SEARCH · PubMed Health

Results for “construct validity”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,333 records · Page 74Linked to original sources

PubMedDate not supplied

The validity and reliability of a Chinese version of the family burden interview schedule.

BACKGROUND: The caregiver burden within the family is one of the most commonly used outcome variables in research studies of patient care provision. However, few measures of family caregiver burden have been validated for use with Asian populations. OBJECTIVE: To examine the reliability and validity of the Chinese version of the Family Burden Interview Schedule. METHOD: The first phase of the investigation involved translation and back translation of the measure for burden and a review by an expert panel. In this phase, equivalence between the Chinese and English versions, content validity, and test-retest reliability of the Family Burden Interview Schedule were assessed using a sample including 30 family caregivers of mental patients. The second phase established the internal consistency and construct validity of the scale using a sample comprising 185 family caregivers of patients with schizophrenia. Sensitivity of the scale for families of schizophrenic patients was examined through comparison with 40 caregivers of patients who had major affective disorder. RESULTS: The Chinese version of the Family Burden Interview Schedule adequately addressed the original concepts and dimensions, achieving 96% on the Content Validity Index. These results demonstrated high levels of equivalence with the original English version (intra-class correlation [ICC] of .87 for the overall scale and.80-.89 for the six domains). It also demonstrated a high internal consistency (Cronbach alpha of .87 for the scale and .78-.88 for the domains) and adequate test - retest response stability (r = .83 for the scale and r = .88-.92 for the domains). The mean scores for the overall scale and domains of the Family Burden Interview Schedule differed significantly between the family providers of care for the two illness groups and between the groups with high and low time involvement in caregiving. The principal components analysis showed the presence of five factors that together explained 65.85% of the variance. It also demonstrated high factor loadings as well as item-to-scale and between-subscales intercorrelations, indicating good construct validity of the burden measure. DISCUSSION: The findings for the psychometric properties of the Chinese version of the Family Burden Interview Schedule established its potential as a research instrument for measuring caregiver burden among Chinese patients with schizophrenia.

Asian People↗

PubMed2001

Construction and validation of automated purge-and-trap-gas chromatography for the determination of volatile organic compounds.

An automated purge-and-trap chromatographic system for the determination of dissolved volatile organic compounds in aqueous samples was built in the laboratory with minimum cost both in the construction and routine operation. This system was built upon a commercial gas chromatograph with full automation capability using self-developed hardware and software. The use of a multi-sorbent bed quantitatively trapped a wide range of volatile organic compounds at ambient temperature, including the extremely volatile ones such as dichlorofluoromethane (CFC-12). Flash heating for rapid desorption and adequate plumbing for minimizing dead volume resulted in excellent chromatographic separation at above-ambient temperatures, which eliminated the need for cryogen for cooling at the head of the column, a second refocusing stage, or entire GC oven for refocusing. This cryogen-free system was tested with standard solutions and environmental samples for determining hydrocarbons with flame ionization detection, and halogenated compounds with electron-capture detection. An innovative method was also developed for validating the system's linearity for extremely volatile compounds. By introducing ambient air, which usually contains constant levels of anthropogenic halocarbons, e.g., CFC-12 and CFC-11 (CCl3F), the need to prepare aqueous standards containing extremely volatile compounds is avoided, hence providing a convenient method for evaluating a purge-and-trap system.

Automation↗

PubMed1997

Development and validation of an instrument to measure factors related to colorectal cancer screening adherence.

