Assessing the concurrent validity, inter-rater reliability and test-re-test reliability of the Australian Treatment Outcomes Profile (ATOP) in alcohol and opioid treatment populations

BACKGROUND AND AIMS

The Australian Treatment Outcomes Profile (ATOP) is a brief instrument measuring recent substance use, risk profile and general health and wellbeing among clients attending alcohol and other drug (AoD) treatment services. This study evaluates the ATOP for concurrent validity, inter-rater and test-re-test reliability among alcohol and opioid treatment groups.

DESIGN

For concurrent validity and inter-rater reliability, participants completed an ATOP with a clinician and an ATOP plus standardized questionnaires (time-line follow-back, Opiate Treatment Index, Kessler-10, 12-item Short Form Survey, World Health Organization Quality of Life-BREF, Personal Wellbeing Index) with a researcher within 3 days. For test-re-test reliability, participants completed two ATOPs with a researcher within a 3-day interval.

SETTING

Outpatient AoD treatment centres in Australia.

PARTICIPANTS

For testing concurrent validity and inter-rater reliability, 278 participants were recruited by advertisements in waiting-rooms or clinician invitation during 2016 to 2018. A further 94 participants were recruited to examine test-re-test reliability.

MEASUREMENTS

Statistical tests used for concurrent validity and test-re-test reliability were Pearson's and Spearman's rank order correlations for continuous variables, and Cohen's κ for nominal variables. Inter-rater reliability was assessed using Krippendorf's α.

FINDINGS

Most Australian Treatment Outcomes Profile items returned excellent or moderate validity and reliability. For the main substances used-alcohol, cannabis and benzodiazepines-concurrent validity, inter-rater reliability and test-re-test reliability all reached excellent or good agreement (0.72-0.96). Psychological health, physical health and quality of life showed fair to strong agreement with their comparator scales (0.47-0.85).

CONCLUSIONS

The Australian Treatment Outcomes Profile is a validated and reliable instrument for assessing recent substance use and clinical risk, health and welfare among alcohol and opioid clients in alcohol and other drug treatment settings. Its ability to reliably measure complex constructs, such as psychological and physical health, against longer scales makes it suitable for integration into routine clinical care, enabling regular monitoring of patient outcomes and safety parameters.

Psychometric Validation of the EQ-5D-3L in Patients with Nontuberculous Mycobacterial (NTM) Lung Disease Caused by Mycobacterium avium Complex (MAC)

PURPOSE

This analysis evaluated the psychometric properties of the EQ-5D-3L among patients with Mycobacterium avium complex lung disease (MAC-LD).

METHODS

Data from the Phase III CONVERT trial were analyzed. Study measures including the EQ-5D-3L, St. George's Respiratory Questionnaire (SGRQ), the 6-minute walk test (6MWT), and percent predicted forced expiratory volume in 1 second (ppFEV1) were collected at baseline, month 3 (M3), month 4 (M4; only 6MWT), and month 6 (M6). Item characteristics and validity were evaluated at baseline. Test-retest reliability was assessed using intraclass correlation coefficients (ICC) and a weighted kappa statistic among a subgroup of stable patients. Validity was tested by evaluating correlations of the EQ-5D-3L index/visual analogue scale (VAS) scores with SGRQ and 6MWT and comparing mean index/VAS scores across known groups defined using 6MWT and ppFEV1. Responsiveness of the EQ-5D-3L was assessed using 6MWT, SGRQ, ppFEV1, and culture conversion as anchors.

RESULTS

The index score was subject to ceiling effects, with 32.6% of patients reporting perfect health at baseline. ICCs for the index (0.80) and VAS (0.85) scores and weighted kappas for the domains (0.5-0.72) indicated adequate test-retest reliability. Correlations between the index/VAS scores and related domains of the SGRQ and 6MWT were as hypothesized (0.31-0.62), and the mean index/VAS scores were significantly different between the 6MWT and ppFEV1 known groups (p<0.05), supporting the validity of the EQ-5D-3L. No evidence was found supporting the responsiveness of the EQ-5D-3L to changes in any of the anchors.

