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PubMed2002

[Quality of nursing diagnosis and patient satisfaction. A study of the correlation].

The research question was whether there exists a relationship between quality of nursing diagnoses in nursing documentations and patient's satisfaction with nursing diagnoses. The hypotheses stated that a positive relationship between nursing diagnosis and patient satisfaction exists; high quality of nursing diagnoses in the nursing documentation goes along with high patient satisfaction with nursing diagnoses. The sample consisted of 57 patients, their nursing documentations and nurses of three dermatological units of a university hospital in Switzerland. Nursing diagnosis was analysed from two points of view: the professional nursing focus and patients' focus. For this purpose, two measurement instruments have been developed. Three subconcepts of quality of nursing diagnoses and patient satisfaction were derived: interaction/personal dimension, patient participation and knowledge of nurses. Content validity of both instruments was established and the reliability coefficents of both instruments were rather high (.91 and .95). To test assessment objectivity, twelve raters analysed three nursing documentations. The tree Kappas were significant at a 5% level. The hypothesis was analysed by a correlational design. The main findings showed a significant relationship between quality of nursing diagnoses in documentations and patient satisfaction (tau = .18, p < or = .03). The evaluation of nursing diagnoses indicated effective communication between nurses and patients and that nurses assessed patients' situations appropriately. Patients satisfaction with nursing diagnoses was rather high. One of three subscales in both instruments yielded a significant correlation. The statistically significant, but low relationship suggests the need for further study.

Communication↗

PubMed2004

[Discomfort of the bed pan--translating and evaluating the Belgian Bedpan Ongemak Schaal (BOS)].

The systematic translation of standardized instruments is an alternative method to the development of an own instrument. Neither German nor English literature provide an answer to the patient view of the discomfort of bedpans. Therefore the Belgian Bedpan Ongemak Schaal((BOS) was translated into German. To maintain the content validity of the instrument is of utmost importance when translating it into a foreign language. It is important too that the new instrument is understandable and easy to handle. The translation of the Bedpan Ongemak Schaal((BOS) shows that it is possible to transfer an instrument from one language to another without losing validity and feasibility.

Adult↗

PubMed2002

The German version of the Oral Health Impact Profile--translation and psychometric properties.

The need for cross-culturally adapted oral-health specific health outcome measures is increasingly recognized in Germany. Following accepted cultural adaptation technique guidelines, we report the development of the German version of the Oral Health Impact Profile (OHIP). The original 49 items were translated using a forward-backward method. A de novo development of German items established content validity. A priori hypothesized associations between the OHIP summary score and self-reported oral health and five oral disorders were confirmed in a random sample of the general population (n = 163, age 20-60 yr). These associations were interpreted as support for construct validity. The instrument's responsiveness, as indicated by a mean OHIP summary score change from 45.0 to 28.3, was established in 67 consecutive patients treated for temporomandibular disorder pain (age 19-85 yr; 72% women). Test-retest reliability was demonstrated by intraclass correlation coefficients of 0.63-0.92 for dimensions and summary scores (convenience sample, n = 30, age 18-85 yr; 53% women). Internal consistency was high (Cronbach's alpha > 0.74). Sufficient discriminative and evaluative psychometric properties of the Oral Health Impact Profile German version (OHIP-G) make the instrument suitable for assessment of oral health-related quality of life in cross-sectional as well as longitudinal studies.

Adolescent↗

PubMed1999

Methodological sources of cultural insensitivity in mental health research.

The concept of procedural norms, which is taken from the analysis of science as an institutionally structured social process, is used to explain the persistence of cultural insensitivity in research. The concept refers to the canons of research that tell scientists what should be studied and how, and they are taught to successive generations of researchers. An examination of cross-cultural studies in mental health reveals that cultural insensitivity stems from procedural norms in the development of content validity based on experts' rational analysis of concepts, in linguistic translations that try to conform to the exact terms of standardized instruments, and in the uncritical transferring of concepts across cultures. We need a wide-ranging examination of our procedural norms, with the objective of keeping such norms from suppressing, biasing, or deflecting cultural understandings. This article proposes a dialogue on the intricate connections between culture and our customary methodologies.

