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PubMed2004

A computerized adaptive knowledge test as an assessment tool in general practice: a pilot study.

Advantageous to assessment in many fields, CAT (computerized adaptive testing) use in general practice has been scarce. In adapting CAT to general practice, the basic assumptions of item response theory and the case specificity must be taken into account. In this context, this study first evaluated the feasibility of converting written extended matching tests into CAT. Second, it questioned the content validity of CAT. A stratified sample of students was invited to participate in the pilot study. The items used in this test, together with their parameters, originated from the written test. The detailed test paths of the students were retained and analysed thoroughly. Using the predefined pass-fail standard, one student failed the test. There was a positive correlation between the number of items and the candidate's ability level. The majority of students were presented with questions in seven of the 10 existing domains. Although proved to be a feasible test format, CAT cannot substitute for the existing high-stakes large-scale written test. It may provide a reliable instrument for identifying candidates who are at risk of failing in the written test.

Algorithms↗

PubMed2005

The high-level mobility assessment tool (HiMAT) for traumatic brain injury. Part 1: Item generation.

PRIMARY OBJECTIVE: To generate a comprehensive list of items for a scale suitable for assessing high-level mobility in people with traumatic brain injury (TBI). RESEARCH DESIGN: High-level mobility items were generated following a critical evaluation of existing adult and paediatric mobility scales and by surveying expert clinicians for opinions about items appropriate for inclusion on a high-level mobility scale. MAIN OUTCOMES AND RESULTS: The critical evaluation identified 18 different items from 31 mobility scales. These included nine walking items in addition to higher level activities such as stair use, running, jumping and hopping. Expert clinicians generated 157 items that were collated and condensed to 88 items for ranking on a questionnaire. Fifteen items on the questionnaire were rated as very important by 80% of the expert clinicians. These included walking forwards, walking on slopes and different surfaces, changing direction, walking long distances and stair use. Running items included forwards, backwards, on slopes and over different surfaces, changing direction, stopping and starting as well as running long distances. Balancing in single limb stance was also included. CONCLUSION: The final list comprised walking, running, hopping, skipping, jumping and balance items. This initial version of the HiMAT has face and content validity although requires further testing to investigate whether it is uni-dimensional and valid for people with TBI.

Activities of Daily Living↗

PubMed1997

Development of a cadence curl-up test for college students.

The purpose of this study was to evaluate a cadence curl-up test in a college population as compared to the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) 1-min sit-up test (Association for Research and Professional Councils and Societies, 1985) and the Robertson 1-min curl-up test (Robertson & Magnusdottir, 1987). A cadence curl-up test, referred to as the GT curl-up test, was set at 25 repetitions per minute. A total of 205 college students completed three trials consisting of one AAHPERD sit-up trial and two GT curl-up trials. A subsample (n = 85) completed the Robertson curl-up test as a fourth trial. Trials were counterbalanced with 7 days rest between each test. To evaluate content validity, electromyography signals from selected muscle sites were measured on 6 participants for each of the three tests. Mean scores and standard deviations for the GT curl-up test, AAHPERD sit-up test, and Robertson curl-up test were M = 46.2, SD = 17.8; M = 46.4, SD = 10.2; and M = 69.7, SD = 14.1), respectively. Pearson product moment correlations among the three tests were low to moderate (r < or = .50). The intraclass correlation reliability estimate for the GT curl-up test was 0.92. In 1-min speed tests, repeated rapid trunk flexion can adversely affect technique and has raised safety concerns (Jette, Sidney & Cicutti, 1984; Faulkner, Sprigings, McQuarrie, & Bell, 1989; Cooper Institute for Aerobics Research, 1994). The Robertson test also requires the use of a curl-up frame. In the GT cadence test these drawbacks are minimized due to a slower, more controlled movement with an objective endpoint that is not dependent on special equipment. Moreover, our EMG findings supported previous reports that curl-up exercise with feet unanchored minimizes rectus femoris involvement. Based on the results of this study, the CT curl-up test was found to be a reliable field test with logical validity supporting its relevance as an index of abdominal muscular endurance among college students.

Abdomen↗

PubMed2001

Adaptation into Danish of the Stanford Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Scale (RAQoL).

OBJECTIVES: The study was designed to adapt the Stanford Health Assessment Questionnaire (HAQ) and the Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) for use in Denmark. METHOD: The instruments were translated into Danish and then field-tested with 10 RA patients for relevance, and face and content validity. Reliability and validity were assessed by administering the new measures and a comparator instrument (the Danish Nottingham Health Profile) to 80 RA patients on two occasions. RESULTS: Patients found both measures acceptable and easy to complete. They had good test-retest reliability (>0.90) and internal consistency and were both able to discriminate between groups with different levels of functional status and self-perceived severity. When compared with the NHP sections, both measures showed expected convergence and divergence. CONCLUSION: Given the excellent psychometric properties of the Danish versions of the RAQoL and HAQ, both are recommended for inclusion in clinical trials and studies.

