Single-item Self-report Measures Research Articles

A brief but comprehensive three-item social connectedness screener for use in social risk assessment tools.

The 2014 IOM report "Capturing Social and Behavioral Domains and Measures in Electronic Health Records" described three subdomains of social relationships that affect patient health and well-being. However, most social risk screeners currently assess only one subdomain, frequency of social connections. We are proposing a three-item Brief Social Connectedness (SC) screener that additionally assesses risks in social/emotional support and loneliness/social isolation subdomains. For this cross-sectional study, we used data from a 2021 Kaiser Permanente Northern California (KPNC) social risk survey for 2244 members ages 35-85 years. The survey included three validated questions that covered the SC subdomains (frequencies of social contacts with people they care about, feeling lonely/socially isolated, and getting enough social/emotional support). Variables representing moderate/high versus low risk were created for each subdomain. We used weighted data for bivariate analyses and modified log-Poisson regression models that adjusted for age, sex, race, and ethnicity to examine cross-sectional associations among the three subdomain risks, as well as with two structural SC risks, living alone and not being in a committed relationship. We then used modified log-Poisson regression models to study cross-sectional associations of these five SC variables with three single-item self-report measures of emotional health. In regression models that included all five SC variables, loneliness/social isolation and social/emotional support risks were significantly associated with all three emotional health measures, while frequency of social contacts, living alone, and no committed relationship were not. However, low frequency of social contacts and no committed relationship significantly increased risk of often feeling lonely/socially isolated and lacking in social/emotional support. A three-item social connectedness screener that assessed risks of loneliness/social isolation, inadequate social/emotional support, and low frequency of social contacts provided more comprehensive information about emotional health risks than social connection frequency alone.

Abstract P6-05-08: Distress Screening for Family Caregivers of Metastatic Breast Cancer Patients

Abstract Metastatic breast cancer (MBC) is an incurable disease that affects over 168,000 women in the US. Family caregivers play a critical role in patients’ adjustment to MBC by providing practical and emotional support. However, the extensive involvement of caregivers in patient care places them at increased risk for clinically significant psychological distress symptoms. In fact, research has shown that distress is as prominent for caregivers as it is for patients and that it can adversely affect caregiver support to the patient. Distress screening with appropriate triage and follow-up for psychosocial concerns is recognized by the Institute of Medicine (IOM) and National Comprehensive Cancer Network (NCCN) as critical for ensuring high-quality comprehensive cancer care. However, clinical tools to assist with recognizing caregiver distress are sparse, creating a practical barrier for caregivers to obtain needed psychosocial support. The NCCN Distress Thermometer (DT) is a validated single-item self-report measure that was developed to screen for cancer patient distress. It is often used with the NCCN 42-item Problem List (PL) which identifies sources of distress to help guide providers in making appropriate referrals. Although the DT has been validated for use with caregivers, most adult oncology practices have yet to establish protocols for identifying caregivers with high distress levels. Part of the problem is that many PL items ask about physical and other concerns that are related to either having or undergoing treatment for cancer. Developing a caregiver-focused PL could thus not only improve clinical uptake of distress screening for cancer caregivers, but also enable greater integration of family-centered support services as part of routine cancer care. With these goals in mind, this mixed-methods study sought to inform development of a PL to address the unique concerns of cancer caregivers. Methods: Caregivers of MBC patients completed a short survey containing sociodemographic questions and the NCCN DT. They also participated in semi-structured interviews about their role in symptom management, psychosocial impacts of cancer, and unmet needs. Interviews were audio-recorded and transcribed. The five NCCN problem domains (i.e., physical, emotional, family, practical, and religious/spiritual concerns) that have been identified as sources of distress were used to guide thematic analysis. Results: Nineteen caregivers (63.2% female; 47.4% racial/ethnic minorities) participated. Most were middle aged (M = 54.4, SD = 16.4) and either spouses (42.1%) or adult children (31.6%). Surveys revealed that caregivers had moderate distress levels (M=4.4 out of 10, SD=3.1); 53% exceeded the DT cut-off of 5, warranting further psychological evaluation. In the interviews, caregivers reported an average of 7.7 concerns (Range = 0 to 17 concerns). The most common issues were worry (63.2%), coping with the patient’s emotions (57.9%), providing emotional support to the patient (52.6%) and assisting with activities of daily living (47.9%). Caregivers also expressed problems coordinating care with other family members, feelings of guilt, and unmet needs for information. Caregivers reporting more concerns reported significantly (p<.05) higher levels of psychological distress. Conclusion: Many of the concerns raised by MBC caregivers did not align with the NCCN PL, suggesting that development of a caregiver-specific PL is warranted. Additional study is needed to determine whether such a PL could help to efficiently route caregivers to information and resources matching their needs and ultimately help to alleviate their distress. Citation Format: Ashley Buchanan, Astrid Sarfo, Hoda Badr. Distress Screening for Family Caregivers of Metastatic Breast Cancer Patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-08.