Cognition↗

PubMed1997

Questionnaire methods of cognitive self-statement assessment.

Questionnaire methods can be used to assess thoughts, which are cognitive products often referred to as self-statements, automatic thoughts, or internal dialogue. This review examines the nature of endorsement measures of self-statements and considers their advantages and disadvantages as well as scoring issues. A psychometric evaluation of self-statement questionnaires discusses the issues of reliability, content validity and scale development, criterion validity, construct validity, and clinical utility. Descriptions of and psychometric findings for over 2 dozen measures are summarized, including measures for depression, anxiety, eating disorders, pain, and applications with children and adolescents, and conclusions and future directions are suggested.

Awareness↗

PubMed2000

Isms and the structure of social attitudes.

Social attitude measurement has been limited by inadequate structural models. In this study, broad, basic dimensions were sought, with the assumption that crucial variables are represented as terms ending in -ism (isms). 266 isms were extracted from a dictionary, and items were built from their definitions. In a sample of 500 college students, the most replicable item structure had 3 factors; one of these 3 factors split into 2 factors in the 4-factor structure. A replication study confirmed that Conservatism and Authoritarianism are subcomponents of the largest factor. The other factors, though highly meaningful, seem more sparsely represented in previous research. No factor was highly related to personality traits other than Openness to Experience. The factors can serve as content-validity benchmarks for developing improved measurement models in this consequential, discrete domain of individual differences.

Adolescent↗

PubMed2002

Assessment of quality of life in a multicultural cancer patient population.

Quality of life (QOL) is increasingly assessed in cancer patients. In this article, the authors examined the psychometric performance of a commonly used QOL questionnaire, the Quality of Life Questionnaire--Cancer 30 (QLQ-C30; N. K. Aaronson et al., 1993), in multiethnic cancer patients. Content validation studies in patients and clinicians identified possible new items. Multiple-group confirmatory factor analysis supported equivalent structure across ethnic groups (Caucasians and Asian/Pacific Islanders [APIs]). A higher order QOL factor appeared to directly affect functioning scales and symptom count. Exploratory factor analysis examined effects of new items. Ten factors were extracted, 6 consistent with the original instrument and 4 reflecting potentially new aspects of QOL: Positive Social Support, Coping, Existential Well-Being, and Sexuality/Intimacy. The QLQ-C30 appears appropriate for use in API cancer patients. Further work needs to ensure that it includes all important domains.

Aged↗

PubMed2006

The development and initial evaluation of the survey of readiness for alcoholics anonymous participation.

This article presents 5 studies related to the development and initial evaluation of the Survey of Readiness for Alcoholics Anonymous Participation (SYRAAP). The SYRAAP is a brief, multidimensional, self-administered instrument that assesses beliefs associated with Alcoholics Anonymous (AA) participation. Study 1 generated 239 candidate items for potential inclusion in the instrument. Study 2 assessed the content validity of these items according to 3 criteria and identified a subset of 60 with the highest values on the criteria for further consideration. Study 3 produced a shorter version of the SYRAAP and evaluated its structure, internal reliability, and validity. Study 4 reevaluated the structure and internal reliability of the SYRAAP and yielded findings that were generally consistent with those from Study 3. Study 5 established stability reliability for the instrument. The collective findings indicated the SYRAAP can reliably and validly assess individual-level beliefs associated with AA participation. The potential use of the SYRAAP for researchers and clinicians, along with limitations of the work presented here, are discussed.

Adolescent↗

PubMed2006

Creating and field-testing diagnostic criteria for partner and child maltreatment.

An integrated set of diagnostic criteria for partner abuse and child abuse and neglect were developed and tested in 4 studies conducted with a branch of America's largest family maltreatment protection agency (i.e., the U.S. military's Family Advocacy Program). Maltreatment criteria then in force were found to have adequate levels of content validity, but experts' and users' feedback indicated ambiguities and poorly specified criteria that undermined reliable application. Criteria incorporating elements of the best existing civilian and military operationalizations were developed and evaluated in two field trials. The final definitions were found to support very high levels of agreement (92%) between base adjudicating committees and master reviewers.

