Psychometric Properties Of Instrument Research Articles

The Validity and Utility of the MD Anderson Symptom Inventory in Patients With Prostate Cancer: Evidence From the Symptom Outcomes and Practice Patterns (SOAPP) Data From the Eastern Cooperative Oncology Group

BackgroundThe MD Anderson Symptom Inventory (MDASI) is a psychometrically validated patient-reported outcome measure that assesses the severity and impact of multiple symptoms related to cancer and its treatment and has the potential to guide treatment specific to patients with prostate cancer. Although the original MDASI validation study encompassed various cancer types, the instrument's psychometric properties have not been examined in a large homogeneous sample of patients with prostate cancer. Patients and MethodsThis study involved secondary analysis of data from the nationwide multicenter Eastern Cooperative Oncology Group (ECOG) SOAPP (Symptom Outcomes and Practice Patterns) study, which enrolled patients from 38 ECOG-affiliated institutions, including 6 academic centers and 32 community clinics. Data were used to establish the psychometric properties of the MDASI in a subsample of 320 patients with prostate cancer. The instrument was administered twice, approximately 1 month apart. ResultsThe MDASI demonstrated good internal consistency and test-retest reliability (with Cronbach alphas of ≥ .84 and intraclass correlations of ≥ 0.76 for all subscales), strong ability to discriminate between clinically different patient groups (by performance status, tumor response, and disease stage), and high sensitivity in detecting symptom change (with respect to patient-reported quality of life [QOL] between the baseline and 1-month follow-up visits). ConclusionThe MDASI is a valid, reliable, and sensitive symptom-assessment instrument that can be used with confidence in descriptive and clinical studies of symptom status in patients with prostate cancer.

Health education literacy in patients with chronic musculoskeletal diseases: development of a new questionnaire and sociodemographic predictors

It was our aim to develop a questionnaire for patients with chronic musculoskeletal diseases to self-report their health education literacy, to analyse the psychometric properties of the instrument and to test hypotheses concerning sociodemographic predictors of health education literacy. A total of 577 patients with chronic back pain or osteoarthritis who underwent inpatient rehabilitation were surveyed. The resulting 'HELP questionnaire' (health education literacy of patients with chronic musculoskeletal diseases) consists of 18 items and three scales (comprehension of medical information, applying medical information, communicative competence in provider interactions). The instrument's psychometric properties are good (Cronbach's alpha between 0.88 and 0.95, unidimensionality and Rasch model fit established). Our sample's average level of self-reported health education literacy is quite high. However, 20-30% of the patients admitted to having difficulty understanding important aspects of health education programmes (i.e. comprehending what medical information means in relation to their disease). The variance explained by sociodemographic and basic medical variables is small (4-8%). Greater effort is required to make health education programmes easier to understand. There is a need for more research on interindividual variability of complex aspects of health literacy.

Development of the Functional Vision Questionnaire for Children and Young People with Visual Impairment: The FVQ_CYP

To develop a novel age-appropriate measure of functional vision (FV) for self-reporting by visually impaired (VI) children and young people. Questionnaire development. A representative patient sample of VI children and young people aged 10 to 15 years, visual acuity of the logarithm of the minimum angle of resolution (logMAR) worse than 0.48, and a school-based (nonrandom) expert group sample of VI students aged 12 to 17 years. A total of 32 qualitative semistructured interviews supplemented by narrative feedback from 15 eligible VI children and young people were used to generate draft instrument items. Seventeen VI students were consulted individually on item relevance and comprehensibility, instrument instructions, format, and administration methods. The resulting draft instrument was piloted with 101 VI children and young people comprising a nationally representative sample, drawn from 21 hospitals in the United Kingdom. Initial item reduction was informed by presence of missing data and individual item response pattern. Exploratory factor analysis (FA) and parallel analysis (PA), and Rasch analysis (RA) were applied to test the instrument's psychometric properties. Psychometric indices and validity assessment of the Functional Vision Questionnaire for Children and Young People (FVQ_CYP). A total of 712 qualitative statements became a 56-item draft scale, capturing the level of difficulty in performing vision-dependent activities. After piloting, items were removed iteratively as follows: 11 for high percentage of missing data, 4 for skewness, and 1 for inadequate item infit and outfit values in RA, 3 having shown differential item functioning across age groups and 1 across gender in RA. The remaining 36 items showed item fit values within acceptable limits, good measurement precision and targeting, and ordered response categories. The reduced scale has a clear unidimensional structure, with all items having a high factor loading on the single factor in FA and PA. The summary scores correlated significantly with visual acuity. We have developed a novel, psychometrically robust self-report questionnaire for children and young people-the FVQ_CYP-that captures the functional impact of visual disability from their perspective. The 36-item, 4-point unidimensional scale has potential as a complementary adjunct to objective clinical assessments in routine pediatric ophthalmology practice and in research.

