High Internal Validity Research Articles

Emotional intelligence in transcendent customer experiences

PurposeThis services marketing research provides a theoretical framework for experiential and relationship marketing and extends the theory of transcendent customer experience (TCE). Specifically, this paper aims to identify how the drivers (emotional intelligence [EI]), outcomes (customer loyalty, willingness to pay and word of mouth [WOM] intentions) and influences (openness to experience) of TCE are integrated. The research contributes to the theoretical debate regarding ability-based and self-reported EI measures by examining their influence on TCE.Design/methodology/approachStudents and general consumers provided data through structured online surveys in three survey-based experiments. Linear and multiple regressions, mediation analyses and simple effects tests were used for data analysis.FindingsFindings suggest that self-reported and ability-based measures of EI influence TCE differently. Participants who had high self-reported EI evaluated positive service encounters as more transcendent than they evaluated negative service encounters. Participants who had high ability-based EI evaluated positive service encounters as less transcendent than they evaluated negative service encounters. TCE experiences evoked higher loyalty, willingness to pay (WTP) and WOM recommendations. Furthermore, dispositional factors were significant in forming TCE: participants who were highly open to experience and had high ability-based EI interpreted their service encounter as less transcendent than did participants who were more closed to experience and had low ability-based EI.Research limitations/implicationsTCE, a relatively new concept, offers theoretical advancement in context and constructs. The student-provided data gave high internal validity; the general consumer-provided data gave external validity. Ideally, a future field study in an actual consumption setting should replicate the findings. A self-reported questionnaire used to measure constructs may have introduced common method variance that biased the results.Practical implicationsBy understanding that EI affects perceptions of transcendence in positive/negative service encounters, marketers can better implement consumer-oriented marketing strategies that will enhance TCE, customer loyalty, WTP and WOM.Originality/valueDespite considerable research in experiential and relationship marketing, room remains for theoretical and practical enhancement in the under-researched concept of TCE. This research is the first attempt to extend TCE theory to marketing by identifying the drivers, outcomes and moderators of TCE in service encounters. The research also provides theoretical advancement in EI research. The results contradict previous research claiming that ability-based and self-reported measures are equally valid. Instead, using the two EI scales interchangeably leads to potentially different outcomes.

Development of a novel risk prediction and risk stratification score for polycystic ovary syndrome.

The aim of this study was to develop a simple phenotypic algorithm that can capture the underlying clinical and hormonal abnormalities to help in the diagnosis and risk stratification of polycystic ovary syndrome (PCOS). The study consisted of 111 women with PCOS fulfilling the Rotterdam diagnostic criteria and 67 women without PCOS. A Firth's penalized logistic regression model was used for independent variable section. Model optimism, discrimination and calibration were assessed using bootstrapping, area under the curve (AUC) and Hosmer-Lemeshow statistics, respectively. The prognostic index (PI) and risk score for developing PCOS were calculated using independent variables from the regression model. Firth penalized logistic regression model with backward selection identified four independent predictors of PCOS namely free androgen index [β 0.30 (0.12), P=0.008], 17-OHP [β=0.20 (0.01), P=0.026], anti-mullerian hormone [AMH; β=0.04 (0.01) P<0.0001] and waist circumference [β=0.08 (0.02), P<0.0001]. The model estimates indicated high internal validity (minimal optimism on 1000-fold bootstrapping), good discrimination ability (bias corrected c-statistic=0.90) and good calibration (Hosmer-Lemeshow χ2 =3.7865). PCOS women with a high-risk score (q1+q2+q3 vs q4) presented with a worse metabolic profile characterized by a higher 2-hour glucose (P=0.01), insulin (P=0.0003), triglycerides (P=0.0005), C-reactive protein (P<0.0001) and low HDL-cholesterol (P=0.02) as compared to those with lower risk score for PCOS. We propose a simple four-variable model, which captures the underlying clinical and hormonal abnormalities in PCOS and can be used for diagnosis and metabolic risk stratification in women with PCOS.

