Average Inter-item Correlation Research Articles

Reliability and Validity of the MD Anderson Dysphagia Inventory Among Japanese Patients.

This study aimed to validate the Japanese version of a dysphagia-specific quality of life questionnaire, the MD Anderson Dysphagia Inventory (MDADI-J), and to verify trends between MDADI-J and Functional Oral Intake Scale (FOIS) scores. The original 20 MDADI items were translated using a forward-backward method following accepted cultural adaptation guidelines. Seventy-two patients with a history of head and neck cancer treatment completed the MDADI-J between October 2015 and August 2016. Concurrent validity was determined by correlations with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) instruments. Discriminant validity was examined using cancer stage grouping between stages I-II and III-IV. Additionally, trends between the FOIS and the MDADI-J total scores were analyzed using a trend test. The Cronbach's α coefficient of the MDADI-J total score was 0.92, indicating high internal consistency. The average inter-item correlation coefficients ranged from 0.39 to 0.49. ICC, an indicator of test-retest reliability, was 0.84 for the total score, and 0.58 to 0.81 for individual subscales. The total score and all subscales were significantly associated with the scores for each factor of the EORTC QLQ-C30 and EORTC QLQ-H&N35. The total score and all subscales were significantly different between clinical tumor stages I-II and III-IV. The total scores all increased with the progress of the FOIS. In conclusion, this study validated the Japanese version of the MDADI and showed that as FOIS scores deteriorate, MDADI-J scores tend to constantly decrease.

Evaluating social (pragmatic) communication disorder.

Social (pragmatic) communication disorder (SPCD) is a new diagnosis introduced by DSM-5, characterised by problems with verbal and nonverbal social communication. It is currently unclear whether SPCD is a valid diagnostic category, because little is known about the characteristics of those who meet its criteria. We sought to identify and describe cases of SPCD, to contribute to debates about its validity. We investigated whether the symptoms of SPCD cluster together to form a coherent syndrome that is distinct from autism spectrum disorder (ASD) in terms of its core and associated features. Participants were young people (N=1,081, age range=4-18years) who had attended a specialist social communication disorders clinic for children with fluent language and normal-range intelligence. Standardised parent-report data were collected using the Developmental, Dimensional and Diagnostic Interview (3Di), Child Communication Checklist (CCC) and Strengths and Difficulties Questionnaire (SDQ). An algorithm was designed using 3Di and CCC items to implement DSM-5 SPCD criteria. Eighty-eight young people met our criteria for SPCD, with 801 meeting DSM-5 ASD criteria and the remaining 192 having neither SPCD nor ASD ('clinical comparison group'). The core symptoms of SPCD co-occurred to a moderate degree (average interitem correlation=.22). SPCD cases had autistic social difficulties that were intermediate between ASD and the clinical comparison group. SPCD was associated with high rates of nonautistic psychopathology, with 63.5% scoring in the abnormal range of the SDQ's Total Problems scale. We did not find evidence that SPCD is qualitatively distinct from ASD. Rather, it appears to lie on the borderlands of the autism spectrum, describing those with autistic traits that fall just below the threshold for an ASD diagnosis. SPCD may have clinical utility for identifying people with autistic traits that are insufficiently severe for ASD diagnosis, but who nevertheless require support.

Data quality and factor analysis of the Danish version of the Relationship Scale Questionnaire.

BackgroundThe Relationship Scale Questionnaire (RSQ) is a widely-used measure of adult attachment, but whether the results obtained by the RSQ fit the attachment construct has only been examined to a limited extent.ObjectiveThe objectives of this study were to investigate the psychometric properties of the Danish translation of the RSQ and to test whether the results are consistent with the hypothesized model of attachment.MethodsThe study included two samples: 602 general practitioners and 611 cancer patients. The two samples were analyzed separately. Data quality was assessed by mean, median and missing values for each item, floor and ceiling effects, average inter-item correlations and Cronbach’s α for each subscale. Test-retest was assessed by intra-class correlations among 76 general practitioners. A confirmatory factor analysis was conducted to establish evidence of the four proposed subscales. Due to an inadequate fit of the model, data was randomly split into two equally sized subsamples and an exploratory factor analysis was conducted for all 30 items in the first subsample comprised of 286 cancer patients and 285 general practitioners. The EFA yielded a three-factor structure which was validated through a confirmatory factor analyses in a second subsample comprised of 278 cancer patients and 289 general practitioners.ResultsThe data quality of the RSQ was generally good, except low internal consistency and low to moderate test-retest reliability. The four subscales of the RSQ were not confirmed by the confirmatory factor analysis. An exploratory factor analysis suggested a three-factor solution for both general practitioners and patients, which accounted for 61.1% of the variance among general practitioners and 62.5% among patients. The new three-factor solution was verified in a confirmatory factor analyses.ConclusionThe proposed four-factor model of the RSQ could not be confirmed in this study. Similar challenges have been found by other studies validating the RSQ. An alternative three-factor structure was found for the RSQ.