Structural neuroimaging measures and lifetime depression across levels of phenotyping in UK biobank

Depression is assessed in various ways in research, with large population studies often relying on minimal phenotyping. Genetic results suggest clinical diagnoses and self-report measures of depression show some core similarities, but also important differences. It is not yet clear how neuroimaging associations depend on levels of phenotyping. We studied 39,300 UK Biobank imaging participants (20,701 female; aged 44.6 to 82.3 years, M = 64.1, SD = 7.5) with structural neuroimaging and lifetime depression data. Past depression phenotypes included a single-item self-report measure, an intermediate measure of ‘probable’ lifetime depression, derived from multiple questionnaire items relevant to a history of depression, and a retrospective clinical diagnosis according to DSM-IV criteria. We tested (i) associations between brain structural measures and each depression phenotype, and (ii) effects of phenotype on these associations. Depression-brain structure associations were small (β < 0.1) for all phenotypes, but still significant after FDR correction for many regional metrics. Lifetime depression was consistently associated with reduced white matter integrity across phenotypes. Cortical thickness showed negative associations with Self-reported Depression in particular. Phenotype effects were small across most metrics, but significant for cortical thickness in most regions. We report consistent effects of lifetime depression in brain structural measures, including reduced integrity of thalamic radiations and association fibres. We also observed significant differences in associations with cortical thickness across depression phenotypes. Although these results did not relate to level of phenotyping as expected, effects of phenotype definition are still an important consideration for future depression research.

Assessing the degree of urbanisation using a single-item self-report measure: a validation study

ABSTRACT The differential impact of rural versus urban residence on mental health remains a controversial topic that requires more in-depth investigations. This calls for a valid and easy measure to assess the degree of urbanisation. The purpose of the present study was to determine the utility of a single-item self-report measure (SIDU) as a tool to classify areas along the rural-urban continuum. The validity of the SIDU was assessed by comparing its scores (1–7) to a commonly used objective surrogate measure of the degree of urbanisation (i.e. surrounding address density, SAD) in two independent older adult samples (A: N = 36, 65+; B: N = 121, 55+). SIDU scores approximated SAD scores, with r = .77 to 0.82, (A), and r = .79 to 0.83 (B). A SIDU threshold score of 6 most accurately distinguished extremely urbanised areas from other areas. Altogether, our findings suggest that SIDU scores could be used as proxy of SAD. Since self-report leaves room for the consideration of additional aspects that confer an urban settlement, this single-item scale may be even more comprehensive, and circumvents the collection and handling of highly sensitive location data when the primary goal is solely to distinguish urbanisation subgroups.

Experiences of hospitalization for suicide ideation and suicide attempt in gender diverse adults.

This study sought to investigate general perceptions of suicide-related hospital-based care that Transgender/Gender Diverse (TGD) adults have experienced as well as correlates of their perceived usefulness of this care. Data were collected via a cross-sectional online survey of N=3718 self-identified TGD individuals. Single-item self-report measures of all constructs of interest were used. A total of n=1056 participants indicated hospitalization for either a past suicide attempt (SA) or suicidal ideation (SI). Irrespective of being hospitalized for SI or SA, perceived usefulness of hospital-based care was low with 50% or more of participants rating their care as some degree of unhelpful. Older age, general trust in mental healthcare providers, and voluntary admission were related to higher perceived helpfulness of care for both SI and SA admissions. Higher pride in TGD identity was positively related to perceived helpfulness of care but only for admissions related to SAs. Improving perceived usefulness of hospital-based care may be important for improving subsequent suicide-related help-seeking. Increasing training and provision of care that improves trust with mental healthcare providers and potentially reduces need for involuntary admission may help improve hospital-based, suicide-related care in TGD adults.

