High Content Validity Index Research Articles

Creation and Validation of a Spanish Questionnaire for Evaluating Pediatricians' Satisfaction with Teledermatology.

Introduction: In 2021, we introduced a program to promote the use of teledermatology among pediatricians. In the present study, we created and validated a satisfaction questionnaire to assess pediatricians' perceptions of teledermatology. We used this questionnaire to evaluate the efficacy of the program. Methods: First, a provisional questionnaire, based on questionnaires available in the literature, was drafted. A group of experts evaluated the clarity, coherence, relevance and sufficiencyof the questions, and we calculated a content validity index (CVI). Only questions with a CVI above 0.78were acceptable. Based on these results and on the experts' comments, we revised the questionnaire and then sent it to a population of pediatricians. We used their responses to validate the revised questionnaire using statistical methods. A Cronbach's alpha above 0.7 indicated adequate internal consistency, and an intraclass correlation coefficient above 0.75 indicated adequate reproducibility. We used the Varimax method to measure construct validity. Results: We clarified and reformulated some questions from the provisional questionnaire based on the experts' comments. All questions had a CVI above 0.78, so no other changes were needed. Although the statistical validation showed suboptimal construct validity, the revised questionnaire had good internal consistency and reliability, and high content validity index. Discussion: The validated questionnaire is a robust tool for assessing pediatricians' satisfaction with teledermatology.

Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome.

To validate the content of the "Health Literacy Behaviour" nursing outcome (NO). A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels. A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI≥0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90. The indicators included in the NO "Health Literacy Behaviour" have content validity. These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

Design and construct of an assessment tool for the handover of critical patient the in urgent care and emergency setting

ObjectivesTo design and construct an assessment tool for the handover of critical patients in the urgent care and emergency setting. Research methodologyThis metric and descriptive study comprised two phases in accordance with the Clinical practice guidelines for A Reporting Tool for Adapted Guidelines in Health Care: The RIGHT-Ad@pt Checklist. In the first phase, the identification and selection of items related to the handover of critical patients were performed by consensus of a group of experts. The second phase consisted of two stages. In the first stage, the items were selected by applying the e-Delphi technique across two assessment rounds and in the second stage, the items were subjected a pilot test in a real critical patient handover scenario. Professionals from different disciplines and work areas (hospital and prehospital) caring for critically ill patients in the urgency and emergency setting participated in each of the phases. ResultsA total of 58 critical patient care, and urgent and emergency care professionals participated in the design and construction of the assessment tool. The initial list consisted of 14 categories and 57 items, which were reduced to 28 items grouped into five categories after the intervention of the participants. The content validity index (CVI) of the instrument was 0.966. ConclusionsThis study describes an assessment tool developed in Spanish-language designed to assess the handover of critical patients in the urgent care and emergency setting. This tool has a high CVI, and is the only currently available tool that consider all of the dimensions and characteristics of the handover process. Implications for clinical practiceThe assessment tool developed in this study could enable critical care professionals in their clinical practice to work in a systematic way, universalizing the handover of critically ill patients in the urgent care and emergency setting through scientifically proven guidelines.

Adaptation and validation of the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV) for the Brazilian context.

Despite significant advancements in antiretroviral therapy (ART) for HIV, adherence remains a challenge. While Brazil has validated scales for treatment adherence, few assess treatment adherence barriers. This underscores the necessity for validated questionnaires on adherence barriers to identify patient-specific challenges and enhance strategies for ART adherence. This study aimed to adapt and validate the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV), a 17-item questionnaire assessing the adherence barriers to ART, for the Brazilian context and to evaluate its psychometric properties in HIV patients. A methodological study on the psychometric properties and factorial structure of ABQ-HIV was conducted. The study followed seven steps: consent of the original authors, two translations, synthesis of the translations, expert committee, back-translation, pre-test, and reliability test. A high content validity index (0.93) was achieved with the expert committee. The study sample consisted of 230 adults with HIV, with 37.0 (29.3-45.0) years as the median age (IQR), and 52.2% were male. The exploratory factor analysis with a three subscales structure of 17 items showed good interpretability (Bartlett's sphericity (1167.2 [136]; p < 0.001) and Kaiser-Meyer-Olkin = 0.602) and internal consistency (α = 0.76; Ω = 0.76). The fit indicators were satisfactory (χ2 = 89.931; df = 88; p > 0.005; RMSEA = 0.010; RMSR = 0.07; CFI = 0.996; GFI = 0.940; AGFI = 0.907; NNFI = 0.995). The Brazilian version of ABQ-HIV is a potential instrument for identifying specific barriers to adherence to ART in adults living with HIV in Brazil.