Avaliação da qualidade do Enem 2009 e 2011 com técnicas psicométricas

<p>Foi realizada uma meta-avaliação do Exame Nacional do Ensino Médio (Enem) de 2009 e 2011, aplicando-se técnicas psicométricas em 2.025.268 provas. Algumas técnicas foram exemplificadas com a apresentação da análise do conteúdo de itens, mostrando sua utilidade aos educadores. Comparou-se indicadores relacionados à prova (coeficiente α e correlação interitem média), mas principalmente relativos aos itens (correlação item-total, coeficiente bisserial – CB –, discriminação e ajuste do modelo logístico de dois parâmetros). A prova de Matemática de 2009 apresentou confiabilidade insuficiente (α < 0,6). As provas de Linguagens e Códigos e Ciências Humanas apresentaram, nos dois anos, melhores indicadores de qualidade. Ao todo, foram encontrados 25% de itens com comportamento empírico fora do esperado em 2009, e 17% em 2011.</p><p><strong>Palavras-chave</strong> Meta-avaliação; Psicometria; Avaliação em Larga Escala; Enem.</p><p> </p><p><em><strong>Evaluación de la calidad del Enem 2009 y 2011 con técnicas psicométricas</strong></em></p><p><em><strong>Resumen:</strong></em></p><p><em>Se llevó a cabo una metaevaluación del Exame Nacional do Ensino Médio (Enem) de 2009 y 2011 por medio de la aplicación de técnicas psicométricas en 2.025.268 pruebas. Algunas de estas técnicas se ejemplificaron con la presentación del análisis del contenido de ítems, lo que puso de manifiesto su utilidad a los educadores. Se compararon indicadores relacionados con la prueba (coeficiente α y correlación inter-ítem media), pero sobre todo los relativos a los ítems (correlación ítem-total, coeficiente biserial – CB –, discriminación y ajuste del modelo logístico de dos parámetros). La prueba de Matemáticas de 2009 presentó confiabilidad insuficiente (α < 0,6). Las pruebas de Lenguajes y Códigos y Ciencias Humanas presentaron, en los dos años de estudio, mejores indicadores de calidad. En total se encontró un 25% de ítems com comportamiento empírico fuera de lo esperado en 2009, y un 17% en 2011.</em></p><p><em><strong>Palabras clave:</strong> Metaevaluación; Psicometría; Evaluación en Gran Escala; Enem.</em></p><p><em><br /></em></p><p><em><strong>Evaluation of Enem (2009 and 2011)quality with psychometric techniques</strong></em></p><p><em><strong>Abstract:</strong></em></p><p><em>This study is a meta evaluation of the Exame Nacional do Ensino Médio [National Secondary Education Examination] (Enem) of 2009 and 2011, applying psychometric techniques to 2.025.268 tests. Some techniques were illustrated by analysis of item content, showing their usefulness to educators. We compared indicators related to the tests (α coefficient and average inter-item correlation), but mainly related to the items (item-whole correlation, biserial coefficient, discrimination and fit of two-parameter logistic model). The 2009 Mathematics test showed insufficient reliability (α <0.6). The Language and Human Sciences tests showed better quality indicators in both years. In total, we found 25% of items with anomalous empirical behavior in 2009 and 17% in 2011.</em></p><p><em><strong>Keywords</strong> Meta Evaluation; Psychometrics; Large-Scale Evaluation; ENEM.</em></p>

Psychometric characteristics of the \u201cGeneral Oral Health Assessment Index (GOHAI) \xbb in a French representative sample of patients with schizophrenia