This report describes the development and refinement of a set of scales for use in research on predictors of colorectal cancer screening adherence. The study population included 2693 of 4490 eligible white male automotive employees who answered a mailed questionnaire (60% response rate) on beliefs and attitudes related to colorectal cancer and screening. Exploratory and confirmatory factor analyses and multitrait scaling analysis were used to evaluate the construct validity of a priori scales developed to measure salience and coherence, perceived susceptibility, worries about screening, screening efficacy, social influence, and intention. Analyses supported the construct validity of scales for salience and coherence, perceived susceptibility, and worries about screening. Four items originally assigned to the salience and coherence construct loaded on a separate factor that appeared to measure self-efficacy. There was no empirical support for scales measuring screening efficacy and social influence, and there was limited empirical support for a scale measuring intention. Confirmatory factor analysis of the scales measuring salience and coherence, self-efficacy, perceived susceptibility, and worries about screening showed a similar factor structure in white men with and without a personal history of polyps, indicating that the scales may be useful for studies of both colorectal cancer screening and surveillance. Multitrait scaling analysis showed some support for internal consistency reliability of those scales in women (n = 42) and in African-American men (n = 56), and there was some support for the factor structure in those two subgroups. Future studies should evaluate the psychometric properties of these and similar scales in diverse population subgroups.

Adult↗

PubMed2003

The Maine-Seattle back questionnaire: a 12-item disability questionnaire for evaluating patients with lumbar sciatica or stenosis: results of a derivation and validation cohort analysis.

STUDY DESIGN: Analysis of health-related quality of life data obtained from a prospective cohort study of patients with sciatica due to an intervertebral disc herniation or lumbar spinal stenosis. OBJECTIVE: To derive and validate a shortened version of a previously validated 23-item modification of the Roland-Morris Disability Questionnaire. SUMMARY OF BACKGROUND DATA: For patients with low back pain, improving health-related quality of life is often the main goal of therapy. The Roland-Morris Disability Questionnaire is one of the best validated and most frequently used back-specific functional status measures. A shortened version may permit more widespread use in clinical and research settings. METHODS: Data from 507 patients with sciatica enrolled in the Maine Lumbar Spine Study were used to derive a shortened version of a 23-item modification of the original Roland-Morris Disability Questionnaire using qualitative and cluster analysis techniques. The internal consistency, construct validity, reproducibility, and responsiveness in detecting change over a 3-month period for a new 12-item scale was compared to the original 23-item scale. The 12-item scale was then validated in an independent cohort of 148 patients with lumbar spinal stenosis. RESULTS: Internal consistency was very good but modestly lower for the 12-item instrument compared to the 23-item original scale. Reproducibility over a 3-month interval was good and did not differ between the 12-item and original scale. Findings from the validation cohort were similar or better than the derivation cohort. A high degree of construct validity with patient-reported symptoms was demonstrated for the 12-item and original scales. The responsiveness and interpretability of the 12-item scale over 3 months was excellent and comparable to the original scale. Responsiveness assessed in patients with lumbar spinal stenosis in the independent validation cohort showed consistent findings compared to patients with a disc herniation in the derivation cohort. CONCLUSIONS: This short, simple, self-administered 12-item back-specific functional status questionnaire performed extremely well in comparison with the original 23-item scale. If validated in additional study populations, this new questionnaire may be useful in the clinical setting as a way for providers to prospectively compare their outcomes of care to other patient populations, and to study treatment effectiveness.

Adult↗

PubMed2001

The validation of a nursing nutritional assessment tool for use on acute elderly wards.

BACKGROUND: Elderly people are at great risk of poor nutritional status. Identifying those at nutritional risk is complex owing to its multifactorial nature and highlights the need for an easily administered nutritional screening tool. AIM: To test the robustness of a tool used to identify those patients who require further dietetic assessment. METHOD: The tool was tested on an 'acute elderly' ward to assess its statistical robustness, i.e. test-retest reliability, inter-rater reliability, internal consistency and factor structure, concurrent and construct validity. The research was carried out by a dietitian and two nurses on an overall sample of 185 consecutive admissions. RESULTS: Test-retest results reflect that the tool is capable of yielding consistent assessments over time. Inter-rater reliability results revealed that when comparisons of agreement between nurses and dietitians were examined there was consistent disagreement. Internal consistency was found to be low but the rotated factor analysis suggested a relationship between the items in the tool. Concurrent validity was exhibited with body mass index, albumin and American Nutrition Risk Index only. Construct validity was not sufficiently exhibited with any of the measures used. CONCLUSION: The tool has not demonstrated reliability as determined by the statistical measures and hence validity at this stage. Issues which need to be addressed to allow this tool to be used appropriately are discussed.

