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PubMed2004

Modification and psychometric examination of a self-report measure of fear in older adults.

The primary purposes of the present study were to: (a) develop a measure of self-reported fear that includes fears that are content valid for older adults, (b) develop an instrument for assessing daily interference associated with fears, and (c) examine the psychometric properties of this new instrument. In the first of two studies, 109 participants, ages 60 through 91, completed a demographic questionnaire and answered an open-ended question about the types of fears they experience. These fears were then included on a modified version of the Fear Survey Schedule-II (Fear Survey Schedule-II for Older Adults (FSS-II-OA)) and administered in a second study. In Study 2, 114 participants (ages 60 through 88) completed a demographic questionnaire, FSS-II-OA, Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Penn State Worry Questionnaire (PSWQ), and answered questions regarding fear avoidance. Study 2 revealed high levels of internal consistency and test-retest reliability for total scores on the FSS-II-OA. Test-retest reliability estimates were mixed for individual fear intensity and daily interference items on the FSS-II-OA. Low-moderate to moderate correlations were found between the FSS-II-OA and BAI, BDI-II, and PSWQ.

Aged↗

PubMedDate not supplied

Functional assessment of repetitive strain injuries: two case studies.

More patients with repetitive strain injuries (RSIs) are being seen in occupational therapy clinics in Hong Kong. To reduce the incidence of work-related RSIs, it is necessary to identify problem jobs and/or specific tasks that are associated with an increased risk of these disorders. Physical assessment, videotaping, ergonomic evaluations, and analyses of workstation designs are used for this purpose. In Hong Kong, however, these methods cannot be implemented at the jobsite without the approval of the employer. This restriction constitutes a major problem in planning the rehabilitation of workers who have RSIs. A self-assessment method using the Work Evaluation Systems Technology (WEST) Tool Sort and the LLUMC Activity Sort was adopted as part of the evaluation of clients with RSIs. The questionnaires were translated into Chinese and reviewed and revised for content validity by ten occupational therapists. Two case studies are presented to illustrate the occupational therapy intervention program based on this self-report instrument. The questionnaires were found to be efficient and useful in assessing the client's abilities at work and in explaining to the client the relationship of his or her working conditions to the RSIs.

Cumulative Trauma Disorders↗

PubMed1999

The effect of adding a cognitive dimension to the EuroQol multiattribute health-status classification system.

A methodological study was conducted to examine the effect of extending a frequently used simple multiattribute health-status classification system by adding a cognitive dimension. The EQ-5D questionnaire is a generic instrument to value health, developed by the EuroQol Group. The EQ-5D defines health according to five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. We defined 18 different health states according to the standard EQ-5D classification. A second set of health states was constructed similar to the first, except for the addition of a cognitive dimension (EQ-5D+C). Valuations of both sets of health states were statistically analyzed to detect the effect of the additional dimension. The cognitive dimension generated systematically different values compared with the standard EQ-5D version, whereas the content validity improved. Both systems evoked equally reliable values. Analyses showed that a simple additive model to predict summary values for health states was not optimal for both systems. Although there is a current lack of consensus regarding the domains that are selected to represent health status, this study has shown the importance of considering the inclusion of a cognitive domain.

Activities of Daily Living↗

PubMed1995

Behçet's disease.

The reliability and ease of use of any activity form has to be balanced against the content validity of the questions being asked. Clinical experience over several years suggests that presence of a high disease activity score is consistent both with the clinician's and patient's overall impression of disease activity. If the onset of the more serious manifestations can be predicted by more readily measured symptoms such as oral and genital ulceration, skin lesions, arthritis and superficial thrombophlebitis, then these organ system subscores could be expanded to provide a more accurate representation of activity. Other organ systems such as auditory system may also provide a measure of disease activity. For the purpose of clinical trials it is likely that if treatment is targeted at a specific organ system then a more comprehensive measure of activity within that organ system would have to be used (e.g. the role of thalidomide in oral ulceration) (Revuz et al, 1990). This would require the use of a form which measured many facets of oral ulceration (duration of ulcers, number of ulcers, size of ulcers, number of crops of ulcers, site of ulcers, etc). However it is recommended that such a form should be used in conjunction with a validated general disease activity form to alert the clinician conducting any trials of the advantageous or deleterious effects of the trial drug on other organ systems.

