Candidate Items Research Articles

Validation of the Ask Suicide-Screening Questions for Adult Medical Inpatients: A Brief Tool for All Ages

BackgroundFew brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk–screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults. MethodsAdult patients hospitalized on inpatient medical/surgical units from 4 hospitals were recruited to participate in a cross-sectional instrument-validation study. The 4-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire as the criterion standard. ResultsA total of 727 adult medical inpatients completed the screening process. Compared with the Adult Suicidal Ideation Questionnaire, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% confidence interval = 90%–100%), a specificity of 89% (95% confidence interval = 86%–91%), and a negative predictive value of 100% (95% confidence interval = 99%–100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion Adult Suicidal Ideation Questionnaire. ConclusionsThe ASQ is a valid and brief suicide risk–screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be performed effectively for both adult and pediatric patients using this brief, primary screener.

A self-report questionnaire for pregnancy-related symphyseal pain

BackgroundSymphyseal pain (SP) experienced during pregnancy is a common condition that can negatively influence function and wellbeing. Despite its adverse impact on quality of life, standardised diagnostic criteria for SP as a distinct type of pelvic girdle pain (PGP) are lacking. ObjectivesTo develop a reliable self-administered instrument that could differentiate SP from posterior PGP in pregnant women, and ultimately be used for epidemiological or clinical purposes. MethodQualitative data from 17 women (four focus groups) were used to develop a questionnaire. The questionnaire was tested against physical therapy diagnoses based on clinical assessment in 122 pregnant women with SP (n = 41), posterior PGP (n = 41) or no PGP (n = 40); 30 women repeated the questionnaire a day later to assess reliability. Multinomial logistic regression models were used to assess the performance of candidate items in distinguishing between the groups. Results/findingsThe single questionnaire item relating to location of worst pain (diagrammatic form) is useful for differentiating SP from posterior PGP and individuals with no PGP. The worst pain location question with the addition of the Pelvic Girdle Questionnaire provides a measure of “SP with impact”, and is the best combination for distinguishing SP and posterior PGP. Test-retest reliability scores were excellent. ConclusionThese findings provide new opportunities for diagnosing pregnancy-related SP, and highlight questionnaire items which best differentiate SP from posterior PGP. These items could be used in future epidemiological research, and in clinical settings as a quick, effective screening tool.

A Knowledge-Aware Attentional Reasoning Network for Recommendation

Knowledge-graph-aware recommendation systems have increasingly attracted attention in both industry and academic recently. Many existing knowledge-aware recommendation methods have achieved better performance, which usually perform recommendation by reasoning on the paths between users and items in knowledge graphs. However, they ignore the users' personal clicked history sequences that can better reflect users' preferences within a period of time for recommendation. In this paper, we propose a knowledge-aware attentional reasoning network KARN that incorporates the users' clicked history sequences and path connectivity between users and items for recommendation. The proposed KARN not only develops an attention-based RNN to capture the user's history interests from the user's clicked history sequences, but also a hierarchical attentional neural network to reason on paths between users and items for inferring the potential user intents on items. Based on both user's history interest and potential intent, KARN can predict the clicking probability of the user with respective to a candidate item. We conduct experiment on Amazon review dataset, and the experimental results demonstrate the superiority and effectiveness of our proposed KARN model.

MatchRec: A User-item Matching Method for Sequential Recommendation

Sequential recommendation is based on the sequence of items that users interact with to predict the items that users will interact with next time. The existing methods usually consider the hidden sequential patterns in the user’s action sequence, but modeling candidate item features is ignored. To solve this problem, in this paper, we use the two-tower network structure to model the user’s action sequence and candidate item features respectively, then recommend items to users according to the matching score of user interest and item attribute. Specifically, we use self-attention mechanism to mine the information in the user’s action sequence, and use Factorization machines to automatically construct the cross features of item. We named this method MatchRec. The experiments on the public datasets demonstrated that MatchRec has a significant improvement in recommendation accuracy compared with that of various baseline methods.