Aged↗

PubMed2004

[Evaluating the reliability, validity and responsiveness of the german short musculoskeletal function assessment questionnaire, SMFA-D, in inpatient rehabilitation of patients with conservative treatment for hip osteoarthritis].

BACKGROUND: Modern patient based outcome measures like the SMFA-D (German Short Musculoskeletal Function Assessment Questionnaire) are able to detect the impairment and functional capacity of patients with musculoskeletal extremity disorders. The SMFA-D was successfully evaluated in several cohorts treated operatively for osteoarthritis of the knee and hip, rotator cuff tears and rheumatoid arthritis. The aim of the present study was the evaluation of the SMFA-D in patients with conservative treatment for hip osteoarthritis. PATIENTS AND METHODS: 69 patients with osteoarthritis of the hip were enrolled in a prospective controlled clinical trial. All patients completed the SMFA-D, SF-36, WOMAC, FFbH-OA. A standardized test of walking speed and the functional status of the patient as judged by the physician were recorded. Statistical analysis were done for the following: re-test reliability (ICC), internal consistency (Cronbach's alpha), validity and responsiveness. RESULTS: Internal consistency (Cronbach's alpha) was alpha = 0.89 and alpha = 0.97 for the SMFA-D scales. The retest reliability (ICC, unjust, mixed effect) was 0.91 (p < 0.001) for the function index and 0.73 (p < 0.001) for the bother index. Both indices correlated significantly with the FFbH-OA (r = 0.66 to r = 0.84), the WOMAC (r = 0.55 to r = 0.86) and the scales of the SF-36 (r = - 0.34 to r = - 0.85) on all three time points, which supports construct validity. There was mainly a significant correlation between the SMFA-D scales and the functional status of the patient (r = 0.21 to r = 0.44), pain reported by the patient (r = 0.43 to = 0.54) and the self selected walking speed (r = 0.28 to r = 0.51), which supports external validity. We were able to differentiate operatively and conservatively treated patients (discriminant construct validity). At the end of the rehabilitation program we were able to demonstrate small to medium treatment effects in SMFA-D and SF-36. The WOMAC and FFbH-OA were not able to demonstrate these treatment effects. CONCLUSION: Even in patients with conservative treatment of hip osteoarthritis the SMFA-D represents a reliable, valid and responsive measure. The use of the SMFA-D can be recommended as a patient based outcome measure.

Activities of Daily Living↗

PubMed2002

Development of a scale to measure patients' trust in health insurers.

OBJECTIVE: To develop a scale to measure patients' trust in health insurers, including public and private insurers and both indemnity and managed care. A scale was developed based on our conceptual model of insurer trust. The scale was analyzed for its factor structure, internal consistency, construct validity, and other psychometric properties. DATA SOURCES/STUDY SETTING: The scale was developed and validated on a random national sample (n = 410) of subjects with any type of insurance and further validated and used in a regional random sample of members of an HMO in North Carolina (n = 1152). STUDY DESIGN: Factor analysis was used to uncover the underlying dimensions of the scale. Internal consistency was assessed by Cronbach's alpha. Construct validity was established by Pearson or Spearman correlations and t tests. DATA COLLECTION: Data were collected via telephone interviews. PRINCIPAL FINDINGS: The 11-item scale has good internal consistency (alpha = 0.92/ 0.89) and response variability (range = 11-55, M = 36.5/37.0, SD = 7.8/7.0). Insurer trust is a unidimensional construct and is related to trust in physicians, satisfaction with care and with insurer, having enough choice in selecting health insurer, no prior disputes with health insurer, type of insurer, and desire to remain with insurer. CONCLUSIONS: Trust in health insurers can be validly and reliably measured. Additional studies are required to learn more about what factors affect insurer trust and whether differences and changes in insurer trust affect actual behaviors and other outcomes of interest.

Adult↗

PubMed1999

Reliability and validity of a new method of measuring posterior shoulder tightness.

