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Nursing-care dependency. Development of an assessment scale for demented and mentally handicapped patients.

This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to characterize the patients' nursing-care dependency as part of the assessment step in the nursing process, and is based on Henderson's 14 human needs. The Delphi technique, using two panels of experts (n = 44), was applied to reach consensus on significant indicators of nursing-care dependency. The experts' reasoning was used to develop criteria for the assessment of nursing-care dependency. Ultimately, the Delphi rounds generated 15 NCD items with their descriptions and item criteria. There was no fundamental difference between the NCD scales for demented and mentally handicapped patients. Nevertheless, there are two versions of the NCD scale because of the need to apply specific concepts in the nursing care of either population. The original Dutch version of the NCD is also available in English and in Norwegian.

Activities of Daily Living↗

Development and validation of a self-critical cognition scale.

A 13-item Self-critical Cognition scale was developed to measure a self-critical and self-defeating cognitive tendency in processing self-relevant information. The scale, administered to 561 male and female university students, evidenced high internal consistency (alpha = .89) and test-retest reliability of r138 = .83 over a 6.5-week interval. A factor analysis yielded a most interpretable 2-factor solution, Factor 1: negative self-processing and Factor 2: failure in positive self-processing. The scale's construct validity was supported by meaningful correlations of -.71 with Rosenberg's self-esteem, .43 with Watson and Friend's social anxiety and distress, .62 with Cheek and Buss's shyness, .57 with Watson and Friend's fear of negative evaluation, .42 with Beck and Beamesderfer's depression, and .34 with negative adjective counts in spontaneous adjective listing in a self-descriptive task. Use of the scale for experimental and clinical research is suggested.

Adult↗

Development of the family therapy enactment rating scale.

This report describes the development of a new scale designed to establish how therapists intervene and clients respond during effective enactments in family therapy sessions. The Family Therapy Enactment Rating Scale (FTERS) was developed by clinically trained investigators who observed 27 videotaped family therapy sessions and listed therapist interventions and client responses during four phases of enactments: pre-enactment preparation, initiation, facilitation, and closing commentary. Interrater reliabilities for the FTERS were calculated by training 6 undergraduate volunteers to rate independently a sample of 12 enactments. When reliabilities were found to be relatively low, a second study was conducted in which the FTERS was revised and reliabilities were calculated with a different sample of 21 videotaped enactments and a new group of 6 undergraduate raters. Reliability for the FTERS was found to be sufficiently robust to make this measure of therapist interventions and client responses a useful instrument for evaluating what takes place during enactments. Findings on the FTERS were used to offer tentative guidelines for effective initiation and facilitation of enactments in family therapy sessions.

Communication↗

Development and validation of the situational self-awareness scale.

This article discusses the manipulation and measurement of levels of situational self-focus, which is generally labeled "self-awareness." A new scale was developed to quantify levels of public and private self-awareness. Five studies were conducted to assess the psychometric properties, reliability, and validity of the Situational Self-Awareness Scale (SSAS). The SSAS was found to have a reliable factor structure, to detect differences in public and private self-awareness produced by laboratory manipulations, and to be sensitive to changes in self-awareness within individuals over time and across situations. The SSAS can be used as a manipulation check of laboratory self-awareness manipulations and as a means of assessing naturally occurring fluctuations in public and private self-awareness in order to clarify the relation between self-awareness and other variables (e.g., mood and memory).

Adolescent↗

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

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

Adult↗

A new front-face optical cell for measuring weak fluorescent emissions with time resolution in the picosecond time scale.

Recent developments of ultrafast fluorimeters allow measuring time-resolved fluorescence on the picosecond time scale. This implies one is able to monitor lifetimes and anisotropy decays of highly quenched systems and of systems that contain fluorophores having lifetimes in the subnanosecond range; both systems that emit weak signals. The combination of weak signals and very short lifetimes makes the measurements prone to distortions which are negligible in standard fluorescence experiments. To cope with these difficulties, we have designed a new optical cell for front-face optics which offers to the excitation beam a horizontal free liquid surface in the absence of interactions with optical windows. The new cell has been tested with probes of known lifetimes and anisotropies. It proved very useful in detecting tryptophan fluorescence in hemoglobin. If only diluted samples are available, which cannot be used in front-face optics, regular square geometry can still be utilized by inserting light absorbers into a cuvette of 1 cm path length.