Development and Psychometric Test of the Inpatients Experiences Measurement Scale (IEMS).

In South Korea, hospitalized patients' experiences significantly impact satisfaction and treatment outcomes. This study developed and evaluated the Inpatients Experience Measurement Scale (IEMS) for its psychometric properties. Participants from three hospitals were recruited using convenience sampling. Scale item generation involved patient interviews and a Delphi survey with experts. Psychometric testing used Exploratory Factor Analysis (EFA) with 150 participants and Confirmatory Factor Analysis (CFA) with 151 participants. A total of 301 patients participated, resulting in a 20-item scale across four factors: "Care Quality and Information Provision", "Patient Safety and Dietary Services", "Facility and Comfort Infrastructure", and "Comprehensive Patient Support Services". Rated on a 5-point Likert scale, the scale showed a high Content Validity Index (CVI) over 0.80. EFA explained 61.43% of the variance. The four-factor model was validated using CFA with favorable fit indices. The IEMS demonstrated strong convergent validity, supported by high composite reliability (CR) and average variance extracted (AVE) values. Significant correlations with the Patient Satisfaction Scale reinforced its convergent validity. Discriminant validity was confirmed, and all reliability measures exceeded the minimum threshold of 0.80. The IEMS effectively captures inpatients' experiences, demonstrating robust reliability and validity. This scale is a valuable tool for assessing patient experiences, facilitating enhancements in patient care and satisfaction within hospital settings.

Translation, and validation of Dysphagia Outcome and Severity Scale (DOSS): Swedish version

BackgroundSwallowing dysfunction (dysphagia) significantly impacts patient and medical outcomes. In Sweden, there is no comprehensive outcome measure for dysphagia that incorporates holistic assessment and dysphagia impact on a person’s impairment, function and participation. The Dysphagia Outcome and Severity Scale (DOSS) was developed and validated (in English) and incorporates the World Health Organisation’s (WHO) aforementioned, International Classification of Functioning (ICF) aspects. This study translated then evaluated the validity and reliability of the Swedish version, DOSS-S.MethodTranslation occurred based on WHO recommendations. The Content Validity Index (CVI) of the translated version (DOSS-S) was assessed twice by 11 (multi-professional) dysphagia experts. Criterion validity and rater reliability was calculated using 18 Speech Pathologists assessing patient cases from International Dysphagia Diet Standardization Initiative—Functional Diet Scale (IDDS-FDS) research.ResultsVery high CVI values (0.96–0.99) for the linguistic correlation, and high CVI values (0.84–0.94) for applicability correlation were achieved. High criterion validity of DOSS-S with IDDSI-FDS was demonstrated (rs = 0.89, p < 0.01), with very high inter and intra rater reliabilities (ICC > 0.90).ConclusionThe DOSS-S demonstrated very high validity values, and very high inter and intra rater reliability. This research contributes to improved dysphagia management by providing interprofessional dysphagia clinicians with a validated scale to identify patient progression, communicate dysphagia status between regions and countries, and document patient outcomes using an ICF framework.

Development and validation of the genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVTAQ): An electronic patient-reported outcomes measure.

To develop and validate an electronic, patient-reported outcomes measure (PROM) specific for genitourinary syndrome of menopause (GSM) patients. The PROM aimed to accurately assess the burden of GSM symptoms, their impact on health-related and sexual quality of life, and the acceptability of vaginal treatments. The study encompassed a comprehensive three-stage approach to the development and validation of the PROM. Initially, during the preliminary design stage, the necessity for a new PROM was recognized, an expert panel was formed, and semi-structured qualitative interviews were carried out with GSM patients. In the second stage, the study used the five-step pre-validation methodology established by Prior et al. to generate and refine the PROM items. The third and final stage encompassed the determination of scale and item content validity indexes to ensure validity. Additionally, the reliability of each construct was evaluated using Cronbach's α. The resulting PROM was named GSM-SVTAQ (GSM-symptoms and vaginal treatments acceptability questionnaire). It demonstrated excellent validity in assessing symptoms burden, health-related and sexual quality of life, and vaginal treatment acceptability, with high content validity indices and strong internal consistency. The scale content validity indices and Cronbach's α coefficients for the three domains were (0.926, 0.939), (0.875, 0.947), and (0.824, 0.855), respectively. The GSM-SVTAQ stands as the first GSM-specific, valid, and reliable PROM capable of comprehensively measuring the three components of GSM and the acceptability of vaginal treatments. Its implementation has the potential to significantly enhance patient care and outcomes in GSM management.