Behcet Syndrome↗

PubMed2001

Measurement of young women's attitudes about communication with providers regarding Papanicolaou smears.

PURPOSE: To describe the psychometric properties of a scale created to measure communication with the provider regarding Papanicolaou (Pap) smears. METHODS: A scale based on expectancy-value theory was developed and administered to 490 young women aged 12 to 24 years in an urban adolescent clinic. Psychometric properties were assessed using factor analysis to evaluate latent variables, intraclass correlation coefficient to evaluate test-retest reliability, and Cronbach coefficient alpha to evaluate internal consistency reliability. Content validity was assessed by qualitative interviews, feedback on a pilot survey, and expert review. Construct validity was evaluated by examining whether relevant health care characteristics, knowledge, and attitudes were significantly associated with perceived communication. RESULTS: Mean respondent age was 18.2 +/- 2.1 years; 50% were black and 22% Hispanic. The scale items loaded on one factor. The intraclass correlation coefficient was 0.83 and Cronbach alpha 0.95. Report of a consistent provider, report that a provider recommended a Pap smear, knowledge of Pap smears and Human Papillomavirus (HPV), intention to return for follow-up Pap smears, and positive attitudes about Pap follow-up were significantly associated with good communication. CONCLUSIONS: The scale appears to be reliable and valid as a measure of young women's communication with providers regarding Pap smears. Future research should focus on whether this newly developed scale is useful in the design and evaluation of cervical cancer prevention programs for young women.

Adolescent↗

PubMedDate not supplied

Psychometric properties of the HIV-Related Fatigue Scale.

The HIV-Related Fatigue Scale (HRFS) was developed to address the specific aspects of fatigue experienced by people who are HIV-positive and are not measured in any commonly used fatigue scale. The necessity for a new scale was determined after analysis of a qualitative study to explore HIV-related fatigue in which it was found that HIV-related fatigue has components related to intensity, circumstances, and consequences that must be included in the measurement of fatigue for this population. The HRFS has 56 items, most of which are on a 1-to-10 scale, drawn from five existing fatigue scales and the data from this qualitative study. The items were deemed content valid, easy to understand, and not fatiguing to complete by people with HIV-related fatigue. Cronbach's alpha for the entire tool was .94; internal consistency for each of the three preliminary subscales is reported as well. Test-retest reliability was moderate at r = .43. Further testing needs to be done, but the HRFS has the potential to be a valuable addition to the measurement of fatigue in seropositive persons.

Activities of Daily Living↗

PubMed1998

Liverpool Seizure Severity Scale revisited.

The purpose of the study was to examine the psychometric properties of the revised Liverpool Seizure Severity Scale. The scale has been adapted to increase its content validity and its potential for detecting change attributable to antiepileptic drug treatment. Ninety-seven patients completed the revised scale of which 32 completed it for both major and minor seizures. Reliability of the revised scale was conducted using assessment of internal consistency and test-retest. T-tests were conducted to assess the ability of patients to differentiate between major and minor seizures on scores of the seizure-severity scale. The psychometric properties of the scale were not adversely affected by either the increase in the number of items or the additional response scores. Patients completing the two scales of major and minor seizures were able to reliably differentiate between the two. We have attempted to improve the Liverpool Seizure Severity Scale in order to enhance its reliability, validity and sensitivity to change. The amendments we have made have not adversely affected its psychometric properties and we hope that it will make it more acceptable for use in clinical trials of new antiepileptic drug treatment. The revised scale is currently being applied to a number of clinical trials.

Adolescent↗

PubMed1996

Development and testing of the ostomy concerns scale: measuring ostomy-related concerns of cancer patients and their partners.