Measuring hospital out-patient service quality in Thailand

Purpose – The purpose of this paper is to determine the dimensions used in judging the hospital services quality; to develop a tool for measuring perceived service quality for hospitals; to test the validity and reliability of the new scale; and finally to use the results of the data collected to suggest improving service quality. Design/methodology/approach – A cross-sectional field study was conducted among 400 hospital out-patients in Thailand. The researchers administered the SERVQUAL instrument in order to assess the applicability of these service quality attributes to the out-patient hospital setting in Thailand. The data collected were used to assess the psychometric properties of the SERVQUAL instrument and to analyze whether and to what extent the SERVQUAL dimensions adequately predicted overall service quality among Thai hospital out-patient respondents. The psychometric properties of the instrument were quite acceptable and the resulting five-factor structure was consistent to and confirms earl...

Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents

IntroductionHarmful drinking among young people is common in Australia and many other countries. Social norms and their influence on adolescents’ alcohol consumption behaviours have received much research attention in recent...

The Validity and Utility of the M. D. Anderson Symptom Inventory in Patients With Breast Cancer: Evidence From the Symptom Outcomes and Practice Patterns Data From the Eastern Cooperative Oncology Group

BackgroundThe M. D. Anderson Symptom Inventory (MDASI) is a psychometrically validated patient-reported outcome measurement that assesses the severity and impact of multiple symptoms related to cancer and its treatment. With the MDASI, patients rate 13 common “core” symptoms and 6 items that reflect symptom interference with functioning. Several MDASI modules (core symptom and interference items plus additional symptoms specific to a particular cancer type or treatment modality) have been developed. Although the original MDASI validation study encompassed various cancer types, the instrument's psychometric properties have not been examined in a homogenous sample of patients with breast cancer in a national multicenter study. Materials and MethodsWe performed a secondary analysis of data from an Eastern Cooperative Oncology Group study to establish the reliability, validity, and sensitivity of the MDASI in a large sample of patients with breast cancer (n = 1544), 78% of whom were receiving treatment. The instrument was administered twice, approximately 1 month apart. ResultsInternal consistency and test-retest reliability were adequate, with Cronbach α values ≥ 0.85 and intraclass correlations ≥ 0.76 for all subscales. Known-group validity was evaluated by using performance status, tumor response, and disease stage. Sensitivity to change in patient-reported quality of life was established. ConclusionThe MDASI is a valid, reliable, and sensitive symptom-assessment instrument that can enhance descriptive and clinical studies of symptom status in patients with breast cancer. Future studies might include cognitive debriefing and qualitative interviews to identify additional disease-specific items for inclusion in a MDASI breast cancer module.

The Psychometric Properties of the Simple Screening Instrument for Substance Abuse

The Simple Screening Instrument for Substance Abuse (SSI-SA) is gaining widespread use as a self-report measure of substance abuse; yet, little information exists regarding the instrument's psychometric properties. This study examined the SSI's psychometric properties within a population of 6,664 adult Medicaid enrollees in Florida, who responded to a survey conducted as part of a statewide evaluation of Medicaid services. The SSI-SA had excellent internal consistency (.85). Evidence of the SSI's validity was strong; SSI-SA scores distinguished among individuals with and without substance abuse needs and were significantly correlated with a measure of functioning in daily living. Using the recommended SSI-SA cutoff score of 4 or higher to indicate the presence of a substance abuse problem, the SSI-SA had respectable sensitivity (.82) and specificity (.90).