BackgroundThe “General Oral Health Assessment Index” (GOHAI) was widely used in clinical or epidemiological studies worldwide, as it was available for use in different languages. Therefore, the aim of this study was to evaluate the psychometric characteristics of the GOHAI in a representative sample of patients with schizophrenia.MethodsA total of 90 schizophrenic patients (in-patients and out-patients) were recruited from the participants of the “buccodor study” (NCT02167724) between March and September 2015. They were selected using a random stratified sampling method according to their age, sex, or residential area (urban/rural area). GOHAI validity (construct, predictive, concurrent and known group validity) and internal consistency (reliability) were tested. Test-retest reliability was evaluated in 32 subjects.ResultsThe mean age was 47.34 (SD = 12.17). Internal consistency indicated excellent agreement, with a Cronbach’s alpha value of 0.82 and average inter-item correlation of 0.65. Intraclass correlation coefficients for test-retest reliability with 95% confidence intervals were not significantly different (p > 0.05). Construct validity was supported by three factor that accounted for 60.94% of the variance observed. Predictive validity was corroborated as statistically significant differences were observed between a high GOHAI score, which was associated with self-perceived satisfaction with oral health, lower age and high frequency of toothbrushing. Concurrent validity was corroborated as statistically significant relationships were observed between the GOHAI scores and most objective measures of dental status. For known group validity, they was no significant difference of the mean GOHAI score between out or in-patients (p > 0.05).ConclusionAcceptable psychometric characteristics of the GOHAI could help caregivers to develop ways to improve the Oral Health related Quality Of Life of schizophrenic patients.Trial registrationClinical Trials Gov NCT02167724. Date registered 17 June, 2014.

Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's rs's=0.33−0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Reliability, Factor Structure, and Associations With Measures of Problem Relationship and Behavior of the Personality Inventory forDSM-5in a Sample of Italian Community-Dwelling Adolescents

In order to assess the reliability, factorial validity, and criterion validity of the Personality Inventory for DSM-5 (PID-5) among adolescents, 1,264 Italian high school students were administered the PID-5. Participants were also administered the Questionnaire on Relationships and Substance Use as a criterion measure. In the full sample, McDonald's ω values were adequate for the PID-5 scales (median ω = .85, SD = .06), except for Suspiciousness. However, all PID-5 scales showed average inter-item correlation values in the .20-.55 range. Exploratory structural equation modeling analyses provided moderate support for the a priori model of PID-5 trait scales. Ordinal logistic regression analyses showed that selected PID-5 trait scales predicted a significant, albeit moderate (Cox & Snell R2 values ranged from .08 to .15, all ps < .001) amount of variance in Questionnaire on Relationships and Substance Use variables.

Development of a Questionnaire to Evaluate Knowledge and Attitude of Obesity and Weight Loss in Thai Overweight/Obese Medical Students: The Pilot Study

Background: Medical students who will grow up as physicians will be role models for patients in health behaviors. However, some medical students are still overweight or obese. A weight reduction program can both decrease weight and change attitude about obesity and losing weight. Unfortunately, there is no validated questionnaire to measure knowledge and attitude about obesity and weight loss for our medical students. Objective: To develop a questionnaire for evaluation of knowledge and attitude toward obesity and weight loss in Thai overweight/obese medical students. Methods: We developed the questionnaire using Health Belief Model under consultation of two experts in obesity, biostatistics and epidemiology. Validity of the questionnaire was evaluated by the index of item-objective congruence under supervision of five experts. This pilot study was performed to test the internal consistency and reliability using Cronbach’s alpha coefficient. Twenty-seven medical students who self-reported as overweight or obese were included in this study. Results: A fifty-seven items questionnaire using five-point Likert scale was developed with the index of item-objective congruence of all items in presented questionnaire more than 60%. Cronbach’s alpha coefficients of all domains were in the range of 0.74-0.90 and overall standardized Cronbach’s coefficient of the questionnaire was 0.87. The average inter-item correlation of each domain was in acceptable range (0.21-0.62) although; those of the total scale were 0.12. Conclusion: Validity and reliability of this questionnaire were acceptable to be used for assessment of knowledge and attitude of obesity and losing weight in Thai overweight or obese medical students.

The Caregiver Contribution to Heart Failure Self-Care (CACHS): Further Psychometric Testing of a Novel Instrument.

