Interscale Correlations Research Articles

Operating characteristics of PROMIS four-item depression and anxiety scales in primary care patients with chronic pain.

Depression and anxiety are prevalent in patients with chronic pain and adversely affect pain, quality of life, and treatment response. The purpose of this psychometric study was to determine the reliability and validity of the four-item Patient Reported Outcomes Measurement Information System (PROMIS) depression and anxiety scales in patients with chronic pain. Secondary analysis of data from the Stepped Care to Optimize Pain care Effectiveness study, a randomized clinical trial of optimized analgesic therapy. Five primary care clinics at the Roudebush VA Medical Center (RVAMC) in Indianapolis, Indiana. Two hundred forty-four primary care patients with chronic musculoskeletal pain. All patients completed the four-item depression and anxiety scales from the PROMIS 29-item profile, as well as several other validated psychological measures. The minimally important difference (MID) using the standard error of measurement (SEM) was calculated for each scale, and convergent validity was assessed by interscale correlations at baseline and 3 months. Operating characteristics of the PROMIS measures for detecting patients who had probable major depression or were anxiety-disorder screen-positive were calculated. The PROMIS scales had good internal reliability, and the MID (as represented by two SEMs) was 2 points for the depression scale and 2.5 points for the anxiety scale. Convergent validity was supported by strong interscale correlations. The optimal screening cutpoint on the 4- to 20-point PROMIS scales appeared to be 8 for both the depression and anxiety scales. The PROMIS four-item depression and anxiety scales are reasonable options as ultra-brief measures for screening in patients with chronic pain.

Phonetic segmentation of speech signal using local singularity analysis

This paper presents the application of a radically novel approach, called the Microcanonical Multiscale Formalism (MMF) to speech analysis. MMF is based on precise estimation of local scaling parameters that describe the inter-scale correlations at each point in the signal domain and provides efficient means for studying local non-linear dynamics of complex signals. In this paper we introduce an efficient way for estimation of these parameters and then, we show that they convey relevant information about local dynamics of the speech signal that can be used for the task of phonetic segmentation. We thus develop a two-stage segmentation algorithm: for the first step, we introduce a new dynamic programming technique to efficiently generate an initial list of phoneme-boundary candidates and in the second step, we use hypothesis testing to refine the initial list of candidates. We present extensive experiments on the full TIMIT database. The results show that our algorithm is significantly more accurate than state-of-the-art ones.

Efeitos da experiência nas dimensões de intensidade, direção e frequência da ansiedade e autoconfiança competitiva: Um estudo em atletas de desportos individuais e coletivos

The present study had the following objectives: i) to examine the inter-scale correlations between the three dimensions of responses (intensity, direction and frequency) of the CSAI-2R and its relationship with competitive experience, and ii) evaluate the effect of competitive experience anxiety (cognitive and somatic) and self-confidence in the total sample and for different types of modalities (individual vs. team). The sample consisted of 267 athletes (196 male and 71 female), of different sports, aged between 18 and 40 years (M = 24.30, SD = 5.62). Athletes completed the Brazilian version of the CSAI-2, which included the addition of the dimensions of direction and frequency response. Spearman test and Manova were used for the data analysis. Overall, it was found that the competitive experience has a high multivariate and significant effect on the dimensions of competitive anxiety. Both individual and team athletes with low competitive experience showed a trend to report lower levels of self-confidence intensity, compared to counterparts with high competitive experience. These results were discussed in view of the theoretic framework and practical implications planning Sport Psychology intervention programs in local athletes with different backgrounds.