STUDY DESIGN: Repeated measures of shoulder flexibility on nonimpaired subjects and intercollegiate baseball pitchers. OBJECTIVES: To present a new objective method of measuring posterior shoulder tightness, define the intratester and intertester reliability of the measurement, and assess its construct validity. BACKGROUND: Posterior shoulder tightness has been linked to anterior humeral head translation and decreased internal rotation. The reliability of an objective assessment of posterior shoulder tightness has yet to be established in the literature. METHODS AND MEASURES: Five repeat measurements were made using a standardized protocol on 21 nonimpaired subjects to determine intratester reliability. To determine intertester reliability, 2 testers (blinded to their measurement) each performed 1 measurement on 49 shoulders. Twenty-two intercollegiate baseball pitchers were measured once by 1 tester to evaluate the construct validity of the measurement. RESULTS: Measurements of posterior shoulder tightness performed by the same physical therapist had high reliability (ICC dominant = 0.92, nondominant = 0.95). Intertester measures revealed good reliability (ICC = 0.80). Pitchers had reduced dominant arm internal rotation and increased external rotation ROM compared to their other arm whereas nonimpaired subjects had less reduction in external rotation compared to the nondominant arm (pitchers: dominant, 109.7 degrees +/-2.4 degrees, nondominant, 98.9 degrees +/-1.6 degrees; nonimpaired subjects: dominant, 95.9 degrees +/-1.5 degrees, nondominant, 95.2 degrees +/-1.6 degrees) and internal rotation (pitchers: dominant, 50.0+/-2.0 degrees, nondominant, 69.5+/-2.5 degrees; nonimpaired subjects: dominant, 46.4+/-1.3 degrees, nondominant, 50.2+/-1.4 degrees). Pitchers had significantly greater posterior shoulder tightness compared to nonimpaired subjects (pitchers; dominant, 44.9+/-0.8 cm, nondominant, 37.5+/-0.7 cm, nonimpaired subjects; dominant, 32.9+/-0.8 cm, nondominant, 31.4+/-0.8 cm) and manifested a significant correlation between posterior shoulder tightness and internal rotation (r = -0.61) that was not evident in nonimpaired subjects. CONCLUSIONS: Measurement of posterior shoulder tightness using this technique is objective and reliable when done by the same physical therapist. Validity of this measurement is supported from the observation of athletes thought to have tight posterior structures. Further study is needed to determine the relationship of this measurement to patients diagnosed with shoulder impingement syndrome.

Adolescent↗

PubMed2000

Development and testing of the Family Caregiving Factors Inventory (FCFI) for home health assessment in Taiwan.

This paper describes the development and psychometric testing of the Family Caregiving Factors Inventory (FCFI). Data were collected from 97 caregivers of frail elders in Taiwan to examine the validity and reliability of the four FCFI scales: caregiving resources, caregiver self-expectations, caregiving task difficulty, and knowledge of the care receiver. Acceptable test-retest and internal consistency reliabilities were found, though inter-rater reliability was unsatisfactory for caregiving task difficulty and knowledge of the care receiver scales. Testing of hypothesized relationships between the FCFI and related variables supported the construct validity of the FCFI. Confirmatory factor analysis with good overall model fits also supported the construct validity of the FCFI scales. In its present form, the FCFI can facilitate home health assessment and problem identification for families with frail elders. Studies with larger samples are needed to further verify the measurement models.

Activities of Daily Living↗

PubMed2004

Impairment in childhood anxiety disorders: preliminary examination of the child anxiety impact scale-parent version.