Psychometric Testing of the CEECCA Questionnaire to Assess Ability to Communicate among Individuals with Aphasia.

(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia were recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: five language dimensions explained 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen's κ: 0.9; p < 0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen's κ: 0.6; p < 0.001), and concordances of up to 96% (Cohen's κ: 0.9; p < 0.001) using NOC indicators. The internal consistency (Cronbach's alpha) was 0.98. Reliability tests revealed test-retest concordances of 76-100% (p < 0.001). (4) Conclusions: the CEECCA is an easy-to-use, valid, and reliable instrument to assess the ability to communicate among individuals with aphasia.

Development of an analytical rubric and estimation of its validity and inter-rater reliability for assessing reflective narrations.

Background Reflective practice is an integral component of continuing professional development. However, assessing the written narration is complex and difficult. Rubric is a potential tool that can overcome this difficulty. We aimed to develop, validate and estimate inter-rater reliability of an analytical rubric used for assessing reflective narration. Methods A triangulation type of mixed-methods design (Qual-Nominal group Technique, Quan-Analytical follow-up design and Qual-Open-ended response) was adopted to achieve the study objectives. Faculties involved in the active surveillance of Covid-19 participated in the process of development of assessment rubrics. The reflective narrations of medical interns were assessed by postgraduates with and without the rubric. Steps recommended by the assessment committee of the University of Hawaii were followed to develop rubrics. Content validity index and inter-rater reliability measures were estimated. Results An analytical rubric with eight criteria and four mastery levels yielding a maximum score of 40 was developed. There was a significant difference in the mean score obtained by interns when rated without and with the developed rubrics. Kendall's coefficient of concordance, which is a measure of concordance of scorers among more than two scorers, was higher after using rubrics. Conclusion Our attempt to develop an analytical rubric for assessing reflective narration was successful in terms of the high content validity index and better inter-rater concordance. The same process can be replicated to develop any such analytical rubric in the future.

The Recurrent Urinary Tract Infection Symptom Scale: Development and validation of a patient-reported outcome measure.

This study aimed to develop and validate a tailored patient-reported outcome measure (PROM) evaluating the patient experience of recurrent urinary tract infection (rUTI) symptom severity. This measure was designed to supplement clinical testing methods, allowing full assessment of the patient experience of rUTI symptom burden, while enhancing patient-centred UTI management and monitoring. The Recurrent Urinary Tract Infection Symptom Scale (RUTISS) was developed and validated using a three-stage methodology, in accordance with gold-standard recommendations. Firstly, a two-round Delphi study was conducted to gain insights from 15 international expert clinicians working in rUTI, developing an initial pool of novel questionnaire items, assessing content validity and making item refinements.Next, two phases of one-to-one semi-structured cognitive interviews were conducted with a diverse sample of 28 people experiencing rUTI to assess questionnaire comprehensiveness and comprehensibility, making refinements after each phase. Finally, a comprehensive pilot of the RUTISS was conducted with 240 people experiencing rUTI across 24 countries, providing data for psychometric testing and item reduction. Exploratory factor analysis indicated a four-factor structure comprising: 'urinary pain and discomfort', 'urinary urgency', 'bodily sensations' and 'urinary presentation', together accounting for 75.4% of the total variance in data. Qualitative feedback from expert clinicians and patients indicated strong content validity for items, which was supported by high content validity indices in the Delphi study (I-CVI > 0.75). Internal consistency and test-retest reliability of the RUTISS subscales were excellent (Cronbach's α = 0.87-0.94 and ICC = 0.73-0.82, respectively), and construct validity was strong (Spearman's ρ = 0.60-0.82). The RUTISS is a 28-item questionnaire with excellent reliability and validity, which dynamically assesses patient-reported rUTI symptoms and pain. This new PROM offers a unique opportunity to critically inform and strategically enhance the quality of rUTI management, patient-clinician interactions, and shared-decision making by monitoring key patient-reported outcomes.