Relationship of Confucian Values to Spiritual Leadership in a South Korean Context

Spiritual leadership is an emerging holistic leadership construct that has been validated in several cultures outside of North America. However, these studies have failed to examine the underlying relationship of embedded cultural values and spiritual leadership. To address this problem, the purpose of this study was to investigate the relationship of Confucian values to spiritual leadership within a South Korean context. Data was gathered through surveys from three firms within Korea’s financial sector. Factor analysis of Confucian values found a two-factor solution, including social order and harmony. Harmony was excluded from analysis due to poor inter-scale correlations. Social order showed a positive, significant relationship to spiritual leadership variables, suggesting Confucian values comprise a portion of the inner life of Koreans and support the emergence of spiritual leadership within a Confucian context. The results of this study increase our understanding of the importance of emic manifestations of leadership theory in generalizing western leadership theories to outside cultures.

Progressive Image Denoising Through Hybrid Graph Laplacian Regularization: A Unified Framework

Recovering images from corrupted observations is necessary for many real-world applications. In this paper, we propose a unified framework to perform progressive image recovery based on hybrid graph Laplacian regularized regression. We first construct a multiscale representation of the target image by Laplacian pyramid, then progressively recover the degraded image in the scale space from coarse to fine so that the sharp edges and texture can be eventually recovered. On one hand, within each scale, a graph Laplacian regularization model represented by implicit kernel is learned, which simultaneously minimizes the least square error on the measured samples and preserves the geometrical structure of the image data space. In this procedure, the intrinsic manifold structure is explicitly considered using both measured and unmeasured samples, and the nonlocal self-similarity property is utilized as a fruitful resource for abstracting a priori knowledge of the images. On the other hand, between two successive scales, the proposed model is extended to a projected high-dimensional feature space through explicit kernel mapping to describe the interscale correlation, in which the local structure regularity is learned and propagated from coarser to finer scales. In this way, the proposed algorithm gradually recovers more and more image details and edges, which could not been recovered in previous scale. We test our algorithm on one typical image recovery task: impulse noise removal. Experimental results on benchmark test images demonstrate that the proposed method achieves better performance than state-of-the-art algorithms.

The use of on-site visits to assess compliance and implementation of quality management at hospital level

ObjectiveStakeholders of hospitals often lack standardized tools to assess compliance with quality management strategies and the implementation of clinical quality activities in hospitals. Such assessment tools, if easy to use, could be helpful to hospitals, health-care purchasers and health-care inspectorates. The aim of our study was to determine the psychometric properties of two newly developed tools for measuring compliance with process-oriented quality management strategies and the extent of implementation of clinical quality strategies at the hospital level.DesignWe developed and tested two measurement instruments that could be used during on-site visits by trained external surveyors to calculate a Quality Management Compliance Index (QMCI) and a Clinical Quality Implementation Index (CQII). We used psychometric methods and the cross-sectional data to explore the factor structure, reliability and validity of each of these instruments.Setting and ParticipantsThe sample consisted of 74 acute care hospitals selected at random from each of 7 European countries.Main Outcome MeasuresThe psychometric properties of the two indices (QMCI and CQII).ResultsOverall, the indices demonstrated favourable psychometric performance based on factor analysis, item correlations, internal consistency and hypothesis testing. Cronbach's alpha was acceptable for the scales of the QMCI (α: 0.74–0.78) and the CQII (α: 0.82–0.93). Inter-scale correlations revealed that the scales were positively correlated, but distinct. All scales added sufficient new information to each main index to be retained.ConclusionThis study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions.

Development and validation of an index to assess hospital quality management systems

ObjectiveThe aim of this study was to develop and validate an index to assess the implementation of quality management systems (QMSs) in European countries.DesignQuestionnaire development was facilitated through expert opinion, literature review and earlier empirical research. A cross-sectional online survey utilizing the questionnaire was undertaken between May 2011 and February 2012. We used psychometric methods to explore the factor structure, reliability and validity of the instrument.Setting and participantsAs part of the Deepening our Understanding of Quality improvement in Europe (DUQuE) project, we invited a random sample of 188 hospitals in 7 countries. The quality managers of these hospitals were the main respondents.Main Outcome MeasureThe extent of implementation of QMSs.ResultsFactor analysis yielded nine scales, which were combined to build the Quality Management Systems Index. Cronbach's reliability coefficients were satisfactory (ranging from 0.72 to 0.82) for eight scales and low for one scale (0.48). Corrected item-total correlations provided adequate evidence of factor homogeneity. Inter-scale correlations showed that every factor was related, but also distinct, and added to the index. Construct validity testing showed that the index was related to recent measures of quality. Participating hospitals attained a mean value of 19.7 (standard deviation of 4.7) on the index that theoretically ranged from 0 to 27.ConclusionAssessing QMSs across Europe has the potential to help policy-makers and other stakeholders to compare hospitals and focus on the most important areas for improvement.

Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales

ObjectiveClinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals.DesignTesting of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-country research project ‘Deepening our Understanding of Quality improvement in Europe’ (DUQuE).Setting and ParticipantsA sample of 3386 leading physicians and nurses working in 188 hospitals located in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey.Main Outcome MeasuresValidity and reliability of professional involvement scales and subscales.ResultsPsychometric analysis yielded four subscales for leading physicians: (i) Administration and budgeting, (ii) Managing medical practice, (iii) Strategic management and (iv) Managing nursing practice. Only the first three factors applied well to the nurses. Cronbach's alpha for internal consistency ranged from 0.74 to 0.86 for the physicians, and from 0.61 to 0.81 for the nurses. Except for the 0.74 correlation between ‘Administration and budgeting’ and ‘Managing medical practice’ among physicians, all inter-scale correlations were <0.70 (range 0.43–0.61). Under testing for construct validity, the subscales were positively correlated with ‘formal management roles’ of physicians and nurses.ConclusionsThe professional involvement scales appear to yield reliable and valid data in European hospital settings, but the scale ‘Managing medical practice’ for nurses needs further exploration. The measurement instrument can be used for international research on clinical management.

The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability.

Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability. A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done. Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed. This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Examination of a short English version of the UPPS-P Impulsive Behavior Scale

The current study examines a recently developed short English version of the UPPS-P Impulsive Behavior Scale. Participants were 251 undergraduate students (59.3% male; mean age=21.16 (SD=4.18); 72% Caucasian). The short version generally replicated the internal consistency (0.74–0.88 across subscales) and inter-scale correlations of the full English UPPS-P. Moreover, the estimated loss of shared variance was small (0%–6.4% reductions across subscales) as compared to a 66% time-savings. Structural equation modeling replicated previously supported factor structures and relationships to external outcomes using the full UPPS-P. This short UPPS-P scale should be considered a valid and reliable alternative to the full UPPS-P in English-speaking non-clinical adult samples.

The instrument ‘Sense of Security in Care - Patients' Evaluation’: its development and presentation

The aim of this paper is to report the development, construction, and psychometric properties of the new instrument Sense of Security in Care - Patients' Evaluation (SEC-P) in palliative home care. The preliminary instrument was based on a review of the literature and an analysis of qualitative interviews with patients about their sense of security. To test the instrument, 161 patients (58% women) in palliative home care were recruited and participated in a structured interview based on a comprehensive questionnaire (response rate 73%). We used principal component analysis to identify subscales and tested the construction in correlation with other scales and questions representing concepts that we expected to be related to sense of security in care. The principal component analysis resulted in three subscales: Care Interaction, Identity, and Mastery, built on a total of 15 items. The component solution had an explained variance of 55%. Internal consistency of the subscales ranged from 0.84 to 0.69. Inter-scale correlations varied between 0.40 and 0.59. The scales were associated to varying degrees with the quality of the care process, perceived health, quality of life, stress, and general sense of security. The developed SEC-P provides a three-component assessment of palliative home care settings using valid and reliable scales. The scales were associated with other concepts in ways that were expected. The SEC-P is a manageable means of assessment that can be used to improve quality of care and in research focusing on patients' sense of security in care.

Development and validation of the Peer Interaction Macro-Coding System Scales (PIMS): a new tool for observational measurement of social competence in youth with spina bifida.