CONCLUSION

EQ-5D-3L exhibited evidence of validity and reliability but poor responsiveness to clinically meaningful changes in patients with MAC-LD.

Psychometric validation of a pre-existing questionnaire used to measure patient satisfaction following orthodontic treatment in a UK population

Objective:

To determine the psychometric properties of a pre-existing orthodontic satisfaction questionnaire and to assess patient satisfaction of their orthodontic treatment.

Design:

Psychometric assessment of a pre-existing orthodontic satisfaction questionnaire.

Setting:

Two sites at King’s College Hospital NHS Foundation Trust.

Participants:

Individuals aged 12–15 years who had completed fixed orthodontic treatment.

Methods:

An expert panel assessed a pre-existing orthodontic treatment satisfaction questionnaire for validity and readability. As a result, revisions were made to the questionnaire and it was distributed to 103 participants aged 12–15 years, on completion of their fixed orthodontic treatment (T1). Test–retest reliability of the questionnaire was assessed through completion of a second questionnaire by 17 participants, at a two-week interval (T2). The questionnaire was assessed for reliability using item-total correlations (I-TC) and Cronbach’s alpha. Factor analysis allowed exploration of the underlying factor structure of the questionnaire. Test–retest reliability was assessed using Cohen’s kappa coefficient. Multiple regression analysis was used to find out the significant demographic variables that predicts the satisfaction level of treatment.

Results:

Following validity and readability assessment by the expert panel, the questionnaire was revised. Eleven items were removed following item analysis (with I-TC ⩽ 0.3). Factor analysis was deemed uninterpretable. The overall scale demonstrated greater reliability than the underlying sub-scales. Therefore, the sub-scales were removed, resulting in one scale which assessed overall orthodontic satisfaction, comprising 37 items, with a Cronbach alpha of 0.92. The test–retest reliability of the revised 37-item scale was deemed to be poor (kappa coefficient = 0.39). Multiple regression analysis identified ethnicity as a significant predictor of orthodontic treatment satisfaction (P = 0.01).

Conclusion:

This study provides a valid measure to assess orthodontic treatment satisfaction for use in a UK population aged 12–15 years on completion of fixed orthodontic treatment.

Developing and Validating Clinical Questionnaires

Coinciding with the development and revision of conceptual models of psychopathology, there has been a proliferation in the number of self-report clinical questionnaires and studies evaluating their psychometric properties. Unfortunately, many clinical measures are constructed and evaluated using suboptimal methods. This review provides current guidelines for the conceptualization, development, and psychometric validation of clinical questionnaires using latent variable methods. A two-stage exploratory-confirmatory framework is provided. The exploratory stage includes item selection and revision, initial structural evaluation, and preliminary tests of concurrent validity (e.g., convergent and discriminant). The confirmatory stage involves replicating factor structure using a more restrictive model, identifying areas of model strain, conducting additional tests of concurrent and predictive validity, and evaluating measurement invariance. Recommendations are provided for (a) item generation, (b) how to use different types of exploratory and confirmatory factor models to determine structure, and (c) evaluating reliability and validity using a latent variable measurement model approach.

Developing and validating the transition status scale for newly graduated nurses in China

AIM

The present study aimed to develop and examine the psychometric properties of the Transition Status Scale for Newly Graduated Nurses.

METHODS

Three phases were conducted: Phase I involved a qualitative research to explore and establish the potential items pool; Phase II reduced the items using the item analysis with a sample of 73 nurses. Phase III evaluated the psychometric properties of the final scale. Data from 814 valid questionnaires were analysed using exploratory factor analysis and confirmatory factor analysis.

RESULTS

Five factors, including 'Interpersonal integration', 'Profession-related positive emotion', 'Competence for nursing work', and 'Active coping strategies', 'Balance between work and life', accounted for 68.87% of total variance. Cronbach's α was 0.891. Confirmatory factor analysis indicated acceptable model fitness.