Caregivers (CGs) contribute important assistance with heart failure (HF) self-care, including daily maintenance, symptom monitoring, and management. Until CGs' contributions to self-care can be quantified, it is impossible to characterize it, account for its impact on patient outcomes, or perform meaningful cost analyses. The purpose of this study was to conduct psychometric testing and item reduction on the recently developed 34-item Caregiver Contribution to Heart Failure Self-care (CACHS) instrument using classical and item response theory methods. Fifty CGs (mean age 63 years ±12.84; 70% female) recruited from a HF clinic completed the CACHS in 2014 and results evaluated using classical test theory and item response theory. Items would be deleted for low (<.05) or high (>.95) endorsement, low (<.3) or high (>.7) corrected item-total correlations, significant pairwise correlation coefficients, floor or ceiling effects, relatively low latent trait and item information function levels (<1.5 and p > .5), and differential item functioning. After analysis, 14 items were excluded, resulting in a 20-item instrument (self-care maintenance eight items; monitoring seven items; and management five items). Most items demonstrated moderate to high discrimination (median 2.13, minimum .77, maximum 5.05), and appropriate item difficulty (-2.7 to 1.4). Internal consistency reliability was excellent (Cronbach α = .94, average inter-item correlation = .41) with no ceiling effects. The newly developed 20-item version of the CACHS is supported by rigorous instrument development and represents a novel instrument to measure CGs' contribution to HF self-care. © 2016 Wiley Periodicals, Inc.

P.2.b.010 - Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's rs's=0.33-0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Validation of the Patient Activation Measure (PAM-13) among adults with cardiac conditions in Singapore.

The Patient Activation Measure (PAM-13) measures patients' knowledge, skill, and confidence in chronic condition self-management. The purpose of this study was to assess the validity of PAM-13 (English version) among English-speaking adults with cardiac conditions in Singapore. A cross-sectional study was conducted in a convenient sample of 270 heart clinic patients. Using the unitary concept of validity, evidence of (1) internal structure via data quality, unidimensionality, differential item functioning, and internal consistency, (2) response process through item difficulty and item fit using Rasch modeling, and (3) relationship to other variables via correlations with depression and self-efficacy were examined. The item response was high with only one missing answer. All items had a small floor effect, but nine out of 13 items had a ceiling effect larger than 15%. Cronbach's α was 0.86, and average inter-item correlations was 0.324. Results suggested unidimensionality; however, differences in item difficulty ranking were found. A low, negative correlation was found with depression, while a moderate, positive correlation was found with self-efficacy. Evidence in all three areas of validity were mixed. Caution should be exercised when using categorical activation "level" to inform clinical decisions.

Psychometric Reevaluation of Parental Press for Academic Achievement and Postsecondary Planning Scale

Objective: Psychometric details of the Parental Press for Academic Achievement and Postsecondary Planning Scale (PPS), developed by Chicago Consortium of Chicago School Research, are scarce. The purpose of this study was to reexamine the properties of this 7-item measure. Method: The study utilized cross-sectional, self-reported data from 100 low-income, first-generation undergraduate students at a university in the southern United States. Results: Factor analysis on the PPS revealed two dimensions with all items loaded, accounting for 81.44% of the variance. Reliability of the PPS was sound, that is, average interitem correlation was .62 and Cronbach’s α and split-half coefficients were .918 and .923, respectively. Convergent validity was suggested via significant correlations between the PPS and its theoretically similar constructs, that is, valuation of high school ( r = .32) and parental support for college ( r = .82). Conclusion: The PPS appears to be psychometrically appropriate for appraising students’ perceptions of parental support for academic success and postsecondary education.

Towards the Construction of Test for Assessing Motor Abilities in Four-aged Preschool Children

The objective of this study is to determine the basic metrical properties of the tests for the assessment latent dimensions of motor abilities at four-year children. Sample included 50 children aged 4 years (±6 months) from three kindergartens in Zagreb, during the first half of 2015. Battery of tests that assess the hypothetical motor abilities (coordination, speed, balance, and strength) was applied. Reliabilities of the tests varied in the range from 0.45 to 0.96 (Cronbach’s alpha). Already satisfactory discriminability is not found only for tests two-leg jumping through hoops and standing on one leg. Homogeneity of the tests varies in range from 0.22 to 0.89 (average inter-item correlation). Analysis of the construct validity revealed two-component structure which has very low reliability of the second component. Results indicate the potential for constructing new instruments for measuring motor abilities in four-aged children, on a larger sample of participants.