Child↗

PubMed2003

Understanding source effects in ADHD rating scales: reply to DuPaul (2003).

G. J. DuPaul (2003) offered two suggestions for additional research to understand the strong source effects reported by R. Gomez, G. L. Burns, J. A. Walsh, and M. A. de Moura (2003) in attention-deficit/hyperactivity disorder (ADHD) rating scales. The first suggestion was to determine whether the source effects represent mostly bias or accuracy. The second suggestion was to minimize source effects through the development of better ADHD rating scales. Because source effects can represent bias or accuracy, it is important to minimize the bias aspect through content validation procedures prior to attempts to determine whether source effects better reflect bias or accuracy. This comment offers various suggestions to reduce the bias in ADHD rating scales.

Attention Deficit Disorder with Hyperactivity↗

PubMed1999

Development of a new dyspepsia impact scale: the Nepean Dyspepsia Index.

BACKGROUND: There is not at present a suitable disease-specific health-related quality of life instrument for uninvestigated dyspepsia and functional (non-ulcer) dyspepsia. AIM: To develop a new multi-dimensional disease-specific instrument. METHODS: The Nepean Dyspepsia Index (NDI) was designed to measure impairment of a subject's ability to engage in relevant aspects of their life and also their enjoyment of these aspects; in addition, the individual importance of each aspect is assessed. A 42-item quality of life measure was developed and tested, both in out-patients presenting to general practice with upper gastrointestinal complaints (n = 113) and in a randomly chosen population-based sample (n = 347). RESULTS: Adequate face and content validity was documented by an expert panel. Factor analysis identified four clinically relevant subscales: interference with activities of daily living, work, enjoyment of life and emotional well-being; lack of knowledge and control over the illness; disturbance to eating or drinking; and disturbance to sleep because of dyspepsia. These scales had high internal consistency. Both symptoms and the quality of life scores discriminated dyspepsia from health. CONCLUSION: The Nepean Dyspepsia Index is a reliable and valid disease-specific index for dyspepsia, measuring symptoms and health-related quality of life.

Adult↗

PubMed2002

Willingness to pay and time trade-off: useful utility indicators for the assessment of quality of life and patient satisfaction in patients with port wine stains.

BACKGROUND: For cost utility analyses in health economic research it is necessary to assess quality of life for content validation. Previously, both quality of life questionnaires and utility indicators such as willingness to pay and time trade-off have been used successfully in patients with chronic skin diseases, such as psoriasis vulgaris or atopic eczema. OBJECTIVE: For the first time to assess willingness to pay and time trade-off in patients with port wine stains, and to study possible correlations between these indicators, patient income, quality of life questionnaires and subjective or objective outcome measures. METHODS: The results of a survey on 36 patients with facial lesions who had completed laser treatment were used for assessments. The 'Chronic Skin Disease Questionnaire' (CSDQ) and the 'Short Form-36 Health Survey' (SF-36) were used as quality of life questionnaires. Special questions were used as a basis for calculating the utility indicators, willingness to pay and time trade-off. RESULTS: Completed questionnaires were sent back by 25 patients (69%). Willingness to pay and time trade-off were used as instruments for the assessment of quality of life [questions answered by 23 (92% of respondents)]; patients were willing to pay 11.8% of their monthly income and would offer a mean value of 1.2 h per day for an imaginary therapy leading to complete cure of the skin problem. Statistical correlation analyses were not performed because this pilot study included only a small number of patients. Frequency distributions show no apparent correlation between willingness to pay and patients' profession (used as a surrogate for income). Possible correlations were seen between willingness to pay, time trade-off, the scales 'anxiety/avoidance' and 'helplessness' of the CSDQ as well as 'social function' of SF-36 and subjective or objective efficacy. Twenty-nine patients (80%) were willing to pay for the treatment, a surrogate measure for patients' satisfaction with treatment modality. Overall, patients would pay an average of 16.0 euros per single treatment and 192.0 euros for the whole course of treatments. In contrast with patients who evaluated treatment modality as excellent or very good (willingness to pay for single treatment, euro 22.0; for whole treatment, 270.0 euros), patients who judged treatment good (8.0 euros, 145.0 euros), moderate or bad (12.0 euros, 146 .0 euros) were willing to pay markedly less. CONCLUSIONS: (i) The questions for willingness to pay and time trade-off were understood by most patients and produced meaningful answers. (ii) There were apparent correlations between the utility indicators, subjective or objective outcome and the scales of the quality of life questionnaires. (iii) The results show that these indicators have a high potential for use in this dermatological condition, especially as a basis for health economic evaluations.