CONCLUSIONS

The Transition Status Scale for Newly Graduated Nurses has good psychometric properties. It can be used to measure the transition status conveniently and effectively.

IMPLICATIONS FOR NURSING MANAGEMENT

The assessment result with the Transition Status Scale for Newly Graduated Nurses can provide information about the transition status of new nurses, thereby providing reference to guide the specific nursing interventions to smooth the transition process. It can also work as an alternative instrument to compare the effectiveness of different transition programs.

Validation of the Death and Dying Distress Scale in patients with advanced cancer

BACKGROUND

Distress about dying and death is an important clinical and research outcome in advanced cancer. A 15-item Death and Dying Distress Scale (DADDS) measure has undergone preliminary validation, but full validation in a large sample has not previously been reported. We investigated its psychometric characteristics and responsiveness to a therapeutic intervention.

METHODS

This is a secondary analysis of baseline data obtained from a randomized controlled trial of psychotherapeutic intervention for patients with advanced cancer. Participants (n = 386) completed the DADDS, and measures of depression, anxiety, demoralization, quality of life (including preparation for end of life), spirituality, attachment security, and symptom burden.

RESULTS

A confirmatory factor analysis revealed factors related to "Finitude" and to "Dying." Both factors showed good internal consistency (Cronbach α = 0.861-0.949). DADDS scores were significantly higher in females, those with lower income and not working. Construct validity was demonstrated by a positive correlation between DADDS and demoralization (r = 0.569-0.679), and a negative correlation with preparation for the end of life (r = -0.475 to -0.678). At 6 months, intervention participants with moderate DADDS scores at baseline reported significantly lower DADDS scores on both factors compared to usual care.

CONCLUSIONS

The DADDS is a valid and brief two-factor measure that assesses distress related to the shortness of time and to the process of dying. The total and factor scores have utility in the clinical and research assessment of death-related distress in patients with advanced cancer.

Measuring Perseverance and Passion in Distance Education Students: Psychometric Properties of the Grit Questionnaire and Associations With Academic Performance

With modern technological advances, distance education has become an increasingly important education delivery medium for, for example, the higher education provided by open universities. Among predictive factors of successful learning in distance education, the effects of non-cognitive skills are less explored. Grit, the dispositional tendency to sustain trait-level passion and long-term goals, has raised much research interest and gained importance for predicting academic achievement. The Grit Questionnaire, measuring Perseverance of Effort and Consistency of Interests, has been shown to be a reliable instrument in traditional university student populations. However, the measurement and predictive validity of this questionnaire is still unknown for adult distance education university students who differ from traditional students in various ways (e.g., having a wider range of student ages). Based on a sample of 2,027 students from a distance education university, this study assessed the psychometric properties of the two-factor structure grit measured by the Grit Questionnaire. The findings suggest that the short form of the Grit Questionnaire is a potentially useful assessment tool for measuring the grit construct for distance learning higher education and that the Consistency of Interests factor is especially relevant to consider the improvement of learning performance for distance education in terms of courses credit and exam attempts. The measurement precision of the Perseverance of Effort factor, however, should be improved in future research to provide higher measurement accuracy and broader item coverage.

Translation, Cultural Adaptation and Validation of General Medication Adherence Scale (GMAS) into the Nepalese Language

BACKGROUND

The General Medication Adherence Scale (GMAS) evaluates intentional and unintentional behaviour of patients, disease and medication burden and cost-related burden associated with non-adherence. GMAS was developed and validated among Urdu-speaking patients with chronic diseases. However, validated tool in Nepalese language to measure medication adherence among chronic illness patients currently does not exist.

AIM

To translate, culturally adapt, and validate the English version of GMAS into the Nepalese language to measure medication adherence among chronic illness patients.