An articulatory-based disyllabic and trisyllabic Non-Word Repetition test: reliability and validity in Italian 3- to 7-year-old children

ABSTRACTThe contribution of the phonological working memory to the Non-Word Repetition (NWR) task is well established, but growing evidence also suggests a valuable underlying role of oro-motor abilities. Assuming that NWR involves output implementation mediated by the speech motor system, the study aimed to develop a novel Italian NWR task of disyllabic and trisyllabic items. The task, for the first time, was composed using each Italian speech sound.The study also aimed to investigate the reliability proprieties of the task (test–retest, intra-rater, inter-rater), internal consistency, concurrent and construct validity, and to collect normative data for pre-school children. An observational cross-sectional study was conducted and 375 Italian-speaking typically developing children aged 3.0–6.11 years were assessed with the novel test. Two raters assessed inter-rater reliability in a random sub-sample; test–retest reliability was examined through a repeated administration of the task two weeks apart; intra-rater reliability was investigated by two evaluations of the same audio-recordings. To evaluate concurrent validity children were also assessed through a pre-existing NWR test, and to estimate construct validity, scores from children of different age groups were compared.Results indicated excellent test–retest, intra-rater, inter-rater reliability agreement, high internal consistency and good concurrent validity. Normative data suggested that successful performance on NWR increases with age and declines with an increase in stimuli length. Despite the low working memory load in the disyllabic and trisyllabic items, a saturation of the task was not observed for any age group.The novel NWR test is a reliable and valid instrument, and it can be applied in clinical practice to assess how the child retains, plans and articulates a phonological and motor programme of unknown verbal material.

Measuring gender norms about relationships in early adolescence: Results from the global early adolescent study

IntroductionGender norms are increasingly recognized as drivers of health and wellbeing. While early adolescence constitutes a critical window of development, there is limited understanding about how adolescents perceive gender relations across different cultural settings. This study used a mixed-method approach, grounded in the voices of young people around the world, to construct and test a cross-cultural scale assessing the perceptions of gender norms regulating romantic relationships between boys and girls in early adolescence. MethodsThe study draws on the Global Early Adolescent study (GEAS), a study focusing on gender norms and health related outcomes over the course of adolescence in urban poor settings worldwide. In-depth interviews were first conducted among approximately 200 adolescents between 10–14 years in seven sites across 4 continents to identify common scripts guiding romantic relations in early adolescence. These scripts were then transformed into a multidimensional scale. The scale was tested among 120 adolescents in each of 14 GEAS sites, followed by a second pilot among 75 adolescents in six sites. We evaluated the psychometric criteria of each sub-scale using principal component analysis, and parallel analysis, followed by exploratory factor analysis to guide the selection of a more parsimonious set of items. ResultsResults suggested a two-factor structure, consisting of an “adolescent romantic expectations” subscale and a “Sexual Double Standard” subscale. Both subscales yielded high internal validity in each site, with polychoric Cronbach alpha values above 0.70 with the exception of Kinshasa for the adolescent romantic expectations scale (0.64) and Hanoi for the sexual double standard scale (0.61). ConclusionThis study reveals common perceptions of gendered norms about romantic engagement in early adolescence, normative for both sexes, but socially valued for boys while devaluated for girls. The findings illustrate that social hierarchies of power in romantic relationships form early in adolescence, regardless of cultural setting.

Development and psychometrics of script concordance test (SCT) in midwifery.

Background: Clinical reasoning plays an important role in the accurate diagnosis and treatment of diseases. Script Concordance test (SCT) is one of the tools that assess clinical reasoning skill. This study was conducted to determine the reliability and concurrent and predictive validity of SCT in assessing final lessons and gynecology exams of undergraduate midwifery students. Methods: At first, 20 clinical scenarios followed by 3 questions were designed by 2 experienced midwives. Then, after examining the content validity, 15 scenarios were selected. The test was used for 55 midwifery students. The correlation of SCT results with grade point average (GPA) was measured. To evaluate the concurrent validity of SCT, the correlation between SCT scores and the final exam of the gynecology course was measured. To measure predictive validity, the correlation of SCT scores with comprehensive exams of midwifery was calculated. Data were analyzed using SPSS software. Descriptive statistics, Pearson correlation, and coefficient Cronbach's alpha were used for analysis. The test’s item difficulty level (IDL) and item discriminative index (IDI) were determined using Whitney and Sabers’ method. Results: The internal reliability of the test (calculated using Cronbach’s alpha coefficient) was 0.74. All questions were positively correlated with the total score. The highest correlation coefficient was related to GPA and comprehensive test with the score of 0.91. The correlation coefficient between SCT and the final test (concurrent validity) was 0.654, and the correlation coefficient between SCT and comprehensive test (predictive validity) was 0.721. The range of item discriminative index and item difficulty level in this exam was 0.39-0.59 and 0.32-0.66, respectively. Conclusion: SCT shows a relatively high internal validity and can predict the success rate of students in the comprehensive exams of midwifery. Also, it showed a high concurrent validity in the final test of gynecology course. This test could be a good alternative for formative and summative tests of clinical courses.