Adult↗

PubMed2003

Development of the PSORIQoL, a psoriasis-specific measure of quality of life designed for use in clinical practice and trials.

BACKGROUND: Patients with psoriasis have significant impairment in their quality of life (QoL). Several patient-completed instruments are available to measure outcome in dermatological conditions but these primarily focus on severity of disease rather than on QoL. OBJECTIVES: To develop a new instrument specifically designed to measure QoL in psoriasis-the Psoriasis Index of Quality of Life (PSORIQoL). METHODS: The content of the instrument was derived from qualitative interviews with 62 psoriasis patients in the U.K., Italy and the Netherlands. Content analysis of the interview transcripts from the three countries identified potential items for the questionnaire. All further stages of the project were conducted in the U.K. only. Face and content validity were determined by means of a focus group held with seven psoriasis patients and face-to-face interviews with a further 21 patients. A new draft version of the PSORIQoL, together with the Dermatology Life Quality Index (DLQI) and the General Well-Being Index (GWBI), were completed by a new sample of psoriasis patients contacted by mail, in order to determine construct validity. A subsample of the respondents completed a similar package 2 weeks later, to assess reproducibility (reliability). RESULTS: The first version of the PSORIQoL consisted of 61 items covering the needs identified in the interviews as having been affected by psoriasis or its treatment. These included fear of negative reactions from others, self-consciousness and poor self-confidence, problems with socialization, physical contact and intimacy, limitations on personal freedom and impaired relaxation, sleep and emotional stability. Following the focus group and field-test interviews, a new draft measure consisting of 45 items was completed by 148 patients, 88 of whom completed and returned a similar package 2 weeks later. Application of Rasch analysis identified a final 25-item version of the PSORIQoL. This version had a test-retest reliability coefficient of 0.89, indicating good reproducibility. The levels of association with the DLQI and PGWB indicated that the PSORIQoL measures a related but distinct construct. CONCLUSIONS: The PSORIQoL appears to be a practical, reliable and valid instrument for measuring the impact of psoriasis on QoL. It remains necessary to establish the instrument's responsiveness to changes in QoL associated with treatment.

Adult↗

PubMed2000

Development of a health-related quality of life questionnaire for women with androgenetic alopecia.

Despite the negative effects of androgenetic alopecia (AGA), no standardized health-related quality of life (HRQOL) questionnaire which is both specific to women and suitable for use in clinical trials currently exists. A questionnaire to assess HRQOL in women with AGA, the Women's Androgenetic Alopecia Quality of Life Questionnaire (WAA-QOL), was recently developed. Aspects of life affected by AGA were generated from literature review, discussion with experts, and a focus group. The number of issues identified was reduced based on importance and relevance to women with AGA. A questionnaire was then constructed and pilot-tested for comprehension. The resulting 25-item instrument was later included in a double-blind, placebo-controlled clinical trial of finasteride 1 mg for the treatment of hair thinning in postmenopausal women (n = 137). Based on test characteristics, several questions were eliminated, resulting in a 16-item questionnaire. The WAA-QOL exhibited excellent test-retest reliability overall (intraclass correlation coefficient = 0.89), and for individual items (kappa = 0.66-0.85), as well as high internal consistency (Crohnbach's alpha = 0.98). Responsiveness of the questionnaire could not be assessed. The WAA-QOL is self-completed in about 10 min, exhibits good content validity, internal consistency, and test-retest reliability, and may be useful in assessing the impact of female AGA on HRQOL or in evaluating therapeutic effects in clinical trials.

Adult↗

PubMed1994

Development of an instrument to measure collaboration and satisfaction about care decisions.