Development and preliminary validation of a patient-reported outcome measure for conversation partner schemes: the Conversation and Communication Questionnaire for People with Aphasia (CCQA)

ABSTRACT Background Conversation Partner schemes are increasingly used as a way of addressing the psychosocial and emotional consequences of aphasia, providing opportunities for people with aphasia to engage in authentic conversation and to develop social relationships. As yet, there are no outcome measures, that are theorised to match what is expected to change and how such changes are best identified, and that specifically address the constructs of Conversation Partner schemes. Aims This study aimed to develop a new, theoretically motivated and accessible patient-reported outcome measure for evaluating the experiences of people with aphasia involved in Conversation Partner schemes, and for assessing the impact of schemes on areas of importance to people with aphasia. Methods & procedures A mixed-methods study was undertaken in two phases. Phase 1 (item generation) used semi-structured one-to-one interviews and focus groups, which were subject to thematic analysis; Nominal Group Technique was used to develop and refine the item pool. In Phase 2 cognitive interviews were used to examine content validity; structural validity was examined using statistical methods (exploratory factor analysis; Rasch model analysis). Outcomes & results Six themes from interviews and focus groups were developed into 41 candidate items through Nominal Group Technique. Item reduction through cognitive interviewing produced a 30-item scale, which was piloted and then field-tested by 123 community-dwelling adults with aphasia; 121 responses were subject to exploratory factor analysis and further item reduction, producing a four factor, 14-item scale. Rasch analysis demonstrated overall fit to the Rasch model and excellent targeting of items to person. Creation of 3 testlets by grouping items together accommodated the dependence found between pairs of items. Conclusions The Conversation and Communication Questionnaire for people with Aphasia V3 is a 14-item, patient-reported measure for use with patients with aphasia taking part in Conversation Partner schemes. It is concise, has strong content validity, and has some supporting evidence of construct validity. Further research is needed to test its reliability and responsiveness.

776 A New Outcome Metric for Young Children with Burns: Item Pool Development for the Preschool Life Impact Burn Recovery Evaluation (LIBRE) Computer Adaptive Test (CAT) Profile

Abstract Introduction The assessment of recovery from burn injury is critical to improving pediatric health. However, there is a lack of brief, burn-specific measures to assess preschool-aged burn survivors’ health outcomes. We developed items pools for a new, parent-reported computer adaptive test based assessment of preschool-aged children’s burn outcomes. Methods Initial item pools were informed by the Preschool LIBRE Conceptual Model based on the International Classification for Children (ICF) and the Burn Outcomes Questionnaires (BOQ 0–5) and generated from a review of existing instruments assessing health and developmental outcomes in children 1–5 years. Candidate items underwent a review process to bin items together based on the underlying construct they assessed. Items were then winnowed down and further refined based on clinical expert consensus meetings. The winnowing process focused on ensuring items assessed abilities and behaviors that could be reliably determined by parent report, were age-relevant, and focused on health and developmental concepts that are important in the assessment of children’s burn recovery. To ensure item quality, we conducted parent cognitive interviews. In final reviews, we standardized item recall periods, response options, verb tense, and literacy demands. Results A total of 9,509 items were identified and extracted. Four item pool domains were established: communication and language development (42 items), physical functioning (53 items), psychological functioning (56 items), and social functioning (37 items). The respective item pools aim to assess: children’s ability to receive meaning and produce language; children’s gross and fine motor abilities; children’s emotions and behavior (internalizing and externalizing behaviors, dysregulation, toileting, response to trauma and resilience); and children’s social participation and abilities. Recall period and response options were refined for consistency for all 188 final items. Conclusions Four item pools were developed assessing four domains 1) communication and language development, 2) physical functioning, 3) psychological functioning and 4) social functioning for preschool-aged children. The item pools are currently being field-tested for the calibration and validation of the Preschool LIBRE CAT Profile. Applicability of Research to Practice This work is relevant to researchers and practitioners evaluating the effects of burn injury on preschool-aged children’s health and developmental outcomes.

Development of a measure to assess acceptance of headache: The Headache Acceptance Questionnaire (HAQ).