Burnout, Compassion Satisfaction, and Intent to Quit Among Long-Term Care Nursing Assistants in the Time of COVID-19

The COVID-19 pandemic has greatly exacerbated the stress and burden of those employed in long-term care (LTC) facilities due to staff shortages, increased risks on the job, and ever-changing COVID-19 protocol requirements. This study examines potential differences in pre-COVID-19 and current COVID-19 LTC facility employed nursing assistants on burnout, compassion satisfaction, job satisfaction, and intent to quit. The sample included 81 nursing assistants employed in LTC facilities across the United States, with data collected prior to (n= 42) and during COVID-19 related shutdowns (n= 39). Participants completed the Professional Quality of Life Scale 5 (ProQOL 5), a single-item self-report measure of job satisfaction, and a two-item self-report measure of intent to quit their current employment. Nursing assistants during COVID-19 reported a higher level of burnout and lower level of compassion satisfaction than nursing assistants Pre-COVID-19. However, there were no differences in job satisfaction or intent to quit. The results suggest there may be additional factors that influence an individual’s decision to remain employed above and beyond the impacts of burnout and compassion satisfaction that may be unique to the caring professions. Future research might investigate factors that influence an individual’s decision to remain employed as a nursing assistant during periods of increased stress and burnout. Additionally, the impact of COVID-19 related stress added to the already high levels of stress and burnout on nursing assistants calls for further attention and research devoted to psychological support of LTC staff during crisis and normal times.

Sleep health mediates the relationship between physical activity and depression symptoms.

PurposeThis study aimed to investigate cross-sectional associations between physical activity, sleep health, and depression symptoms using mediation models.MethodsParticipants (N = 1576, MAge = 39.3 years, 40% female) were recruited online from Amazon’s Mechanical Turk crowd-sourcing service. Physical activity was measured using a single-item self-report measure and depression symptoms were reported using the Hospital Anxiety and Depression Scale. Sleep health was measured using the 6-question RUSATED Sleep Health survey V2.0.ResultsGood sleep health (direct effect: β = − .273, t = − 13.87, p < .0001) and high levels of physical activity (direct effect: β = − .092, t = − 4.73, p < .0001) were both individually associated with fewer depression symptoms. Sleep health significantly mediated 19% of the association between physical activity and depression symptoms (indirect effect: β = − .022, 95% CI [− .036 to − .008]), while physical activity significantly mediated 3% of the relationship between sleep health and depression symptoms (indirect effect: β = − .008, 95% CI [− .014 to − .003]).ConclusionPhysical activity and sleep health act as predictors and mediators of depression symptoms.

Perceptions of Patient Safety Culture and Medication Error Reporting among Early- and Mid-Career Female Nurses in South Korea.

Reporting medication errors is crucial for improving quality of care and patient safety in acute care settings. To date, little is known about how reporting varies between early and mid-career nurses. Thus, this study used a cross-sectional, secondary data analysis design to investigate the differences between early (under the age of 35) and mid-career (ages 35–54) female nurses by examining their perceptions of patient safety culture using the Korean Hospital Survey on Patient Safety Culture (HSPSC) and single-item self-report measure of medication error reporting. A total of 311 hospital nurses (260 early-career and 51 mid-career nurses) completed questionnaires on perceived patient safety culture and medication error reporting. Early-career nurses had lower levels of perception regarding patient safety culture (p = 0.034) compared to mid-career nurses. A multiple logistic regression analysis showed that relatively short clinical experience (<3 years) and a higher level of perceived patient safety culture increased the rate of appropriate medication error reporting among early-career nurses. However, there was no significant association between perception of patient safety culture and medication error reporting among mid-career nurses. Future studies should investigate the role of positive perception of patient safety culture on reporting errors considering multidimensional aspects, and include hospital contextual factors among early-, mid-, and late-career nurses.

Single-Item Self-Report Measures of Team-Sport Athlete Wellbeing and Their Relationship With Training Load: A Systematic Review.

