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Psychometric assessment of measures of psychological symptoms, functional status, life events, and context for low income Hispanic patients in a primary care setting.

This study assessed the psychometric properties of a set of nine commonly used lists in an English-speaking Hispanic sample taken from a primary care setting. Those were the General Health Questionnaire-12, the Anxiety, Depression, and Somatization scales from the SCL-90, the Medical Outcomes Study Short Form-36, the Holmes and Rahe Family Life Changes, abbreviated versions of the Daily Hassles and Uplifts, the Herth Hope Index, Duke Social Support and Stress scales, Alcohol Use Disorders Identification Test, and Marlowe-Crowne Brief Social Desirability Scale. 68 adult patients completed the measures via structured interview. Internal consistency was measured using Cronbach alpha and the Kuder-Richardson-20. Construct validity was assessed using Pearson correlations among sets of scores. Internal consistencies were good-to-excellent for all measures except for the Duke Social Support and Stress scales (Stress scale), and the Brief Social Desirability Scale. Construct validity was suggested for all except the Mental Health and Energy/Fatigue scales of the Short Form-36. Further study is needed to verify these results in other Hispanic populations and to address other forms of reliability and validity.

Activities of Daily Living↗

Validation of 'personal strain' and 'role strain': subscales of the short version of the Japanese version of the Zarit Burden Interview (J-ZBI_8).

The eight-item short version of the Japanese version of the Zarit Burden Interview (J-ZBI_8) has been confirmed for reliability and validity, and its two subscales (personal strain and role strain) are based on the factor structure of the ZBI. It has been demonstrated that these subscales have good reliability. The aim of the present study was to confirm their construct validity. A total of 51 impaired elderly who had been receiving regular nurses' visits in Kyoto Prefecture, Japan and their family primary caregivers, participated in the present study. Each caregiver was asked to complete a questionnaire which included the J-ZBI_8, the hours spent in caregiving, and the physical and cognitive disability of the impaired elderly. A principal component analysis identified the following two principal components of these variables: 'Activities of Daily Living deficits' and 'behavioral disturbances'. Consequently, Barthel Index (BI) and Troublesome Behavior Scale (TBS) were selected as the representative variable, respectively, for each component. We subsequently calculated the Spearman's rank correlations among the subscales of J-ZBI_8, BI and TBS. Personal strain was found to be correlated with TBS (rho = 0.48, P < 0.01), while role strain was correlated with the BI (rho = -0.29, P = 0.04). The correlation between personal strain and BI was not significant, nor was the correlation between role strain and TBS. These findings indicate that the personal strain and role strain measured by J-ZBI_8 correspond to the personal strain and role strain of the ZBI originally described by Whitlatch et al. Therefore, the construct validity of the J-ZBI_8 subscales is confirmed.

Activities of Daily Living↗

Short Form 36 in the intensive care unit: assessment of acceptability, reliability and validity of the questionnaire.

The aim of this study was to assess the acceptability, validity and reliability of the Short Form 36 quality of life questionnaire in 166 adult patients following discharge from a general intensive care unit. Reliability was quantified by measuring internal consistency using correlation among items and Cronbach's alpha coefficient. Reliability coefficients were calculated from two-way analysis of variance. Construct validity was tested by examining differences in scores between sex and age groups. Content validity was reflected by the spread of dimension scores. Acceptability to patients appeared reasonable, although considerable nursing time was required to administer the questionnaire. The measures of reliability exceeded recognised statistical standards in all but two instances. Construct validity was confirmed by lower scores being reported by women and older age groups. The scores of six of the eight dimensions were spread throughout the entire range of possible scores suggesting acceptable content validity.

Adolescent↗

Adolescent psychopathy and personality theory--the interpersonal circumplex: expanding evidence of a nomological net.