METHODS

The study was conducted among patients with chronic diseases in both hospital and community pharmacies of Nepal. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Good Practice Guideline for linguistic translation and cultural adaptation was used to translate and culturally adapt the English version of GMAS into the Nepalese version. The translated version was validated amongst patients with chronic diseases in Nepal. Exploratory factor analysis was carried out using principal component analysis with varimax rotation. Test-retest reliability and internal consistency were analysed.

RESULTS

A total of 220 (53.6% females, and 51.4% of 51 to 70 aged patients) patients with chronic diseases participated in the study. The majority of patients took two medications (27.3%) from six months to five and half years (68.2%). Kaiser Meyer Olkin was found to be 0.83. A principal axis factor analysis was conducted on the 3 items of GMAS without and with orthogonal rotation (varimax). The scree plot showed an inflexion on the third item that meant three components were present. The overall Cronbach's alpha value of the full-phase study was 0.82.

CONCLUSION

The General Medication Adherence Scale was successfully translated into the Nepalese language, culturally adapted, and validated amongst chronic diseases patients of Nepal. Therefore, the GMAS-Nepalese version can be used to evaluate medication adherence among Nepalese-speaking patients with chronic disease.

The Severity of Dependence Scale (SDS) for Codeine: Preliminary Investigation of the Psychometric Properties of the SDS in an Online Sample of Codeine Users From the UK

Objective: Investigate the psychometric properties of the Severity of Dependence Scale (SDS) for codeine and its association with aberrant codeine related behaviors. Design: A voluntary and uncompensated cross-sectional online survey. Setting: Online population (≥18 years). Respondents: Two hundred and eighty-six respondents (66% women) who had used codeine containing medicines in the last 3 months and were living in the UK. Results: Of the respondents (mean age = 35.4 years, SD = 12.5), more than half were employed. Only 3.5% respondents reported no income. The majority of respondents (45.1%) primarily obtained prescription-only codeine from a consultation with a health professional, whilst 40.9% mainly purchased "over-the-counter" codeine containing medicines in a pharmacy without a medical prescription. Principal component analysis indicated a single factor solution accounting for 75% of the variance. Factor loadings ranged from 0.83 to 0.89. Cronbach's Alpha was high (α = 0.92). Several behaviors relating to codeine use were found to significantly predict probable codeine dependence. These included: daily codeine use in the last 3 months (OR = 66.89, 95% CI = 15.8-283.18); tolerance to codeine (OR = 32.14, 95% CI = 13.82-74.75); problems with role responsibility due to intoxication (OR = 9.89, 95% CI = 4.95-19.78); having sought advice on the internet to manage codeine use (OR = 9.56, 95% CI = 4.5-20.31); history of alcohol or drug treatment (OR = 3.73, 95% CI = 1.88-7.43). Conclusions: The SDS was acceptable and feasible to use to assess probable psychological codeine dependence in an online sample of people using codeine containing medicines. SDS scores were associated with behaviors known to be indicators of codeine dependence. Studies are needed in well-defined populations of people who use codeine to test the different aspects of psychometry of the scale compared against "gold standard" criterion [a diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)].

Short Sexual Well-Being Scale - a cross-sectional validation among transgender and cisgender people

BACKGROUND

Sexual well-being is often mistakenly operationalized simply as sexual satisfaction. The concept of sexual well-being has been often used as an umbrella term for positive aspects of sexuality, apart from its negative spheres. A new concept of sexual well-being was proposed in line with the World Health Organization (WHO) definition of sexual health. The definition tried to enrich the concept of sexual well-being, but it did not solve the problem of its operationalization. The aim of this study was to verify the psychometric properties of the new scale measuring the concept of sexual well-being.

PARTICIPANTS AND PROCEDURE

Two separate studies were conducted for the psychometric validation of the Short Sexual Well-Being Scale (SSWBS). This was because the first study on a group of transgender people was characterized by a smaller than recommended sample for confirmatory factor analysis. On this basis, a second study was conducted on a group of cisgender people. The study on a sample of transgender people (N = 111) verified the psychometric properties of the 4-point version of the scale. In the study on the cisgender sample (N = 211), it was decided to verify the psychometric properties of the 7-point version of the scale and verify whether a bigger response scale would have a positive effect on the reliability of the questionnaire.