Adult↗

PubMed1990

Measurement issues in the use of the Coopersmith Self-Esteem Inventory with Navajo women.

In this article the authors describe the measurement error associated with the Coopersmith Self-Esteem Inventory when used with a population of Navajo women. This instrument was used with 29 Navajo women to determine if the questions were culturally acceptable. The results showed that this instrument has some content validity issues when used with Navajo women. More research is needed using this instrument as well as other psychometrically sound self-esteem measures with cultural and racial groups other than whites.

Adolescent↗

PubMedDate not supplied

Is Rubin's "taking-in" and "taking-hold" a useful paradigm?

Rubin's "taking-in" and "taking-hold" model has been a dominant paradigm for postpartum nursing. To determine whether "taking-in" and "taking-hold" apply to contemporary hospitalized postpartum women, I conducted a repeated measures survey of 95 women with uncomplicated postpartum courses after vaginal births during their hospital stay. "Taking-in" and "taking-hold" were measured with the Martell Postpartum Questionnaire-Revised (MPQ-R), a paper-and-pencil instrument. An expert panel established the content validity of the MPQ-R in this study. Cronbach's alpha for the two subscales ranged from .40 to .60, a result of skewed distribution of items or lack of variability in scores. The participants were neither "taking-in" nor "taking-hold." The distribution of the participants' responses was similar to each others' and indicated that their postpartum experiences included some aspects of both "taking-in" and "taking-hold." Despite the limitations of the MPQ-R and the research methods, the findings suggest that Rubin's theory has limited usefulness for postpartum nursing of contemporary women.

Adaptation, Psychological↗

PubMed1990

The Life Closure Scale: a measure of psychological adaptation in death and dying.

The Life Closure Scale (LCS) is a measure of the multidimensions of psychological adaptation during the dying process and was developed in two phases. The first phase of instrument construction was based on a retroductive method utilizing: theoretical and empirical sources, a small qualitative study and analysis of concept definitions. Three subscales identifying dimensions of psychological processes and patterns of adaptation were defined: the self-reconciled, self-restructuring, and self-closing. A corrected content validity of .83 was established by a panel of experts. The LCS scale of 45 items was devised into a 5 point Likert scale with responses from 1 (not at all) to 5 (most of the time). Phase two began a study, with 45 hospice subjects, to determine internal consistency reliability and construct validity. On preliminary testing with 20 subjects, the self-closing subscale was found to interrelate with the other two subscales. An intercorrelation of r = -.10 defined the presence of two independent subscales: the self-reconciled and the self-restructuring. Internal consistency reliability coefficients of a = .85 for the self-reconciled subscale and a = .86 for the self-restructuring subscale. Construct validity is reported for the LCS. A Pearson correlation coefficient of r = .75 was found between the LCS and the convergent measure of quality of life and an r = -.60 substantiated discriminant validity with a depression tool. Plans for tool development include further testing.

Adaptation, Psychological↗

PubMed1992

Psychosocial antecedents of athletic injury: the effects of life stress and social support on female collegiate gymnasts.

The article presents information from two studies of a research program investigating psychosocial antecedents of athletic injury. Study 1 describes the development of the Life Events Survey for Collegiate Athletes (LESCA). The LESCA demonstrated good content validity and provided a stable measure of life stress. The LESCA's validity and the moderating effects of social support were explored in the second study. The LESCA provided a construct-valid measure of life stress and was a better predictor of athletic injury than the Social and Athletic Readjustment Rating Scale. Social support moderated the stress-injury relationship in such a way that LESCA negative life stress accounted for 11% to 22% of injury variances in low-support conditions; LESCA positive life stress accounted for 14% to 20% of injury variances in high-support conditions. Mechanisms underlying the stress-injury relationship and directions for future research are discussed with respect to the model outlined by M. B. Andersen and J. M. Williams in 1988.

Adolescent↗

PubMed1995

Development of a physical characteristics assessment (PCA): a checklist for determining appropriate computer access for individuals with cerebral palsy.

The physical characteristics assessment (PCA), a newly developed illustrated checklist, is designed for use by allied health and education professionals to identify a viable method for an individual with cerebral palsy to access a computer. The PCA was developed in response to a documented void of such assessments in the literature. The value of PCA was assessed with respect to content validity, clinical utility, reliability (inter-rater), and opinion of persons with cerebral palsy and health and education professionals. Professionals (n = 72) and persons with cerebral palsy (n = 78) from 20 sites in Canada, Chile, England, Israel, Spain, and the United States participated in the study. Statistically, the PCA produced a highly significant (p < 0.001) assessment time savings compared with non-PCA methods. A statistically significant difference in the number of user/computer interface changes during five post-assessment computer training sessions was not shown between the PCA and non-PCA methods. Inter-rater reliability ranged between 90% and 100% (n = 33 pairs). Both persons with cerebral palsy assessed via the PCA and professionals using the PCA gave positive opinions. Overall results support the value of the PCA.