The construct validity of psychopathy was examined in a sample of 114 male and female young offenders (M(age) = 15.16) at a southeastern detention center. The interpersonal circumplex served as a framework of general personality from which to examine the construct of adolescent psychopathy. A supplementary analysis of the psychopathy measures and the Big 5 factors of personality was also conducted using a matrix approach. Measures included: (a) Antisocial Process Screening Device (P. J. Frick & R. D. Hare, 2001); (b) Child Psychopathy Scale (D. R. Lynam, 1996); (c) Psychopathy Checklist--Youth Version (A. E. Forth, D. S. Kosson, & R. D. Hare, 2003); and (d) Interpersonal Adjective Scales Revised--Big 5 Version (P. Trapnell & J. S. Wiggins, 1991; J. S. Wiggins, 1995). Results showed substantial convergence among the three psychopathy measures. In addition, meaningful associations between psychopathy and constructs within the interpersonal circumplex and broader domains of the Big 5 were obtained. Two psychopathy scales correlated to a higher degree than expected with neuroticism. These findings provide evidence linking personality theory to the concept of child and adolescent psychopathy, thereby adding to its construct validity. However, they do so with the caveat that youth may also be displaying some characteristics of neuroticism, suggesting that worry and anxiety may accompany psychopathic features in earlier developmental stages. The implications of the current study are discussed.

Adolescent↗

Development of a supplement to the HOME Scale for children living in impoverished urban environments.

A Supplement to the HOME (Home Observation for Measurement of the Environment Scale) for impoverished Families (SHIF) was developed for use with young children living in impoverished urban environments. After interviews with clinicians and pilot studies with families, we developed 20 items and added them to the HOME. The supplement was field tested in a sample of 73 high-risk families to evaluate its psychometric properties and ease of use. During the home visit, the Nursing Child Assessment Feeding Scale and the Nursing Child Assessment Teaching Scale were also administered to examine construct validity. Results indicated that the SHIF provided new clinical data, was easy to administer, and, when added to the HOME, had good psychometric properties, e.g., high inter-rater reliability, internal consistency, item-total reliability, and intact construct validity. The SHIF offers a reliable and valid addition to the HOME for use with young children living in impoverished urban environments.

Adult↗

Identifying patients who require a change in their current acute migraine treatment: the Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire.

BACKGROUND: Currently available measures of the efficacy of acute migraine medications are not frequently used in primary care. They may be too burdensome and complicated for routine use. OBJECTIVES: To design and test a new, easy to use, 4-item assessment tool, the Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire for use by clinicians, to quickly evaluate how a recently prescribed acute medication is working, and to identify patients who require a change of their current acute treatment. METHODS: A 27-item Migraine-ACT questionnaire was developed by an international advisory board of headache specialists. Questions were formulated in four domains: headache impact, global assessment of relief, consistency of response and emotional response. All these are clinically important measures of migraine severity and treatment outcome. All questions were dichotomous and answered by yes or no. Patients (n = 185) attending secondary care headache clinics who were diagnosed with migraine according to International Headache Society criteria entered a multinational, prospective, observational study to investigate the test-retest reliability and construct validity of the 27-item Migraine-ACT. Patients completed the Migraine-ACT on two occasions, separated by a 1-week interval, and test-retest reliability was assessed by Pearson product moment and Spearman rank measures. Construct validity was assessed by correlating patients' answers to the 27-item Migraine-ACT with those to other questionnaires (individual domains and total scores) conceptually related to it; the Short-Form 36 quality of life questionnaire (SF-36), the Migraine Disability Assessment (MIDAS) questionnaire and the Migraine Therapy Assessment Questionnaire (MTAQ). Discriminatory t-tests were used to identify the four Migraine-ACT questions (one in each domain) which discriminated best between the domains of the SF36, MIDAS, and MTAQ. These four items constituted the final 4-item Migraine-ACT. RESULTS: The test-retest reliability of the 27 Migraine-ACT questions ranged from good to excellent, and correlation coefficients were highly significant for all items. The consistency of reporting the yes and no answers was also excellent. Correlations of Migraine-ACT items with SF-36 and MIDAS items and SF-36, MIDAS and MTAQ total scores indicated that the following were the most discriminating items, in the respective four domains, and constitute the final Migraine-ACT questionnaire: Consistency of response: Does your migraine medication work consistently, in the majority of your attacks? Global assessment of relief: Does the headache pain disappear within 2 h? IMPACT: Are you able to function normally within 2 h? Emotional response: Are you comfortable enough with your medication to be able to plan your daily activities? The 4-item Migraine-ACT was shown to be highly reliable (Spearman/Pearson measure r = 0.82). The individual questions, and the total 4-item Migraine-ACT score, showed good correlation with items of the SF-36, MIDAS and MTAQ questionnaires, particularly with the total MTAQ and SF-36 scores. CONCLUSIONS: The 4-item Migraine-ACT questionnaire is an assessment tool for use by primary care physicians to identify patients who require a change in their current acute migraine treatment. It is brief and simple to complete and score, and has demonstrated reliability, accuracy and simplicity. Migraine-ACT can therefore be recommended for everyday clinical use by clinicians.

