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PubMed2005

Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire.

OBJECTIVE: The objective of this study is to develop and validate a questionnaire designed to assess the culture, organization, and management of intensive care units. DESIGN: This is a prospective multicenter study. SETTING: The study was conducted in 26 intensive care units located in Paris. PARTICIPANTS: All personnel were asked to complete the questionnaire. INTERVENTION: The questionnaire was developed in 2 steps: (1) development of a theoretical framework based on organizational theory and (2) testing of the reliability and validity of a comprehensive set of measures. METHOD: The internal consistency of the items composing each scale was tested by using the Cronbach alpha. Convergent, and discriminant validity was assessed by factor analysis with varimax rotation. RESULTS: The overall completion rate was 74% with 1000 respondents (750 nurses, 26 head nurses, 168 physicians, and 56 medical secretaries). Starting with a 220-item questionnaire, we constructed a short version-conserving metrological characteristics with good reliability and validity. The short questionnaire, entitled Culture, Organization, and Management in Intensive Care, consists of 106 items distributed in 9 dimensions and 22 scales: culture (n = 3), coordination and adaptation to uncertainty (n = 3), communication (n = 3), problem solving and conflict management (n = 2), organizational learning and organizational change (n = 2), skills developed in a patient-caregiver relationship (n = 1), subjective unit performance (n = 3), burnout (n = 3), and job satisfaction and intention to quit (n = 2). All the scales showed good-to-high reliability, with Cronbach alpha scores higher than .7 (with the exception of coordination [.6]). Team satisfaction-oriented culture is positively correlated with good managerial practices and individual well-being. CONCLUSIONS: The Culture, Organization, and Management in Intensive Care questionnaire enables staff and managers to assess the organizational performance of their intensive care unit.

Attitude of Health Personnel↗

PubMed2005

Preliminary evidence on the measurement properties of the Chinese version of the Child Health Questionnaire, parent form (CHQ-pF50) and child form (CHQ-CF87).

UNLABELLED: The objective of this study was to evaluate the reliability and construct validity of the Chinese parent form (PF50) and child form (CF87) of the Child Health Questionnaire (CHQ). METHODS: To assess the construct validity and reliability of the Chinese versions, we invited 1099 parents of healthy children and 816 school children to complete the Chinese CHQ-PF50 and CHQ-CF87, respectively. RESULTS: Psychometric analysis on item convergent validity and discriminant validity showed > or = 99% rates of success for all 10 scales in the CF87 and > or = 94% for all but one scale in the PF50, the exception being general health scale (86%). We observed minimal floor effects for both questionnaires, but substantial ceiling effects for five scales in both the PF50 and CF87 (physical functioning, role-emotional/behavioral, role-physical, bodily pain and family activities). A substantially lower ceiling effect was observed for the physical scale and bodily pain in the CF87 (19% and 25%, respectively) relative to the PF50 (46% and 42%, respectively). The median alpha coefficient for CF87 and PF50 was 0.90 (range, 0.80-0.94) and 0.78 (range, 0.44-0.88), respectively. CONCLUSIONS: Our findings suggest that the Chinese CHQ-PF50 and CHQ-CF87 are robust and sufficiently reliable for group comparisons and perhaps also for use in other Chinese populations.

Adolescent↗

PubMed2004

Instrument development of the Self-Efficacy Scale for Abused Women.

The development of a scale to measure an abused woman's self-efficacy is described. The Self-Efficacy Scale for Abused Women (SESAW) originally was a 27-item 100-mm visual analog scale. It underwent face and content validity testing and was administered to a community sample of abused women (N = 50). The SESAW was tested for internal consistency, test-retest reliability, and construct validity. Cronbach's alphas were.95 and.96 at times 1 and 2, respectively. The bivariate correlation between the SESAW at times 1 and 2 was r =.85, p <.01. Construct validity was established by a moderate bivariate correlation with the criterion as measured by the Self-Efficacy Scale-general/global subscale (r =.64, p <.01 at time 1, and r =.78, p <.01 at time 2). The SESAW was streamlined to 19 items. The SESAW is an acceptable measure of situation-specific self-efficacy in community-based abused women.

Adult↗

PubMed1999

Feasibility, validity and test-retest reliability of scaling methods for health states: the visual analogue scale and the time trade-off.