Disability resulting from headache disorders is attributable in part to avoidant coping. Acceptance of pain connotes a willingness to experience pain in the service of life values, such that meaningful activities and goals are pursued despite pain. Acceptance facilitates positive health outcomes but has rarely been investigated in headache. Because headache disorders manifest differently than other forms of chronic pain, the present study sought to develop and validate a measure of acceptance of headache. Forty-five candidate items were developed and, with input from an expert panel, reduced to 24 items. Five items were eliminated following administration to a development sample and exploratory factory analysis. Nineteen items were administered to a validation sample for confirmatory factory analysis and assessment of psychometric properties. Factor analysis produced a unidimensional six-item measure, the Headache Acceptance Questionnaire (HAQ). The HAQ evidenced good internal consistency, convergent validity with headache disability and related psychological constructs, and divergent validity with social desirability. The measure also distinguished between headache diagnostic groups. Pending further validation in clinical settings, the HAQ may have utility in assessing psychological responses to headache symptoms, identifying targets of treatment for interventions that focus on reducing avoidance, and studying mechanisms of change.

Abstract WP310: PRIMED Preclinical Evidence Scoring Tool to Assess Readiness for Translation of Neuroprotection Therapies

Introduction: Multiple neuroprotective therapies (NPT’s) for treatment of acute ischemic stroke have failed in translation to human studies, indicating a need for more rigorous quality assessment of all the cumulative preclinical evidence supporting an NPT prior to conducting human trials. There is a need for an updated translational readiness assessment tool to assess candidate therapies that combines desirable elements of existing instruments (STAIR 2.0, CAMARADES, RoB2) and include additional important elements. Methods: Candidate items for the intervention translational readiness scale, based on prior instruments, were rated by importance, reliability, and feasibility. For illustrative purposes, the assessment tool was applied to four NPT in current development, including two pharmacologic agents [uric acid (UA) and trans sodium crocetinate (TSC)] and two neuromodulatory device interventions [cathodal direct current stimulation (C-DCS) of ischemic hemisphere and fastigial nucleus stimulation (FSN)]. Results: The final Preclinical evidence of Readiness In stroke Models Evaluating Drugs/Devices (PRIMED) assessment tool rates evidence available from all reported animal studies in 10 domains (Fig1). Among the four assessed candidate NPT’s, the scores for two pharmacologic NPT’s indicated high translational readiness (UA and TSC 17) and the two neuromodulatory NPT’s had intermediate readiness-for-translation (C-DCS 12, FNS 8). Conclusion: The PRIMED assessment tool is an updated, multidimensional tool that provides a detailed assessment of multiple important readiness features across all preclinical experiments testing an NPT to assess readiness for translation, applicable to both pharmocologic and device therapies for acute stroke, providing both qualitative profiling of agent strengths and weaknesses and a quantitative summary score. Based on this tool, translational readiness is high for UA and TSC and intermediate for C-DCS and FNS.

Dramatically Reducing Search for High Utility Sequential Patterns by Maintaining Candidate Lists

A ubiquitous challenge throughout all areas of data mining, particularly in the mining of frequent patterns in large databases, is centered on the necessity to reduce the time and space required to perform the search. The extent of this reduction proportionally facilitates the ability to identify patterns of interest. High utility sequential pattern mining (HUSPM) seeks to identify frequent patterns that are (1) sequential in nature and (2) hold a significant magnitude of utility in a sequence database, by considering the aspect of item value or importance. While traditional sequential pattern mining relies on the downward closure property to significantly reduce the required search space, with HUSPM, this property does not hold. To address this drawback, an approach is proposed that establishes a tight upper bound on the utility of future candidate sequential patterns by maintaining a list of items that are deemed potential candidates for concatenation. Such candidates are provably the only items that are ever needed for any extension of a given sequential pattern or its descendants in the search tree. This list is then exploited to significantly further tighten the upper bound on the utilities of descendent patterns. An extension of this work is then proposed that significantly reduces the computational cost of updating database utilities each time a candidate item is removed from the list, resulting in a massive reduction in the number of candidate sequential patterns that need to be generated in the search. Sequential pattern mining methods implementing these new techniques for bound reduction and further candidate list reduction are demonstrated via the introduction of the CRUSP and CRUSPPivot algorithms, respectively. Validation of the techniques was conducted on six public datasets. Tests show that use of the CRUSP algorithm results in a significant reduction in the overall number of candidate sequential patterns that need to be considered, and subsequently a significant reduction in run time, when compared to the current state of the art in bounding techniques. When employing the CRUSPPivot algorithm, the further reduction in the size of the search space was found to be dramatic, with the reduction in run time found to be dramatic to moderate, depending on the dataset. Demonstrating the practical significance of the work, experiments showed that time required for one particularly complex dataset was reduced from many hours to less than one minute.