Self-management in heart failure using mHealth: A content validation

AimTo describe the development of a mobile health application –mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity. MethodsCritical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed. ResultsThe developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI ≥ 0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851. ConclusionsmICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation.

Cognitive interviewing as a method to inform questionnaire design and validity - Immersive Technology Evaluation Measure (ITEM) for healthcare education

Research of immersive technology in education is rapidly expanding with potential to educate future students in healthcare disciplines. Despite increasing literature there is a lack of validated instruments to investigate the effects of these technologies. Cognitive interviewing is a valuable evaluation method to check comprehension of a measure and was applied to a new measure of user experience of immersive technology for healthcare education (ITEM). A 5 domain self-reported measure of: immersion, intrinsic motivation, cognitive load, system usability, and debrief. Prior to the interview 9 participants were allocated to augmented reality and virtual reality educational activities. Verbal probing and think aloud techniques through semi-structured cognitive interviews were conducted. The ITEM was found to have high content validity index scores and relationships between domains were further explored through qualitative analysis. The results indicate high clarity of understanding for those completing the ITEM and supports future research as part of an ongoing validation process.

Menopausal Voice-Related Work Limitation Scale (MenoVWL): Development and Validation

Menopause has been reported to affect the voice of female professional voice users (FPVUs). The present study aims at the development and validation of a scale to measure self-perceived menopausal voice-related limitation to work in FPVUs, henceforth the Menopausal Voice-Related Work Limitation Scale (MenoVWL). Items were drawn from previous studies on impacts of sex steroid hormones on voice, available validated scales, and in-depth interviews with post-menopausal FPVUs. A preliminary version with 16 items was evaluated by a panel of 15 voice experts. The resulting revised version was filled in online, together with questions on current endocrinological reproductive status and related symptoms, history of amenorrhea, professional occupation, and demographic information. Responses concerning only professional voice users were selected and inclusive and exclusive criteria were applied for correct allocation of participants into pre- and post-menopausal stages within a restrict age range;192 responses were subject to factorial analysis for MenoVWL validation. Cronbach's alpha measured internal reliability. The scale was tested by comparing MenoVWL scores between pre- and post-menopausal FPVUs (98 and 94, respectively). Thirteen items were retained from the expert panel evaluation. Items presented a high Content Validity Index (.94 out of 1) and high Item Acceptance Ratio (86.25 %). Both exploratory and confirmatory factorial analysis rendered one dimension scale with an excellent internal consistency (Cronbach's alpha=.9). The results of a Mann-Whitney test showed a higher MenoVWL score for post- as compared to pre-menopausal FPVUs (Z=- 2.818; P=.005). MenoVWL is a comprehensive and validated scale with a known factor structure. It constitutes a health care and safety outcome self-perceived measure of value to the early detection of voice-related limitations to work in FPVUs during menopause.

Design and content validation of an instrument measuring user perception of the persuasive design principles in a breastfeeding mHealth app: A modified Delphi study

BackgroundPersuasive design principles are increasingly employed in mHealth apps for motivating users and promoting healthy behaviours among individuals. However, how the persuasive design principles are perceived by the mHealth app users remains unclear. AimTo develop and validate the content validity of an instrument designed to measure the user’s perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app. MethodsA critical review of the literature guided the development of the research instrument. The developed instrument was refined and validated through a two-round modified Delphi process. Ten experts drawn from academic and clinical settings evaluated the items through two content validity indicators, relevance, and clarity and provided narrative feedback. The content validity of the instrument was determined by calculating the Content Validity Index (CVI). Content validity indicators at the scale-level (S-CVI) and item-level (I-CVI) were calculated. ResultsThe results demonstrated high content validity index of individual items in the instrument. All items in the instrument reached an excellent I-CVI ≥ 0.78 for both relevance and clarity except one item. The overall content validity index of the instrument using the average approach was moderate to high (S-CVI/Ave was 0.89 and 0.92 for relevance and clarity, respectively). The developed research instrument is composed of 5 constructs representing 24 items: (1) primary task support, (2) dialogue support, (3) system credibility support, (4) social support and (5) perceived persuasiveness. ConclusionsUsing a modified Delphi approach, the development and validation of the research instrument demonstrated moderate to high content validity for measuring users’ perceptions of the persuasive design principles assimilated in a breastfeeding mHealth app. The evidence from this study supports that the research instrument is valid, relevant, and clear.