The feasibility, validity and reliability of the Time Trade-Off (TTO) and Visual Analogue Scale (VAS) methods in obtaining preference values for health states were compared in a random sample of the Spanish population (n = 294). Respondents valued 43 EuroQol-5D health states in face-to-face interviews. Convergent validity was assessed by examining the relationship between values, and the effect of sociodemographic and health variables on values was used as a means of assessing construct validity. Test-retest reliability was analysed in a subgroup of 50 respondents, using the intraclass correlation coefficient (ICC) and generalisability theory. Rates of non-response and missing data were low on both methods, though the VAS took considerably less time to administer. VAS and TTO values correlated highly (r = 0.92), though there were differences in the ordering of health states between methods, and in the number of health states rated worse than death. VAS values were compressed into a considerably smaller valuation space than TTO values. Respondents in higher educational categories assigned higher TTO values to 12 health states. Mean ICCs (95% CI) at individual level were 0.90 (0.88-0.92) and 0.84 (0.81-0.87) for the VAS and TTO, respectively. Generalisability analysis showed variance due to time to be 0 for both methods. In conclusion, the VAS was more feasible and slightly more reliable than the TTO, whilst doubt can be cast on the degree of convergent validity existing between the two methods. The compression of VAS values means that the TTO is likely to discriminate better between health states, and it may have greater construct validity if results from larger samples confirm that there are genuine differences between sociodemographic subgroups.

Adult↗

PubMed1993

Test of an instrument to measure function-related quality of life in patients with ulcerative colitis.

An instrument for measuring function-related quality of life (QOL) in patients with ulcerative colitis was tested for validity, reliability, and responsiveness, using concepts and statistical methods easily understandable for pharmaceutical researchers. For this 8-week study, 374 patients were randomised and received placebo or oral mesalazine (mesalamine) at 1g, 2g, or 4g daily. A 10cm visual analogue scale and patient diaries were used to measure the 12 QOL parameters at baseline and study termination. Physician's Global Assessment was measured at end-point and used to assess change in the disease state of each patient. Analysis of covariance was used to test the construct validity, reliability and responsiveness of the instrument. Construct validity (p less than or equal to 0.0001), reliability (p greater than 0.05), and responsiveness (p less than or equal to 0.0001) were established for all 12 parameters of the instrument. We conclude that the instrument demonstrated precision in measuring function-related QOL in patients with active ulcerative colitis. Furthermore, content validity was maximised by combining disease-specific and general questions in the instrument.

Adult↗

PubMed1995

The assessment of unwanted intrusive thoughts: a review and critique of the literature.

In this paper we review the assessment and measurement of normal unwanted intrusive thoughts, images, and impulses that are considered the basis of clinical obsessions. After highlighting some difficulties with how the definition of cognitive intrusion has been applied to the development of assessment measures, we evaluate the construct validity of a number of retrospective self-report instruments such as the Intrusive Thoughts Questionnaire, Cognitive Intrusions Questionnaire, and Obsessional Intrusions Inventory, as well as interview and diary procedures. Measures of personal responsibility and meta-cognitive beliefs, which are still in the developmental phase, are also discussed. We conclude with a number of recommendations and areas of further research which would strengthen the construct validity of measures of intrusive thoughts and related constructs.

Attention↗

PubMed2000

Development and validation of a self-report symptom inventory to assess the severity of oral-pharyngeal dysphagia.

BACKGROUND & AIMS: The aim of this study was to develop and evaluate the validity and reliability of a self-report inventory to measure symptomatic severity of oral-pharyngeal dysphagia. METHODS: Test-retest reliability and face, content, and construct validity of a prototype visual analogue scale inventory were assessed in 45 patients who had stable, neuromyogenic dysphagia. RESULTS: Normalized scores varied over time by -0.5% +/- 17.6% (95% confidence interval, -9.2% to 8.2%). Factor analysis identified a single factor (dysphagia), to which 18 of 19 questions contributed significantly, that accounted for 56% of total variance (P < 0.0001). After deletion of 2 questions with poor face validity and patient compliance, this proportion increased to 59%; mean test-retest change was -2% (95% confidence interval, -11% to 7%); and total score correlated highly with an independent global assessment severity score (r = 0.7; P < 0.0001). A mean 70% reduction in score (P < 0.0001) was observed after surgery in patients with Zenker's diverticulum (discriminant validity). CONCLUSIONS: Applied to patients with neuromyogenic dysphagia, the 17-question inventory shows strong test-retest reliability over 2 weeks as well as face, content, and construct validity. Discriminant validity (responsiveness) has been demonstrated in a population with a correctable, structural cricopharyngeal disorder. Responsiveness of the instrument to treatment in neuromyogenic dysphagia remains to be quantified.