Although anxiety disorders are prevalent among children and adolescents, with a chronic and often disabling course, there is a paucity of research examining the specific ways in which anxiety interferes with various domains of functioning in childhood. The purpose of the current investigation was to examine the initial reliability and construct validity of the Child Anxiety Impact Scale-Parent version (CAIS-P). The CAIS-P is a parent-report measure consisting of School, Social, and Home/Family subscales. In a clinical sample (N = 92), the internal reliability and the convergent and divergent validity were evaluated. Internal consistency was good for the total score as well as each subscale (Cronbach's alpha ranged from 0.73-0.87). The CAIS-P total score demonstrated good construct validity, showing predicted significant correlations with the Child Behavior Checklist Internalizing Scale and the Child Depression Inventory but not the Externalizing Scale of the Child Behavior Checklist. The Social subscale of the CAIS-P was also significantly correlated with measures of social anxiety. The results provide initial support that the CAIS-P is a reliable and valid measure for the assessment of the impact of anxiety on child and adolescent functioning.

Adolescent↗

PubMed1991

Patient satisfaction with hospital services: development and testing of a measuring instrument.

The present study was undertaken with the aim of developing and testing an instrument that could be used to measure patient satisfaction with hospital services in Kuwait. The instrument, which comprised 57 items, and measured satisfaction with 7 specific dimensions of hospital services, was administered to 493 patients using the interview technique. Statistical analysis showed that the instrument yields good response variability. Reliability of the instrument, measured in terms of the internal consistency coefficient alpha, exceeded the acceptable criterion level, the coefficients ranging between 0.73 and 0.86. Evidence of the construct validity of the instrument was found in significant positive correlation between the dimension specific satisfaction scale scores and scores for allegiance scale and for overall rating of quality of hospital services. Construct validity was further supported by convergent discriminant analysis, which showed that correlations between items of all 7 scales and their total scale scores were greater than correlations between scale items and the total scores of scales they do not represent. Analysis of an open-ended question about dissatisfying aspects of hospital services not included on the interview was undertaken to examine the instrument's content validity. Results indicated that patients identified 11 items, 8 of which were identified more than once, and 2 of which were not classifiable to the 7 dimensions assessed by the instrument. It was suggested to add the 8 items that were identified more than once, and to reassess the reliability and validity of the revised instrument. Assessment of the test-retest reliability, by comparing scale scores over time, was also suggested.

Evaluation Studies as Topic↗

PubMed2006

Technical skills continue to improve beyond surgical training.

BACKGROUND: There is growing focus on surgical technical competence and the means by which we are able to measure it. Ongoing studies have shown a plateau effect with increasing experience of the operator. The aim of this study was to assess the technical competence of five groups of surgeons with increasing experience and validate a new rating tool for use in surgical assessment. METHODS: Fifty surgeons performed a saphenofemoral junction ligation on a synthetic groin model. The procedure was videotaped, blinded, and reviewed independently by three assessors. Performance was assessed using a previously validated global rating scale of generic surgical skill. In addition, each procedure was rated with the procedure-specific Imperial College Evaluation of Procedure-Specific Skill (ICEPS) rating scale to establish the construct validity (ability to differentiate on the basis of skill) and inter-observer reliability. RESULTS: Both rating scales showed improved scores with ascending grades (P < .001) and demonstrated a high inter-observer reliability both for generic and procedure-specific skill (alpha = 0.97 and alpha = 0.96, respectively). Total operative scores demonstrated significant differences between surgeons in postgraduate years 1 and 2 and surgeons in years 3 and 4 and also between newly appointed and experienced consultants (P < .041). Procedure-specific performance showed a plateau effect at the registrar level. Generic skill continued to improve, and significant differences were seen between newly appointed and senior consultants (P < .026). CONCLUSION: This study shows that surgical performance continues to improve significantly beyond consultancy, and the data suggest that generic and procedural performance continue to improve, with significant improvement in the former with increasing experience. The ICEPS rating scale demonstrates construct validity and a high inter-observer reliability supporting its use in formative and summative assessment.

Clinical Competence↗

PubMed1988

Evaluation of functional capacity after stroke with special emphasis on motor function and activities of daily living.