Chemistry Techniques, Analytical↗

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

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

Adult↗

Development and validation of the Attitude Toward Arthritis Patients Scale (ATAPS).

The development and validation of a four-item scale, the ATAPS, measuring attitude toward working with arthritis patients is described. Three separate samples of occupational and physical therapists were surveyed. Data from the first random sample were used to select a reliable subset of items from a larger pool and to provide a baseline for comparison with the second sample. The second sample comprised arthritis workshop attendees and confirmed the scale's reliability and its ability to differentiate between therapists with an active interest in arthritis and a group with no special interest in the disorder. The third stratified random sample further confirmed the scale's reliability and demonstrated that the ATAPS scores were associated with the number of arthritis patients in therapists' practices but not with measures of professional experience unrelated to arthritis.

Arthritis↗

Development of an interview-based geriatric depression rating scale.

The geriatric depression rating scale (GDRS) is a new interview-based depression rating scale designed for use with adults 60 years of age or older. The scale was developed to fill a need for an instrument that would be sensitive to the problems encountered in assessing depression among older adults. The GDRS was designed by using items from the self-report Geriatric Depression Scale (GDS) as topic areas in a structured clinical interview similar to that of the Hamilton Rating Scale for Depression (HRSD). The 35-item rating scale was administered to 68 older individuals with a range of affective disturbance. The scale was found to have internal consistency and split-half reliability comparable to the HRSD and GDS. Concurrent validity, construct validity, external criterion validity, sensitivity, and specificity were all found to be acceptable.

Aged↗

Semantic development in textual contexts during the school years: noun scale analyses.

The paper examines the nominal lexicon in later language acquisition as a window on linguistic knowledge and usage across childhood and adolescence. The paper presents a psycholinguistically motivated and cognitively grounded analysis of the distribution of ten semantic noun categories (the Noun Scale) across development, modality, and genre. Eighty Hebrew-speaking children (9;0 to 10;0), adolescents (12;0 to 13;0 and 16;0 to 17;0), and a group of adult university graduate students participated in the study. Each produced four different texts: a spoken and written narrative and a spoken and written expository, yielding a total of 320 texts. All lexical noun tokens in each of the 320 texts were analysed to determine their score on the Noun Scale. Results indicate that nominal density, which underlies much of the syntactic architecture of texts, increases dramatically in adolescence, towards adulthood. The paper analyses the developmental patterns of each of the ten Noun Scale categories, showing that the nominal lexicon of schoolaged children is already very different from that of young children in having only a small amount of genuinely concrete nouns, and these too only in narrative texts. The quantitative analysis shows that nouns grow more categorical and abstract with age and schooling, especially in adolescence. Written expository texts are the preferred habitat of abstract, categorical nouns from early on. The systematic qualitative analysis of noun tokens in their textual context demonstrates how the nominal lexicon undergoes fundamental changes that are affected by linguistic, cognitive and social development, in interaction with text genre and modality.

Adolescent↗

The development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers.

This paper describes the development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers (low dependence drinkers consuming more than recommended levels). This work, which forms part of a larger matching study of brief intervention, is based on the general proposition that outcome expectations of reduced consumption might be more important than previously thought for understanding and predicting behavior change. Twelve outcomes, derived from interviews with excessive drinkers, formed the basis of a questionnaire, the Excessive Drinker Outcome Expectations Scale (EDOES), which examined not only the valence of each outcome, but a comparison between expectations of reduced consumption versus drinking usual amounts. The questionnaire was administered to 235 hospitalized excessive drinkers. Principal components analysis produced two scales, reflecting the costs and benefits of change. The questionnaire proved to have acceptable levels of test-retest reliability and predictive validity. Analyses of construct validity revealed that outcome expectations of reduced consumption were increasingly positive across stages of change.

Adaptation, Psychological↗

Development and testing of a 25-item patient satisfaction scale for black South African diabetic outpatients.