Development and Validation of the Chinese Version Non-Nutritive Sweetener Food Frequency Questionnaire with Urinary Biomarker in Children and Adolescents.

The purpose of this study was to develop a validated food frequency questionnaire (FFQ) to evaluate the intake of non-nutritive sweeteners (NNSs) in child and adolescent Asian populations. Intensive and overall market research was performed to create the applicable NNS-FFQ with 13 food categories and 305 items. Six intense sweeteners, including acesulfame potassium, aspartame, sucralose, glycyrrhizin, steviol glycosides and sorbitol, were investigated. The validity and reproducibility of the NNS-FFQ were evaluated. The validity was further assessed by examining the consistency of reported NNS intake compared with urinary biomarkers using Cohen's κ analysis. This work was considered to be relevant in Asian societies. One hundred and two children and adolescents recruited from several clinics were invited to participate in this study. High content validity indices and high content validity ratio levels were revealed for each sweetener and food category. Reproducibility among subjects was satisfactory. Significant moderate correlations between estimated steviol glycoside/sucralose consumption and sensitive urinary biomarker levels were demonstrated (κ values were 0.59 and 0.45 for steviol glycosides and sucralose, respectively), indicating that the NNS-FFQ can be used to assess an individual's NNS intake. The dietary intense sweetener consumption pattern evaluated in this measurement was similar to those observed in other Asian countries but differed from those observed in Western populations with respect to types and amounts of NNSs. This validated NNS-FFQ can be an applicable and useful tool to evaluate NNS intake in future epidemiological and clinical studies.

Validation of a Questionnaire of Food Education Content on School Catering Websites in Spain.

The aim of this study was to design and validate a questionnaire on quality and food education on catering company websites. For the validation of the questionnaire, its reliability, feasibility and content validity characteristics were determined. For content validity, a panel of experts was used and the overall and item-wise Content Validity Index (CVI) of the experts’ responses was calculated. Reliability was determined by the inter-judge agreement method with the analysis of 30 websites using the intraclass correlation coefficient (ICC) and the Bland and Altman plot. Adequate content validity was verified by obtaining a very high CVI (above 0.80) in the analysis of the expert panel’s responses and excellent inter-observer agreement with a very high global ICC (above 0.90) value in the determination of test-retest reliability. The questionnaire is a valid instrument for the evaluation of the quality of school catering websites and their content in food education, as it has good feasibility, high content validity and excellent reliability.

Development and validation of a questionnaire investigating endurance athletes practices to manage gastrointestinal symptoms around exercise.

To develop and validate a questionnaire investigating endurance athletes' carbohydrate beliefs, knowledge, information sources, and other dietary and non-dietary practices related to exercise-associated gastrointestinal symptoms. A questionnaire was developed by a review of relevant literature and sports-related questionnaires, and input from five experienced sports dietitians. Item construct and format was adapted and modified from a previous questionnaire. The modified questionnaire sought information on demographics, nutrition knowledge, beliefs, intended practices, information sources and exercise-associated gastrointestinal symptoms. A five-phase validity process was conducted to determine content, face and construct validity, item difficulty and internal reliability of the questionnaire. The Delphi technique was applied with experts over three anonymous rounds. Items were reviewed to determine whether to keep, modify, or delete, rate the relevance of each item using a content validity index (CVI), and provide comments. A content analysis was conducted on all comments after each round. Online interviews were conducted with a pilot group of endurance athletes (n=15) to assess item difficulty and feasibility. Nutrition knowledge was compared between pilot group of athletes and experts to determine construct validity and internal consistency. A test-retest process was applied to a second pilot group (n=8) to verify questionnaire reliability. High CVI (≥.83) and agreement scores were obtained through the Delphi technique. High reliability (r=.942) and acceptable internal consistency (α=.53-.78) of the questionnaire were obtained. The questionnaire was shown to be a valid and reliable tool that will be of use for clinicians and research purposes.

