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PubMed2006

Utility and validity of the self-administered SF-36: findings from an older population.

INTRODUCTION: The objectives of this study were to assess the utility and validity of the self-administered SF-36 and the effect of visual or cognitive impairment on these measures in an older population. MATERIALS AND METHODS: Attempt rates, completion rates and internal consistency (Cronbach alpha) were compared within the second cross-sectional, population-based Blue Mountains Eye Study (n = 3509, mean age 66.7 years, 57% women). RESULTS: The SF-36 was attempted by 3162 (90.1%) participants, of which 2470 (78.1%) completed all items and 2873 (90.9%) completed sufficient items for calculation of all dimensions. In a multivariate model adjusting for age, sex, and presenting visual and cognitive impairments, women (P = 0.011) and participants with visual or cognitive impairments (P < 0.0001) were less likely to attempt the questionnaire. Completion rates were significantly lower with increasing age (P < 0.0001), in men (P < or = 0.0005) and in those with cognitive impairment (P < 0.0001). A high level of internal consistency (Cronbach alpha > 0.85 for all dimensions) and construct validity was demonstrated, the latter distinguishing between those with and without medical conditions, disabilities or recent hospital admissions (P < 0.01). As the prevalence of visual or cognitive impairment was relatively low in this population, we found no apparent effect of these impairments on the validity of SF-36. CONCLUSIONS: Attempt and completion rates, but not internal consistency and construct validity, of the SF-36 were influenced by age, gender, and presenting visual and cognitive impairments. The overall high attempt and completion rates, internal consistency and construct validity suggest that the self-administered SF-36 is a suitable healthrelated quality of life (HRQOL) measure in similar older community-living populations.

Aged↗

PubMed2002

Assessing the reliability and validity of the Chinese version of the California Critical Thinking Disposition Inventory.

The purpose of this study was to: (1) translate the California Critical Thinking Disposition Inventory (CCTDI) from English to Chinese; (2) ascertain the reliability and validity of Chinese CCTDI; and (3) assess the psychometric equivalencies across Chinese and English versions of the CCTDI. The CCTDI was designed to measure critical thinking dispositions of truth-seeking, open-mindedness, analyticity, systematicity, inquisitiveness, self-confidence and maturity, which has been approved with a significant difference from prior conceptualizations of critical thinking dispositions. It is the only measurement that has been validated to measure critical thinking disposition and is appropriate for use in nursing. Based on translation theory, the comparative study goal precisely matched with the strategy of decentered translation. The CCTDI was translated in multiple stages and back translated by a panel of bilingual experts. Content validity index (CVI) ranged from 0.50 to 0.80, with an overall CVI of 0.85. Pearson r ranged from 0.33 to 0.79, with an overall correlation of 0.79, indicating that evidence for stability in truth-seeking, open-mindedness and self-confidence existed. To ascertain internal consistency reliability and construct validity, monolingual samples were obtained from 214 and 196 undergraduate nursing students from Taiwan and the USA, respectively. For the Chinese CCTDI, subscale alphas ranged from 0.34 to 0.73, with an overall alpha of 0.71. For the English CCTDI, subscale alphas ranging from 0.52 to 0.73 and an overall alpha of 0.71 were obtained. In terms of a confirmatory factor analysis with LInear Structural RELationships (LISREL), the results indicate that evidence for construct validity existed for truth-seeking, open-mindedness, systematicity, and maturity for the Chinese CCTDI. After allowing some error to exist and deleting three items, evidence for construct validity existed for the remaining subscales. The results of the psychometric equivalencies across Chinese and English CCTDI showed similarity for content validity and reliability for inquisitiveness. In terms of multisample analysis, there were equal forms across all subscales of the two versions. Consequently, although the translation adequacy of the Chinese CCTDI needs to be improved, there is evidence that it is useful for evaluating critical thinking dispositions.

California↗

PubMed1997

The construction and validation of a high containment nose-only rodent inhalation facility.