Although there is general agreement that patient satisfaction is an integral component of service quality, there is a paucity of South African research on reliable and valid satisfaction measures and the effects of health status on satisfaction. A 25-item patient satisfaction scale was developed and tested for evaluating the quality of health care for black diabetic outpatients. It was hypothesised that: (1) the underlying dimensions of patient satisfaction were interpersonal and organisational; and (2) patients in poor health would be less satisfied with the quality of their care than patients in good health. The questionnaire was administered to 263 black outpatients from Pretoria Academic Hospital and Kalafong Hospital. Factor analysis was conducted on the patient satisfaction scale and three factors, accounting for 71% of the variance, were extracted. The major items on Factor I were helpfulness, communication, support and consideration, representing the interpersonal dimension. Factors II and III were mainly concerned with service logistics and technical expertise, with the emphasis on waiting time, follow-up and thoroughness of examination. The three factors had excellent reliability coefficients, ranging between 0.82 (technical), 0.85 (logistics) and 0.98 (interpersonal). Multiple analyses of co-variance showed that patients in poor general health were significantly less satisfied with the logistical (p = 0.004) and technical (p = 0.007) quality of their care than patients in good health; patients in poor mental health were significantly less satisfied with the interpersonal quality of their care (p = 0.05) than patients in good mental health. These findings provided support for both hypotheses and suggested that patients in poor health attend to different aspects of their care than patients in good health. Of more importance to clinical practice, the results endorsed the need for a multidisciplinary health team comprising nurse/social worker (Factor I: support, communication), health service managers (Factor II: service logistics) and physician (Factor III: technical expertise) to enhance treatment outcome for diabetic patients. It is recommended that: (1) further research is conducted on this patient satisfaction scale with diverse populations in different settings to complement and validate the scale for generalised use in South Africa; (2) the scale is used to collect information on patient satisfaction before and after implementing an intervention to improve the quality of health care, and (3) measurement of health status is an essential adjunct to assessment of patient satisfaction.

Adolescent↗

Large-scale mapping of mutations affecting zebrafish development.

BACKGROUND: Large-scale mutagenesis screens in the zebrafish employing the mutagen ENU have isolated several hundred mutant loci that represent putative developmental control genes. In order to realize the potential of such screens, systematic genetic mapping of the mutations is necessary. Here we report on a large-scale effort to map the mutations generated in mutagenesis screening at the Max Planck Institute for Developmental Biology by genome scanning with microsatellite markers. RESULTS: We have selected a set of microsatellite markers and developed methods and scoring criteria suitable for efficient, high-throughput genome scanning. We have used these methods to successfully obtain a rough map position for 319 mutant loci from the Tübingen I mutagenesis screen and subsequent screening of the mutant collection. For 277 of these the corresponding gene is not yet identified. Mapping was successful for 80 % of the tested loci. By comparing 21 mutation and gene positions of cloned mutations we have validated the correctness of our linkage group assignments and estimated the standard error of our map positions to be approximately 6 cM. CONCLUSION: By obtaining rough map positions for over 300 zebrafish loci with developmental phenotypes, we have generated a dataset that will be useful not only for cloning of the affected genes, but also to suggest allelism of mutations with similar phenotypes that will be identified in future screens. Furthermore this work validates the usefulness of our methodology for rapid, systematic and inexpensive microsatellite mapping of zebrafish mutations.

Animals↗

Teaching tape for the motor section of the unified Parkinson's disease rating scale.

We developed a teaching tape of the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS) to provide investigators with a visual document of three raters' interpretations of the scoring system for each item except rigidity. The rate of agreement for the selected samples was always significant, with Kendall's coefficient of concordance W ranging between 0.97 and 0.62. We also provided full UPDRS ratings on sample patients that may be used for training and for multicenter studies to assure uniformity of rating. The study identified several items of the UPDRS motor examination for which written instructions were vague, including speech, action tremor, finger taps, rapid alternating movements, and postural stability. Future versions of the scale should address these problems and correct ambiguities. This project offers the first attempt to provide a visual analog for the UPDRS.

Audiovisual Aids↗

Development of the Workload Analysis Scale (WAS) for the assessment and rehabilitation services of Ballarat Health Services.