Validation of an Evidence-Based Medicine Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET)

Competence in evidence-based medicine (EBM) is an important clinical skill. Pediatrics residents are expected to acquire competence in EBM during their education, yet few validated tools exist to assess residents' EBM skills. We sought to develop a reliable tool to evaluate residents' EBM skills in the critical appraisal of a research article, the development of a written EBM critically appraised topic (CAT) synopsis, and a presentation of the findings to colleagues. Instrument development used a modified Delphi technique. We defined the skills to be assessed while reviewing (1) a written CAT synopsis and (2) a resident's EBM presentation. We defined skill levels for each item using the Dreyfus and Dreyfus model of skill development and created behavioral anchors using a frame-of-reference training technique to describe performance for each skill level. We evaluated the assessment instrument's psychometric properties, including internal consistency and interrater reliability. The EBM Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET) is composed of 14 items that assess residents' EBM and global presentation skills. Resident presentations (N = 27) and the corresponding written CAT synopses were evaluated using the EBM C-PET. The EBM C-PET had excellent internal consistency (Cronbach α = 0.94). Intraclass correlation coefficients were used to assess interrater reliability. Intraclass correlation coefficients for individual items ranged from 0.31 to 0.74; the average intraclass correlation coefficients for the 14 items was 0.67. We identified essential components of an assessment tool for an EBM CAT synopsis and presentation with excellent internal consistency and a good level of interrater reliability across 3 different institutions. The EBM C-PET is a reliable tool to document resident competence in higher-level EBM skills.

Human Resource Development Climate in India: Examining the Psychometric Properties of HRD Climate Survey Instrument

The purpose of the present study was to examine the psychometric properties of scores from human resource development (HRD) climate survey instrument by Rao and Abraham (1986). Data were obtained from 403 Indian business executives working in both public and private sector business organizations. Six interpretable factors were extracted as a result of exploratory factor analysis instead of three dimensional structure proposed by the authors of the scale. Confirmatory factor analysis (CFA) results provided support for the superiority of six factor model over alternative models. All the six factors were found to be internally consistent. Results indicated that Rao and Abraham’s scale with sound psychometric properties showed promise for HRD research. Establishing the psychometric properties of the instrument will further accelerate the HRD research in India. Importantly, the study has made an attempt to address the lack of research and practice on organizational climate, which is a matter of concern as expressed by several researchers, and revive the interest in climate studies to some extent.

The N2N instrument to evaluate healthy work environments: an Italian validation

The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18-26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as "healthy". Working under a functional model of care delivery (χ(2) 24.856, p 0.000) and being responsible for one project or more (χ(2) 5.256, p 0.021) were associated with healthy environments. The instrument--valid and reliable, short in the number of items, easy to understand and based on international standards--allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and international comparisons.

Suffering Assessment: A Review of Available Instruments for Use in Palliative Care

The prevention and relief of suffering in palliative care are critical to the well-being and quality of life of patients and families facing life-threatening diseases. Many tools to assess different issues in health care are available, but few are specifically designed to evaluate suffering, which is essential for its prevention, early management, and treatment. The purpose of this review was to identify and describe existing instruments developed to assess suffering in palliative care, as well as to comment on their psychometric properties. A review of articles indexed in MEDLINE, PsycINFO, and SciELO up to June 2011 was conducted. All articles reporting the development, description, or psychometric properties of instruments that assess suffering were included. An assessment of their psychometric quality was performed following a structured checklist. Ten instruments that assess suffering were identified. Their main features and psychometric properties are described in order to facilitate the selection of the appropriate one given each patient's context. By taking into consideration all features of the assessment instruments under review, the evaluation of suffering can be made easier. A wide and ever expanding range of approaches is now available, which facilitates the selection of the suffering-assessment instrument that is best suited to the needs of the specific patient. One of the challenges ahead will be to further analyze the psychometric properties of some existing instruments.

Quality improvement tools for chronic disease care – more effective processes are less likely to be implemented in developing countries

Chronic disease services may be improved if care management processes (CMPs), such as disease-specific flowsheets and chronic disease registries, are used. The newly industrialized Gulf state health service has underdeveloped primary care but higher diabetes prevalence. This paper's aim is to investigate care management processes in United Arab Emirates (UAE) primary care clinics to explore these issues. A cross-sectional survey using self-administered questionnaires given to family physicians and nurses attending a UAE University workshop was used to collect data. All 38 participants completed the questionnaire: 68 per cent were women and 81 per cent physicians. Care management processes in use included: medical records, 76 per cent; clinical guidelines, 74 per cent; chronic disease care rooms, 74 per cent; disease-specific flowsheets, 61 per cent; medical record audits, 57 per cent; chronic disease nurse-educators, 58 per cent; electronic medical records (EMR), 34 per cent; and incentive plans based on clinical performance, 21 per cent. Only 62 per cent and 48 per cent reported that flowsheets and problem lists, respectively, were completed by physicians. Responses to the open-ended question included using traditional quality improvement (QI) approaches such as continuing education and staff meetings, but not proactive systems such as disease registries and self-management. The study used a small, non-random sample and the survey instrument's psychometric properties were not collected. Chronic disease care CMPs are present in UAE clinics but use is limited. Quality improvement should include disease registries, reminder-tracking systems, patient self-management support and quality incentives. This report highlights the lag regarding adopting more effective CMPs in developing countries.

