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The refractive status and vision profile: a questionnaire to measure vision-related quality of life in persons with refractive error.

OBJECTIVE/BACKGROUND: To describe the Refractive Status and Vision Profile (RSVP), a questionnaire that measures self-reported vision-related health status (symptoms, functioning, expectations, concern) in persons with refractive error. DESIGN: Cross-sectional study by survey. PARTICIPANTS: The RSVP was self-administered by 550 participants with refractive error (or history of refractive surgery) recruited from five refractive surgery practices and one optometric practice. Information on refraction, uncorrected and best-corrected visual acuity, and history of refractive surgery was obtained from physicians' records. METHODS: Internal consistency, test-retest reliability, agreement with global measures of vision (criterion validity), discriminant validity, content validity, and construct validity (associations of scale scores with patient status variables) were assessed using Cronbach's alpha, Spearman rank correlations, factor analysis, and multitrait analysis. OUTCOME MEASURES: Scores on the overall RSVP scale (S) and on eight RSVP subscales (functioning, driving, concern, expectations, symptoms, glare, optical problems, problems with corrective lenses) were calculated based on 42 items. RESULTS: Cronbach's alpha was 0.92 for S and ranged from 0.70 to 0.93 for RSVP subscales, indicating good internal consistency. Satisfaction with vision was more strongly associated with S than with refractive error or with visual acuity. Individuals with more refractive error had significantly lower (worse) scores for S and for subscales concern, functioning, driving, optical problems, and glare. Scores for S and for subscales concern, functioning, optical problems, and driving remained significantly associated with satisfaction with vision after adjustment for age, gender, corrective lens type, and refractive error. CONCLUSIONS: The RSVP measures a range of visual, functional, and psychologic impacts of refractive error that are likely to be important to patients. The RSVP would be a useful tool for evaluating interventions for correction of refractive error and may be useful for assessing refractive surgery candidates in clinical practice.

Adolescent↗

Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group.

BACKGROUND: The paper reports on the development of the WHOQOL-BREF, an abbreyiated version of the WHOQOL-100 quality of life assessment. METHOD: The WHOQOL-BREF was derived from data collected using the WHOQOL-100. It produces scores for four domains related to quality of life: physical health, psychological, social relationships and environment. It also includes one facet on overall quality of life and general health. RESULTS: Domain scores produced by the WHOQOL-BREF correlate highly (0.89 or above) with WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF domain scores demonstrated good discriminant validity, content validity, internal consistency and test-retest reliability. CONCLUSION: These data suggest that the WHOQOL-BREF provides a valid and reliable alternative to the assessment of domain profiles using the WHOQOL-100. It is envisaged that the WHOQOL-BREF will be most useful in studies that require a brief assessment of quality of life, for example, in large epidemiological studies and clinical trials where quality of life is of interest. In addition, the WHOQOL-BREF may be of use to health professionals in the assessment and evaluation of treatment efficacy.

Adult↗

Development of the Korean versions of WHO Quality of Life scale and WHOQOL-BREF.

The purpose of this study was to develop the Korean version of World Health Organization Quality of Life study assessment instrument (WHOQOL) and WHOQOL-BREF, an abbreviated version of WHOQOL and to identify contributing factors in the quality of life of Koreans. The WHOQOL and WHOQOL-BREF were translated into colloquial Korean according to instructions of the WHOQOL study group. Then the Korean questionnaire was applied to 538 subjects, composed of 171 medical patients and 367 healthy subjects who volunteered to rate the scale. Finally, 486 subjects completed the rating. Collected data were analyzed statistically. The Korean version of WHOQOL and WHOQOL-BREF domain scores demonstrated good test-retest reliability, internal consistency, criterion validity, content validity and discriminant validity. The physical, psychological, social and environmental domains made a significant contribution to explaining the variance in the quality of life while the independence and spiritual domains made a lesser contribution. The domain scores produced by the WHOQOL-BREF correlated highly with the WHOQOL. The physical health domain contributed most in overall quality of life, while the social domain made the least contribution. These results suggest that the Korean version of WHOQOL and WHOQOL-BREF are valid and reliable in the assessment of quality of life and that physical domain is contributing most and social and spiritual factors are contributing least to the quality of life in Koreans.