This study describes the development of the Workload Analysis Scale (WAS), designed to predict the likely workload involved for social workers working with clients in the assessment and rehabilitation areas of Ballarat Health Services (BHS). Such a scale would allow more equitable case allocation, flagging of difficult cases, better work prioritisation, training of new staff and tracking changes over time. Items for the scale were developed in consultation with workers. Initially the scale consisted of 33 items divided into five subscales, relating respectively to treatment factors, demographics, psychosocial complexity, planned interventions and variable staff factors. Eight staff members of BHS contributed to the completion of the scale for 111 clients seen over a four month period on the rehabilitation and assessment wards. Initial analysis of the data led to a modification of the scale and subsequent satisfactory measures of reliability and validity.

Adult↗

Development and evaluation of the Osteoporosis Self-Efficacy Scale.

The Osteoporosis Self-Efficacy Scale was developed as a measure of self-efficacy, or confidence, for behaviors related to physical activity and calcium intake. An item pool of 21 statements, responded to on a visual analog self-report format, was reviewed by a panel of expert judges. The revised item stems were tested with a sample of 201 women, ages 35 to 95. Concurrent data on sport, leisure, and exercise activity and calcium in diet and dietary supplements were collected from the respondents. Factor analysis of responses to the self-efficacy items revealed a logical, theoretically meaningful two-factor structure, one for physical activity and one for calcium intake. Internal consistency estimates for each of the two factors were in the .90s. Convergent and discriminant validity analyses as well as hierarchical regression analyses to explain self-reports of physical activity and calcium intake were supportive. The final version of the brief, psychometrically sound scale contains items reflecting initiation, maintenance, and persistence at osteoporosis preventive behaviors; thus, the Osteoporosis Self-Efficacy Scale is a potentially beneficial research instrument.

Activities of Daily Living↗

[Effecting factors on depression in patients with fibromyalgia].

PURPOSE: The purpose of this research was to provide basic data in the control of depression found in patients with fibromyalgia by analysing the main factors that affect them. METHOD: The subjects were 207 out-patients in three university medical centers diagnosed with fibromyalgia according to the conditions by American College of Rheumatology (1990). Depression was measured by the CES-D Scale. Dependant variables, such as stress and anxiety were measured by the VAS Scale and physical activity was measured using 10(4-point-scale) questions developed by the researcher. The number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al.(1989) for arthritis patients. RESULT: The main factors that affect depression of patients with fibromyalgia were self-efficacy, anxiety, physical activity, tender points fatigue, and family support, which explained 49% of the depression. CONCLUSION: It has been confirmed that the regression equation model of this research may serve as a predictor of depression in patients with fibromyalgia.

Adult↗

Development & standardization of a scale to measure socio-economic status in urban & rural communities in India.

BACKGROUND & OBJECTIVES: The commonly used available scales for measurement of socio-economic status (SES) with some cross regional applicability are old and have lost their relevance. There is a need for the development of a valid and reliable instrument for measurement of SES in rural and urban communities in India. The present study was undertaken to develop a cross regionally applicable scale for the purpose of enlisting true measures of socio-economic items applicable in multilingual, multicultural, multireligious, setting of the country. METHODS: For developing the scale, seven indicators (house, materials possession, education, occupation, monthly income, land, social participation and understanding), presumably determining the socioeconomic status were selected. These indicators were named as profiles. Thus, initially the scale had seven profiles and every profile contained five alternatives. This instrument was prepared on a 10-point scale. Weightage system of scoring (varying from 2 to 10) was followed from first to sixth profile while the additive pattern of scoring was followed in seventh profile. The final version of the scale was arrived at through three trial administrations on rural and urban families. The basis of selection of the families for the first two trials was stratified random. The validity and reliability of the scale was established through a defined visual analogue scale (VAS) and test-retest methods. RESULTS: Both the initial version as well as the final version of the scale for the measurement of SES of incumbents had seven profiles. The difference between the two versions was in terms of contents and range of items in different categories of SES. The final version was arrived at through field trials and suggestions of the experts. The reliability of the scale was high with a correlation coefficient of 0.998. INTERPRETATION & CONCLUSION: The new scale appears to be a valid and reliable instrument for the assessment of socio-economic status of the families/individuals from urban as well as rural areas in India.

Humans↗