Adult↗

PubMed1989

Factorial validity of the EE scales.

High 'expressed emotion' (EE) has been held to be predictive of a poor course in patients with schizophrenia, a finding that has emphasized the predictive validity of the EE measure. We review appropriate research examining properties of the EE measure to suggest that, in particular, little is known about the construct validity of the EE measure. We report a longitudinal study examining three measures of parental style (EE; Parental Bonding Instrument or PBI; and interviewer ratings). By comparing EE scale scores with ratings derived by an interviewer we find support for the accuracy of the process generating EE scale scores, and by factor analytic techniques we examine the factorial (construct) validity of the EE scales. A principal components analysis suggested two other dimensions of relevance in parents involved with a schizophrenic member (vigilance, and acceptance of illness in their child) which may be of value in predictive studies. We examined the capacity of interviewer-generated scores (as a simple clinical rating) and factor scores (as central constructs) to predict the course, and were unable to discriminate 'relapsers' and 'non-relapsers' with either predictor.

Adaptation, Psychological↗

PubMed2002

The practicality and validity of directly elicited and SF-36 derived health state preferences in patients with low back pain.

Recent research has derived preference scores from the SF-36. We compare the practicality and construct validity of SF-36 derived preference scores with directly elicited time trade off (TTO) and visual analogue scale (VAS) scores. In this observational study, low back pain (LBP), patients were asked to complete disease specific, generic (SF-36), and health state preference (VAS and TTO) instruments. Baseline SF-36 responses were converted to preference scores using six published algorithms. Response rates for the SF-36 derived and TTO preference values were 354 of 379 (93%) and 303 of 379 (80%), respectively. Thirty patients were excluded from the TTO exercise because of difficulties comprehending the scaling task. Choice based methods (standard gamble, TTO) yielded higher and more uniform estimates of preference (0.77-0.79) than non-choice based methods (VAS) (0.42-0.70). Directly elicited TTO values were variable and had less power to distinguish among patients with differing severity of LBP. All SF-36 derived preferences exhibited a minimum threshold implying a potential floor effect for severely ill patients. SF-36 derived preferences demonstrated good practicality and construct validity in this setting, however different methods will yield disparate estimates of marginal benefit. This emphasises the need for a standardised algorithm for deriving SF-36 preference scores.

Algorithms↗

PubMedDate not supplied

[HoNOS-Rome: an extended, customized, and longitudinal oriented version of the HoNOS].

AIMS: To clarify the acceptability, reliability and factorial validity of a new Italian version of the HoNOS called HoNOS-Rome. Its main innovations are both in design and in contents. METHODS: Face validity was assessed by surveying 3 focus groups. Reliability was assessed in 8 different pairs of raters on a sample of 24 patients; construct validity was analysed by factor analysis using a sample of 187 patients at 6 day centres. Acceptability was investigated by means an anonymous questionnaire filled by professionals that were using the instrument. RESULTS: Time of completion was low (range 4-12 minutes), the tool proved very acceptable and the reliability was good (weighted kappa > or = 0.71 for all items). Factor analysis was consistent with the division of HoNOS-Rome into four sensible factors accounting for 52% of the total variance. CONCLUSIONS: The findings indicate that HoNOS-Rome has a satisfactory degree of acceptability, construct validity and reliability, and may promote the routine evaluation of outcomes in mental health services.

Adolescent↗

PubMed2000

The development and validation of the Sense of Support Scale.

Two studies were conducted to develop and validate the Sense of Support Scale (SSS). Study 1, which consisted of scale development and an evaluation with a sample of corporate and university employees, supported the scale's internal consistency and construct validity. Study 2, which was conducted with a sample of undergraduate students, was designed to evaluate the revised and shortened version of the SSS. The scale was found to be internally consistent and had a high test-retest reliability. Concurrent validity was supported by significant correlations to the Social Provisions Scale and the Interpersonal Support Evaluation List. Construct validity was supported by significant positive correlations to hardiness and approach-coping and significant negative correlations to avoidance-coping, stress, and symptoms of illness. The relationship between the SSS and symptoms of illness supported a main effect rather than a stress-buffering model. Implications for using the SSS to investigate the influences of social support on health are discussed.

