Psychometric Validation Process Research Articles

Ranking bovine pain-related behaviors using a logistic regression algorithm

Pain identification in farm animals is a welfare challenge worldwide. In the last decade, our research team validated the Unesp-Botucatu Cattle Acute Pain Scale (UCAPS) based on specific pain or discomfort behaviors and alterations to maintenance behaviors when the cattle experiences pain. Recently, for other specific-species pain scales, such as sheep, pigs, and horses, we have used algorithms to weigh the pain-related behaviors, ranking their heterogeneous importance. Because the ranking of cattle pain-related behaviors' importance is still unknown, we aimed to investigate whether UCAPS pain-related behaviors have different statistical weights and rank their importance. We used a dataset comprising behavioral scores from 40 bulls in the perioperative period subjected to surgical castration in our previous study. Bulls were filmed between 16 and 24 hours before castration, between 1 and 4 hours after castration, 1 hour after analgesia, and 24 hours after the end of the surgery. Three experienced observers assessed all videos blind to the timepoint. After watching each video, the observers decided whether they felt analgesia should be indicated for the individual (expert assessment) and score UCAPS behaviors. Each pain-related behavior was weighted using a multilevel binomial logistic regression. Among the 17 UCAPS behaviors, four were not significant (‘Activity 1: restless, moves more than normal or lies down and stands up with frequency’, ‘Appetite 1: hyporexia’, ‘Wagging tail’, and ‘Licking wound’), suggesting minor importance. The algorithm highlighted ‘Kicking’, ‘Hind limbs extended’, ‘Extends neck’, ‘Head down’, and ‘Interaction 2’ (apathetic: may be isolated or may not accompany the other animals; does not react to tactile, visual and/or audible environmental stimuli) respectively, as the five most important pain-related behaviors within this sample. Statistical weighting might contribute to the acute pain scoring approach and selecting behaviors in the psychometric validation process for pain scales. In conclusion, the statistical weighting based on multilevel binomial logistic regression raised evidence for a ranking of the importance of UCAPS pain-related behaviors in determining the need for analgesia in bulls after surgical castration. These findings contribute to a better understanding of bulls' behavioral responses to acute pain, potentially improving pain identification and monitoring, and enhancing welfare.

Perception of the professional self-image by nurses and midwives. Psychometric adaptation of the Belimage questionnaire

BackgroundThe aim of this paper is to present the research results on the perception of the professional self-image by Polish nurses and midwives as well as the psychometric adaptation of the Belimage scale.MethodsA cross-sectional survey was conducted from January to November 2018. The study group consisted of 670 clinical practice nurses and midwives. A diagnostic survey method was applied using the Belimage questionnaire after it obtained acceptable psychometric properties through an adaptation procedure.ResultsIn the group of respondents, the professional image of nurses and midwives is dominated by instrumental skills, documentation and organization of care, and communication skills. There is a statistically significant difference in the image of these two professions in terms of the ability to think and act creatively and critically, as well as innovation and evidence-based practice. The respondents' opinion regarding the perception of their image by themselves and society is statistically significant in each of the analyzed areas. In the professional image created by the public, nurses and midwives recognize that being a nurse/midwife is a vocation—277 (41.3%). However, in terms of their self-image, most nurses and midwives consider their work to be hard—442 (66%) and poorly paid—445 (66.4%). In the psychometric validation process, the Belimage questionnaire retained the original item structure, and the reliability of the subscales assessed with the Cronbach's alpha coefficient ranged from 0.845 to 0.730.ConclusionsThe professional image of nurses and midwives varies depending on the profession and the perspective of the assessment in relation to themselves and society. The study showed a particularly unfavorable social image of nurses and midwives, which significantly influences the outlook of nurses and midwives themselves on this issue.