A new nose-only inhalation facility for rodents has been designed and built for operation within a high containment glove box facility. All operations using the equipment, whether concerned with aerosol generation or animal handling and exposure are conducted under high containment with total operator protection. The facility has been used to investigate known carcinogenic fibres such as the amphiboles. It has been designed to be resistant to most chemicals, under the conditions of an experiment, and can be used with radioactive material within the limitations which would be imposed for radiological protection. This paper describes the construction and validation of the equipment using titanium dioxide.

Administration, Inhalation↗

PubMed2005

Beyond return to work: testing a measure of at-work disability in workers with musculoskeletal pain.

BACKGROUND: There are a limited number of validated measures of a patient's perception of the level of difficulty that they are having at their job. The purpose of this study was to evaluate the psychometric properties of the 16-item Work Limitations Questionnaire (WLQ-16). METHODS: A sample of 42 workers reporting to a workplace occupational health unit with upper limb or low back pain were enrolled in an observational study. Participants were assessed at baseline, 4 and 12 weeks post reporting. Psychometric testing (distributions, Cronbach's alpha, construct validity and responsiveness to change in problem and pain) was done using the baseline and 12-week data. RESULTS: The WLQ-16 had evidence of internal consistency, construct validity and responsiveness. Some ceiling effect was found in the domains of mental-interpersonal and output demands. Physical demands suffered from missing values in 18/42 due to not-applicable content. Construct validity revealed that there was less discrimination at the higher (less limited) end of the scale. Responsiveness was present, though less than found with other measures of function and pain. CONCLUSIONS: The WLQ-16 shows promise as a measure of at-work disability. Further testing to evaluate the ceiling effect and responsiveness to constructs of change more closely related to work disability is recommended.

Adult↗

PubMed1999

The Nottingham Health Profile: score distribution, internal consistency and validity in asthma and COPD patients.

This cross-sectional study among patients with asthma or Chronic Obstructive Pulmonary Disease (COPD) in general practice examined the psychometric properties of the Nottingham Health Profile (NHP). From 380 asthma patients and 170 COPD patients, data were obtained on the NHP, subjective measurements (i.e. sleep disturbances, problems in performing household activities, dyspnoea) and more objective measurements (peak expiratory flow rate, consultation rate, comorbidity). These data were used to compute score distributions, internal consistency (Cronbach's alpha-coefficient) and construct validity. Score distributions were very skewed, with more than 50% of the patients achieving the best score. The internal consistency was moderate in the asthma group (mean alpha = 0.68) and acceptable in the COPD group (mean alpha = 0.74). Acceptable construct validity was found in both groups. Correlations between the NHP and the subjective measurements were, in general, statistically significant and higher than between the NHP and the more objective measurements. In conclusion, acceptable internal consistency and construct validity implies that the NHP can be used in cross-sectional studies concerning asthma and COPD patients in general practice, and in studies comparing these patients with other patient populations. Further research on the responsiveness of the NHP is needed to justify its use in longitudinal studies.

Adult↗

PubMedDate not supplied

Measurement of affectionate behaviors adolescent mothers display toward their infants in neonatal intensive care.

This paper describes two studies that had three purposes: (a) to modify a parent-child interaction tool used previously in a neonatal intensive care unit (NICU); (b) to demonstrate interrater reliability, Chronbach's Alpha reliability, and construct validity of the tool with adolescent mothers, and (c) to determine the ability of nurses engaged in usual work duties to observe maternal behaviors. The first study tested interrater reliability. Two NICU nurses were trained, observed adolescent mothers (n = 20) for the same 15 min, and then separately completed the measure. The second study tested internal consistency reliability and construct validity with 107 adolescent mothers with infants in a NICU. Nurses in the neonatal intensive care unit completed the measure, and data on maternal visits were gathered for construct validity. The intraclass correlation coefficient for the first study was r = .83. Results of the second study demonstrated a Chronbach's Alpha of .85 and a significant correlation between ratings of maternal behavior and visits. The instrument obtained acceptably reliable and valid estimates of adolescent mothers' affectionate behaviors toward their infants. In addition, the studies demonstrated that nurses can observe maternal behaviors while performing their usual duties.