Can we measure patients’ perception during dental impressions? The Burdens in Dental Impression-Making Questionnaire – BiDIM-Q

PurposeTo develop a reliable and valid instrument for the comprehensive assessment of patients’ burdens during dental impression making, the Burdens in Dental Impression Making Questionnaire, BiDIM-Q. MaterialsThe item pool was generated in a convenience sample of 20 prosthodontic patients using semi-structured face-to-face interviews. The final instrument was tested in 145 consecutively recruited patients, and psychometric properties of the BiDIM-Q were determined. Four different impression materials were used according to the manufacturers’ instructions and indications: alginate, c-silicone, polyvinylsiloxane, and polyether. ResultsThe final BiDIM-Q consisting of 12 items showed sufficient reliability, indicated by Cronbach's alpha of .82 and an average inter-item correlation of .29. Validity was supported by Pearson correlation coefficients for the correlation between the instrument's total score with the patients’ overall satisfaction rating (r=.63), and by the correlation matrix for the correlations of the patients’ perceptions with the practitioners’ satisfaction ratings. Overall, patient perceived burdens were low with highest burdens observed when using polyether in partially dentate patients for pick-up impressions, while lowest burdens were reported when using c-silicone for impressions of edentulous jaws. ConclusionThe BiDIM-Q is a reliable and valid tool for assessing patient-based process-related quality of care in dentistry allowing a deeper insight into patients’ perspective during dental impression making.

Psychometric properties of the Albanian version of chewing-function questionnaire CFQ-ALB.

BackgroundThe new Chewing Function Questionnaire (CFQ) was lately developed in Croatia to measure the chewing ability in prosthodontic patients, as a one-dimensional instrument consisting of 10-items. Therefore, the objective of this study was to develop an Albanian version of the CFQ questionnaire and to test its psychometric properties in a new typical environment among the Kosovo population. Materials and methodsThe original version of CFQ questionnaire was translated and cross-culturally adapted from the English language into Albanian in accordance with international guidelines. Its validity (construct, convergent and discriminative) and internal consistency (reliability) were tested in 205 participants. Test-retest reliability was evaluated in 61 subjects with natural teeth, and responsiveness was evaluated in 51 prosthodontic patients with treatment needs.ResultsInternal consistency of CFQ-ALB indicated excellent agreement, with Cronbach’s alpha values of 0.974 and average inter-item correlation of 0.792. Intraclass correlation coeficinets for test-retest were found without significant differences by 95 % of confidence intervals (p > 0.05). Construct validity was supported by a single factor that accounted for 81.711 % of the variance observed. Convergent validity was supported by the association between self-reported general satisfactions with chewing and CFQ summary scores. Discriminat validity was supported as statistically significant differences were observed between pre-defined groups. Responsiveness was confirmed by the significant difference between baseline summary scores and the after treatment scores; the mean change was 15.57 (SD =2.49) (p < 0.001).ConclusionThe obtained results suggest excellent psychometric properties of the CFQ-ALB questionnaire for determining chewing function in the Republic of Kosovo.

Validation of a Dutch version of the Geriatric Oral Health Assessment Index (GOHAI-NL) in care-dependent and care-independent older people.

BackgroundThe GOHAI is a frequently used instrument to measure oral health-related quality of life (OHRQoL) of adults, in particular older people. The aim of this study was to translate the original English version of the GOHAI into a Dutch version (GOHAI-NL), and to test the validity and reliability of the GOHAI-NL in care-independent and care-dependent older people.MethodsThe GOHAI questionnaire was translated into Dutch, discussed by an expert panel, back-translated to the original, pilot-tested and assessed for cognitive and conceptual equivalence. The resulting GOHAI-NL was tested in a groups of care-independent (Group A, n = 109, mean age 73.1 ± 5.4 years) and care-dependent (Group B, n = 118, mean age 85.6 ± 7.0. years) cognitively alert people of 65 years and over. Psychometric properties including reliability (internal consistency, item-total, item-dimension, dimension-total, inter-item correlation, and test-retest stability), and validity (convergent, discriminant, known-group), and floor and ceiling effects were assessed.ResultsInternal consistency was confirmed by Cronbach’s alphas of 0.86 (group A) and 0.80 (group B). Item-total score correlations were between 0.4 and 0.7 except for item 3 in group A (0.34) and B (0.08) and for item 12 in group A (0.20). Item-dimension and dimension-total correlations were between 0.30 and 0.78 and around 0.7 respectively for the dimensions ‘physical functioning’ and ‘psychosocial functioning’, but lower for the dimension ‘pain and discomfort’ with item-dimension correlations between 0.13 and 0.44. Average inter-item correlations were 0.34 ± 0.11 (group A) and 0.33 ± 0.08 (group B). Test-retest correlation of the total score (GOHAI-ADD) was 0.88 in group A (ICCs: 0.62 - 0.88) and 0.93 in group B (ICCs: 0.64 – 0.91). Significant correlations in the expected direction were found between GOHAI and most oral health-related variables except for presence of caries in group A, and perceived general health, prosthodontic status and number of natural teeth in group B. No floor or ceiling effects were detected at GOHAI-ADD level; however ceiling effects did occur at dimension level.ConclusionThe GOHAI-NL has satisfactory reliability and validity and can be used to measure OHRQoL in Dutch care-dependent and care-independent older people.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0227-0) contains supplementary material, which is available to authorized users.