An Analysis of the Teachers’ Sense of Efficacy Scale within the Malaysian Context using the Rasch Measurement Model

Many concerns have been raised about the psychometric properties of instruments when used in different culture. Studies show that adaptation of instrument within a particular context sometimes has different meaning since a particular psychology construct is considered cultural specific. The purpose of the present study is to examine the psychometric properties of the Teachers’ Sense of Efficacy Scale (TSES) within the Malaysian educational context A total of 191 Malaysian in-service and 122 pre-service teachers participated in the study. A Rasch Measurement Model analysis is used to examine the psychometric properties of the scale, particularly the reliability and construct validity. Analyses showed somewhat similar variability with the in-service group demonstrated wider spread of item difficulty compared to the pre-service teachers. One important observation was that both group endorsed different set of items. Consistency of both item difficulty and teachers’ efficacy were high and threats to construct validity in terms of construct irrelevant-variance and construct under-representation were minimum. One worrying finding, however, was that the differential item function (DIF) analysis showed that 13 items (54.17%) behaved significantly different across groups of teachers. Even though several items shown to behave differently across both group of teachers, overall results are encouraging and seem to support the suitability of the TSES to assess teachers’ sense of efficacy within the Malaysian educational context.

An International Comparison of the Ohio Department of Aging-Resident Satisfaction Survey: Applicability in a U.S. and Canadian Sample

The majority of resident satisfaction surveys available for use in assisted living settings have been developed in the United States; however, empirical assessment of their measurement properties remains limited and sporadic, as does knowledge regarding their applicability for use in settings outside of the United States. This study further examines the psychometric properties of the Ohio Department of Aging-Resident Satisfaction Survey (ODA-RSS) and explores its applicability within a sample of Canadian assisted living facilities. Data were collected from 9,739 residential care facility (RCF) residents in Ohio, United States and 938 assisted-living residents in British Columbia, Canada. Confirmatory factor analysis was used to assess the instrument's psychometric properties within the 2 samples. Although the ODA-RSS appears well suited for assessing resident satisfaction in Ohio RCFs, it is less so in British Columbia assisted living settings. Adequate reliability and validity were observed for all 8 measurable instrument domains in the Ohio sample, but only 4 (Care and Services, Employee Relations, Employee Responsiveness, and Communications) in the British Columbia sample. The ODA-RSS performs best in an environment that encompasses a wide range of RCF types. In settings where greater uniformity and standardization exist, more nuanced questions may be required to detect variation between facilities. It is not sufficient to assume that rigorous development and empirical testing of a tool ensures its applicability in states or countries other than that in which it was initially developed.

Measuring service quality in public and private sector university libraries of Pakistan

The problem addressed in this study investigates the perceived service quality of public and private sector university libraries of Pakistan from its users' perspective. More precisely the study compares the following four aspects between public and private universities: zone of tolerance for overall and individual user groups, dimension wise zone of tolerance for overall and individual user group, gaps between desires and perceptions, and significant differences in the service quality. The data were collected through LIBQUAL print questionnaire from 1473 library users (faculty, graduates and undergraduates) of 22 public and private sector university libraries (main/central) of Pakistan. The psychometric properties of instrument were established through exploratory and confirmatory factor analyses. The comparisons of overall, individual service level, and dimension wise gap scores revealed that private sector university libraries were generally meeting the minimum requirements of their users (except information control dimension) but, on the other hand, public sector libraries were not meeting minimum requirement in information control and affect of service dimensions. The study also found significant difference on service quality between private and public sector university libraries. The researcher found very interesting findings that small collection creates small expectations, and it is easy to meet or satisfy the needs of the users of small collection. The article also discusses findings, implications of results and limitations of the study at the end.