Many children with chronic health conditions encounter enduring difficulties in their peer interactions and friendships. This study aimed to create and validate scales derived from an observational coding system (i.e., Peer Interaction Macro-Coding System, or PIMS) in a sample of children with spina bifida and their peers. Participants were 106 target child-peer dyads who completed a battery of questionnaires and interviews and were videotaped performing 4 interaction tasks, which were then coded across multiple domains of social functioning. Five scales (i.e., Control, Prosocial Skills, Positive Affect, Conflict, and Dyadic Cohesion) were rationally derived based on a review of the literature and a panel of experts. Internal consistency and interrater reliability at the scale level were good to excellent for all 5 scales. Interscale correlations were in the low-to-moderate range for 4 of the scales, although the Dyadic Cohesion Scale was highly correlated with two other scales and was subsequently dropped. Convergent validity and discriminant validity were established by examining the 4 remaining scales in association with comparable questionnaire and interview data. The 4 PIMS scales appear to be reliable and valid measures of social competence and may enhance future multimethod research efforts aimed at learning more about peer interactions and overall social competence.

The city of hope-quality of life-ostomy questionnaire: persian translation and validation.

Background:Since there is no disease-specific instrument for measuring quality-of-life (QOL) in Ostomy patients in Persian language.Aim:This study was designed to translate and evaluate the validity and reliability of City of Hope-quality of life-Ostomy questionnaire (COH-QOL-Ostomy questionnaire).Subjects and Methods:This study was designed as cross-sectional study. Reliability of the subscales and the summary scores were demonstrated by intra-class correlation coefficients. Pearson's correlations of an item with its own scale and other scales were calculated to evaluated convergent and discriminant validity. Clinical validity was also evaluated by known-group comparisons.Results:Cronbach's alpha coefficient for all subscales was about 0.70 or higher. Results of interscale correlation were satisfactory and each subscale only measured a single and specified trait. All subscales met the standards of convergent and discriminant validity. Known group comparison analysis showed significant differences in social and spiritual well-being.Conclusion:The findings confirmed the reliability and validity of Persian version of COH-QOL-Ostomy questionnaire. The instrument was also well received by the Iranian patients. It can be considered as a valuable instrument to assess the different aspects of health related quality-of-life in Ostomy patients and used in clinical research in the future.

Translation and Linguistic Validation of the Korean Version of the Dysfunctional Voiding Symptom Score

Although studies on pediatric dysfunctional voiding are increasing, there have not been enough efforts to validate the Dysfunctional Voiding Symptom Score (DVSS) questionnaire. Therefore, we aimed to translate and validate the DVSS into Korean. The DVSS questionnaire was validated between January and October, 2013. Two bilinguals independently translated the English version of the DVSS questionnaire into Korean, and then reconciled the forward translation of the Korean version. The original DVSS was back-translated into English, then assessed for equivalence to the original. Cognitive debriefing interviews with 5 patients to test the interpretation of the translation were made, then modified and distributed to 48 patients for re-evaluation. A statistical analysis of inter-scale correlation, and test re-test consistency was performed with the Cronbach's alpha coefficient. The changes from patient interviews were reflected in the final version. In an intra-class correlation, the Cronbach's alpha was high in all of the questions (0.97, P < 0.001). Test re-test Cronbach's alpha analysis of reproducibility was higher than 0.8 for all of the 10 questions (P < 0.001). Translation and linguistic validation of Korean version of the DVSS questionnaire was completed by a proper process, with high reliability and validity.