Adolescent↗

PubMed2003

Evaluating health plan quality 3: survey measurement properties.

OBJECTIVE: To assess the measurement and scaling properties of survey items designed to measure health plan quality from a physician's perspective. STUDY DESIGN: Prospective survey design with multivariate regression analysis. METHODS: Data were from 3798 physicians representing 23 health plans in 5 regions: Florida, New York, Colorado, Pennsylvania, and Washington. Scale reliability was assessed by using the Cronbach alpha. Generalist and specialist scales were compared with structural equation modeling. Multivariate analysis was used to examine internal validity by testing theoretically based hypotheses. RESULTS: Scales constructed from the data were reliable, were stable across both generalist and specialist physicians, and demonstrated construct validity. Hypotheses about the relationship between physician experiences with a health plan and physician recommendations of the plan were confirmed, supporting construct validity. CONCLUSION: The items on the survey instrument can be used with confidence to measure health plan quality from a physician perspective.

Attitude of Health Personnel↗

PubMed2001

Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants.

OBJECTIVE: To develop and validate a scale suitable for use in clinical practice as a tool for assessing prolonged pain in premature infants. METHODS: Pain indicators identified by observation of preterm infants and selected by a panel of experts were used to develop the EDIN scale (Echelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale). A cohort of preterm infants was studied prospectively to determine construct validity, inter-rater reliability, and internal consistency of the scale. RESULTS: The EDIN scale uses five behavioural indicators of prolonged pain: facial activity, body movements, quality of sleep, quality of contact with nurses, and consolability. The validation study included 76 preterm infants with a mean gestational age of 31.5 weeks. Inter-rater reliability was acceptable, with a kappa coefficient range of 0.59-0.74. Internal consistency was high: Cronbach's alpha coefficients calculated after deleting each item ranged from 0.86 to 0.94. To establish construct validity, EDIN scores in two extreme situations (pain and no pain) were compared, and a significant difference was observed. CONCLUSIONS: The validation data suggest that the EDIN is appropriate for assessing prolonged pain in preterm infants. Further studies are warranted to obtain further evidence of construct validity by comparing scores in less extreme situations.

Chronic Disease↗

PubMed1996

The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system.

BACKGROUND AND PURPOSE: Disorders of the facial neuromuscular system can result in marked disfigurement of the face and difficulties in activities of daily living such as eating, drinking, and communicating. No systematic means of measuring the disability associated with facial nerve disorders exists. The purpose of this investigation was to examine the reliability and construct validity of the Facial Disability Index (FDI), a disease-specific, self-report instrument for the assessment of disabilities of patients with facial nerve disorders. SUBJECTS AND METHODS: The FDI was administered to 46 ambulatory patients of the University of Pittsburgh Medical Center's Facial Nerve Center. The relationship of the FDI subscale and total scores with clinical impairment measures was determined, and a comparison of the use of the FDI and subscales of the more general SF-36 was made. RESULTS: The FDI subscales produced reliable scores (theta reliability: physical function = .88; social/well-being function = .83). Construct validity of the FDI physical function subscale was demonstrated by a correlation with the clinician's physical examination of facial movement. The FDI social/well-being subscale was associated with the FDI physical function subscale and with a clinical assessment of psychosocial status within a subset of the sample (n = 14). The FDI represented the relationship between impairments, disability, and psychosocial status better than the generic SF-36 did. CONCLUSION AND DISCUSSION: The FDI subscales produce reliable measurements, with construct validity for measuring patient-focused focused disability of individuals with disorders of the facial motor system.

Activities of Daily Living↗

PubMed2001

The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment.

OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses.

Journal Article↗

PubMed1980

Halstead-Reitan Test Battery: a problem of differential diagnosis.