Adult↗

Measurement validity in physical therapy research.

This article considers the role of measurement validity within physical therapy research. The concept of measurement validity is identified as a component of internal validity, and it is differentiated from the notion of reliability; these concepts are related to systematic and random sources of error, respectively. Using examples from physical therapy and rehabilitation, four main types of validity are reviewed: face validity, criterion-related validity, content validity, and construct validity. The differing implications of these types of validity for quantitative and qualitative research are discussed. Three principal areas of concern are then addressed, based on a critical discussion of selected examples from the literature. First, it is argued that validity is often poorly distinguished from the allied concept of reliability and that purported claims for validity often only demonstrate reliability. Second, it is claimed that validity is too often neglected in favor of reliability, and specific examples relating to gait analysis are put forward to support this argument. Third, some of the methodological difficulties that may occur when attempts are made to demonstrate validity are considered. The article concludes with a plea for a closer focus on the issue of measurement validity within physical therapy research.

Bias↗

Measuring safety climate in health care.

AIM: To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct. METHOD: A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis. RESULTS: Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations. CONCLUSIONS: More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.

Attitude of Health Personnel↗

A diabetes-specific measure of patient desire to participate in medical decision making.

PURPOSE: The goal of this study was to develop a diabetes-specific scale of patient desire to participate in medical decision making (DPMD) and examine its internal consistency reliability, stability, and validity (content, discriminant, convergent, and construct). METHODS: In a cross-sectional study, 65 patients with type 2 diabetes from a teaching hospital's general medical clinic were interviewed at baseline and 2 weeks later to measure their DPMD scores. Data were collected on demographic/clinical features, health value, social support, desire to make a final decision, and value of patient autonomy. RESULTS: Of the 11 DPMD items, 2 distinct factors emerged representing desire for discussion and desire for information. The DPMD scale had high internal consistency reliability, was stable over 2 weeks and demonstrated good content validity. DPMD scale items were more correlated with each other than with health value or social support. Overall, patients who obtained diabetes education reported greater desire to participate in decisions. Younger patients had a greater overall desire for discussion. The DPMD desire for discussion subscale correlated with patients' desire to make the final treatment decision but not with patients' value of autonomy. CONCLUSIONS: The DPMD is a brief, reliable, valid measure for assessing patient desire to participate in diabetes medical decision making.

Attitude to Health↗

The ECOS-16 questionnaire for the evaluation of health related quality of life in post-menopausal women with osteoporosis.

BACKGROUND: The aim of this study is to validate the questionnaire ECOS-16 (Assessment of health related quality of life in osteoporosis) for the evaluation of health related quality of life (HRQoL) in post-menopausal women with osteoporosis. METHODS: An observational, prospective and multi-centre study was carried out among post-menopausal women with osteoporosis in primary care centres and hospital outpatient clinics. All patients attended 2 visits: at baseline and at 6 months. In addition, the subgroup of outpatients attended another visit a month after the baseline to assess the test-retest reliability. The psychometric properties of the questionnaire were evaluated in terms of feasibility, validity (content validity and construct validity) and internal consistency in baseline, and in terms of test-retest reliability and responsiveness to change in visit at month and visit at 6 months, respectively. In all visits, ECOS-16, EUROQoL-5D (EQ-5D) and four 7-point items about health status (general health status, back pain, limitation in daily activities and emotional status) were administered, whereas only outpatients were given MINI-OQLQ (Mini Osteoporosis Quality of Life Questionnaire), besides all clinical variables; and sociodemographic variables at baseline. RESULTS: 316 women were consecutively included, 212 from primary care centres and 104 from hospital outpatient clinics. Feasibility: 94.3% of patients answered all items of the questionnaire. The mean administration time was 12.3 minutes. VALIDITY: factor analysis suggested that the questionnaire was unidimensional. In the multivariate analysis, patients with vertebral fractures, co-morbidity and a lower education level showed to have worse HRQoL. Moderate to high correlations were found between the ECOS-16 score and the other health status questionnaires (0.47-0.82). Reliability: internal consistency (Cronbach's alpha) was 0.92 and test-retest reliability (ICC) was 0.80. Responsiveness to change: ECOS-16 scores increased according to change perceived by the patient, as well as the effect size (ranges between 1.35 to 0.43), the greater the perception of change in patients' general health status, the greater the changes in patients' scores. The Minimal Clinically Important Difference (MCID) suggested a change of 0.5 points in the ECOS-16 score, representing the least improvement in general health status due to their osteoporosis: "slightly better". CONCLUSION: ECOS-16 has been proven preliminarily to have good psychometric properties, so that it can be potentially a useful tool to evaluate HRQoL of post-menopausal women with osteoporosis in research and routine clinical practice.