Development of the Behavioral Inflexibility Scale for Children with Autism Spectrum Disorder and Other Developmental Disabilities.

Behavior inflexibility (BI) refers to rigid patterns of behavior that contrast with the need to be adaptable to changing environmental demands. We developed a parent‐reported outcome measure of BI for children with autism spectrum disorder (ASD) and other developmental disabilities with a multi‐step iterative process. A pool of 62 candidate items was generated through expert panel feedback, review of existing scales and focus groups. A consensus process was used to generate the final 38 items. Parents of 943 children (age range, 3–18 years; average, 11.4 years; 79% boys) with ASD completed an online survey. One hundred thirty‐three parents rated their child twice within 3 weeks (average = 16.5 days). A series of factor analyses suggested that the 38 items measured a single construct. Scores had a weak correlation with level of functioning (−0.12) and did not differ based on sex. Scores had a negligible correlation with age (−0.07), although measurement invariance was not supported. The mean total score for the Behavioral Inflexibility Scale (BIS) was normally distributed. Internal consistency was α = 0.97 and temporal stability was r = 0.92. Correlations with parent ratings on the subscales of the Repetitive Behavior Scale—Revised varied from 0.48 to 0.89. The correlation with parent ratings on the Social Communication Questionnaire total score was 0.52. Our data show that BI in children with ASD ranges significantly from mild to severe and that the 38‐item BIS is valid and reliable. Autism Res 2020, 13: 489–499. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.Lay SummaryWe developed a parent‐completed rating scale of behavior inflexibility (BI) for children with developmental disabilities using a multistep process. The Behavioral Inflexibility Scale (BIS) contains 38 questions rated on a 6‐point scale. Parents of 943 children with autism spectrum disorder (ASD) completed an online survey. We examined associations between the BIS and other scales and demographic variables. The BIS is valid and reliable. BI in children with ASD ranges from mild to severe.

Developing item banks to measure three important domains of health-related quality of life (HRQOL) in Singapore

ObjectivesTo develop separate item banks for three health domains of health-related quality of life (HRQOL) ranked as important by Singaporeans – physical functioning, social relationships, and positive mindset.MethodsWe adapted the Patient Reported Outcomes Measurement Information System Qualitative Item Review protocol, with input and endorsement from laymen and experts from various relevant fields. Items were generated from 3 sources: 1) thematic analysis of focus groups and in-depth interviews for framework (n = 134 participants) and item(n = 52 participants) development, 2) instruments identified from a literature search (PubMed) of studies that developed or validated a HRQOL instrument among adults in Singapore, 3) a priori identified instruments of particular relevance. Items from these three sources were “binned” and “winnowed” by two independent reviewers, blinded to the source of the items, who harmonized their selections to generate a list of candidate items (each item representing a subdomain). Panels with lay and expert representation, convened separately for each domain, reviewed the face and content validity of these candidate items and provided inputs for item revision. The revised items were further refined in cognitive interviews.ResultsItems from our qualitative studies (51 physical functioning, 44 social relationships, and 38 positive mindset), the literature review (36 instruments from 161 citations), and three a priori identified instruments, underwent binning, winnowing, expert panel review, and cognitive interview. This resulted in 160 candidate items (61 physical functioning, 51 social relationships, and 48 positive mindset).ConclusionsWe developed item banks for three important health domains in Singapore using inputs from potential end-users and the published literature. The next steps are to calibrate the item banks, develop computerized adaptive tests (CATs) using the calibrated items, and evaluate the validity of test scores when these item banks are administered adaptively.