Behavior Assessment Battery: Normative and Psychometric Investigation Among Polish Adults Who Do and Do Not Stutter.

The aim of this study was to establish normative data for Polish persons who stutter (PWS) and persons who do not stutter (PWNS) with the adapted version of the Behavior Assessment Battery (BAB; Vanryckeghem & Brutten, 2018) for adults and to investigate whether or not gender and age influenced the results. In addition, the BAB subtests' reliability and validity were examined. A Polish version of the BAB test procedures, including the Speech Situation Checklist-Emotional Reaction, Speech Situation Checklist-Speech Disruption, Behavior Checklist, and Communication Attitude Test for Adults Who Stutter (Vanryckeghem & Brutten, 2018), were individually administered to 123 adults who stutter and 151 adults who do not stutter between the ages of 17 and 70. PWS scored statistically significantly higher on all BAB subtests compared to PWNS. No significant between-groups gender or age difference was detected. The test data indicate high internal validity. The test items correlate well with the total score and significantly differentiate the two groups. The test battery validly differentiates PWS from PWNS with high accuracy. The Polish version of the BAB for adults confirms data collected in previous cross-cultural investigations. The results once again differentiate PWS from PWNS in a powerful way. Compared to PWNS, PWS report significantly more anxiety and speech breakdown when speaking in particular speech situations. They also report their attitude toward speech to be significantly more negative compared to the typical speaker and indicate using a significant number of coping behaviors to avoid or escape difficult speaking conditions. The BAB test battery, in its totality, assists in multidimensional assessment, pre- and posttreatment comparison, and identification of treatment targets based on the answers of PWS to each test item.

Assessment of clinical ability in the removal of teeth among undergraduate dental students: a longitudinal comparative study

To evaluate the clinical ability of undergraduate students to remove teeth, we have developed a new, structured, and objective assessment scale including 11 items that measure the various skills required on a visual analogue scale (VAS). We did a pilot study to validate the new format and included 10 students, each one of whom was rated by three examiners. The assessment form was then used to evaluate the ability of students taking teeth out throughout the academic year 2017–2018. Results showed high inter-examiner reliability, significant correlation of mean scores (p<0.001), and high internal validity of the assessment form (Cronbach’s α from 0.8257 to 0.9191). A total of 340 extractions were assessed (228 by fifth-year, and 112 by fourth-year, students). In addition, 73 students (47 fifth-year, and 26 fourth-year) were assessed halfway through the year and at their final examinations. The fail/pass rate was (64/164) for the fifth-year students, and (43/69) for the fourth year students, with no significant difference between them (chi squared 3.719; p=0.054). Fifth-year students had significantly higher mean scores than fourth-year students in the subscales “use of the elevator” and “confidence” (p=0.004 and 0.003 respectively). Both groups showed significant improvement in their mean scores between the mid-term and final examinations (p=0.001 and 0.010, respectively). The newly developed VAS-based format for assessing the removal of teeth offered an objective, standardised, and feasible method for assessment of clinical skills of undergraduate students for both formative and summative purposes.

Astronomy And Science Student Attitudes (ASSA): A Short Review And Validation Of A New Instrument

A new survey for measuring students’ astronomy and science attitudes that has been validated for use with high school students (with a future intent to expand to middle school and university) is presented. We initially present a short review of instruments in the literature that attempt to measure attitudes in astronomy together with the difficulties encountered in measuring these by researchers in the subsequent analyses of results. To illustrate this, we present an example from an Astro101-level university course to display the problems with the current, most commonly used, astronomy attitude instrument. We then present the initial design and the Factor Analysis of a new instrument designed to address the deficiencies of this existing instrument from a sample of students in a high school-level astronomy education project. The factors identified by this instrument include: Interest in Astronomy, Interest in Science Outside of School, Practical Work in Science, Teacher’s Actions in science, Perceptions of Ability in Science, Future Aspirations in Science, Benefits of Science, and Personal Relevance of School Science, all of which possess high internal response consistency and construct validity.

From clinical trials of antiepileptic drugs to treatment.