Cerebral Palsy↗

PubMed2000

Item analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) is an outcomes assessment tool designed to measure satisfaction with assistive technology in a structured and standardized way. The purpose of this article is to present the results of an analysis of the 24 items comprising QUEST and to explain how a subset of items demonstrating optimal measurement performance was selected. The criteria against which the items were measured were general acceptability, content validity, contribution to internal consistency, test-retest stability, and sensitivity. The items that ranked best in terms of these measurement properties were submitted to factorial analysis in order to complete the item selection. The first series of analyses reduced the item pool approximately by half, and the second series of analyses led to the final selection of 12 items. Factor analysis results suggested a bidimensional structure of satisfaction with assistive technology related to the assistive technology device (eight items) and services (four items). The 12-item revised version that will result from this study should prove to be a reliable and valid instrument for measuring outcomes in the field of assistive technology.

Consumer Behavior↗

PubMedDate not supplied

A novel inexpensive IV catheterization training model for paramedic students.

INTRODUCTION: Teaching paramedic students venipuncture and intravenous catheterization has traditionally relied on bulky, expensive phlebotomy models. A gelatin intravenous model (GIM) costing less than 50 cents is currently being used in the training of medical students and interns. The study objective was to evaluate paramedic students' perceptions of the GIM as a training tool. METHODS: GIMs are created using gelatin, psyllium, Penrose drains, food coloring, salt, and water. Penrose drains are filled with artificial blood composed of salt water and food coloring. The drains are placed in an aluminum pan with a base of hardening gelatin, with half-inch drains at the bottom of the pan and quarter-inch drains higher up in layers of mixed psyllium and gelatin to simulate deep and superficial veins respectively. A convenience, volunteer sample of 14 paramedic students who previously trained with traditional phlebotomy models each made two to five attempts at intravenous insertion using the GIM. Perceptions of the GIM were measured using a Likert scale (1, worst rating; 5, best rating). Means are reported. RESULTS: Study subjects rated ease of use at 4.17, realism at 4.07, and effectiveness in learning intravenous insertion at 4.28. GIM as a more effective teaching tool than the conventional rubber arm yielded a rating of 4.14. CONCLUSIONS: This study is limited by a small sample size, and further studies evaluating the GIMs construct and content validity are needed. Despite these limitations, given the GIMs simplicity and value, paramedic instructors may wish to consider implementation of this device in their training programs.

Adult↗

PubMed2006

A preliminary psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people living with a spinal cord injury.

This study aimed to evaluate the preliminary psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a community sample of adults living with a spinal cord injury (SCI). A cross-sectional design was used with 963 people living in the community with an SCI. Participants were recruited via three spinal centres in the United Kingdom. They completed the HADS and the Life Satisfaction Questionnaire. Psychometric analyses were conducted for the whole sample, by gender and level of injury. The HADS demonstrated good internal consistency, with promising content validity. Two factors, approximating to anxiety and depression were extracted via factor analysis for the whole sample, by gender and level of injury. In line with existing literature, females scored significantly higher than males on the anxiety subscale. Item 7 ("I can sit at ease and feel relaxed") was found to be a complex item, with a potentially different meaning within this population. This study presents preliminary findings, which support the psychometric integrity of the HADS within an outpatient population with SCI. Items that included potential somatic components revealed a more complex factor loading profile. Recommendations are made to further investigate this measure with amendments to such items, incorporating inpatients and independent measures of anxiety and depression to address validity directly.

Adult↗

PubMed1999

Cultural diversity, stress, and depression: working women in the Americas.

Social support lengthens life, and stressors induce morbidity early in life and death later. Social supports and stressors, however, particularly those embedded in daily social interactions, exhibit important forms of cultural variation not yet incorporated into stress measurements. This article reports a clinically useful measure of stress applicable to culturally diverse populations. Ninety working women with a wide range of ages, educational attainments, class backgrounds, and historical origins (Africa, northwest Europe, Hispanic, and Native Americans) provided cultural data on the meaning of stress. Consensus analysis, principal components analysis and Cronbach's alpha, and logistic regression document content validity of the stress scale items and the reliability and construct validity of the stress scale. The meaning of social supports (words or acts that imply respect, equality, or help or otherwise lead one to feel special and important) and stressors (words or acts that demean, imply inferiority, impede achievement, or otherwise lead one to feel bad about oneself) experienced in the course of daily social interaction cuts across cultural differences in other realms of life. Informants with a recent history of stress experienced a risk of depressive symptoms 85 times higher than informants without such a history. Standardized cultural research methods yield an instrument based on potential cultural universals that can facilitate clinical assessment and management of stress and health outcomes, such as depression, in culturally diverse populations.