In a multidisciplinary study comprising 280 patients with acute cerebrovascular disease (median age 76, range 30-96 years), instruments for functional assessment in stroke care were developed. The improvements of motor function and activities of daily living were investigated during a period of up to one year after a stroke. A new chart for motor capacity assessment, which includes both the paretic and the non-paretic side, modified after that of Fugl-Meyer et al, was tested for its reliability and validity. At the same time the Activity Index of Hamrin & Wohlin was further tested. The internal consistency reliability measured with the standardized item alpha method confirmed that the two instruments have high homogeneity. Construct validity was investigated by factor analysis and showed a logical structure. The predictive validity of the scores on admission was significant and the two tools had a satisfactory predictive capacity for survival and later functional outcome. The improvements in different motor functions were followed up for up to one year after the stroke among the 183 one-year survivors. In patients with minor impairment, the improvement occurred mostly during the first week. Patients with moderate or moderately severe impairment improved more continuously for up to three months, while the few surviving patients with very severe impairment continued to recover to some extent even after three months. Older patients with severe functional loss seemed to improve more slowly and not as well as younger patients with equivalent impairment. The patterns of instrumental activities of daily living (I-ADL), such as household work, locomotion, psychosocial functions and intellectual activities, were investigated in the 207 three-month survivors and the 183 one-year survivors. At both the three-month and the one-year follow-ups the scores had decreased considerably, compared with before the stroke, for all activities except locomotion, and many patients were dependent on somebody else for help. The same group of patients was also examined by a Standardized Practical Equipment (SPE) test constructed by Tömquist three months and one year after the stroke. The construct validity of the SPE test was estimated through factor analysis. Three factors emerged, one concerning mainly cognitive factors and co-ordination, one concerning hand function and one concerning mainly mobility and balance. The instruments developed in the course of this study have proved to be reliable and valid, and useful in assessing functional losses and following progress. The tools are well suited for any clinical settings and for home care examinations as well as research.

Activities of Daily Living↗

PubMed2004

Using exposure prediction rules for exposure assessment: an example on whole-body vibration in taxi drivers.

BACKGROUND: It is often difficult and expensive to make direct measurements of an individual's occupational or environmental exposures in large epidemiologic studies. METHODS: In this study, we used information collected in validation studies to develop a prediction rule for assessing exposure in a study with no direct measurement. We established a prediction rule through mixed-effect modeling of direct measurement data and information on observable exposure predictors and their interactions. Specifically, we used 383 measures of whole-body vibration from 247 professional taxi drivers and attempted to quantify vibration exposures for individuals in a large study on low back pain. RESULTS: Using the "jackknife method," we found that our prediction rule had an acceptably low relative prediction error of 11% (95% confidence interval-10-12%). Implementing the prediction rule would result in measurement errors independent of low back pain and of all identified and observable predictors of whole-body vibration. We applied the predicted levels to compute each person's daily exposure, and found a strong association between the predicted daily whole-body vibration exposure and prevalence of low back pain. This supported the construct validity of the exposure prediction rule. CONCLUSIONS: The predictive and construct validity of our prediction rule suggests that this general statistical approach can be useful in other occupational settings to improve the quality of exposure assessment.

Adult↗

PubMedDate not supplied

Reliability and validity of a measure of perceived diabetes and dietary competence in African American women with type 2 diabetes.

PURPOSE: A general measure of perceived diabetes and dietary competence (PDDC) was developed to assess a person's sense of confidence and perceived behavioral control in diabetes and dietary self-management. Internal structure, reliability, and construct validity were evaluated. METHODS: There were 2 samples of African American women with type 2 diabetes; 226 patients in the development sample and 225 patients in the validation sample. Factor analysis, Cronbach's coefficient alpha, and correlation analysis were used to assess reliability and validity of the PDDC measure. RESULTS: Three subscales were empirically determined by factor analysis: positive competence, negative dietary competence, and negative control. Cronbach's alphas for all subscales were good. Predicted relationships with measures of perceived health competence, self-efficacy, social support, and perceived dietary barriers were largely supported in construct validation. CONCLUSIONS: This study provides initial support for the internal reliability and validity of a perceived diabetes and dietary competence measure. Further research is needed to determine its validity in other samples of African Americans with type 2 diabetes and its clinical utility in evaluating diabetes self-management training.

Adult↗

PubMed2003

The Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE).