This article reports the third phase of a project undertaken to develop and test the Ostomy Concerns Scale. The Ostomy Concerns Scale measures concerns of cancer patients with ostomies and of their partners. The tool was pilot tested for clarity, apparent internal consistency (nonquantitative assessment of homogeneity of content), and content validity by a panel of experts. The scale met or exceeded the preset criteria specified in this phase of testing. Subsequent testing included estimates of the scale's reliability and validity with a sample of 40 patients and their partners. Internal consistency estimates, as measured by Cronbach's alpha coefficient, were 0.92 at two test times. A test-retest reliability estimate of 0.73, as measured by Spearman's correlation coefficient, was obtained. The results are promising and suggest that the Ostomy Concerns Scale provides a clinically useful evaluation of concerns of patients with ostomies and their partners.

Aged↗

PubMed2002

Psychometric evaluation of the Body Change Inventory: an assessment instrument for adolescent boys and girls.

A new instrument, the Body Change Inventory, was developed to provide an assessment of body change strategies that are used by both adolescent girls and boys. The novel aspect of this instrument is that it evaluates strategies to increase body size and increase muscle size, as well strategies to decrease body size. Independent samples of adolescent girls and boys aged between 11 and 17 years (N=1732) participated in four studies. The revised instrument consisted of three body change scales-Strategies to Decrease Body Size, Strategies to Increase Body Size, and Strategies to Increase Muscle Size. The studies demonstrated content validity, construct validity, internal consistency, and concurrent and discriminant validity for the new scales. The new scales provide a valuable addition in the literature for assessing three global body change strategies among adolescent girls and boys. They are needed in order to examine further the normative development of different kinds of body change strategies and how these may lead to behavioural problems such as disordered eating, exercise dependence, and steroid use.

Journal Article↗

PubMedDate not supplied

The 1999-2000 ACC task analysis of nurse-midwifery/midwifery practice: a consideration of the concept of professional issues.

The American College of Nurse-Midwives (ACNM) Certification Council periodically conducts a task analysis study as evidence supporting the content validity of the national certification examination in nurse-midwifery and midwifery. The purpose of this article is to report findings related to the examination of the relationship between professional issues and safe beginning-level midwifery as measured by the 1999-2000 Task Analysis of American Nurse Midwifery and Midwifery Practice. Study findings suggest that newly certified midwives place strong emphasis on the importance of tasks related to the ACNM "Hallmarks of Midwifery," which characterize the art and science of the profession: these include tasks dealing with health promotion and cultural competency. The beginning midwives, however, gave consistently low ratings to tasks related to ACNM "Core Competencies" that mirror the professional responsibilities of midwives; these include tasks related to the history of midwifery, research, or health policy. The study has implications for nurse-midwifery/midwifery educators, experienced midwifery mentors, and other persons interested in reinforcing the relevance of these important professional issues to the new midwife.

Adult↗

PubMedDate not supplied

Measuring outcomes of midwifery care: development of an instrument to assess optimality.

Research on the outcomes of midwifery care is hampered by the lack of appropriate instruments that measure both process and outcomes of care in lower risk women. This article describes an effort to adapt an existing measurement instrument focused on the optimal outcomes of care (The Optimality Index-US) to reflect the contemporary style of U.S.-based nurse-midwifery practice. Evidence for content validity of the instrument was derived from literature reports of randomized clinical trials, synthetic reviews, and the clinical consensus of professional reviewers. Eleven perinatal health professionals and consumers, representing disciplines of obstetrics and gynecology, midwifery, epidemiology, and neonatology reviewed the instrument. The instrument was then applied to an existing data set of women who intended to give birth at home (N = 1,286 women) to determine its utility in measuring events in the process and outcome of perinatal health care as managed by nurse-midwives. Results suggest that the tool holds promise for use in outcomes studies of U.S. perinatal care. Further testing of the instrument among diverse multicultural population groups, with various providers, and in diverse birth settings is warranted.