SummaryRational prescribing should be based on the assessment of high‐quality evidence about the benefits and risks of available treatment options. Because clinical trials, particularly randomized controlled trials (RCTs), provide the best source of evidence, their design and results need to be carefully scrutinized. The majority of RCTs of antiepileptic drugs (AEDs) have been designed to address regulatory requirements, and generally they involve restrictive eligibility criteria, rigid dosing schemes, short duration of follow‐up, and comparison with placebo rather than standard treatments. Although these studies have high internal validity, they are conducted in a setting that is distant from routine clinical practice and therefore their usefulness in guiding treatment decisions is limited. Information more directly applicable to clinical practice can be derived from a relatively small number of comparative effectiveness monotherapy RCTs, although the design of some of these studies was probably biased in favor of the sponsor's product. Alarmingly, there is a paucity of well‐designed trials in epilepsy syndromes other than focal epilepsies, and no RCTs at all in most of the less common epileptic syndromes of infancy and childhood. In the light of these shortcomings, there is scope for re‐assessing regulatory requirements to facilitate generation of data more directly applicable to the routine clinical setting. Likewise, research‐funding organizations should be sensitized about the lack of adequate evidence to guide therapeutic practice in epilepsy, and the need to promote high‐quality comparative effectiveness trials. Future prospective pragmatic trials may benefit from the increasingly widespread availability of electronic health records.

The Measurements and an Elaborated Understanding of Chinese eHealth Literacy (C-eHEALS) in Chronic Patients in China.

The rapid rise of Internet-based technologies to disseminate health information and services has been shown to enhance online health information acquisition. A Chinese version of the electronic health literacy scale (C-eHEALS) was developed to measure patients’ combined knowledge and perceived skills at finding and applying electronic health information to health problems. A valid sample of 352 interviewees responded to the online questionnaire, and their responses were analyzed. The C-eHEALS, by showing high internal consistency and predictive validity, is an effective screening tool for detecting levels of health literacy in clinical settings. Individuals’ sociodemographic status, perceived health status, and level of health literacy were identified for describing technology users’ characteristics. A strong association between eHealth literacy level, media information use, and computer literacy was found. The emphasis of face-to-face inquiry for obtaining health information was important in the low eHealth literacy group while Internet-based technologies crucially affected decision-making skills in the high eHealth literacy group. This information is timely because it implies that health care providers can use the C-eHEALS to screen eHealth literacy skills and empower patients with chronic diseases with online resources.

Effects of Intranasal Oxytocin Administration on Sexual Functions in Healthy Women: A Laboratory Paradigm.

The neuropeptide oxytocin (OXT) has a variety of physiological functions in maternal behavior and attachment including sexual behavior. Based on animal research and our previous human studies, we set out to investigate intranasal administration of OXT and hypothesized that OXT should be able to modulate sexual function in women. In a double-blind, placebo-controlled, crossover laboratory setting, the acute effects of intranasal administered OXT (24 international units) on sexual drive, arousal, orgasm, and refractory aspects of sexual behavior were analyzed in 27 healthy females (mean age ± SD, 27.52 ± 8.04) together with physiological parameters using vaginal photoplethysmography. Oxytocin administration showed no effect on subjective sexual parameters (eg, postorgasmic tension; P = 0.051). Physiological parameters (vaginal photoplethysmography amplitude and vaginal blood volume) showed a response pattern towards sexual arousal but were not affected by OXT. Using a well-established laboratory paradigm, we did not find that intranasal OXT influences female sexual parameters. Also, sexual drive and other functions were not affected by OXT. These findings indicate that OXT is not able to significantly increase subjective and objective parameters of sexual function in a setting with high internal validity; however, this might be different in a more naturalistic setting.

Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta-analysis of controlled trials.