Consulta de enfermagem na Atenção Primária à Saúde: cuidado às pessoas com doenças crônicas cardiometabólicas

Objetivo: desenvolver um instrumento para Consulta de Enfermagem às pessoas com hipertensão arterial e/ou diabetes mellitus tipo 2 em seguimento na Atenção Primária à saúde. Método: estudo metodológico, composto por duas etapas, desenvolvido em Unidade Básica de Saúde (UBS) no interior do Estado de São Paulo. A Etapa 1 correspondeu à Construção do Instrumento e à Validação de Conteúdo por cinco juízes. A Etapa 2 correspondeu ao pré-teste e à avaliação de suas propriedades de medida. O questionário foi pré-testado com 30 pessoas com hipertensão arterial e/ou debates mellitus usuárias da UBS. Resultados: o questionário apresentou alto índice de validade de conteúdo (IVC=0,96) e moderada aplicabilidade (pelo tempo de aplicação). Conclusão: o instrumento se apresentou adequado à realidade e à necessidade da Atenção Primária em termos de conteúdo.

Evaluation of the content validity index of the Australian/Canadian osteoarthritis hand index, the patient-rated wrist/hand evaluation and the thumb disability exam in people with hand arthritis

BackgroundThe Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Patient-Rated Wrist/Hand Evaluation (PRWHE) and the Thumb Disability Exam (TDX) are patient-reported outcome measures (PROM) designed to assess pain and hand function in patients with hand arthritis, hand pain and disability, or thumb pathology respectively. This study evaluated the content validity of AUSCAN, PRWHE and TDX in people with hand arthritis.MethodsThis study enrolled participants with hand arthritis to rate the items of all 3 PROM in terms of relevance and clarity. The Content Validity Index (CVI) was computed for each item in each scale (I-CVI) as well as for the overall scale (S-CVI). Kappa was used to determine the inter-rater agreement among the raters.ResultsOverall, 64 individuals with hand arthritis (27% with OA, 67% with rheumatoid arthritis and 6% with psoriatic arthritis) participated in the study. The I-CVI for all items and all scales were very high (I-CVI > 0.76) and the modified Kappa agreement among the raters demonstrated excellent agreement (k > 0.76). The S-CVI for all PROMs was very high for relevance (AUSCAN = 0.92, 95% CI 0.90 to 0.94; PRWHE = 0.85, 95% CI 0.82 to 0.88 and TDX = 0.87, 95% CI 0.85 to 0.89) and for clarity (AUSCAN = 0.99, 95% CI 0.98 to 1.00; PRWHE = 0.95, 95% CI 0.93 to 0.97 and TDX = 0.91, 95% CI 0.89 to 0.94), respectively.ConclusionsThis study demonstrated very high content validity indices for the AUSCAN, PRWHE and TDX; with strong consensus across raters. This augments prior studies demonstrating appropriate statistical measurement properties, to provide confidence that all three measures assess important patient concepts of pain and disability.

Measuring assessors’ experiences of grading marginal student performances in clinical assessments – The assess-safe tool: Development and preliminary psychometric validation

Assessment of fitness for practice in the nursing student population is an essential yet challenging component of nursing education. The aim of this research was to describe the development and preliminary validation of the Assess-Safe instrument that explores assessors' experiences of grading nursing student performances in clinical courses when that performance is not a clear pass or fail. A 3 phase approach was used to develop and psychometrically test the instrument. Phase 1 involved the development of a pool of items following a literature review, coupled with findings from qualitative data. In phase 2, an expert panel rated the items for clarity and relevance, reducing the item pool. Assessors of Australian undergraduate nursing students from industry and academia were recruited for this study. A sample of 149 assessors across industry and academia completed the resultant survey to pilot test the instrument; constituting Phase 3. A high content validity index score of 0.95 was achieved through expert review. Construct validity using factor analysis revealed four factors including: assessor support; process support; assessor introspection; and student support. The Assess-Safe instrument achieved good internal reliability with an overall Cronbach's alpha coefficient of 0.77; and sub-scale scores ranging from 0.71 to 0.79. The Assess-Safe instrument demonstrated satisfactory psychometric properties and has utility for education programmes, research and policy development across a variety of practice based professions. Nonetheless, further psychometric validation is warranted.