Acute Disease↗

[Present status and prospects about an animal model of post-traumatic stress disorder in rats using a shuttle box].

Wistar rats exposed to inescapable foot shocks (IS) for 2 wk exhibited PTSD-like bi-directional changes similar to avoidance/numbing and hyperarousal symptoms when placed in a shuttle box. Paroxetine administration after IS reduced the hyperarousal-like behavior, and its therapeutic effect on avoidance/numbing-like behavior was also significant. Further, F344 rats, which were more vulnerable to various kinds of stressors, showed more significant 'bi-directional changes' than Wistar rats. Thus, the paradigm we have developed could serve as a useful PTSD model because of its face, predictive, and construct validity. Moreover, the intensity of IS dose-dependently induced PTSD-like behaviors and hypo-activity in a shuttle box, similar to the 'avoidance/numbing' that reappeared in a square open field. These findings further support the construct validity of this paradigm. Both electro-convulsive shock treatment before and after IS ameliorated the PTSD-like behaviors in this model, so electro-convulsive therapy may be an effective method for prevention and medical treatment of PTSD in the future. On the other hand, pretreatment with fluvoxamine before IS did not have a significant effect, and its improving effect after IS was only observed for 'hyperarousal' behavior. Lastly, we recently developed a useful criterion, which is represented as a 'bi-directional index', for separating real PTSD rats from those exposed to IS.

Animals↗

Reliability and validity of trunk assessment for people with multiple sclerosis.

BACKGROUND AND PURPOSE: Standardized scales are a prerequisite for rehabilitation and research. This study was designed to determine the reliability and validity of scores on items of the trunk assessment of the Melsbroek Disability Scoring Test (MDST) and Trunk Impairment Scale (TIS) in people with multiple sclerosis (MS). SUBJECTS: Thirty people with MS participated in the study. METHODS: Interrater and test-retest reliability and construct validity were assessed. RESULTS: Kappa and weighted kappa values for the items of the trunk assessment of the MDST ranged from .74 to .95, and the kappa and weighted kappa values for the TIS items ranged from .46 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .93 and .92, respectively, for the trunk assessment of the MDST and .97 and .95, respectively, for the TIS. Bland-Altman analysis showed consistency of scores without observer bias. Construct validity was established. DISCUSSION AND CONCLUSION: The MDST and TIS provide reliable assessments of the trunk and are valid scales for measuring trunk performance in people with MS.

Abdomen↗

The coronary heart disease in-patient experience questionnaire (I-PEQ (CHD)): results from the survey of National Health Service patients.