Single-item athlete self-report measures consist of a single question to assess a dimension of wellbeing. These methods are recommended and frequently used for athlete monitoring, yet their uniformity has not been well assessed, and we have a limited understanding of their relationship with measures of training load. To investigate the applications and designs of single-item self-report measures used in monitoring team-sport athletes and present the relationship between these measures and measures of training load. PubMed, Scopus, and SPORTDiscus were searched between inception and March 2019. Articles were included if they concerned adult athletes from field- or court-sport domains, if athlete well-being was measured using a single-item self-report, and if the relationship with a measure of modifiable training load was investigated over at least 7 days. Data related to participant characteristics, self-report measures, training load measures, and statistical analysis and outcomes were extracted by 2 authors (C.D. and C.D.). A total of 21 studies were included in the analysis. A narrative synthesis was conducted. The measures used most frequently were muscle soreness, fatigue, sleep quality, stress, and mood. All measures presented various relationships with metrics of training load from no association to a very large association, and the associations were predominantly trivial to moderate in the studies with the largest numbers of observations. Relationships were largely negative associations. The implications of this review should be considered by users in the application and clinical utility of single-item self-report measures in athlete monitoring. Great emphasis has been placed on examining the relationship between subjective and objective measures of training load. Although the relationship is still unclear, such an association may not be expected or useful. Researchers should consider the measurement properties of single-item self-report measures and seek to establish their relationship with clinically meaningful outcomes. As such, further study is required to inform practitioners on the appropriate objective application of data from single-item self-report measures.

PREVALENCE OF LONELINESS AND ISOLATION AMONG PEOPLE WITH DEMENTIA AND THEIR CARERS

People with dementia and carers may be vulnerable to loneliness and isolation. The IDEAL study includes two loneliness measures: 6 item de Jong Gierveld (DJG) scale (range 0-6) and a single-item self-report measure and the six-item Lubben social network scale (range 0-30). Full data are available for 1533 people with dementia for self-rated loneliness and for 1455 for the DJG scale and 1232 and 1195 carers respectively. For isolation complete data are available for 1489 people with dementia and 1252 carers. The prevalence of severe loneliness for people with dementia were 10% (self-rated) and 5% (DJG score 5+), approximately the population norm, and 15% and 18% respectively for carers. Most people with dementia or carers did not rate themselves as lonely ((79% and 71%) compared with 65% and 39% using the DJG scale. One third, 35%, of people with dementia were at risk of isolation compared with 18% of carers.

HOW LONELY AND ISOLATED ARE OLDER PEOPLE WITH DEMENTIA AND THEIR CARERS: A DYADIC ANALYSIS

Studies of loneliness and isolation have rarely explored is how these experiences are reported within couples or the wider households. The IDEAL study has collected details of loneliness, as measured by the de Jong Gierveld (DJG) scale (range 0-6) and a single-item self-report measure, and isolation, using the six-item Lubben social network scale (range 0-30) from both people with dementia and carers. Loneliness is classified into three groups: not lonely (score 0-2), moderately lonely (3-4) and severely lonely (5+) and isolation into two: not isolated (score of 13+) or isolated (12 or less). Of the 1547 people with dementia and 1283 carers interviewed at baseline we have 1089 dyads who provided complete data on loneliness and 1204 for social isolation. Loneliness ratings are congruent between 43.1% of dyads and for 67.8% for isolation highlighting the subjective evaluative nature of loneliness as compared with more objectively measured isolation.

A Large-Scale Effectiveness Trial of Reiki for Physical and Psychological Health.