Aged↗

The Acne Quality of Life Index (Acne-QOLI): development and validation of a brief instrument.

BACKGROUND: Acne affects many people and can be detrimental to affected patients' quality of life. Assessing the impact of acne on quality of life requires well-validated and reliable measures of acne-specific quality of life that are brief and easy to administer and interpret. OBJECTIVES: This paper reports on the development and validation of the Acne Quality of Life Index (Acne-QOLI) for use in clinical care, research, and product development. METHODS: Focus groups consisting of people from demographically different populations were conducted to identify the most relevant domains of functioning affected by acne; on the basis of these findings, candidate items were developed. An initial item pool of 58 items was included in a survey of 480 persons with mild to severe acne ranging in age from 12 to 62 years. Factor analysis and qualitative analysis were used to reduce the item pool to 21 items. The construct validity, concurrent validity, internal consistency, and test-retest reliability of the items were evaluated. RESULTS: The 21-item Acne-QOLI showed excellent face validity, content validity, concurrent validity, and construct validity. High internal consistency and test-retest reliability were also found. CONCLUSIONS: Quality of life is now recognized as an important outcome in medical care. The Acne-QOLI is a brief and easily administered and interpreted measure of acne-related quality of life that can be used in clinical care, research, and product development.

Acne Vulgaris↗

Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty.

BACKGROUND: In 1998, the Oxford 12-item knee questionnnaire was developed by Dawson et al. as a self-administered disease- and site-specific questionnaire, specifically developed for knee arthroplasty patients. Since then,it has proven to be an effective outcome questionnaire, and is widely used. Despite the positive psychometric properties for the Total Knee Arthroplasty (TKA) population, the 12-item knee questionnaire has only been translated into a few languages. We thus translated and validated the Oxford 12-item knee questionnaire for the Dutch population. METHODS AND RESULTS: After translation according to a forward/backward protocol, 174 knee arthroplasty patients were asked to answer the questionnaire together with an SF-36, an AKSS and a VAS. The reliability, validity, content validity and the sensitivity to change were all tested. Our Dutch version of the Oxford 12-item knee questionnaire achieved excellent scores in all of these properties. INTERPRETATION: The Dutch Oxford 12-item knee questionnaire proved to be an excellent evaluation instrument for the Dutch orthopedic surgeon and can be used for all total knee arthroplasty patients.

Arthroplasty, Replacement, Knee↗

A correlational study on health training program participation and influences upon communities volunteers in Taipei City.

