alpha = 0.85 to 0.95) and validity (content, convergent, discriminant) of all scores. The scale differs clearly between cervical spine patients, other orthopedic patients and healthy individuals, and between cervical spine patients with different subjective operative outcomes. For applied clinical purposes the cervical spine scale can be included in a quality of life profile (QL-profile); this allows for a readily understandable graphic depiction of individual patients' QL-status.

Activities of Daily Living↗