An Adaptive Similarity-Measuring-Based CMAB Model for Recommendation System

Online context-based domains such as recommendation systems strive to promptly suggest the appropriate items to users according to the information about items and users. However, such contextual information may be not available in practical, where the only information we can utilize is users' interaction data. Furthermore, the lack of clicked records, especially for the new users, worsens the performance of the system. To address the issues, similarity measuring, one of the key techniques in collaborative filtering, as well as the online context-based multiple armed bandit mechanism, are combined. The similarity between the context of a selected item and any candidate item is calculated and weighted. An adaptive method for adjusting the weights according to the passed time from clicking is proposed. The weighted similarity is then multiplied with the action value to decide which action is optimal or the poorest. Additionally, we come up with an exploration probability equation by introducing the selected times for the poorest action and the variance of the action values, to balance the exploration and exploitation. The regret analysis is given and the upper bound of the regret is proved. Empirical studies on three benchmarks, random dataset, Yahoo!R6A, and MovieLens, demonstrate the effectiveness of the proposed method.

The Development and Preliminary Validation of Chinese Nurses’ Workplace Stressor Scale-30 (CNWSS-30)

Objective: The purpose of this study was to develop a concise and widely applicable Chinese nurse workplace stressor scale (CNWSS). Methods: 3895 Nurses were investigated by a questionnaire including 159 candidate items of nurse work stressors. The Automatic Thoughts Questionnaire (ATQ-30) and Scale of Medical Staff Resilience (SMSR) were used as validity criterion. 162 samples were further selected for the test-retest after 4 weeks. Results: By means of exploratory factor analysis (EFA), 30 items were finally extracted for CNWSS (CNWSS-30), including 6 subscales, namely, organizational role adaptability, workload, nurse-patient relationship, income and respect, self-efficacy, and responsibility. Moreover, confirmatory factor analysis (CFA) showed good fitness (GIF = 0.90, AGFI = 0.89, CFI = 0.91, RMSEA = 0.06). The results also found strong positive correlations among six subscales of CNWSS-30 with ATQ-30 (r = 0.15 - 0.34, p p p p < 0.01) also revealed high stability. Conclusion: Generally, CNWSS-30 is reliable and valid, and can be used as a tool for measuring the Chinese nurse stressors at workplace.

Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

Measuring Behavioural Dependence in Gambling: A Case for Removing Harmful Consequences from the Assessment of Problem Gambling Pathology.

Behavioural dependence (BD) for gambling has traditionally been subsumed under the concept of 'problems': a hybrid construct that includes both indicators of BD, and adverse consequences (harm) arising from excessive time and money expenditure. Although progress has been made towards specific measurement of harm, dedicated measures of BD do not exist. Theory led us to expect that (1) dependence and harm are measurably distinct constructs, (2) harm mediates the relationship between dependence and wellbeing, and finally, that (3) separate measures should be more effective than a unidimensional problems measure in predicting wellbeing. Candidate BD items from six existing measures of gambling problems were extracted and evaluated with respect to DSM-5 criteria and content overlap, leading to 17 candidate items. This was further reduced to 8 items based on both item content and psychometric criteria, using data from an online panel of 1524 regular gamblers, with demographic characteristics similar to Australian population norms. Participants also completed measures of harm, problems, and subjective wellbeing. All three hypotheses were confirmed. BD was shown to be highly reliable and unidimensional, and measurably distinct from gambling harms. Harm mediated the negative relationship between BD and wellbeing. The harm + BD model yielded better predictions of personal wellbeing that a unidimensional, continuous problems measure-and explained about twice the variance of a simple contrast between problem and non-problem gamblers. We conclude that is psychometrically justified to specifically measure gambling BD, and this may be of particular use in theoretically-driven applications.

The expansion and validation of a new upper extremity item bank for the Patient-Reported Outcomes Measurement Information System\xae (PROMIS)