OBJECTIVE: Analysis of data from the National Survey of Coronary Heart Disease patients to develop a core measure of patient experiences of health care. A secondary purpose was to determine whether a single summary index figure could be generated from the instrument. DESIGN: The data reported here comes from the survey of coronary heart disease (CHD) patients, which was the second in the programme of National Surveys of National Health Service (NHS) patients. It took place during 1999. After an in-patient episode for CHD, questionnaires were mailed out to patients with a covering letter and a pre-paid stamped addressed envelope. Those patients who did not reply within two weeks of the initial mailing were sent a reminder letter and, if this elicited no reply within two weeks, they were sent another copy of the questionnaire. SAMPLE: Of the 116,872 patients who were sent questionnaires, 3399 proved to be ineligible or out-of scope to the survey. Responses were gained from 84,310 (74.3% of eligible respondents). RESULTS: Reliability analysis supported the existence of seven dimensions which seem to be tapping distinct underlying phenomena: hospital environment, information and communication, patient involvement, coordination of care, discharge and transition, and pain. Higher order factor analysis indicated these dimensions constituted one factor and, consequently, can be summed to create an index figure. The construct validity of the measure was assessed, and it distinguished between groups as was hypothesised. CONCLUSIONS: The dimensions of the questionnaire have high internal reliability. Both the dimensions of the instrument and the index score were found to have high construct validity. The instrument provides a core set of issues that should be covered when assessing the quality of care for hospital patients with coronary heart disease.

Adult↗

Validity of the Arnadóttir OT-ADL Neurobehavioral Evaluation (A-ONE): performance in activities of daily living and neurobehavioral impairments of persons with left and right hemisphere damage.

OBJECTIVE: The Arnadóttir OT-ADL Neurobehavioral Evaluation (A-ONE) is a standardized assessment that links performance in activities of daily living (ADL) to neurobehavioral impairments. This study tested the construct validity of the A-ONE. METHOD: From two hospitals in Iceland, 42 patients between 45 and 87 years of age who had sustained either a right or a left cerebrovascular accident (CVA) were evaluated on the Functional Independence Scale (FIS) and Neurobehavioral Specific Impairment Subscale (NSIS) of the A-ONE. The Mann Whitney Utest and chi-square test were used to explore possible differences between the performance of participants with left and right CVA. Descriptive statistics were calculated for demographic data and for items on the FIS and NSIS. The level of significance was set at p < .05. RESULTS: Three of 18 ADL items observed on the FIS and 13 of 46 items on the NSIS discriminated at a statistically significant level between the left and right CVA groups. CONCLUSION: The results provide minimal support for the construct validity of the A-ONE related to differentiating between ADL performance of persons with left and right CVA. However, results regarding the ability of the A-ONE to detect and lateralize impairments agreed with literature regarding lesion sites for the impairments.

Activities of Daily Living↗

Validation of a voice prosthesis questionnaire to assess valved speech and its related issues in patients following total laryngectomy.

OBJECTIVES: To establish the reliability and validity of a new self-administered questionnaire to assess valved speech and its related issues in patients who have undergone a total laryngectomy operation. DESIGN: Cross-sectional psychometric validation study. SETTING: Tertiary cancer care centre. PATIENTS: We identified sixty-one total laryngectomy patients with no sign of recurrent disease and using voice prosthesis from the speech and language therapy database of the Royal Marsden Hospital. The patients were assessed using a postal self-administered voice prosthesis questionnaire concerning the voice valve and it's related issues. Patients were also asked to complete the University of Michigan voice related quality of life and University of Washington head and neck quality of life (version 4) questionnaires. MAIN OUTCOME MEASURES: Test-retest and internal consistency reliability; content; criterion and construct validity. RESULTS: We received completed questionnaires from fifty-one of the sixty-one total laryngectomy patients identified for the study providing a response rate of 84%. The median age of the group was 65 years (range: 40-85) with thirty-seven males and fourteen females. The internal consistency reliability using the Cronbach's alpha coefficient was 0.87 (range: 0.85 to 0.89). Test-retest reliability showed that more than 75% of patients had a score on re-test that was within 1 point of their original score. Content validity was ensured during the design process. The median Spearman correlation coefficient was 0.25 for convergent construct validity with the University of Washington head and neck quality of life questionnaire and 0.64 for criterion validity on comparison with the University of Michigan voice related quality of life scale. CONCLUSIONS: The voice prosthesis questionnaire is the first validated and reliable self-administered questionnaire designed specifically for evaluating valved speech and its related issues in patients who have undergone total laryngectomy. The voice prosthesis questionnaire has significant utility for audit, outcomes research and monitoring in this unique group of patients.