The Halstead-Reitan Test Battery is one of the most widely recognized neuropsychological test batteries. Many claims have been made as to its validity. Despite these claims, doubts persist. A critical review of the literature shows that the battery can separate brain-damaged patients from normal patients, general medical patients, and patients with certain psychiatric disorders. However, the battery cannot separate brain-damaged patients as a group from schizophrenics as a group, though in individual cases there may exist pathognomonic signs indicating brain damage. The impairment index, as a summary score of the basic tests, as well as other "methods of inference," fail at this point. Four alternatives are discussed. First, brain-damaged patients differ from schizophrenic patients not in test performance but in test-taking behavior. Second, the battery is a valid measure of brain damage but has limited applicability. Third, the battery is a measure not of brain damage but of degree of degradation of psychological processes. And fourth, schizophrenics perform poorly on the battery because they have undetected brain damage. Only the third and fourth alternatives appear viable. Both question the validity of the traditional criteria of brain damage. It is argued that future validation studies of the battery should be of construct validation type and not of the criterion-oriented type, as these are defined by Cronbach and Meehl (1955). Possible procedures for construct validation are briefly discussed.

Bipolar Disorder↗

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↗

PubMed2000

Clinimetric properties of a parent report on their offspring's quality of life.

The objective of this study was to assess the reproducibility, construct validity, and responsiveness of the parent report version of the "How are you" (HAY), a quality of life questionnaire for children with a chronic disease. The reproducibility of the HAY was assessed by comparing the scores of two measurement cycles of children with stable asthma. Construct validity was evaluated by testing the differences between scores of the HAY of parents of children with and without asthma and by investigating the correlations between the HAY and instruments supposed to correlate with the HAY. Responsiveness was investigated in parents of children whose clinical status changed clinically relevant between two measurements. The HAY showed acceptable reproducibility. Also the HAY detected anticipated differences in quality of life between parents of asthmatic and healthy children. It furthermore showed acceptable ability to measure change in health status of children with asthma. The parent report version of the HAY shows acceptable reproducibility, supportive evidence for construct validity, and good responsiveness. The measurement of quality of life of asthmatic children and changes therein can truly rely on parental report.

Asthma↗

PubMed2006

Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in Asians with knee osteoarthritis in Singapore.

OBJECTIVE: To cross-culturally adapt and validate Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in patients with knee osteoarthritis (OA) in Singapore. METHODS: Singapore English and Chinese versions were cross-culturally adapted from the source English version following standard guideline (including cognitive debriefing). Patients were asked to complete an identical, pretested questionnaire containing the Lequesne index, Short Form 36 Health Survey (SF-36), and EQ-5D twice within 6 days. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICC). Dimensionality was assessed by principal component factor analysis. Construct validity was tested by item-to-scale correlations and 12 and six a priori hypotheses for convergent and divergent construct validities, respectively. RESULTS: Singapore English and Chinese Lequesne indices were well accepted by patients in pilot testing and were therefore administered to a consecutive sample of 127 English- and 131 Chinese-speaking Singaporeans with knee OA. Acceptable internal consistency was observed for activities of daily living and the global index (alpha=0.72-0.82), and the good test-retest reliability for all scales in both versions (ICC=0.66-0.94). Expected item-to-scale correlations were presented only in activities of daily living in both versions. Factor analysis yielded two factors for both versions. Convergent and divergent construct validities were supported by the presence of hypothesized correlations between the Lequesne index and SF-36 and EQ-5D scales. CONCLUSION: Both versions of the Lequesne index demonstrated acceptable reliability and validity among multiethnic Asian patients with knee OA, which suggests that it could be used as a global index in the health-related quality of life (HRQoL) measurements in Singapore and possibly other Asian countries.

Activities of Daily Living↗

PubMed2004

Patient-assessed health instruments for the knee: a structured review.