Development and validation of the parents' healthcare needs scale for adolescents with congenital heart disease

PurposeThe healthcare needs of parents of adolescents with congenital heart disease (CHD) have been under-investigated as no valid and reliable tools have been developed for assessing their needs. Therefore, this study aims to develop and validate the Parents' Healthcare Needs Scale for adolescents with CHD (PHNS-CHD). Design and methodsA multi-method approach and multi-phase design were employed. Phase one referred to generating scale items based on emerging themes in the literature, and phase two showed the validation process, divided into three steps. Step one tested the content and face validity of the first version of the PHNS-CHD. After that, step two described the initial psychometric validation process of scale using an exploratory factorial analysis (EFA). Then, step three confirmed the PHNS-CHD factorial structure and assessed its internal consistency. ResultsThe PHNS-CHD showed evidence of face and content validity, adequate construct, and internal consistency and stability. Specifically, it had 22 items grouped into five domains, labeled as follows: Healthcare education to the child; to be supported as a parent, clinical support to the child, the continuum of care to the child; emotional support to the child. ConclusionsThe PHNS-CHD is a psychometrically robust measure for assessing the healthcare needs of parents of adolescents with CHD. Practice implicationsThe PHNS-CHD might help clinicians, especially pediatric nurses, assess the healthcare needs of parents of adolescents with CHD and design adequate care plans for the whole family.

Vietnamese Version of the General Medication Adherence Scale (GMAS): Translation, Adaptation, and Validation.

Background: We aimed to translate, cross-culturally adapt, and validate the General Medication Adherence Scale (GMAS) into Vietnamese. Methods: We followed the guidelines of Beaton et al. during the translation and adaptation process. In Stage I, two translators translated the GMAS to Vietnamese. Stage II involved synthesizing the two translations. Stage III featured a back translation. Stage IV included an expert committee review and the creation of the pre-final version of the GMAS, and in stage V, pilot testing was conducted on 42 Vietnamese patients with type 2 diabetes. The psychometric validation process evaluated the reliability and validity of the questionnaire. The internal consistency and test–retest reliability were assessed by Cronbach’s alpha and Spearman’s correlation coefficients. The construct validity was determined by an association examination between the levels of adherence and patient characteristics. The content validity was based on the opinion and assessment score by the expert committee. The Vietnamese version of the GMAS was created, including 11 items divided into three domains. There was a good equivalence between the English and the Vietnamese versions of the GMAS in all four criteria. Results: One hundred and seventy-seven patients were participating in the psychometric validation process. Cronbach’s alpha was acceptable for all questionnaire items (0.817). Spearman’s correlation coefficient of the test–retest reliability was acceptable for the GMAS (0.879). There are significant correlations between medication adherence levels and occupation, income, and the Beliefs about Medicines Questionnaire (BMQ) score regarding construct validity. Conclusions: The Vietnamese version of GMAS can be considered a reliable and valid tool for assessing medication adherence in Vietnamese patients.

Design and preliminarily validation of a tool to assess the impact of chronic non-cancer pain on people's daily life in Spanish-language: PAIN_Integral Scale©.

To build and preliminarily validate a Spanish-language instrument to assess the impact that CNCP has on the daily lives of people who suffer from it. The experience of pain is multifactorial and a correct assessment of it helps to control the intensity of pain. Although there are instruments that evaluate areas on which Chronic Non-Cancer Pain impacts, it would be necessary to include other aspects that scientific literature identifies as relevant. Instrument and construct cross-sectional study for psychometric validation. A total of 157 items based on items from validated questionnaires were evaluated by a group of 21 chronic pain experts using Delphi methodology in three evaluation rounds. A final questionnaire of 55 items with a 5-point Likert-type scale was formed. This questionnaire was piloted on a total of 30 patients to assess their understanding of the items and the psychometric validation process was carried out (January to March 2020) on a subsequent sample of 395 people, all of whom attended Pain Units and Primary Care Centres of the Public Health System in Spain. The PAIN_Integral Scale© showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of nine factors that explain 71.02% of the total variance, from 157 to a final total of 36 items. Confirmatory Factor Analysis showing adequate values confirmed this structure. The effect size was used to calculate the cut-off points for the overall scale, setting them at scores of 130 and 135. This instrument would allow to assess other constructs and dimensions not included in the instruments previously available such as treatment compliance, proactivity, resilience, hopelessness due to pain and pain catastrophizing. However, despite the fact that the preliminary analysis shows good results, it is necessary to continue with its validation process in subsequent studies. The PAIN_Integral Scale© , once the validation process is finished, could be a complete enough instrument to allow a comprehensive healthcare assessment of Chronic Non-Cancer Pain's impact on daily nursing clinical practice and other healthcare professionals.