This is a cross-sectional study that purposely selected healthy community centers (HCC) in Taipei City to explore factors affecting volunteers' health training program participation (HTPP). The major objectives were to: (1) examine volunteer's HTPP; (2) explore relationships among volunteers' HTPP, self-efficacy (SE) in healthy community building, and community activities participation (CAP); and (3) identify key factors affecting volunteers' HTPP. A self-developed instrument with validity (content validity index > .91) and reliability (alpha = .63-.87) was used. A total of 250 participants were recruited. Study results revealed that a majority of the volunteers were middle-aged women who held at least a high school education, worked part-time, held Buddhist religious beliefs, were married and were middle class in terms of income. The average HTPP value was 19, with Xin Yi, Zhong Zhen and Bei Tou HCCs exhibiting higher HTPP values. Those not currently employed and housewives volunteers had lower HTPP values. 66.4% of volunteers participated at community activities after training and contributed 60-120 service hours a year. Volunteers' SE in healthy community building was low (M = 2.01, SD = 1.01), which, however, could explain 21% variance of HTPP. Factors affecting HTPP included HCC site, SE and CAP, which accounted for 57% of variance. Study results indicated that SE and CAP could serve as training evaluation indicators and a well-organized training program could increase volunteers' SE. Standard health training programs should incorporate three programs, including volunteerism perception, health promotion, and middle aged and elderly care to thus further improve volunteers' participation in community health activities.

Adult↗

Translation and validation of the Dutch version of the International Knee Documentation Committee Subjective Knee Form.

BACKGROUND: For knee-related surgery, there is a great demand for internationally useable subjective scoring systems. Before such measurements can be used, they should be translated and validated for the population they are used on. For the Dutch population, only the Western Ontario and McMaster Universities Osteoarthritis Index and Oxford 12 Questionnaire have been validated. However, these scores can only be used regarding osteoarthritis of the knee. In 2001, the International Knee Documentation Committee presented the Subjective Knee Form, which is a knee-specific rather than a disease-specific questionnaire. STUDY DESIGN: Cohort study (diagnosis/symptom prevalence); Level of evidence, 2. METHODS: The authors describe the translation procedure and validation of the Dutch Subjective Knee Form. After a forward-backward translation protocol, the reliability, validity, and content validity were tested. The responses of 145 consecutive knee patients on 2 questionnaires containing the Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Oxford 12 Questionnaire score, a visual analog scale, and the Dutch International Knee Documentation Committee Subjective Knee Form were used. Reliability was tested by measuring the test-retest reliability and internal consistency. Validity was tested by correlating the questionnaire to the other outcome measurements, and content validity was tested by measuring the floor and ceiling effects. RESULTS: The reliability proved excellent with an intraclass coefficient of 0.96 for test-retest. Internal consistency was strong (Cronbach alpha, .92). The construct, convergent, and divergent validities were good. The content validity was good; no floor or ceiling effect occurred. CONCLUSION: The validation procedure shows that the Dutch International Knee Documentation Committee Subjective Knee Form is an excellent evaluation instrument for Dutch patients with knee-related injuries.

Adult↗

[Validation of a measurement scale: example of a French Adverse Drug Reactions Preventability Scale].

Adverse drug reactions (ADRs) have been recognised as an important cause of hospital admission. Most of these drug-related admissions were expected ADRs and, thus, partly preventable. However, as far as we know, the assessment of the preventability of ADRs was addressed in only two studies performed in France. In contrast, several other studies have been performed, mainly in the USA, and using different methods of assessing preventability. None of these methods were clearly evaluated with regard to reproducibility, validity or relevance. The purpose of this study was to initiate the validation of a French preventability scale. Here, we propose the first two phases of validation: the content validity and reliability of the scale. A working group of pharmacovigilance experts has been specifically established for this purpose. The content validity was assessed by collecting items representative of preventability. The choice and the formulation of items and a proposal of a score (global and for each item) were adopted after the consensus of the experts. A definitive version of the ADR preventability scale was used for the assessment of reliability. During the second phase, experts independently tested the new scale from observations of ADRs (49 central nervous system haemorrhages with antivitamine K). The concordance of the experts' judgements was calculated using two statistical methods (Kappa statistic and correlation coefficient). The content validity phase was performed during several workshops where experts discussed the choice and formulation of the best items. We decided to construct a scale with a small number of items, allowing a rapid evaluation of the preventability of ADRs. On the basis of a global score, four categories of preventability of ADRs ("preventable", "potentially preventable", "unclassable", "not preventable" ADRs) were proposed. The agreement of experts regarding the global score was low, with a poor correlation coefficient value (coefficient interclass = 0.491). Classification of ADRs in the four categories by the experts showed discrepancies (Kappa = 0.1136). The preventability assessment using this scale was feasible, although poor concordance between the judges has raised some questions. Several experts found use of this scale difficult in terms of a clear understanding of the items, and found that two of them were redundant. We have oversimplified some items and revision of their formulation will be necessary. Moreover, most of ADR notifications were poorly documented, resulting in a frequent choice of an "unevaluable" item. This represented an important bias in the calculation of the global score. This experience suggests the need for further studies to improve this French ADR preventability scale and validate it in differing circumstances, in order to provide a useful tool to enhance the rational use of drugs.