Validation of the Spanish version of the questionnaire Practice Environment Scale of the Nursing Work Index

BackgroundThe importance of the practice environment in the provision of care and its relation with patient outcomes and nurse-reported outcomes, support the need to have an instrument to measure such practice environment. ObjectiveTo evaluate the validity and reliability of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI), determining the content validity, test–retest reliability, internal consistency and construct validity. DesignA cross-sectional survey of bedside care nurses undertaken in 2009 in medical, surgical and critical care wards of 33 Spanish National Health Service hospitals with more than 150 beds. MethodsThe validation process followed the internationally recognized guidelines about psychometric properties of instruments: translation and back-translation, content validity, test–retest reliability, internal consistency and construct validity. Other study variables included, like nurses’ intention to leave and job satisfaction. ResultsThe Intraclass Correlation Coefficient (ICC) for an overall score on the 31 item questionnaire was 0.87 (CI 95%: 0.85–0.89). Cronbach's alpha was 0.90 (CI 95%: 0.87–0.93).The weighted Kappa Index obtained for each of the items ranges from 0.24 (CI 95%: 0.22–0.26) to 0.51 (CI 95%: 0.49–0.53).The Content Validity Index score ranges from 0.5 for the item “Opportunities for advancement” to 1. Five of the terms attain this maximum level of agreement: “Active staff development or continuing education programs for nurses”, “Enough registered nurses on staff to provide quality patient care”, “Enough staff to get the work done”, “Management that listens and responds to employee concerns” and “Collaboration between nurses and physicians”. ConclusionsThe validation process indicates that the Spanish version of the PES-NWI is valid and reliable in its current version and it can be used to measure the practice environment of Spanish nurses working in clinical practice in hospitals of the Spanish NHS.

Short Assessment of Health Literacy for Portuguese-speaking Adults

OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coefficient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.

P3‐245: Culture matters: Clarifying the effect of ethnicity on memory and attention and its implications for assessment of Alzheimer's disease

controls (P1⁄40.002). ApoE4 was detected in 44 (40.7%) with mild AD and 41 (40.2%) with moderate/severe AD. There were no significant differences among ApoE4 carriers and non-carriers on instrument scores.Conclusions: This study is the first to evaluate the psychometric properties of multiple AD instruments in five Asian countries/regions. These promising results support the initial psychometric properties of these instruments, enabling their use in Chinese, Korean, and English-speaking AD population in a psychometrically soundmanner. Data collection is on-going to evaluate their responsiveness over time.

Increasing Meaning in Measurement

In today's increasingly violent society, many childhood incidents that begin as simple teasing deteriorate into persistent bullying. The Child-Adolescent Teasing Scale (CATS) was developed to measure self-perceived teasing in youths aged 11-15 years. It was validated initially using the principles of classical test theory and deemed to be a reliable and valid measure of teasing; it has been responsive to change in intervention studies. The aim of this study was to evaluate further the psychometric properties of the CATS by evaluating the degree to which the CATS items are congruent with the primary assumptions of the Rasch measurement model. A methodological study design using a Rasch Rating Scale Model was utilized to examine the psychometric properties of the 32-item CATS. The sample of the CATS consisted of 666 youths aged 11-15 years from diverse racial and socioeconomic backgrounds and geographic regions. Unidimensionality, hierarchical ordering, and stretching of the variable's responses along a continuum were examined. The current CATS subscales do not fit the criteria for the Rasch model. The subscales are not unidimensional or hierarchical and do not exist on upon a continuum upon which items can be ordered and children can be placed. The divergent results between the classical test theory and Rasch analyses, although not completely surprising, underscore the need for continued refinement of an instrument's psychometric properties to ensure it is measuring the concept of interest in the way it was intended.

Convergent Validity and Internal Consistency of an Arabic Snaith Hamilton Pleasure Scale

Anhedonia, a reduced capacity for pleasure, is viewed as a trait-like vulnerability marker for schizophrenia and depressive disorders. To date there are scarce data from the Arab world on anhedonia as a symptom, and even less on the psychometric properties of instruments designed to assess it. This study examines the internal consistency of an Arabic version of the Snaith Hamilton Pleasure Scale (SHAPS), and its convergence with real-time hedonic responses to emotional stimuli. A correlational study design is used; undergraduate students ( N = 113) in the United Arab Emirates (UAE) completed the SHAPS, and also undertook an expanded version of the picture rating task (PRT). The PRT required participants to rate a series of pleasant and unpleasant images in terms of emotional valence. Levels of anhedonia as assessed by SHAPs were similar to those observed in nonclinical populations in other countries. Internal consistency for the Arabic version of SHAPs was very good; α = .86. Furthermore, SHAPS scores were correlated with lower valence ratings for pleasant images ( r = .36), and uncorrelated with unpleasant images. The SHAPS appears to be a useful instrument for assessing anhedonia in the present UAE student population.