RESULTS

The confirmatory factor analysis, reliability analysis using alpha and total omega coefficients, and two measures of validity (content and criterion validity) were applied. The results indicated that the SSWBS had good psychometric properties.

CONCLUSIONS

Overall, the presented scale shows good psychometric properties. Both versions of the scale can be used in the quantitative research, but it is recommended to use the 7-point version of the scale. The SSWBS is one of the first questionnaires constructed in accordance with the sexual well-being concept.

The Beliefs About Breastfeeding Questionnaire (BAB-Q): A psychometric validation study

Objectives

Questionnaires used to assess women’s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB‐Q).

Design

A two‐phase evaluation in an online cross‐sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten‐item questionnaire was proposed to assess women’s beliefs about the benefits and efforts of breastfeeding.

Methods

Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences.

Results

EFA found a shortened 8‐item, 2‐factor model had good fit (χ² = 23.3, df = 13, p < .040; CFI = .99, TLI = .99, RMSEA = .05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ² = 49.6 df = 19, p < .010; CFI = .97, TLI = .96, and RMSEA = .078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women’s beliefs significantly predicted the likelihood that women experienced breastfeeding as ‘much more’ positive and negative than they expected.

Conclusions

The eight‐item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB‐Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required.

Impact of Vulvovaginal Symptoms in Women Diagnosed with Cancer: A Psychometric Evaluation of the Day-to-Day Impact of Vaginal Aging Questionnaire

Background: Vulvovaginal symptoms (VVS), such as dyspareunia, dryness, and itching, are common following cancer treatment and can negatively impact sexual well-being, daily activities, mood, self-concept, and overall quality of life. Information about the impact of VVS after cancer treatment is scarce, mainly because of a dearth of validated measures. This study aimed to validate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire, which assesses impact of VVS on women's lives, in a sample of women with cancer. Methods: Women diagnosed with cancer (n = 202) completed a questionnaire package, including the DIVA and measures of VVS, sexual function, and sexual distress. Data were collected as part of study evaluating an educational workshop. Confirmatory factor analysis (CFA) was used to examine whether the factor structure of the DIVA in this population reflected that of the original validation study. Results: CFA showed that the DIVA assesses VVS impact on four domains: activities of daily living, sexual functioning, emotional well-being, and self-concept and body image. All subscales showed excellent internal consistency reliability; however, item analyses indicated that items in the activities of daily living subscale showed very low means. Correlations with sexual function and distress provided evidence that the DIVA assesses impact of VVS. Conclusions: This is the first study aimed at validating the DIVA in women treated for cancer. Results provide evidence of the DIVA's utility in assessing the impact of VVS on four relevant domains. Although issues with certain scale items need to be resolved in future research, the DIVA provides opportunity to understand the impact of VVS after cancer treatment, to address unmet needs of cancer survivors.

Psychometric validation of the survey of autobiographical memory: confirmatory factor analysis and network analysis

Autobiographical memory (AM) represents the ability to remember personal experiences. There are several laboratory or neuropsychological tasks to assess different aspects of memory function. However, there has been little research on self-reported AM ability. The Survey of Autobiographical Memory (SAM) is a self-report questionnaire, developed to assess individual differences in AM. Evidence for the factor structure and network properties of the SAM is still needed. Here, using an integral approach, we validated the SAM using a Multiple Correspondence Analysis (Study 1) as in the original study, a Confirmatory Factor Analysis (Study 2), and a Network Analysis (Study 3) using two large independent samples (total n = 2896). We first replicated the original findings, then confirmed the existence of 4 factors and found that the Episodic and Semantic categories were the most central ones. Finally, we found between "groups" differences for Gender and Anxiety. Overall, three different methods revealed a robust profile of the SAM.