OBJECTIVES: To identify patient-assessed health instruments specific to the knee and review evidence for reliability, validity and responsiveness. METHODS: Instruments were identified through systematic searches of the literature. Information relating to instrument content, patient population, reliability, validity and responsiveness was extracted from published papers. RESULTS: The 16 instruments that met the inclusion criteria varied in length from 4 to 42 items. The majority form a single index; six produce a profile of scores. Eight have been evaluated in patients with a variety of knee problems. All instruments have satisfactory internal or test-retest reliability. However, there is limited empirical support for the health domains of six instruments. Patients informed the development of items within just five instruments. Few authors gave explicit consideration to the size of expected relationships in tests of construct validity. Eleven instruments have evidence for responsiveness to changes in health. The minimally important difference was not determined for any of the instruments. CONCLUSIONS: In the absence of comparative evidence, the large number of patient-assessed instruments for knee problems makes instrument selection difficult. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Pain Scale and Oxford Knee Score have good evidence for reliability, content validity and construct validity. The KOOS and Oxford instruments also have evidence for responsiveness. The instruments have not been evaluated for all knee problems, and instrument appropriateness, including content relevance, must be assessed before application. The comparative evaluation of instruments is recommended.

Health Status Indicators↗

PubMed2006

The Acne Quality of Life Index (Acne-QOLI): development and validation of a brief instrument.

BACKGROUND: Acne affects many people and can be detrimental to affected patients' quality of life. Assessing the impact of acne on quality of life requires well-validated and reliable measures of acne-specific quality of life that are brief and easy to administer and interpret. OBJECTIVES: This paper reports on the development and validation of the Acne Quality of Life Index (Acne-QOLI) for use in clinical care, research, and product development. METHODS: Focus groups consisting of people from demographically different populations were conducted to identify the most relevant domains of functioning affected by acne; on the basis of these findings, candidate items were developed. An initial item pool of 58 items was included in a survey of 480 persons with mild to severe acne ranging in age from 12 to 62 years. Factor analysis and qualitative analysis were used to reduce the item pool to 21 items. The construct validity, concurrent validity, internal consistency, and test-retest reliability of the items were evaluated. RESULTS: The 21-item Acne-QOLI showed excellent face validity, content validity, concurrent validity, and construct validity. High internal consistency and test-retest reliability were also found. CONCLUSIONS: Quality of life is now recognized as an important outcome in medical care. The Acne-QOLI is a brief and easily administered and interpreted measure of acne-related quality of life that can be used in clinical care, research, and product development.

Acne Vulgaris↗

PubMed1995

Evaluation of a Swedish version of the arthritis self-efficacy scale in people with fibromyalgia.

The major purpose of this study was to determine the utility and construct validity of the Swedish version of the Arthritis Self-Efficacy Scale (ASES-S). Ninetynine women with fibromyalgia (FS) were included in a randomized, controlled trial of fibromyalgia efficacy-based self-management education and physical training. Several self-report instruments were used to evaluate the outcome of the intervention. Evidence of construct validity of the ASES-S was revealed in the factor analysis which produced a three factor solution similar to previous results. Significant correlations between ASES-S and pre and post health status measures were consistent with theoretically derived hypotheses, further testifying to construct validity. Multiple regression analyses confirmed that pretest ASES-S was the strongest predictor of posttest ASES-S. The results indicated that the intervention had produced a significant change in ASES-S and that this positive change in self-efficacy was associated with changes in health status. In conclusion, this study has shown the ASES-S to be a valid measure of treatment effects also for patients with FS.

Adult↗

PubMed2000

Assessing quality of life in Mexican-American children with asthma: impact-on-family and functional status.

OBJECTIVE: To assess the internal consistency reliability and construct validity of two questionnaires, the Impact on Family (IOF) and the Functional Status II (R) (FSIIR), in a Mexican-American population of children with asthma. METHODS: We interviewed 115 Hispanic parents of children with asthma and compared the IOF and FSIIR scores and reliability coefficients for the following subgroups: English or Spanish language and high or low educational level. We assessed the construct validity of the IOF Total score and FSIIR Illness score by examining the relationship between these scores and other health status variables. RESULTS: The IOF Total score and FSIIR Illness score demonstrated acceptable construct validity and reliability for language and education subgroups, although several of the IOF subscales had low reliability. CONCLUSIONS: IOF Total score and FSIIR Illness score can be recommended for use by Spanish- and English-speaking Mexican-American respondents.

Adaptation, Psychological↗