Adaptation and psychometric validation of a questionnaire about organizational safety culture and climate for the Brazilian reality

Surveys are the most widely used instruments to assess safety opinions, attitudes and behaviours of workers, as a reflection of a dimensional manifestation of an organization’s safety culture. The fact that there are few instruments of this nature adapted to the Brazilian reality motivated the attempt to validate tools used in Portugal in this field. The questionnaire to workers about occupational safety culture and climate (QTCCS) will be explored in this article. The main objective is to present the data from the cultural adaptation and psychometric validation process of this instrument, and it can be confirmed that this intention was properly achieved. Through a study carried out with a sample of 200 workers from a company in the northeast of Brazil, it was statistically confirmed that it is possible to maintain the factorial structure of the original instrument when applied to Brazilian workers of different characteristics.

Antimicrobial Resistance, Pharmacists, and Appreciative Inquiry: Development of a Novel Measurement Tool.

Antimicrobial resistance (AMR) is a threat to achieving the United Nation’s (UN) sustainable development goals (SDGs). The behavior of stakeholders has directly influenced the extent of AMR and understanding underpinning knowledge and attitudes is an important step towards understanding these behaviors. The aim of this study was to develop and validate a novel questionnaire, utilizing the theory of Appreciative Inquiry, to measure knowledge and attitudes around antibiotic resistance amongst community pharmacists throughout Thailand. A survey tool was developed using the Appreciative Inquiry theory, and was piloted in a non-probability sample of practicing community pharmacists. Descriptive and inferential statistics were applied and the tool validated, using a three-step psychometric validation process. A total of 373 community pharmacists participated in the study. The survey tool was found to be valid and reliable. The “Knowledge” domain of the survey tool showed an acceptable level of reliability (Cronbach’s alpha 0.64); while the “Attitude” domain showed an excellent reliability level (Cronbach’s alpha 0.84). This new survey tool has been designed to measure attitudes and knowledge of antibiotic resistance by utilizing the Discovery phase of Appreciative Inquiry theory amongst community pharmacists in Thailand. This survey tool has the potential to be used by other researchers across different settings.

Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting

BackgroundMeasuring functional status in palliative care may help clinicians to assess a patient’s prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the psychometric validation process of a Polish translation of this tool (PPSv2-Polish).MethodsTwo hundred patients admitted to a free-standing hospice were evaluated twice, on the first and third day, for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPSv2-Polish was evaluated simultaneously with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index, to determine its construct validity.ResultsA high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P < 0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen’s kappa 0.91; P < 0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P < 0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; − 0.62; and 0.58, respectively (P < 0.0001).ConclusionPPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.

Italian Validation of the Healthcare Needs Scale for Youth with Congenital Heart Disease and Its Short-Form Development

Aims: This study aimed at providing an Italian short version of the ‘healthcare needs scale for youth with congenital heart disease’ (I-HNS-CHD-s), describing its construct validity and reliability. Methods: A multi-method and multi-phase design were adopted. Phase one referred to the cultural-linguistic validation of the original scale into Italian. Phase two tasted content and face validity of the Italian-translated scale. Phase three included the psychometric validation process of scale, encompassed two different steps: first cross-sectional data collection (sample A) purposed at determining the psychometric characteristics of the I-HNS-CHD-s, using an exploratory factor analysis (EFA). Then, a second round of cross-sectional data collection (sample B) was performed using the version of I-HNS-CHD-s derived from the previous step, and it purposed at confirming the scale factor structure and at assessing its reliability. Results: I-HNS-CHD-s showed evidence of face and content validity, adequate construct and internal consistency and stability. Specifically, I-HNS-CHD-s had 14 items kept by four domains, labelled as follows: Healthcare education, clinical support, emotional support, continuum of care. These domains were predicted by a secondorder factor, which was labelled as Healthcare needs. Overall I-HNS-CHD-s encompassed only the items that showed high performance in the psychometric analysis. Accordingly, I-HNS-CHD-s is a shorter form of the original scale (14 items instead of 25). Conclusions: I-HNS-CHD-s is a psychometrically robust measure of the healthcare and psychosocial needs of Italian adolescents and young adults with congenital heart disease.