Objectives: The main purpose of this study was to measure the effect of a single session of Reiki on physical and psychological health in a large nonclinical sample. Design: The study design was a single arm effectiveness trial with measures at pre-and postintervention. Settings: The study took place at private Reiki practices across the United States. Subjects: Reiki practitioners were recruited from an online mailing list to participate in the study with their Reiki clients. A total of 99 Reiki practitioners met the inclusion criteria and participated in the study. Reiki practitioners were instructed to give a flyer to each of their Reiki clients that contained information about the study and invited the client to complete a survey before and after their Reiki session. Interventions: Trained and certified Reiki Masters conducted the Reiki sessions in person, with each session lasting between 45 and 90 min. Outcome measures: The well-validated 20-item Positive and Negative Affect Schedule was used to assess affect, and brief, single-item self-report measures were used to assess a wide range of physical and psychological variables immediately before (pre) and after (post) the Reiki session. Results: A total of N = 1411 Reiki sessions were conducted and included in the analysis. Statistically significant improvements were observed for all outcome measures, including positive affect, negative affect, pain, drowsiness, tiredness, nausea, appetite, shortness of breath, anxiety, depression, and overall well-being (all p-values <0.001). Conclusions: The results from this large-scale multisite effectiveness trial suggest that a single session of Reiki improves multiple variables related to physical and psychological health.

The Simple Aphasia Stress Scale.

Purpose Clinically accessible and concise measures of acute stress in adults with aphasia are lacking. The current article evaluated some psychometric features of a single-item self-report measure of acute stress in adults with aphasia, the Simple Aphasia Stress Scale. Method Three archival data sets utilizing varying iterations of a stress scale developed for studies of stress in adults with aphasia were included in the present analysis. Results The single-item stress scale had good levels of absolute and relative stability. Scores were generally unaffected by aphasia severity, age, or sex. The scale was strongly correlated with emotional arousal. Conclusion The single-item scale performed reasonably well across different studies and psychometric indicators. A 7-point rather than a 5-point response version of the scale was recommended as a clinically accessible and concise measure of acute stress in adults with aphasia. Future research should examine whether the tendency for adults with aphasia to use a restricted range of lower stress responses was due to underreporting, not perceiving acute stress, or some other factor. The high correlation between stress and arousal in women suggests that there needs to be further investigation of discriminant validity. Future work should also expand the scope of variables to evaluate further evidence of convergent and criterion-related validity.

Self-Perceived Mate Value Is Poorly Predicted by Demographic Variables.

Mate value is a construct that can be measured in various ways, ranging from complex but difficult-to-obtain ratings all the way to single-item self-report measures. Due to low sample sizes in previous studies, little is known about the relationship between mate value and demographic variables. In this article, we tested the Mate Value Scale, a relatively new, short, 4-item self-report measure in two large samples. In the first sample of over 1,000, mostly college-age participants, the scale was found to be reliable and correlated with criterion variables in expected ways. In the second, larger sample, which included over 21,000 participants, we have tested for differences across demographics. Contrary to theoretical expectations and previous findings with smaller samples, the differences were either very small (sexual orientation, age, education) or small (sex, socioeconomic status, relationship status) in terms of their effect size. This suggests that the scale is not measuring "objective" mate value (as understood either in terms of fitness or actual mating decisions by potential partners on the "market"), but a self-perception of it, open to social comparison, relative standards, possibly even biases, raising questions about measuring self-perceived versus objective mate value.

Ready or Not: Examining Self-Reported Readiness for Behavior Change at Intake Assessment for Adults With an Eating Disorder.

We explored whether a single-item self-report measure (i.e., the Readiness Ruler) was an appropriate measure of treatment engagement in adult outpatients with eating disorders. In total, 108 women diagnosed with an eating disorder completed the Readiness Ruler and measures of symptom severity at intake to a hospital-based outpatient treatment program. Treatment engagement was operationalized as attendance to a minimum of one session of a cognitive-behavioral therapy (CBT) treatment group, the number of CBT group sessions attended, and whether the participants dropped out of the CBT group prematurely. Results suggest that the Readiness Ruler was not associated with attending the CBT group. Among the participants who attended the program, the Readiness Ruler was not associated with the number of CBT group sessions attended or CBT group dropout. Higher Readiness Ruler score was associated with more severe symptomatology. In conclusion, the Readiness Ruler may not be a good predictor of CBT group treatment engagement for individuals with eating disorders and may instead be a proxy for symptom severity.

Towards a multiple motives meta-theory for social psychology

An exploratory measure of multiple motives (EMMM) is presented. The EMMM enables researchers to make quick exploratory assessments of a relatively large number of general motives. It includes 14 single-item self-report measures that assess self-control, self-esteem, sensation-seeking, the need for acquisition, the need for affect, the need for cognition, the need for meaning, the need for power, the need for precision, the need for self-consistency, the need for structure, the need for uniqueness, the need to belong, and the need to buffer anxiety about death. Each single-item measure is sourced from previously-established psychometric scales. The EMMM's rationale, development, operationalization, and analysis, and exploratory nature are discussed, and evidence is provided for the divergent and convergent validity of its items.