BackgroundThe Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a Physical Function (PF) item bank and an Upper Extremity (UE) item bank, which is composed of a subset of items from the PF bank. The UE item bank has few items and known ceiling effects. Therefore, this study aimed to expand the item bank to assess a wider range of functioning. With the additional content, other psychometric properties—improved content validity, item bank depth, range of measurement, and score reliability—were also evaluated. We convened an expert panel to review potential items, and then conducted psychometric analyses on both extant and newly-collected data.ResultsExpert focus groups reviewed the PF item bank for items that were “sufficiently” related to upper extremity functioning for inclusion in the expanded UE item bank. The candidate item bank was quantitatively evaluated in a new sample of 600 people. The final items were calibrated in an aggregated dataset (n = 11,635) from two existing datasets, and the newly collected sample. The original UE item bank included 15 items. After expert review and quantitative evaluation, 31 items were added. The combined 46 items were calibrated using item response theory (IRT). Then computer adaptive tests (CATs) were simulated based off of the psychometric results. These indicated that the new UE item bank has an extended measurement range compared to the original version.ConclusionsThe expanded PROMIS UE item bank assesses a wider range of upper extremity functioning compared to the initial UE item bank. However, ceiling effects remain a concern for unimpaired groups. The new UE item bank is recommended for individuals with known or suspected upper extremity limitations.

Evaluation of Candidate Items for Severe PTSD Screening for Patients With Chronic Pain: Pilot Data Analysis With the IRT Approach.

Post-traumatic stress disorder (PTSD) commonly co-occurs with chronic pain. Although PTSD symptoms are associated with negative health outcomes in patients with chronic pain, PTSD is typically under-detected and under-treated in outpatient pain settings. There is a need for rapid, brief screening tools to identify those at greatest risk for severe PTSD symptoms. To achieve that goal, our aim was to use item response theory (IRT) to identify the most informative PTSD symptoms characterizing severe PTSD in patients with chronic pain. Fifty-six patients (71% female, 61% White) with mixed etiology chronic pain completed the PTSD Checklist-Civilian Version (PCL-C) as part of their appointment with a pain psychologist at a tertiary outpatient pain clinic. We used an IRT approach to evaluate each item's discriminant (a) and severity (b) parameters. Findings revealed that "feeling upset at reminders" (a=3.67, b=2.44) and "avoid thinking or talking about it" (a=3.61, b=2.17) as being highly discriminant for severe PTSD. We identified 2 candidate items for a brief PTSD screener as they were associated with severe PTSD symptoms. These 2 items may provide clinical utility in outpatient pain treatment settings to identify those suffering from severe PTSD, enabling physicians to refer them to trauma-specific evaluation or therapy. Future research is needed to further validate and confirm these candidate PTSD items in a larger clinic sample. The current study used the IRT approach to identify candidate items for a brief screener for severe PTSD. We examined 17 items of the PCL-C, and identified 2 items that were highly discriminant for severe PTSD. The 2 items were "feeling upset at reminders" and "avoid thinking or talking about it." These 2 items may provide clinical utility, since they may enable physicians to screen and make a referral for further assessment or treatment for PTSD.

Measuring psychological need states in sport: Theoretical considerations and a new measure

ObjectivesResearch guided by Self-determination Theory (Deci & Ryan, 1985; Ryan & Deci, 2017) has repeatedly demonstrated the importance of focusing on both the bright (satisfaction) and dark (frustration) sides of the three basic psychological needs. Recently, researchers have also argued for the utility of assessing a third need state, that of “unfulfillment”. In this paper, we outline an effort to develop and provide initial validity evidence for scores of a new multidimensional and sport-specific measure, the Psychological Need States in Sport-Scale (PNSS-S), to assess the satisfaction, frustration, and unfulfillment of all three needs. MethodIn Study 1, we developed 46 candidate items, and tested evidence for the factorial structure of the responses to the newly developed items, internal consistency and discriminant validity of the subscale scores. Following refinement, the replication of the favored model was tested using an independent sample of athletes in Study 2. Evidence for the nomological network of the subscales of the new measure was also demonstrated in Study 2. ResultsFactor models incorporating all three need states showed poor fit with the data. However, following post-hoc modifications, a six-factor model assessing the need states of satisfaction and frustration, separately for autonomy, competence, and relatedness, was found to have good fit to the data. After refinement, the 29-item six-factor model was found to demonstrate good fit, good standardized factor loadings, factor correlations in the expected directions, and acceptable estimates of internal consistency in Study 2. Tests of nomological networks showed that the six need states were significantly predicted by contextual autonomy, competence, and relatedness support/thwarts as expected. Autonomy and competence need satisfaction were significantly associated with engagement; and competence and relatedness need satisfaction were significantly associated with positive affect. In addition, autonomy and competence need frustration were significantly associated with exhaustion and all three need frustration states significantly predicted negative affect. ConclusionsA tripartite conceptualization of the need states was not empirically supported. Nevertheless, the PNSS-S makes a unique contribution to the sport literature, as it represents the first sport-specific measure of six distinct, yet, correlated states of the satisfaction and frustration of autonomy, competence, and relatedness needs.