Development and validation of a speech pathology-specific questionnaire for persons with multiple sclerosis (SMS)

Purpose: The aim of this study was to develop and validate the Speech pathology-specific questionnaire for persons with Multiple Sclerosis (SMS).Method: Forty-one items were generated through a literature review. Items were submitted to a preliminary psychometric validation process consisting of principal component analysis, internal consistency, test-retest reliability, and floor and ceiling effects using data from 164 participants. Criterion validity was assessed by comparing the SMS with the 12-item Short Form Health Survey (SF-12). Participants were recruited internationally through online channels and questionnaires were completed online.Result: The SMS contains 16 items describing three components: speech and voice, language, and swallowing. Internal consistency (Cronbach’s alpha) of the three components was satisfactory (α = 0.89–α = 0.91). Criterion validity was evaluated using Spearman’s rank correlation coefficient (ρ). A statistically significant weak to moderate correlation between the SMS and the SF-12 was identified (ρ = –0.004–ρ = –0.359). No floor or ceiling effects were present. The SMS demonstrated strong test-retest reliability. All items had an intra-class correlation coefficient ≥0.70.Conclusion: The SMS is a psychometrically robust patient-reported outcome measure to assess speech-language pathology symptoms in persons with MS.

Evaluación de la tutoría en los estudios d posgrado: construcción y validez de escalas

&lt;p&gt;El posgrado orientado a la formación de investigadores es una pieza angular en el desarrollo del conocimiento y las sociedades contemporáneas. Este nivel posee escasos instrumentos para evaluar la tutoría con énfasis en sus funciones y actividades. Dicha carencia puede explicarse en virtud de la falta de definiciones sobre el constructo denominado “tutoría en posgrado”. La tutoría en los estudios de posgrado se reconoce como un modelo de formativo personalizado que coadyuva al desarrollo de capacidades para la investigación, la práctica profesional y la incorporación a la docencia en la educación superior. No obstante este concepto debe ser ampliado para incluir a los aspectos relacionados con la socialización y la integración de los estudiantes a las comunidades epistémicas y profesionales. En el presente artículo se fortalecen estos atributos y se da cuenta del proceso de construcción y validación de once escalas de respuesta tipo Likert, que permiten valoran el desempeño de la tutoría en los estudios de posgrado. Las escalas fueron elaboradas con base en un modelo conceptual que integra tanto funciones formativas como las socializadoras así como aspectos interpersonales que promueven la interacción entre posgraduados y tutores. Cada escala presenta una consistencia interna aceptable. La validez de las mismas se obtuvo mediante análisis factoriales, cada escala explica más del 50% de la varianza.&lt;/p&gt;&lt;div&gt; &lt;/div&gt;

The Inventory of Complicated Spiritual Grief: Assessing Spiritual Crisis Following Loss

Following the death of a loved one, many grievers endorse spirituality as a source of both solace and strain. Studies show that some grievers struggle significantly with both their relationship with God and their faith community, a condition known as complicated spiritual grief (CSG). However, researchers have lacked a simple, multidimensional, well-validated, grief-specific measure of CSG. In this brief report, we reviewed the psychometric validation process and clinical utility of a measure called the Inventory of Complicated Spiritual Grief (ICSG), which was tested with 304 Christian grievers. The 18-item ICSG was shown to have strong internal consistency, high test–retest reliability, and convergent and incremental validity and supported a two-factor model, measuring one’s insecurity with God and the disruption in one’s religious practice.

Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale.

The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. The 30-item GAH scale was designed through a multi-step process to cover 8 relevant dimensions. This is an observational study conducted in 363 patients aged≥65years, newly diagnosed with different hematological malignancies (myelodysplasic syndrome/acute myeloblastic leukemia, multiple myeloma, or chronic lymphocytic leukemia), and treatment-naïve. The scale psychometric validation process included the analyses of feasibility, floor and ceiling effect, validity and reliability criteria. Mean time taken to complete the GAH scale was 11.9±4.7min that improved through a learning-curve effect. Almost 90% of patients completed all items, and no floor or ceiling effects were identified. Criterion validity was supported by reasonable correlations between the GAH scale dimensions and three contrast variables (global health visual analogue scale, ECOG and Karnofsky), except for comorbidities. Factor analysis (supported by the scree plot) revealed nine factors that explained almost 60% of the total variance. Moderate internal consistency reliability was found (Cronbach's α: 0.610), and test-retest was excellent (ICC coefficients, 0.695-0.928). Our study suggests that the GAH scale is a valid, internally reliable and a consistent tool to assess health status in older patients with different hematological malignancies. Future large studies should confirm whether the GAH scale may be a tool to improve clinical decision-making in older patients with hematological malignancies.