The measurement of psychological literacy: a first approximation.

Psychological literacy, the ability to apply psychological knowledge to personal, family, occupational, community and societal challenges, is promoted as the primary outcome of an undergraduate education in psychology. As the concept of psychological literacy becomes increasingly adopted as the core business of undergraduate psychology training courses world-wide, there is urgent need for the construct to be accurately measured so that student and institutional level progress can be assessed and monitored. Key to the measurement of psychological literacy is determining the underlying factor-structure of psychological literacy. In this paper we provide a first approximation of the measurement of psychological literacy by identifying and evaluating self-report measures for psychological literacy. Multi-item and single-item self-report measures of each of the proposed nine dimensions of psychological literacy were completed by two samples (N = 218 and N = 381) of undergraduate psychology students at an Australian university. Single and multi-item measures of each dimension were weakly to moderately correlated. Exploratory and confirmatory factor analyses of multi-item measures indicated a higher order three factor solution best represented the construct of psychological literacy. The three factors were reflective processes, generic graduate attributes, and psychology as a helping profession. For the measurement of psychological literacy to progress there is a need to further develop self-report measures and to identify/develop and evaluate objective measures of psychological literacy. Further approximations of the measurement of psychological literacy remain an imperative, given the construct's ties to measuring institutional efficacy in teaching psychology to an undergraduate audience.

Sugar levels relate to aggression in couples without supporting the glucose model of self-control.

Sugar levels relate to aggression in couples without supporting the glucose model of self-control.

Physical activity guidelines: is the message getting through to adults with rheumatic conditions?

This study examines the awareness and self-report knowledge of physical activity (PA) guidelines among adults with rheumatic conditions and evaluates rates of adherence to PA recommendations. Secondary aims include (i) investigating perceived benefits and barriers to exercise and (ii) exploring correlates associated with PA. This cross-sectional study involved adults attending an outpatient rheumatology clinic completing a questionnaire. Closed- and open-ended questions enquired about awareness and knowledge of PA guidelines, and a single-item self-report measure of PA was included. Perceptions of exercise were assessed using the Exercise Benefits and Barriers Scale. Descriptive statistics described participant characteristics and age-adjusted bivariate analyses explored associations between socio-demographic and condition-related factors and PA. A total of 401 adults (134 males, 267 females) completed the questionnaire. Only 17.6% of respondents were aware of national PA guidelines and 17.4% accurately identified the frequency and duration of the recommendations. A quarter of respondents (26.7%) reported adherence to the guidelines, while 30.5% reported no weekly PA. Higher perceived benefits and lower perceived barriers to exercise were positively associated with PA behaviour. A large majority of respondents were not aware of PA guidelines and self-report knowledge of PA recommendations was largely inaccurate. Despite the role of PA in health promotion and in the management of rheumatic conditions, adherence to PA recommendations was low. Level of education, perceived benefits and barriers to exercise, and awareness and self-report knowledge of PA guidelines are associated with PA behaviour.

Evaluation of the Single-Item Self-Rating Adherence Scale for Use in Routine Clinical Care of People Living with HIV

The self-rating scale item (SRSI) is a single-item self-report adherence measure that uses adjectives in a 5-point Likert scale, from "very poor" to "excellent," to describe medication adherence over the past 4 weeks. This study investigated the SRSI in 2,399 HIV-infected patients in routine care at two outpatient primary HIV clinics. Correlations between the SRSI and four commonly used adherence items ranged from 0.37 to 0.64. Correlations of adherence barriers, such as depression and substance use, were comparable across all adherence items. General estimating equations suggested the SRSI is as good as or better than other adherence items (p's <0.001 vs. <0.001-0.99) at predicting adherence-related clinical outcomes, such as HIV viral load and CD4(+) cell count. These results and the SRSI's low patient burden suggest its routine use could be helpful for assessing adherence in clinical care and should be more widespread, particularly where more complex instruments may be impractical.