Defining Employment Specialist Competencies: Results of a Participatory Research Study.

The preponderance of research conducted on supported employment has focused on the structure of interventions with little empirical investigation into the contribution of employment specialists to work outcomes. Using a participatory approach, we identified competencies essential to the role of the employment specialists, operationalized and refined those competencies using the perspectives of experts, service recipients, and employment specialists themselves. We conducted an online survey with 34 candidate items and n = 142 respondents. Results suggested good psychometric properties, stability and coherence of the Vocational Practices and Relationship Scale. A total of n = 23 finalitems tapping the working alliance coalesced into a strong factor, as did strategies for promoting vocational recovery, suggesting that the scale warrants wide-scale testing for predictive validity. We consider these constructs and competencies to be a potential blueprint for training employment specialists, not only in technical skills and strategies, but also to increase the hope for vocational recovery among those they serve.

1663P - Measuring financial toxicity of cancer in the Italian health care system: Initial results of the patient reported outcome for fighting financial toxicity of cancer project (proFFiT)

BackgroundFinancial toxicity in cancer patients has been initially reported in the United States and subsequently in other countries, including Italy, despite a health care system grounded on universal coverage. Considering that the way healthcare and welfare systems are shaped does impact on financial problems faced by cancer patients, we are developing an instrument for evaluating occurrence, gravity, and consequences of financial toxicity in Italy, and hopefully for fighting it. MethodsConcept elicitation, item generation and qualitative analyses represented the initial tasks of the project. Literature review, focus groups with 34 cancer patients or caregivers in three regions located in North, Central, and South Italy, and semi-structured interviews with 97 oncologists were conducted for concept elicitation. A recursive process was used to identify themes in the data to inform the instrument until saturation was reached. Importance analysis questionnaires were administered to a further 44 cancer patients to evaluate and revise the draft item pool. A multi-disciplinary committee (including oncologists, psychologists, statisticians, patient association’s representatives, nurses, social science researchers and economists) oversaw the project. ResultsOverall, 156 concepts were distributed among 10 themes (bureaucracy, medical care, domestic economy, emotion, family, job, health workers, welfare state, free time, transportation). After controlling for redundancy, 55 candidate items were generated and 30 items, with at least one per each theme, remained after importance analysis. Out of the 30 items, 23 (77%) refer to material conditions, 4 (13%) to psychological response, and 3 (10%) to coping behaviors. ConclusionsThe first results of the proFFiT project show that most of the items selected by patients are related to material conditions that cause, or derive from, financial hardship. The final questionnaire will be ready by the end of 2019. Supported by Fondazione AIRC IG grant 2017-20402. Clinical trial identificationNCT03473379. Legal entity responsible for the studyIstituto Nazionale per lo Studio e la Cura dei Tumori Fondazione Pascale IRCCS, Naples, Italy. FundingFondazione AIRC IG grant 2017-20402. DisclosureS. Riva: Honoraria (self): CSL-Behring; Honoraria (self): GlaxoSmithLine Foundation. M. Di Maio: Honoraria (self): BMS; Honoraria (self): MSD; Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): Janssen. F. Efficace: Honoraria (self): BMS; Honoraria (self): Incyte; Honoraria (self): Orsenix; Honoraria (self): Amgen. V. Montesarchio: Honoraria (self): BMS; Honoraria (self): Italfarmaco; Spouse / Financial dependant: Bayer. F. Perrone: Honoraria (self): AstraZeneca; Honoraria (self): Bayer; Honoraria (self): Celgene; Honoraria (self): Incyte; Honoraria (self): Janssen-Cilag; Honoraria (self): Pierre Fabre; Honoraria (self): Sandoz. All other authors have declared no conflicts of interest.