Adaptation, Psychological↗

PubMed2005

Reliability and validity of the Self-Efficacy for Performing Energy Conservation Strategies Assessment for persons with multiple sclerosis.

The purpose of the study was to determine the test-retest reliability, internal consistency, and construct validity of the Self-Efficacy for Performing Energy Conservation Strategies Assessment (SEPECSA) for persons with multiple sclerosis (MS). The current study was part of a larger study (Mathiowetz et al., in review) to determine the effects of the Packer et al. (1995) energy conservation course. Thirty-six individuals were recruited from the local MS society. Participants completed the SEPECSA three times with a six-week control period between the first two assessments and the six-week Packer course between the second and third assessments. The test and retest correlation was high (r = .776, ICC = .771) indicating good reliability of the SEPECSA. Construct validity was supported by the significant increase in SEPECSA score after the Packer et al. course. The results of the study demonstrated that the SEPECSA is a reliable and valid assessment for individuals diagnosed with MS. Limitations of this study included its confinement within a larger study and the eight individuals who did not complete this study in its entirety. Future research will include a follow-up study of individuals who completed the course to determine the use and effectiveness of the energy conservation strategies.

Adult↗

PubMedDate not supplied

Evaluating the performance of the Centers for Disease Control and Prevention core Health-Related Quality of Life scale with adolescents.

OBJECTIVE: The purpose of this study was to evaluate the performance of the Centers for Disease Control and Prevention's core Health-Related Quality of Life (HRQOL) scale using data from 5,520 public high school students. METHODS: The 1997 South Carolina Youth Risk Behavior Survey was the source of data. Chi-square analysis was applied to assess scale construct validity. Adjusted multiple logistic regression with selected tobacco and substance use variables was used to assess known-groups validity of the scale's Healthy Days index (items regarding poor physical and mental health days during the past 30 days). RESULTS: Construct validity was supported for the core HRQOL scale by the associations between self-perceived health and physical health, mental health, and activity limitation days. A greater number of poor physical health days, poor mental health days, or activity limitation days was associated with poorer self-perceived health (p<0.0001); however, correlation coefficients for the associations between self-perceived health and physical health days (r=0.24; p<0.001), self-perceived health and mental health days (r=0.26; p<0.0001), and self-perceived health and activity limitation days (r=0.23; p<0.0001), although significant, were low in magnitude. Logistic regression analyses conducted with the Healthy Days index revealed significant (p<0.05) HRQOL differences between users and non- users of tobacco and other substance use variables. As hypothesized, as the usage of each substance increased, reported poor HRQOL days increased, supporting the known- groups validity of the scale. CONCLUSIONS: This study provides preliminary evidence that the HRQOL scale items are valid and potentially useful for adolescent surveillance. The results, however, are mixed regarding the inclusion of self-perceived health as a measure of HRQOL for adolescents, given the low correlation coefficients for the associations between self-perceived health and the other HRQOL scale items. These results suggest that adolescents may be rating two separate dimensions of health when rating their self-perceived health and HRQOL. Further research is needed to confirm these findings in different adolescent populations.

Adolescent↗

PubMed1998

Screening of depression in patients with chronic medical diseases in a primary care setting.

BACKGROUND: Patients with chronic medical diseases may have depression that is not recognized by their primary care physicians. OBJECTIVES: We aimed to examine the application of Zung's Self-Rating Depression Scale (SDS) in the screening of depression in primary care patients with chronic medical diseases in a Chinese population. METHODS: We studied 268 patients with chronic medical diseases in the Family Medicine Outpatient Clinic using a structured questionnaire including basic demographic data, a Chinese version of the SDS and a rating for the self-perceived severity of physical condition. The severity of chronic medical diseases was assessed by the authors using the Duke University Severity of Illness Scale from a chart audit. Fifty patients were randomly selected for a diagnostic interview according to the DSM-IV criteria. The construct validity and internal consistency reliability, sensitivity and specificity of the SDS were examined. RESULTS: The results revealed that the SDS has good construct validity and internal consistent reliability in the evaluation of depression in Chinese patients with chronic medical diseases. A cut-off point of 55 had a sensitivity of 66.7% and a specificity of 90.0%. Depressed patients reported more cognitive symptoms than depressed affect and physical symptoms. Female patients had more severe depressed affect than male patients, but males had more prominent diurnal variation of mood than females. CONCLUSIONS: We concluded that SDS can be a good screening tool for depression in Chinese patients with chronic medical diseases. Owing to constraints in the expression of sexual desire in the Chinese, elderly subjects tended to report loss of libido in the response to the SDS.