Using qualitative methods in developing an instrument to identify barriers to self-care among persons with type 2 diabetes mellitus.

To develop a questionnaire to address barriers and self-care behaviour among persons with type 2 diabetes mellitus. Several instruments are available in the literature to measure barriers to self-care in this population, but many of them present limitations in its psychometric validation process, and lack of theoretical background. Content validation study using multiple qualitative methods. A systematic review was conducted, and two focus groups with fifteen participants (n = 15) were analysed to identify key topics and categories concerning barriers and self-care behaviour. These categories were used to generate items that were subjected to expert scrutiny, using the Delphi technique. The resulting list of items was tested for readability and comprehension by nine diabetic patients (n = 9), through cognitive interviews. The whole process was conducted in accordance with the Theory of Planned Behaviour. The mean age (standard deviation) of participants in the focus groups and cognitive interviews was 66·05 (8·47) and 63·11 (6·13) years, respectively. 46·7% of the members of the focus groups and 44·4% of those interviewed were female, and the mean duration (standard deviation) of their diabetes was 6·53 (3·17) and 4·89 (3·84) years, respectively. After the qualitative analysis, 27 codes were obtained. Thereafter, items were generated in accordance with the dimensions of this theory: attitudes towards the behaviour (n = 23), social norms (n = 13), perceived behavioural control (n = 17) and behavioural intention (n = 15). A rigorous process of content validation with multiple methods was implemented to obtain an instrument aimed at addressing barriers and self-care behaviour of patients with type 2 Diabetes Mellitus. An instrument theoretically rooted and supported on professional and patients' views is available to assess self-care behaviours in patients with type 2 Diabetes Mellitus. The evaluation of its reliability and construct validity will determine the instrument's value and practical application in the clinical context.

Using rasch measurement to score, evaluate, and improve examinations in an anatomy course

Any examination that involves moderate to high stakes implications for examinees should be psychometrically sound and legally defensible. Currently, there are two broad and competing families of test theories that are used to score examination data. The majority of instructors outside the high-stakes testing arena rely on classical test theory (CTT) methods. However, advances in item response theory software have made the application of these techniques much more accessible to classroom instructors. The purpose of this research is to analyze a common medical school anatomy examination using both the traditional CTT scoring method and a Rasch measurement scoring method to determine which technique provides more robust findings, and which set of psychometric indicators will be more meaningful and useful for anatomists looking to improve the psychometric quality and functioning of their examinations. Results produced by the more robust and meaningful methodology will undergo a rigorous psychometric validation process to evaluate construct validity. Implications of these techniques and additional possibilities for advanced applications are also discussed.

Patient-Satisfaction Measures in Anesthesia

Patient satisfaction is an important measure of the quality of health care and is used as an outcome measure in interventional and quality improvement studies. Previous studies have found that there are few appropriately developed and validated questionnaires available. The authors conducted a systematic review to identify all tools used to measure patient satisfaction with anesthesia, which have undergone a psychometric development and validation process, appraised the quality of these processes, and made recommendations of tools that may be suitable for use in different clinical and academic settings. There are a number of robustly developed and subsequently validated instruments, however, there are still many studies using nonvalidated instruments or poorly developed tools, claiming to accurately assess satisfaction with anesthesia. This can lead to biased and inaccurate results. Researchers in this field should be encouraged to use available validated tools, to ensure that patient satisfaction is measured and reported fairly and accurately.

Spanish validation of the University of Washington Quality of Life questionnaire for head and neck cancer patients