Achievement↗

PubMed1999

Infant acceptance and effectiveness of a new oral liquid medication delivery system.

A medication acceptance scale (MAS) for pediatric oral liquids was developed and used to evaluate effectiveness and infant acceptance of a medication delivery system. The MAS incorporated five behavioral elements associated with pediatric drug administration: cry, facial expression, body movement or level of agitation, reaction to placement of medication in the mouth, and swallowing. A score of 1-10 was possible, with 10 indicating the highest level of infant acceptance. Preliminary field testing was conducted. In an open-label clinical study, a single dose of acetaminophen was administered to 20 infants with approximately one fluid ounce of infant formula or apple juice by pediatric nurses using the Rx medibottle (The Medicine Bottle Company). Past medication acceptance was rated on an infant global acceptance scale. The intended dose, the amount consumed, and the time taken to administer the dose were recorded. Infant acceptance was independently scored by a nurse and two pharmacists. A high preliminary estimate of internal consistency reliability of the MAS was found. Interrater reliability was high, with the highest correlation between the two pharmacists. Sixteen (80%) of the infants received 100% of the intended dose; it took 0.5-9 minutes to administer these doses. The median MAS score was 9 for each of the three raters. Mean MAS scores for the three raters were 7.85 and 7.45 (pharmacists) and 8.50 (nurse). There was a strong correlation between MAS scores and infant global acceptance scale scores. A pediatric oral liquid MAS that had content validity, concurrent validity, high internal consistency reliability, and high interrater reliability was developed; the Rx medibottle was an effective oral liquid medication delivery system and had a high level of infant and rater acceptance.

Acetaminophen↗

PubMed1984

Written simulation of patient-doctor encounters. 1. Research instrument for registration of the performance of general practitioners.

A written simulation of patient-doctor encounters is described, involving five patients with vague complaints, an 'instruction' patient with sinusitis and a 'test' patient with acute appendicitis. Nineteen general practitioners were confronted with it. The extent to which the simulation distorted reality and the implications of such distortions were considered in an attempt to assess the content validity. The conclusion was that the simulation gave a realistic impression of the general practitioners' diagnostic and therapeutic approach to patients with vague complaints. The searching procedures in relation to the complaint and the patient's perception of the complaint were adequately depicted, and the therapeutic procedures approximated closely to reality. There was some distortion in the attention paid to psychosocial aspects as these were given more attention in the simulation than they receive in reality.

Acute Disease↗

PubMed1983

Structure and development of metamemory in adulthood.

A multiple factor instrument was designed to represent a multidimensional construct of metamemory. Eight theoretically meaningful dimensions were defined: (a) Use of memory strategies (Strategy); (b) Knowledge of memory tasks (Task); (c) Knowledge of own memory capacities (Capacity); (d) Attitudes toward own memory: Perception of change (Change); (e) Activities supportive of memory (Activity); (f) Memory and state anxiety (Anxiety); (g) Memory and achievement motivation (Achievement); and (h) Locus of control in memory abilities (Locus). After content validity was established for a pool of items, the instrument was administered sequentially to three separate samples of adults. Computation of internal consistency estimates (by age and sample) and factorial validity (by sample) resulted in a 120-item instrument. Multivariate analyses of variance revealed robust significant age differences on the Task. Capacity, Change, and Locus subscales, with young adults evincing higher levels of knowledge regarding the first three of these dimensions, and more internality on the fourth, than older adults.

Adolescent↗

PubMed1991

Burden: a review of measures used among caregivers of individuals with dementia.

This paper critiques and discusses 10 measures of burden that have been used with caregivers of individuals with dementia. Current measures target diverse caregiver and care recipient populations, and vary in conceptualization and measurement of burden. Although many measures contain reliability data, relatively few report content validity, convergent/divergent validity, criterion validity, or sensitivity to change. Implications of these limitations for research and clinical practice are discussed.

Alzheimer Disease↗

PubMed1991

The screen for caregiver burden.

The Screen for Caregiver Burden (SCB) is a measure designed to identify distressing caregiver experiences rapidly. The 25-item SCB, created specifically for spouse caregivers of Alzheimer's care recipients, provides scores for objective burden (OB; number of potentially negative experiences) and subjective burden (SB; appraised distress in response to the experiences). Three separate studies (total N = 191) demonstrate the internal consistency, test-retest reliability, and validity (content, divergent, convergent, and criterion) of the scales. Finally, evidence suggests that changes in OB and SB over time are explained by changes in care-recipient functioning and caregiver distress.

Aged↗