Female↗

PubMedDate not supplied

Development and testing of the Clinical Post-Conference Learning Environment Survey.

Clinical postconference is an integral component of the required laboratory hours in undergraduate baccalaureate nursing education. Empirical evidence supporting the educational benefits of this activity are nearly nonexistent. This article describes the development and psychometric testing of a self-report instrument designed to measure clinical postconference learning environments as perceived by undergraduate nursing students and faculty. The Clinical Post-Conference Learning Environment Survey (CPCLES) consists of 54 items and has been tested with more than 500 participants in three schools of nursing in the Midwest. Based on theoretical support and comprehensive review of the literature, six components of the learning environment are measured in two forms of the instrument; an actual scale and an importance scale. Content validity, internal consistency, and test-retest reliability are discussed. Using the CPCLES, perceptions of undergraduate nursing students and faculty were measured. Significant differences between the actual components of the learning environment and the correlated ratings of the importance of these components were found. Faculty perceived a significantly greater amount of teacher support, task orientation, and innovation in the postconference learning environment than did undergraduate students. No differences were noted between faculty and students regarding the importance of the learning environment components. This study presents findings with the use of the first instrument developed to measure clinical postconference learning environments. The congruence and discrepancy among and between learning groups' perceptions carry implications for educational practices in this setting. Subseqent investigations using this tool may be able to link the perceived learning environment to valued cognitive, affective, and behavioral learning outcomes.

Adult↗

PubMed1993

A new interview for the multiaxial assessment of psychiatric morbidity in medical settings.

A new semistructured instrument, the Standardized Polyvalent Psychiatric Interview or SPPI has been developed primarily for assessing medical patients. It has been built on the Clinical Interview Schedule and is intended to evaluate individuals in a multiaxial schema: psychopathology, including duration and severity of disorder; somatic disturbance; social problems and social supports: and pre-morbid personality, with special emphasis on 'neuroticism'. The SPPI generates enough information to allow the use of different research diagnostic criteria, including DSM-III-R, ICD-10 and Goldberg's criteria of 'attribution' of somatic symptoms and 'relationships between psychiatric and physical disorder'. It also includes a section related to recommended treatment. The new interview fulfils standards of feasibility, face and content validity. An incomplete block design, inter-rater reliability study was carried out with a consecutive sample of 48 out-patients referred to the Psychosomatic-Liaison Service of the University Hospital of Zaragoza. A broad range of agreement coefficients were calculated, the results being quite acceptable (most kappas are in the range from 0.7 to 0.9) and tending to support the procedural validity of the interview.

Adolescent↗

PubMed2000

Using Evidence to Improve Evaluation: A Comprehensive Psychometric Assessment of a SP-Based OSCE Licensing Examination.

Background: Bridging the theory of psychometric assessment to an evaluation instrument is a challenging and continuous task. Such a task was completed for the SP-based OSCE licensing examination used in Quebec since 1990. Purpose: To review the comprehensive series of psychometric studies undertaken on the examination based on the theory of psychometric assessment. Methods: The examination is a 5.5 hour-long OSCE composed of 26 clinical cases of 7, 10 or 15 minutes' duration. Candidates' total scores and case scores are used for licensing decisions. Reliability coefficients were obtained as well as generalizability studies to assess the impact of examination sites (4), tracks (14) and languages (French and English) on candidates' results. Its content validity was assessed by experts as well as by practicing family physicians, examiners and exam coordinators. Concurrent validity was assessed. Through differential item functioning (DIF) statistical approach, possible gender biases were analyzed. The predictive validity of the examination scores on selected aspects of practice was analyzed as well as the impact of the examination on the teaching and learning process. Results: These studies confirmed the validity, reliability and generalizability of the examination scores. No biases were demonstrated. Examination scores predicted elements of practice. Educational impact was present. Conclusion: This study confirmed the quality of the examination, ensured its continuous improvement and supported the inferences made from the examination results.