The effectiveness of psychological therapies for those receiving acute adult mental health inpatient care remains unclear, partly because of the difficulty in conducting randomized controlled trials (RCTs) in this setting. The aim of this meta-analysis was to synthesize evidence from all controlled trials of psychological therapy carried out with this group, to estimate its effects on a number of important outcomes and examine whether the presence of randomization and rater blinding moderated these estimates. A systematic review and meta-analysis of all controlled trials of psychological therapy delivered in acute inpatient settings was conducted, with a focus on psychotic symptoms, readmissions or emotional distress (anxiety and depression). Studies were identified through ASSIA, EMBASE, CINAHL, Cochrane, MEDLINE, and PsycINFO using a combination of the key terms 'inpatient', 'psychological therapy', and 'acute'. No restriction was placed on diagnosis. The moderating effect of the use of assessor-blind RCT methodology was examined via subgroup and sensitivity analyses. Overall, psychological therapy was associated with small-to-moderate improvements in psychotic symptoms at end of therapy but the effect was smaller and not significant at follow-up. Psychological therapy was also associated with reduced readmissions, depression, and anxiety. The use of single-blind randomized controlled trial methodology was associated with significantly reduced benefits on psychotic symptoms and was also associated with reduced benefits on readmission and depression; however, these reductions were not statistically significant. The provision of psychological therapy to acute psychiatric inpatients is associated with improvements; however, the use of single-blind RCT methodology was associated with reduced therapy-attributable improvements. Whether this is a consequence of increased internal validity or reduced external validity is unclear. Trials with both high internal and external validity are now required to establish what type, format, and intensity of brief psychological therapy is required to achieve sustained benefits. Clinical implications: This review provides the first meta-analytical synthesis of brief psychological therapy delivered in acute psychiatric inpatient settings. This review suggests that brief psychological therapy may be associated with reduced emotional distress and readmissions. The evidence in this review is of limited quality. The type, format, and intensity of brief psychological therapy required to achieve sustained benefits are yet to be established.

Internal Validation of the Acoustic Voice Quality Index version 03.01 und Acoustic Breathiness Index

Acoustics might have the potential to objectify voice quality (eg, hoarseness and breathiness). The Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) revealed sufficient valid and reliable results in the evaluation of voice quality. The aim of the present study is to validate the recent version of AVQI 03.01 and ABI in their internal validation. The responsiveness of change is evaluated on the hoarseness and breathiness severity after voice therapy. In total, 84 voice samples of continuous speech and sustained vowel [a:] before and after a voice therapy were used. All 42 subjects presented organic and nonorganic voice disorders and various degrees of dysphonia severity before and after behavioral voice therapy. The voice samples were judged by three voice experts using the RBH-scale, which is based on the GRBAS-scale. The intra-rater reliability was high for hoarseness (mean kappa = 0.76) and breathiness (mean kappa = 0.69).The inter-rater reliability was lower for both voice quality characteristics and ranged between kappa = 0.27 to 0.29. A strong correlation was identified between the perceived rating of hoarseness and breathiness and AVQI and ABI before and after voice therapy (r = 0.715, p < 0.01, and r = 0.712, p < 0.01, respectively). Additionally, no significant differences were revealed. The present results showed that AVQI version 03.01 und ABI had a high internal validity to assess voice changes after voice therapy. AVQI and ABI are two valid and robust voice measures to objectify hoarseness and breathiness.

Expanding the Unidirectional View on Parental Television Mediation: Children’s Guidance of Their Parent’s Television Use

Compared to parental mediation research, much less is known about how children influence and guide their parents’ media use. This study examined whether children also mediate the television use of their parents. Measures of an existing television mediation scale were reversed to the perspective of the child guiding the parent’s television use. A sample of 187 parent-child dyads completed a cross-sectional survey in Flanders (Belgium). Factor analyses showed that the original subscales were reproduced with high internal validity. Both parents and children had congruent views about children’s television mediation; television mediation and children's restrictive mediation was positively associated with conflict in the family.

A New Resource for Health &amp; Fitness Professionals

A New Resource for Health &amp; Fitness Professionals

Regression Discontinuity and Beyond

Treatment effect estimates from a regression discontinuity design (RDD) have high internal validity. However, the arguments that support the design apply to a subpopulation that is narrower and usually different from the population of substantive interest in evaluation research. The disconnect between RDD population and the evaluation population of interest suggests that RDD evaluations lack external validity. New methodological research offer strategies for studying and sometimes improving external validity in RDDs. This article examines four techniques: comparative RDD, covariate matching RDD, treatment effect derivatives, and statistical tests for local selection bias. The goal of the article is to help evaluators understand the logic, assumptions, data requirements, and reach of the new methods.