Abstract P3-09-07: Construction of two quality of life questionnaires from young breast cancer patients and their partner

Abstract Background : The quality of life of couples which one of the members is affected by a cancerous pathology at a relatively young age is important to evaluate in global care. No questionnaire specifically addresses some thematic proper to young women (ex education, desire for a child(s), couple relationship), problems which are yet important for young women suffering from breast cancer. Besides, no questionnaire evaluates the partner's quality of life in this particular context, even if he is frequently the first source of support for the woman (Vanlemmens et al., 2012). Objectives : The main objective was to create a particular and specific tool for measuring the impact of breast cancer on the quality of life of young women (&amp;lt; 45 years of age) with non-metastatic disease and the quality of life of their partners. This work presents the psychometric validation of two questionnaires for patient and partner consisted of items comparable to the semantic level. Methods: We followed the different steps to construct a quality of life tool. After preliminary non-directive interviews and identification of relevant items, we administered the questionnaires on a wide sample of 546 young breast cancer patients and 497 partners. Psychometric testing assessed the hypothesized scale structure based on an examination of item-scale correlation, scale reliability by testing for internal consistency using Cronbach's alpha coefficient, construct validity with inter-scale correlations. Results : Items analyses indicate a good internal consistency of both questionnaires (superior to .75). This questionnaire includes 37 items. The factorial structure highlights 8 factors : 1) management of children and of everyday life, 2) negative affectivity and apprehension about future, 3) feeling of couple cohesion, 4) financial difficulties, 5) body image and sexual life, 6) deterioration with close relations, 7) sharing and support of close relations, and 8) management of the professional life..This structure explains respectively 56% for the patients and 58% for the partners of the total variance. As expected, convergent validity showed strong correlations with Kalicou scales and quality of life measures (QLQC-30 and QLQBR-23). Conclusions: Overall psychometric results for the 2 Kalicou questionnaires confirmed them as valid questionnaires for breast cancer patients and partners. This study will allow the clinicians to have a measurement tool for subjective real-life experience of young breast cancer women and their partner. These questionnaires will also allow comparisons according to the stage and study the interactions of couple. This tool should help to identify modifications of the subjective quality of life. The objective is to improve the medical, psychological and social care for patients and their partner, with a systemic, dynamic approach. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-09-07.

The CSAI-2: An Examination of the Instrument's Factorial Validity and Reliability of the Intensity, Direction and Frequency Dimensions with Brazilian Athletes

The Competitive State Anxiety Inventory (CSAI-2) has been a widely used instrument for the assessment of anxiety in sport but within limited cultural contexts. Conceptual issues as well as concerns about the psychometric properties of the measure have resulted in questions surrounding its use. The purposes of the present study were (a) to examine the factorial validity and reliability of the CSAI-2, including the intensity, direction, and frequency dimensions with a Brazilian sample; (b) to investigate the inter-scale correlations among the three measured dimensions and between the original and the reduced scales; and (c) to examine the properties of the CSAI-2 within a novel cultural context. A sample of 334 athletes (245 male, 89 female) completed the CSAI-2 questionnaire 1hr prior to competition. Confirmatory factor analyses were conducted that contrasted the proposed model with competing models. These results provided support for a reduced measurement model (CSAI-2R; 16 items) that was comprised of three factors (cognitive anxiety, somatic anxiety and self-confidence). The pattern of inter-scale associations revealed correlated, but not identical, factors. Correlations between the original and the reduced scales were high. In conclusion, these results provide evidence that the CSAI-2R (16 items) has good psychometric properties for all response dimensions within a Brazilian cultural context and is a valid competitive state anxiety and self-confidence measure when used immediately prior to competition.

The small scale power asymmetry in the cosmic microwave background

We investigate the hemispherical power asymmetry in the cosmic microwave background on small angular scales. We find an anomalously high asymmetry in the multipole range ℓ = 601−2048, with a naive statistical significance of 6.5σ. However, we show that this extreme anomaly is simply a coincidence of three other effects, relativistic power modulation, edge effects from the mask applied, and inter-scale correlations. After correcting for all of these effects, the significance level drops to ∼ 1σ, i.e., there is no anomalous intrinsic asymmetry in the small angular scales. Using this null result, we derive a constraint on a potential dipolar modulation amplitude, A(k) < 0.0045 on the ∼ 10 Mpc-scale, at 95% C.L. This new constraint must be satisfied by any theoretical model attempting to explain the hemispherical asymmetry at large angular scales.