The psychometric assessment of a new instrument for measurement of the construct of nurse-physician collaboration in making specific patient care decisions. Collaboration and Satisfaction About Care Decisions (CSACD), is reported. Content validity for the tool was supported by literature review, nurse and physician experts, and potential subjects. In a pilot study 58 neonatal intensive care nurses' and resident physicians' responses showed variance; alpha reliability of the collaboration questions was 0.95. Construct validity of the collaboration questions was supported by finding expected correlational patterns and by factor analysis revealing a single factor that explained 75% of the variance in collaboration. Further psychometric testing of the instrument is proposed, particularly in the context of substantive studies that would allow investigation of its association with patient outcomes.

Adult↗

PubMed1997

Informational needs of women with a recent diagnosis of breast cancer: development and initial testing of a tool.

This study developed and tested the Toronto Informational Needs Questionnaire-Breast Cancer (TINQ-BC), a questionnaire designed to identify the information which women with a recent diagnosis of breast cancer need to deal with their illness. The 73-item questionnaire had content validity based on findings in the literature and opinions of expert oncology nurses. It was administered to 114 women with a recent diagnosis of breast cancer during chemotherapy (n = 39), radiation therapy (n = 40) or surgery (n = 35). Item analysis determined that 51 items in five subscales should be retained in the questionnaire. The subscales, labelled Disease, Investigative Tests, Treatments, Physical, and Psychosocial had good internal consistency reliabilities with Cronbach's alphas of 0.81 to 0.93. Informational needs of women were high with mean scores over 200 in a possible range of 51-255. Informational needs were greatest in either the Disease or Treatments subscales. Marital status, level of education, and level of income were not related to level of informational need. Younger women had a greater need for information than older women (r = -0.35, P = 0.003). The results suggest that information is important to help women with breast cancer manage their illness. Nurses should give women an opportunity to ask questions and be prepared to give accurate information.

Adult↗

PubMed1997

Psychometric evaluation of a questionnaire to document side-effects of chemotherapy.

This paper reports the psychometric testing of the Worthing Chemotherapy Questionnaire (WCQ). The WCQ is a patient self-report instrument to document side-effects of chemotherapy. Literature review of relevant studies shows that psychometric testing of similar instruments is rarely rigorous. Content validity for the WCQ was established in five ways: literature review, Delphi review among oncology staff, pre-pilot unstructured interviews, pilot study and amendment of the instrument and items for spontaneous reporting of problems on the questionnaire. A three-stage approach to construct validity was used. The hypothesis adopted was that as certain cytotoxic agents cause stomatitis, incidence and severity of stomatitis will decrease following cessation of treatment. Stage 1: factor analysis confirmed the presence of a sole factor, with an eigenvalue of 5.3, for mouth problems which explained 65.5% of the variance. Stage 2: the hypothesis was confirmed using research findings. Stage 3: the Wilcoxon test showed highly significant results for during and post chemotherapy stomatitis scores. Reliability of the questionnaire was assessed using the test-retest method. Weighted kappa was chosen as the test statistic. A median value of wk = 0.87 was obtained. The results indicate that the WCQ is a reliable and valid instrument.

Antineoplastic Agents↗

PubMed1998

The quality of assessment of patients with chest pain: the development of a questionnaire to audit the nursing assessment record of patients with chest pain.

The quality of nursing and medical records has been a source of concern for many years (Audit Commission 1995). This study has two main purposes: firstly, to design an audit questionnaire to evaluate the quality of nursing assessment records of patients with chest pain; and secondly, to make some tentative conclusions about the quality of nursing assessment of patients with a chest pain in order to pinpoint areas that need further study. A sample of 30 patients was selected for this study on the basis of some well-defined inclusion criteria. The nursing assessment notes of these patients were evaluated using the audit questionnaire. It was found that the questionnaire was effective in gleaning appropriate information from the nursing notes to be able to derive some tentative conclusions about the quality of nursing assessment of patients with chest pain, i.e., on the whole nursing assessment was found to be superficially carried out, potentially making errors of omission and commission likely to occur. The inter-rater reliability of the questionnaire was found to be good. The questionnaire also seems to measure what it purports to measure (i.e. has content validity). However, this needs to be further checked by using a larger sample.

Adult↗