Metric characteristics of a new test for the evaluation of dynamic balance

The aim of the study was to determine psychometric characteristics of a new test for the evaluation of dynamic balance in healthy individuals. The research was conducted on a sample of 60 female students (21.18±.86 years). The participants performed three trials of the new test for each of the two different ways of walking. The results of reliability have shown high values of factor loadings (.91-.97) and standardized Cronbach’s alpha values (.87-.98), as well as the average inter-item correlation values (full feet walking, tip toe walking and the number of steps) (.78-.94). High values of factor loadings (.88-.97) and the fact that the total explained variance was very high (93.3%), with a relatively small variability between the attempts, suggests that all the rules for consistency of testing have been satisfied and that the new test is reliable enough for its application in practice.

Measuring patient activation in Italy: Translation, adaptation and validation of the Italian version of the patient activation measure 13 (PAM13-I).

BackgroundThe Patient Activation Measure (PAM13) is an instrument that assesses patient knowledge, skills, and confidence for disease self-management. This cross-sectional study was aimed to validate a culturally-adapted Italian Patient Activation Measure (PAM13-I) for patients with chronic conditions.Methods519 chronic patients were involved in the Italian validation study and responded to PAM13-I. The PAM 13 was translated into Italian by a standardized forward-backward translation. Data quality was assessed by mean, median, item response, missing values, floor and ceiling effects, internal consistency (Cronbach's alpha and average inter-item correlation), item-rest correlations. Rasch Model and differential item functioning assessed scale properties.ResultsMean PAM13-I score was 66.2. Rasch analysis showed that the PAM13-I is a good measure of patient activation. The level of internal consistency was good (α = 0.88). For all items, the distribution of answers was left-skewed, with a small floor effect (range 1.7–4.5 %) and a moderate ceiling effect (range 27.6–55.0 %). The Italian version formed a unidimensional, probabilistic Guttman-like scale explaining 41 % of the variance.ConclusionThe PAM13-I has been demonstrated to be a valid and reliable measure of patient activation and the present study suggests its applicability to the Italian-speaking chronic patient population. The measure has good psychometric properties and appears to be consistent with the developmental nature of the patient activation phenomenon, although it presents a different ranking order of the items comparing to the American version.PAM13-I can be a useful assessment tool to evaluate interventions aimed at improving patient engagement in healthcare and to train doctors in attuning their communication to the level of patients’ activation. Future research could be conducted to further confirm the validity of the PAM13-I.

Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients.

No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries.

The Neck Disability Index-Russian Language Version (NDI-RU): A Study of Validity and Reliability.

Cross-cultural adaptation and psychometric testing. To perform a validated Russian translation and then to evaluate the validity and reliability of the Russian language version of the Neck Disability Index (NDI-RU). Neck pain is highly prevalent and can greatly affect daily activity. The Neck Disability Index (NDI) is the most frequently used scale for self-rating of disability due to neck pain. Its translated versions are applied in many countries. However, the Russian language version of the NDI has not been developed yet. Cross-cultural adaptation of the NDI-RU was performed according to established guidelines. Then, the NDI-RU was evaluated for content validity, concurrent criterion validity, internal consistency, test-retest reliability, factor structure, and minimum detectable change. Two hundred thirty-two patients took part in the study in total: 109 in validity (39.5 ± 10 yr), 123 in reliability (38.4 ± 11 yr; 80 in the test-retest phase). A culturally valid translation was achieved. NDI-RU total scores were distributed normally. Floor/ceiling effects were absent. Good values of Cronbach α were obtained for each item (from 0.80 to 0.84) and for the total NDI-RU (0.83). A 2-factor solution was found for the NDI-RU. The average interitem correlation coefficient was 0.53. Intraclass correlation coefficients for test-retest reliability coefficients ranged from 0.65 to 0.92 for different items and 0.91 for the total NDI-RU. Moderate correlation (Spearman rs = 0.62; P < 0.05) was found between the NDI-RU total score and graphic rating scalepain score. Completion of the NDI-RU takes 3.6 ± 1 minutes. The development of a Russian language version of the Neck Disability Index resulted in a valid, reliable instrument that can be used both in clinical practice and scientific investigations. 1.