Adult↗

Cross-cultural validation of the Leeds sleep evaluation questionnaire (LSEQ) in insomnia patients.

The Leeds sleep evaluation questionnaire (LSEQ) is a standardized self-reporting instrument comprising ten 100 mm visual analogue scales that pertain to the ease of getting to sleep (GTS), quality of sleep (QOS), ease of awakening from sleep (AFS) and alertness and behaviour following wakefulness (BFW). Although the LSEQ has been used in a variety of populations, published psychometric data on insomnia patients are limited. The LSEQ reliability and construct validity was evaluated in 396 French insomnia patients aged 55 years and over, who were treated with placebo (2 weeks) and melatonin (3 weeks). The results supported LSEQ internal consistency, reliability and construct validity with minor differences from those of the original English version. Then the internal consistency of the LSEQ was evaluated in 257 insomnia patients (age 20-80 years) in France and Israel who, following a 1 week placebo baseline, were randomized to placebo or melatonin treatment for 3 weeks. Cronbach's alpha and Pearson's r correlation coefficients for placebo and drug treatment conditions (p<0.001 for all) supported LSEQ internal consistency in different treatment and age groups and in different languages. It is concluded that the consistency, reliability and validity of the four LSEQ domains allows them to be singled out as independent outcome variables in cross cultural sleep research and clinical practice in adult and elderly patients with insomnia.

Aged↗

The pediatric cancer quality of life inventory-32 (PCQL-32): I. Reliability and validity.

BACKGROUND: Multidimensional measurement of pediatric cancer patients' health-related quality of life (HRQOL) in Phase III randomized controlled clinical trials is being recognized increasingly as an essential component in evaluating the comprehensive health outcomes of modern antineoplastic treatment protocols. The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32) is a standardized patient self-report and parent proxy-report assessment instrument designed to assess systematically pediatric cancer patients' HRQOL outcomes. METHODS: To validate a patient-report form and a parent-report form, the PCQL-32 was administered to 291 pediatric cancer patients and to their parents. Both forms yield a total score and five a priori multidimensional scales. Clinical validity was determined by the known-groups approach by comparing patients classified as either on or off treatment. To determine construct validity, a battery of standardized psychosocial measures was administered and a multitrait-multimethod matrix was constructed. RESULTS: For both patient and parent forms, internal consistency reliability of the PCQL-32 total scale was high (0.91 and 0.92, respectively). The internal consistency reliabilities of the five component scales for both patient and parent forms were in the acceptable range for group comparisons. With regard to clinical validity, the PCQL-32 total scale and the disease/treatment and physical functioning scales of the PCQL-32 distinguished between patients on and off treatment for both patient- and parent-report. The results of the multitrait-multimethod matrix approach were consistent with hypotheses and lent evidence for the construct validity of the patient and parent forms of the PCQL-32 total scale and the psychological functioning, social functioning, cognitive functioning, physical functioning, and disease/treatment scales. CONCLUSIONS: The PCQL-32 has demonstrated acceptable internal consistency reliability, clinical validity, and construct validity for both patient-report and parent-report forms. Further field testing of the PCQL-32 will determine its practicality and utility in multisite pediatric cancer randomized controlled clinical trials.

Adolescent↗

Development and validation of the parent experience of child illness.

OBJECTIVE: To develop a measure of parent adjustment related to caring for a child with a chronic illness and to evaluate the reliability and validity of the measure with a group of parents of children with brain tumors. METHODS: One-hundred forty-nine parents of patients (age <1-17 years) diagnosed with a brain tumor were assessed using the 25-item self-report Parent Experience of Child Illness (PECI). Internal consistency, construct validity, and factor structure were assessed. RESULTS: Exploratory factor analysis yielded four theoretically coherent factors including: Guilt and Worry, Emotional Resources, Unresolved Sorrow and Anger, and Long-term Uncertainty. Internal reliability for the PECI scales ranged from .72 to .89, suggesting acceptable reliability. As evidence of construct validity, the PECI scales show significant, positive correlations with scales from established measures of parent adjustment. CONCLUSION: The PECI augments the current literature by providing a brief measure of parents' subjective distress and perceived Emotional Resources, domains that are critical but understudied in children with chronic illness and their caregivers.