Adult↗

PubMed1985

MMPI Scales for measuring Eysenck's personality factors.

Four new MMPI Scales were constructed to identify Eysenck's personality factors of psychoticism, extraversion, and neuroticism as well as a lie score. The scales showed good construct validities against the Eysenck Personality Questionnaire and the Friedman Overlap Scales developed from items in the MMPI. The study also supported the construct validity of the Friedman overlap scales.

Journal Article↗

PubMedDate not supplied

EPM-ROM Scale: an evaluative instrument to be used in rheumatoid arthritis trials.

Different tools are available for the measurement of functional status; however, only a few of them are based on the evaluation of the joint range of motion (ROM). This study is aimed at the design and evaluation of the measurement properties of a ROM scale to be used as an evaluative instrument in rheumatoid arthritis (RA) trials. The EPM-ROM Scale evaluates 10 distinct movements of the small and large joints. The score of each joint varies from 0 (full movement) to 3 (severe limitation) and the cut-off degrees of motion are, in general, based on the lack of ability to perform some determined activities of daily living. The test-retest characteristic of the scale was assessed by administering the scale twice, 5 days apart, to 35 RA patients. The product moment correlation was 0.775 (P less than 0.001). The cross-sectional construct validity of the scale was assessed by the concomitant scoring of the EPM-ROM Scale and the functional ability dimension of the Health Assessment Questionnaire (a reliable, valid and responsive instrument) in these patients. The product moment correlation was 0.518 (P less than 0.001). The evaluation of its longitudinal construct validity and responsiveness are now in progress.

Arthritis, Rheumatoid↗

PubMed1995

Validation of the revised UCLA Loneliness Scale for adolescents.

The purposes of this study were to determine the dimensionality of the revised UCLA Loneliness Scale for adolescents through factor-analytic techniques, and to provide construct validity for the instrument by testing four theoretically derived hypotheses in 333 adolescents, ages 12 to 21. Using a prior criteria, a two-factor structure, resulting from a principal components analysis with an orthogonal rotation, best represented the dimensionality of the instrument for adolescents. The two factors demonstrated acceptable coefficient alpha reliabilities. Evidence of construct validity for the total scale was provided by three statistically significant correlations found between the scale and the theoretically relevant variables of future time perspective, close friend solidarity, and dependency. Contrary to expectation, slow tempo was not appreciably related to loneliness. The results support the use of the revised UCLA Loneliness Scale in future research concerning loneliness in adolescents.

Adolescent↗

PubMed2006

The development and validation of the impact of multiple sclerosis scale and the symptoms of multiple sclerosis scale.

OBJECTIVE: To develop and validate the Impact of Multiple Sclerosis Scale (IMSS) and the Symptoms of Multiple Sclerosis Scale (SMSS) using the Extended Disability Status Scale (EDSS) for construct validity. DESIGN: Panel design involving test-retest over 4 months. SETTING: A mailed survey. PARTICIPANTS: Volunteers with a diagnosis of multiple sclerosis (MS) recruited from an MS support service in Australia: 193 people (mean age, 39y) and 150 people participated at time 1 and time 2, respectively. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Principal components analyses, the Cronbach alpha, and descriptive statistics for the 2 scales; correlations for construct validity with the EDSS and retest; and confirmatory factor analysis to test the stability of IMSS and SMSS components over time. RESULTS: The IMSS yielded 5 independent and reliable components; the SMSS yielded 3 components; both component structures were stable over time. These scales showed convergent validity with the EDSS. CONCLUSIONS: The IMSS and SMSS are psychometrically sound scales suitable for clinical and research purposes to assess the symptoms and impact of MS.

Adult↗