Adverse Drug Reaction Reporting Systems↗

Patient-reported outcome measures for depression or anxiety symptoms in patients with cardiovascular disease: A COSMIN systematic review.

BACKGROUND: Depression and anxiety are common in patients with cardiovascular disease (CVD), but the measurement quality of patient-reported outcome measures (PROMs) used in this population remains unclear. This review aimed to evaluate the methodological quality, measurement properties, and certainty of evidence for depression and anxiety PROMs in adults with CVD and to inform instrument selection. METHODS: Following COSMIN and PRISMA guidance, four databases were searched from inception to February 2026. Studies assessing measurement properties of PROMs in adults with CVD were included. Methodological quality was evaluated using the COSMIN Risk of Bias checklist, and certainty of evidence was graded using an adapted GRADE approach. RESULTS: Sixty-six studies assessing 38 PROMs were included, comprising 29 generic and 9 CVD-specific instruments. Six PROMs met COSMIN Category A criteria: Cardiac Depression Scale-Short Form, Patient Health Questionnaire-9, Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Generalized Anxiety Disorder-7, and Major Depression Inventory. Four instruments were classified as Category C because of insufficient structural validity. Content-validity evidence was largely indeterminate or of limited certainty. Only 24 studies used confirmatory factor analysis or Rasch analysis, and no study assessed measurement error or responsiveness. Cross-cultural validity evidence was scarce. CONCLUSIONS: Six PROMs met Category A criteria, but selection should remain purpose- and context-specific. Particular attention should be given to somatic symptom overlap and intended clinical use. Further validation should prioritize content validity, measurement invariance, responsiveness, measurement error, and clinimetric performance.

Humans↗

[Elaboration and validation of a tool to measure psychological well-being: WBMMS].

Psychological well-being scales used in epidemiologic surveys usually show high construct validity. The content validation, however, is less convincing since these scales rest on lists of items that reflect the theoretical model of the authors. In this study we present results of the construct and criterion validation of a new Well-Being Manifestations Measure Scale (WBMMS) founded on an initial list of manifestations derived from an original content validation in a general population. It is concluded that national and public health epidemiologic surveys should include both measures of positive and negative mental health.

Adolescent↗

Establishing a standardized clinical assessment tool of pathologic and prosthetic hand function: normative data, reliability, and validity.

OBJECTIVE: To develop a new assessment procedure, the Southampton Hand Assessment Procedure (SHAP), that allows contextual results of hand function to be obtained readily in a clinical environment. DESIGN: Reliability (test-retest, interrater) and validity (criterion, content) of new assessment procedure against standard medical outcome measure techniques. SETTING: Normative data collected in a university laboratory. PARTICIPANTS: Twenty-four volunteers selected on the basis of optimum hand function using these criteria: age (range, 18-25 y), and no adverse hand trauma, neurologic condition, or disabling effects of the upper limb. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The normative control group was assessed for variability, and the procedure measured in terms of interrater and test-retest reliability. The absence of a direct comparison prevents a criterion standard from being established; however, content validity was shown by expert peer review. RESULTS: The control group data were shown to be multivariate gaussian; test-retest and interrater reliability were demonstrated at the 95% confidence level. The content validity was demonstrated by peer panel approval. CONCLUSIONS: Results of the control group established the statistical integrity of SHAP. Clinical trials are underway, although more extensive use of the procedure is advocated in primary care and rehabilitation centers where physiotherapy and occupational therapy are actively used in hand rehabilitation.