Adaptation, Psychological↗

Validation of the holyoake codependency index.

Some clinicians working with families with alcohol or other drug problems continue to use the codependency model to guide their practice despite the limited empirical support for this approach. Research into codependency has been hampered by the lack of psychometrically sound instruments. The Holyoake Codependency Index (HCI; G. E. Dear & C. M. Roberts, 2000) is a 13-item self-report measure of codependent traits that has previously shown adequate to high reliability, initial evidence of construct validity, and an internal structure that is consistent across samples. In the 4 studies reported here, the internal structure of the HCI was confirmed using confirmatory factor analysis, and further evidence of construct validity was found in that the HCI subscales showed meaningful associations with other psychological and demographic variables.

Adult↗

A self-administered rheumatoid arthritis disease activity index (RADAI) for epidemiologic research. Psychometric properties and correlation with parameters of disease activity.

OBJECTIVE: To examine the psychometric properties and construct validity of a self-administered Rheumatoid Arthritis Disease Activity Index (RADAI). METHODS: Five items of the Rapid Assessment of Disease Activity in Rheumatology (RADAR) questionnaire were aggregated into the RADAI and assessed for their factor loading, internal consistency, and construct validity. RESULTS: In 55 patients with RA, the RADAI had a high internal consistency (Cronbach's alpha = 0.91) and correlated with physician's assessment of disease activity (r = 0.54, P < 0.01), the swollen joint count (r = 0.54, P < 0.01), and the C-reactive protein value (r = 0.43, P < 0.01). CONCLUSION: The RADAI is a highly reliable and valid self-administered measure of disease activity for clinical, health services, and epidemiologic research. Its sensitivity to change in longitudinal studies needs further study.

Adult↗

Objective assessment of technical skills of surgical trainees in Hong Kong.

BACKGROUND: The need for assessment of technical skills is well recognized and objective methods of assessment are currently under investigation in the UK. The applicability of these assessment tools to trainees with a different training background in another country was examined. METHODS: Six bench-top models for basic surgical trainees (BSTs) and eight for higher surgical trainees (HSTs) (five in common) were assessed for construct validity in 70 subjects. Objective assessment methods included motion analysis using the Imperial College Surgical Assessment Device, Objective Structured Assessment of Technical Skills and Minimally Invasive Surgical Trainer in Virtual Reality. RESULTS: All models shared between BSTs and HSTs exhibited construct validity (range P = 0.050 to P < 0.001). Of the three modules for HSTs alone, only one gave significant results (small bowel anastomosis; P = 0.005). Reasons for this were sought. CONCLUSION: The methods of objective technical skills assessment of trainees in the UK are applicable to those in Hong Kong. Their use should be promoted and the tracking of skills development encouraged.

Adult↗

Development of control-of-outcome scales and self-efficacy scales for women in four life roles.

Scales to measure control-of-outcome expectancies and self-efficacy expectancies based on social comparisons were developed for adult females in the four life roles of occupation, parenting, marriage, and economic management. Internal consistency and construct validity of the scales were examined in two studies. Internal consistency estimates of six of the eight scales exceeded .70. A factor analysis within each role supported the distinction between control-of-outcome expectancies and self-efficacy expectancies. Construct validity was supported by finding the hypothesized relations between the developed scales and standard measures of self-esteem, depression,and locus of control. As hypothesized, the developed scales accounted for unique portions of the variance in role-specific coping orientation and role stress. Specifically, control-of-outcome expectancies predicted active or passive coping orientation in the personal roles of parenting and marriage. It was concluded that the developed scales might have utility for understanding coping and experienced stress in various life roles.

Adult↗