The aim of the study was to obtain a conceptually equivalent Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), and to test its feasibility, reliability and preliminary construct validity. The methodology used for adaptation was forward-back translation, including two focus groups with adolescents and a panel of experts. Reliability and validity were assessed in healthy convenience samples from school settings (n = 417). Three different illness groups (n = 67) were used to examine differences in health status between healthy, acutely ill, chronically ill and mentally ill adolescents. Preliminary construct validity was examined by comparing mean scores for each of the subdomains to determine if they differed in predicted ways according to age, gender and illness group. The majority of items (154 out of 203) were conceptually equivalent to the original version. Some items (46) had to be modified to increase clarity and/or to adapt them for use in Spain and 3 items were considered not applicable. Single construct subdomains achieved alpha coefficients between 0.65 and 0.92, and intraclass correlation coefficients (ICC) between 0.57 and 0.93. The mentally ill group presented the worst scores in most domains. The Spanish CHIP-AE is acceptable for Spanish adolescents and shows adequate metric characteristics, which are similar to those reported in the US version.

Activities of Daily Living↗

PubMed1999

Outcome for adjustment disorder with depressed mood: comparison with other mood disorders.

BACKGROUND: A review of the research literature on the diagnostic category of adjustment disorder indicates that its construct validity has not been established. Nevertheless, the diagnosis is made frequently, with an estimated incidence of 5-21% in psychiatric consultation services for adults. METHODS: Retrospective data was used to evaluate the construct validity of the adjustment disorder diagnostic category. The data primarily consisted of SF-36 Health Status Survey responses by a large group of adult psychiatric outpatients before treatment and again six months after beginning treatment. Subjects were divided into five diagnostic groups, and MANOVA, MANCOVA and chi square were used to clarify relationships among diagnoses, sociodemographic data and SF-36 scores. RESULTS: Diagnostic categories were significantly different at baseline, but did not differ in terms of outcome at six-months follow-up. There was a significant gender difference at baseline and a significant difference in gender distribution across diagnostic categories. LIMITATIONS: Structured interviews were not used for initial diagnoses, nor is there an estimate of the reliability of diagnoses among the clinicians. The patient attrition rate for six-months follow-up data was about 50%. Finally, patients received individualized treatment, with some patients receiving both medication and psychotherapy. CONCLUSIONS: Female patients were significantly more likely to be diagnosed with major depression or dysthymia than with an adjustment disorder. Females were also more likely than males to score lower on the mental health related scales of the SF-36 at admission. Patients diagnosed with an adjustment disorder scored higher on all SF-36 scales than did the other diagnostic groups at baseline and again at follow-up. There was no significant difference among diagnostic groups with regard to treatment outcome, suggesting that the adjustment disorder group can benefit as much as the other groups from treatment.

Adjustment Disorders↗

PubMed2002

The use of Rasch measurement to improve the Oswestry classification scheme.

OBJECTIVES: To use Rasch measurement to assess and modify the original classification categories of the Oswestry Low Back Pain Disability Questionnaire (Oswestry), to examine the hypothesis that the items from the Oswestry form a unidimensional construct and a hierarchical representation of low back pain (LBP) disability, and to compare ordinal Likert resultant scores to interval Rasch scaled scores with disability categories serving as a framework. DESIGN: Rasch analysis model. Existing Oswestry admission data generated by FOTO were analyzed. SETTING: Statistical analysis of sample database. PARTICIPANTS: A sample of 942 patients with LBP referred for physical therapy between 1993 and 1994. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Construct validity; disability categories (as assessed by Likert and Rasch models); and fit statistics (infit, outfit as mean squares). RESULTS: All items from the Oswestry except the pain item fit the Rasch model. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4. A hierarchical representation of LBP disability was supported. A comparison of the disability categories based on Likert and Rasch scaling revealed them to be nonequivalent. The new scaling changed the disability categories for 44% of patients. CONCLUSION: Rasch analysis produced disability categories in the Oswestry that are linear and, therefore, useful for quantitatively assessing self-reported disability levels.

Adolescent↗