Examining a developmental approach to health-related quality of life assessment: Psychometric analysis of DISABKIDS generic module in a Portuguese sample

The aim of this study was to assess the properties of a generic instrument for pediatric health-related quality of life (HRQL) assessment – DISABKIDS-37 – in a sample of Portuguese children and adolescents with chronic health conditions. Participants were 349 children/adolescents with asthma or epilepsy and their parents/caregivers, who reported on children/adolescents’ HRQL, along with generic quality of life and psychological adjustment measures in self- and proxy-report formats. Using classical statistic validation procedures, reliability, scale inter-correlations, and convergent, divergent, and discriminant validities were analyzed. Results were reported using age group stratifications, attesting the developmental appropriateness of DISABKIDS-37 questionnaire to assess HRQL in children, adolescents, and mixed samples.

Person-centered care in Chinese residential care facilities: a preliminary measure

Objectives: Person-centered care (PCC) is one of the most desirable approaches for elderly with dementia. However, it has not been initiated and systematically studied in China, on which lacking of reliable and valid measurement tools is one of the key barriers. This paper aims to validate person-centered care assessment tools (P-CAT) in a Chinese context.Method: The original 13-item was translated and back translated. And 11 items were added based on literature review and expert consultation. The resulting 24-item P-CAT-C was validated among a sample of formal caregivers (n = 330) in all 34 residential care facilities in urban Xi’an, a representative city in north-western China. Chinese versions of staff-based measures of individualized care for institutionalized persons with dementia (IC) and caregiver psychological elder abuse behavior (CPEAB) scale were used to test the criterion validity.Results: Confirmatory factor analysis (CFA) showed that a three-factor 15-item solution provided adequate fit indices to the data (χ2 = 145.691, df = 81, p < 0.001, comparative fit index (CFI) = 0.926, Tucker-Lewis index (TLI) = 0.905, root mean square error of approximation (RMSEA) = 0.050). Four new items were identified and two original items were excluded. The three factors are named as (1) individualized care (6-item); (2) organizational support (6-item); and (3) environmental accessibility (3-item). The internal consistency coefficient (Cronbach's α = 0.684) is satisfactory. The interscale correlation among P-CAT-C, IC, and CPEAB showed good criterion validity.Conclusion: P-CAT-C is a culturally adapted version of the original P-CAT, which showed satisfactory reliability and validity for evaluating PCC in Chinese residential care facilities. It also provides insight to other developing countries.

The development and validation of a questionnaire to measure the clinical learning environment for undergraduate dental students (DECLEI)

The aim of this study was to develop and validate according to psychometric standards a self-administered instrument to measure the students' self-perceptions of the undergraduate clinical dental environment (DECLEI). The initial questionnaire was developed using feedback from dental students, experts' opinion and an extensive literature review. Critical incident technique (CIT) analysis was used to generate items and identify domains. Thirty clinical dental students participated in a pilot validation that generated a 67-item questionnaire. To develop a shorter and more practical version of the instrument, DECLEI-67 was distributed to 153 clinical students at the University of Athens and its English version to 51 students from various dental schools, attending the 2012 European Dental Students Association meeting. This final procedure aimed to select items, identify subscales and measure internal consistency and discriminant validity. A total of 202 students returned the questionnaires (response rate 99%). The final instrument included 24 items divided into three subscales: (i) organisation and learning opportunities, (ii) professionalism and communication and (iii) satisfaction and commitment to the dental studies. Cronbach's α for the total questionnaire was 0.89. The interscale correlations ranged from 0.39 to 0.48. The instrument identified differences related to school of origin, age and duration of clinical experience. An interpretation of the scores (range 0–100) has been proposed. The 24-item DECLEI seemed to be a practical and valid instrument to measure a dental school's undergraduate clinical learning environment.