THE INTERNAL AND EXTERNAL VALIDITY OF THE REGRESSION DISCONTINUITY DESIGN: A META‐ANALYSIS OF 15 WITHIN‐STUDY COMPARISONS

AbstractTheory predicts that regression discontinuity (RD) provides valid causal inference at the cutoff score that determines treatment assignment. One purpose of this paper is to test RD's internal validity across 15 studies. Each of them assesses the correspondence between causal estimates from an RD study and a randomized control trial (RCT) when the estimates are made at the same cutoff point where they should not differ asymptotically. However, statistical error, imperfect design implementation, and a plethora of different possible analysis options, mean that they might nonetheless differ. We test whether they do, assuming that the bias potential is greater with RDs than RCTs. A second purpose of this paper is to investigate the external validity of RD by exploring how the size of the bias estimates varies across the 15 studies, for they differ in their settings, interventions, analyses, and implementation details. Both Bayesian and frequentist meta‐analysis methods show that the RD bias is below 0.01 standard deviations on average, indicating RD's high internal validity. When the study‐specific estimates are shrunken to capitalize on the information the other studies provide, all the RD causal estimates fall within 0.07 standard deviations of their RCT counterparts, now indicating high external validity. With unshrunken estimates, the mean RD bias is still essentially zero, but the distribution of RD bias estimates is less tight, especially with smaller samples and when parametric RD analyses are used.

Emerging Concepts in Evidence-Based Asthma Management.

Asthma management is in an intriguing phase, with acceptance of asthma as a heterogeneous condition with different phenotypes and underlying mechanisms and the potential for personalized asthma care, in parallel with increasing evidence about the population-level impact of basic strategies to increase access to medicines and improve inhaler technique and adherence. These changes have been facilitated by a more comprehensive view of evidence, including both randomized controlled trials with high internal validity and pragmatic and observational studies with high generalizability to patients in clinical practice. Evolving concepts of asthma control have led to new approaches to asthma assessment, recognizing the potential for discordance between symptom control and risk of exacerbations. A re-evaluation of evidence has also led to substantial changes in initial treatment of asthma, with the focus moving away from bronchodilator-only treatment, toward early use of inhaled corticosteroids and novel strategies for mild asthma. Sputum-guided treatment, where available, is successful in patients with moderate-severe asthma, but exhaled nitric oxide has not yet satisfied initial assumptions about its utility for biomarker-guided treatment. New interventions are emerging to improve adherence with asthma controller medications. A re-evaluation of evidence about written asthma action plans has led to encouragement of a rapid increase in controller dose, rather than relying on bronchodilator treatment and oral corticosteroids. Finally, new models of asthma care are emerging, utilizing the skills of allied health professionals and recognizing the potential role of telehealth.

A systematic review of technology-assisted interventions for co-morbid depression and substance use

Introduction Mental health interventions disseminated via, or accessed using, digital technologies are an innovative new treatment modality for managing co-morbid depression and substance use disorder. The present systematic review assessed the current state of this literature. Methods A search of the Cochrane Library, Embase, Pubmed, PsycInfo and Scopus databases identified six eligible studies (Nparticipants = 862), utilising quasi-experimental or randomised controlled designs. Reporting quality was evaluated and Hedges’ g effect sizes (with 95% confidence intervals and p-values) were calculated to determine treatment effectiveness. Process outcomes (e.g. treatment satisfaction, attrition rates) were also examined. Results Quality ratings demonstrated high internal validity, although external validity was low. Effect size data revealed medium to large and short-term improvements in severity of depression and substance use symptoms in addition to global improvement in social, occupational and psychological functioning. Longer-term treatment effectiveness could not be established, due to the limited available data. Preliminary findings suggest that there was high client satisfaction, therapeutic alliance and client engagement. Discussion Mobile phone devices and the Internet can help to increase access to care for those with mental health co-morbidity. Large-scale and longitudinal research is, however, needed before digital mental healthcare becomes standard practice. This includes establishing critical therapeutic factors including optimum levels of assistance from clinicians.

The GlucoCoper - a Tool for the Assessment of Coping Mechanisms.

Diabetes distress – commonly encountered as a part of life with diabetes mellitus – can be effectively managed by coping skills training. Systematic assessment and documentation of the existing coping skills (and lack thereof) is a pre-requisite for planning such coping skills training. A six-item tool, the GlucoCoper – which assesses two negative (resistance, blame) and four positive (acceptance, optimism, planning and action) coping mechanisms – was administered to English-literate adult participants with type 2 diabetes (T2DM) at an endocrine centre in India. Each item was graded on a 10-point Likert scale. The GlucoCoper was administered to 338 participants. The tool demonstrated high internal validity. Total score on the GlucoCoper correlated with fasting and postprandial glucose. The GlucoCoper is a valid tool which can be used to assess and rate coping in persons with T2DM. It has potential in helping plan, deliver and monitor coping skills training in persons with diabetes distress.