Objective The University of Washington Quality of Life (UW-QOL) questionnaire is one of the most widely used instruments to evaluate the quality of life of head and neck cancer patients. The aim of this study was to perform a Spanish translation and validation of the UW-QOL questionnaire. Study Design A cross-sectional study. Setting Three tertiary-care hospitals and a laryngectomee rehabilitation center. Subjects and Methods The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines. The psychometric validation was performed on a consecutive series of patients treated for squamous cell carcinoma of the upper aerodigestive tract with no signs of relapse, recruited from May 2007 to December 2008. Eligible subjects were invited to complete the Spanish version of the UW-QOL questionnaire during routine clinical consultation, and complete it again within 15 days. Subjects also completed a validated Spanish version of the Goldberg Mental Health Survey and were evaluated by the use of the Karnofsky Index. Results A Spanish version of the questionnaire was developed in iterative fashion. In the psychometric validation process, a total of 76 patients were analyzed. Reliability was excellent, including both internal consistency (Cronbach's alpha of 0.84) and test-retest reliability (intraclass correlation coefficient between 0.91 and 0.97 with a confidence interval of 95%). Construct validity was supported by statistically significant relationships between the Karnofsky Index, the Goldberg Mental Health Survey, and the translated UW-QOL questionnaire. Conclusion The Spanish version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid.

An empirically validated quality management measurement instrument

PurposeTo develop a quality management (QM) measurement instrument that has sound psychometric properties and recognizes a key feature of the field, i.e. QM is currently characterized by three competing approaches: standards‐based; prize‐criteria; and, elemental implementation approaches.Design/methodology/approachThe three disparate approaches were analyzed to identify sets of key constructs and associated items. The assembled instrument was empirically validated through a survey of 418 Australian manufacturing organizations. A full set of reliability and validity tests were performed. Wherever applicable, confirmatory approach using structural equation modeling was used.FindingsThe results of psychometric tests suggest that the constructs of the three approaches have good empirical support. In the manner in which the instrument is presented, it is possible to separately measure constructs related to each of the three approaches.Research limitations/implicationsThe measurement instrument has been validated with manufacturing organizations from Australia. It is applicability to other industry sectors or country contexts needs to be verified.Practical implicationsPractitioners and consultants can use the measurement instrument for conducting QM benchmarking exercises within and across organizations. Researchers can use the instrument in future studies for, inter alia, theory development in the area.Originality/valueThe measurement instrument overcomes the shortcomings of the existing instruments by explicitly including all three practical approaches to quality management. Also, a rigorous psychometric validation process is adopted that provides credible outcomes.

Brazilian–Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer

The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages. The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines. The psychometric validation was performed on a consecutive series of patients with at least 1 year of disease-free survival after treatment for squamous cell carcinoma of the upper aerodigestive tract, recruited from October 2004 to January 2005 from a tertiary cancer center hospital. Eligible subjects were invited to complete the Portuguese version of the UW-QOL questionnaire during routine clinical consultation and complete it again within 15 days. They also completed a validated Portuguese version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and a questionnaire to evaluate anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]). A Portuguese version of the questionnaire was developed in iterative fashion. In the psychometric validation process, a total of 109 patients were analyzed. Reliability was excellent, including both internal consistency (Cronbach's alpha [alpha] of 0.744) and test retest reliability (intraclass correlation coefficient [ICC] of 0.882). Construct validity was supported by statistically significant relationships between the SF-36 and HAD questionnaires and the translated UW-QOL questionnaire. The Brazilian-Portuguese version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid. This version is a valuable tool to evaluate accurately the quality of life of Brazilian patients with head and neck cancer.

The Treatment Satisfaction Scale: A Multidimensional Instrument for the Assessment of Treatment Satisfaction for Erectile Dysfunction Patients and Their Partners

Background: The development of the Treatment Satisfaction Scale (TSS) was previously reported (Kubin et al., 2004). Objective: This article describes the psychometric validation process and psychometric properties (e.g., reliability, validity, and responsiveness) of TSS. Methods: Initial patient and partner questionnaires were administered in a multi-national clinical trial. On the basis of exploratory analyses, iterative psychometric testing, and consideration of face validity and interpretability, the number of items was reduced, and six scales were constructed: “Satisfaction with Medication,” “Ease with Erection,” “Satisfaction with Erectile Function,” “Pleasure from Sexual Activity,” “Satisfaction with Orgasm,” and either “Sexual Confidence” (for patients) or “Confidence in Completion” (for partners). Results: Multi-item scales had good internal consistency reliability and concurrent validity with the IIEF. All patient scales and most partner scales were valid in relation to clinical criteria, and all tested scales were responsive to change over time. Conclusion: The TSS is brief, culturally valid, and the most comprehensive multidimensional measure of satisfaction with ED treatment for patients and their partners, and addresses some of the shortcomings of existing measures.