Journal Article↗

PubMed2001

Functional assessment taxonomy relevant to low-back impairments.

A taxonomy of functional assessment constructs was developed to help the Social Security Administration refine the measurements of work disability. This report addresses content validity of the new taxonomy by examining the relevance of its constructs to a specific disability, and by examining the relationship between these constructs and constructs in other taxonomies. Seven experts linked the new taxonomy to consequences of low-back impairments. The selected constructs were compared to those reported independently by patients (Harper AC, Harper DA, Lambert L, Andrews HB, Lo SK, Ross FM, Straker LM. Pain 1992; 50(2): 189-195). The International Classification of Impairments, Disabilities and Handicaps served to bridge the two exercises. The findings reveal that it is feasible to use the taxonomy to define the impact of a specific disability and consequently link it to a set of standard measurements. Low-back impairments may be best assessed through measures of physical functional limitations, vocational impact, and interpersonal and emotional behavior. The study did not yield cognitive and intellectual measures that were relevant to this impairment.

Back Injuries↗

PubMed1998

The development of a scale to assess war-time atrocities: the War Events Scale.

The War Events Scale (WES) was developed to assist clinicians with the assessment of war zone veterans' exposure to, and participation in war-time atrocities distinct from combat, and their current distress from these events. Data concerning content validity, test-retest reliability, internal consistency, as well as correlational data with the Combat Exposure Scale and the Mississippi Scale are presented. Results indicate that the WES does have adequate internal consistency and test-retest reliability, and correlates moderately with the Combat Exposure and Mississippi Scales. Initial results suggest that the WES may be helpful in collecting extremely sensitive information concerning the exposure of war zone veterans to atrocities.

Combat Disorders↗

PubMed2004

A national study of the importance of oral health to life quality to inform scales of oral health related quality of life.

OBJECTIVES: To assess the content validity of traditional oral health status scales as measures of oral health related quality of life (OHQOL), based on a general public's perception of the most important ways in which oral health affects quality of life (QoL). METHODS: A nationwide United Kingdom study involving a random probability sample of 1778 adults. Data were collected by face-to-face interviews in participants homes. RESULTS: Most 75% (1332) perceived oral health as being important to QoL. Among them, 53% (699/1332) identified oral health's importance to QoL as being in a positive manner. Existing scales predominantly fail to include this dimension. The general public ranked oral health's importance to QoL through a range of physical, social and psychological domains. Most frequently though affecting eating or comfort; domains considered by all instruments. Other domains/ways are presented. It is apparent that even when some of the multidomain scales are employed, they frequently omit items that the public perceives as being most important to QoL. CONCLUSION: The study raises concerns about the appropriateness of utilising many of the existing oral health status scales as measures of OHQOL because the concepts do not appear to be interchangeable.

Adolescent↗

PubMed2001

[Factor structure of the Autism Diagnostic Interview-Revised (ADI-R): a study of dimensional versus categorical classification of autistic disorders].

OBJECTIVES: This study investigated whether empirically derived dimensions of autistic behavior are consistent with the content-valid construction of the autistic behavior domains according to ICD-10 and DSM-IV (social interaction, communication and repetitive, stereotyped behavior). METHODS: A principal component exploratory factor analysis routine with varimax-rotation and extraction of factors following the Scree criterion was run using data from the Autism Diagnostic Interview-Revised (ADI-R) of N = 262 individuals exhibiting autism or autistic features. RESULTS: A three-factor solution consisting of two socio-communicative and one language dimension and accounting for 46.1% of the total variance was found to best describe the data. These factors yielded only vague correspondence with the idea of behavior domains described in ICD-10 and DSM-IV. In addition, factor loadings of items representing repetitive, stereotyped patterns were generally weak. CONCLUSIONS: The factor-analytic approach to autism indicates a conception of the disorder divergent from that defined in the contemporary psychiatric classification systems, especially regarding the area of repetitive, stereotyped behavior.

Adolescent↗