Activities of Daily Living↗

The Spanish version of Skindex-29.

BACKGROUND: Most currently available dermatologic quality-of-life measures were originally created in English, and must be translated and adapted for use in other cultures. Our purpose was to translate and adapt culturally into Spanish a skin-related quality-of-life measure, Skindex-29, and to begin preliminary assessments of its reliability and validity. METHODS: Transcultural adaptation and cross-sectional questionnaire studies were performed. One hundred and fourteen adult persons (patients and healthy people) responded to the Spanish version of Skindex-29. Evaluations of the semantic equivalence of back-translated items, reliability, construct validity, and content validity of the Spanish version were the main outcome measures. Comparison between Spanish and American responses was also performed. RESULTS: Six problematic items required a second translation and back-translation to achieve satisfactory agreement with the original instrument. The final Spanish version of Skindex-29 was internally reliable (range of Cronbach alpha for the scales, 0.70-0.87). The instrument demonstrated both construct and content validity. As hypothesized, scores for dermatologic patients were higher than those for healthy persons (mean global scores 21 vs. 5, P < 0.01) and scores for patients with inflammatory diseases were higher than those for persons with isolated skin lesions (mean global scores 32 vs. 11, P < 0.01), indicating a poorer quality of life. In addition, most patients' responses to an open-ended question about their skin disease were addressed by items in the instrument. Skindex scale scores of American and Spanish respondents were similar. CONCLUSIONS: We have developed a semantically equivalent translation of Skindex-29 into Spanish. Our preliminary evaluation of its measurement properties suggests that it is a reliable and valid measure of the effects of skin disease on the quality of life in Spanish patients.

Adult↗

Measuring imaging ability in children.

INTRODUCTION: Guided imagery has been suggested as an intervention to help children cope with noxious symptoms associated with medical care. A measure of imaging ability, that is, the ability to generate vivid mental images and to experience those images as if they were real, could be helpful in identifying children most likely to succeed in relieving symptoms with guided imagery. The purpose of this study was to test psychometric properties of a new instrument, the Kids Imaging Ability Questionnaire (KIAQ). METHOD: Three expert clinicians and researchers were asked to review the KIAQ to assess content validity. A convenience sample of 58 children were invited to complete the questionnaire twice to obtain data for tests of reliability and criterion-related validity. RESULTS: Content validity, internal consistency (alpha =.75-.76), and test-retest reliability (r =.73) were acceptable. Criterion-related validity using the Singer Fantasy Proneness Interview as a standard was poor (rho =.31-.46). DISCUSSION: Some psychometric properties were acceptable; however, continued research will be necessary to test validity of the questionnaire and demonstrate a relationship between KIAQ score and success with imagery. With continued research, pediatric nurses may use the KIAQ in practice to identify children most likely to benefit from guided imagery.

Adolescent↗

Development and psychometric evaluation of supportive leadership scales.

The purpose of this study was to develop and evaluate the psychometric properties of 2 supportive leadership scales, the Charge Nurse Support Scale and the Unit Manager Support Scale, designed for long-term-care environments. These 6-item self-report scales were administered to 70 nursing staff and their internal consistency reliability, test-retest reliability, content validity, factor structure, and construct validity investigated. Content validity was established with the assistance of experts. Both scales were deemed reliable. As hypothesized, a significant relationship was found between the measure of how nursing staff related to residents and measures of charge nurses' supportive behaviours (r = .42, p = .05). Reliable and valid measures of supportive leadership could be developed for use in identifying the quality of support provided to staff in long-term-care environments.

Adult↗