Adaptation and Validation of the Diabetic Foot Ulcer Scale-Short Form in Spanish Subjects

Diabetic foot ulcer (DFU) is a chronic complication that negatively affects the quality of life (QoL) of diabetic patients. In Spain, there is no specifically designed and validated instrument to assess the QoL of patients with DFU. Our aim was to adapt the Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire to a Spanish population and validate it. A prospective, observational design was used. The DFS-SF was administered by personal interview. The validated SF-36 and EQ-5D generic instruments were used as reference tools. The reliability, validity, and sensitivity to changes were assessed using standard statistical methods. A sample of 141 patients with DFU was recruited. The content validity was 3.46 on average (maximum score of 4). The internal consistency of the DFS-SF subscales showed a standardized Cronbach’s α range between 0.720 and 0.948. The DFS-SF domains showed excellent reproducibility measures (intraclass correlation coefficient from 0.77–0.92). The criterion validity was good with significant correlations between each DFS-SF subscale and its corresponding SF-36 and EQ-5D subscales (p < 0.001). However, the questionnaire structure was not validated (comparative fit index = 0.844, root mean square error of approximation = 0.095, and standardized root mean square residual = 0.093). The instrument showed high sensitivity to ulcer changes over time (p < 0.001). The adapted and validated Spanish version of the DFS-SF questionnaire has good psychometric properties and shows good sensitivity to ulcer changes, although the construct validity was not optimal. The adapted questionnaire will be a useful tool specifically to assess the QoL in subjects with diabetic foot ulcers in the clinical and research settings in Spain.

Development of a Short Instrument for Measuring Health-Related Quality of Life in Oncological Patients for Clinical Use: Protocol for an Observational Study

Background

Cancer patients often suffer from the physical and psychological burden of their disease and its treatment. This is frequently insufficiently identified and addressed in clinical practice. In the context of improving patient-centered care in oncological patients, patient-reported outcomes (PROs) represent an important addition to current routine care. So far, available PRO questionnaires for cancer patients are unsuitable for routine procedures due to their length and complexity.

Objective

This study aimed to develop and psychometrically test a short questionnaire to measure health-related quality of life (HrQoL) in cancer patients for use in routine care.

Methods

This observational study consists of two parts: (1) a qualitative study to develop a short questionnaire measuring HrQoL and (2) a quantitative study to psychometrically test this questionnaire in five oncological departments of a comprehensive cancer center. In part 1 of the study, semistructured interviews with 28 cancer patients, as well as five focus groups with 22 clinicians and nurses, were conducted to identify clinically relevant dimensions of HrQoL. The identified dimensions were complemented with related dimensions from empirical studies and reviewed via expert discussion. Based on this, a short instrument was developed. In part 2 of the study, the developed questionnaire was tested in cancer in- and outpatients at five participating oncological clinics using additional standardized questionnaires assessing HrQoL and other important PROs. The questionnaire was presented to more than 770 patients twice during treatment.

Results

The project started in May 2017 with recruitment for study phase I beginning in December 2017. Recruitment for study phases I and II ended in April 2018 and February 2019, respectively. After study phase II and psychometrical analyses, the newly developed questionnaire measuring the HrQoL of all cancer entities in routine care was finalized.

Conclusions

With five to six dimensions and one item per dimension, the developed questionnaire is short enough to not disrupt routine procedures during treatment and is profound enough to inform clinicians about the patient’s HrQoL impairments and status.

Trial Registration

Open Science Framework Registries 10.17605/OSF.IO/Y7XCE; https://osf.io/y7xce/

International Registered Report Identifier (IRRID)

RR1-10.2196/17854

Development and Psychometric Validation of a Screening Questionnaire to Detect Excessive Menstrual Blood Loss That Interferes in Quality of Life: The SAMANTA Questionnaire

Background: Heavy menstrual bleeding (HMB) affects up to 35% of women at some point in their lives, and has an important impact on their quality of life (QoL). Current techniques to assess and quantify menstrual blood loss are inconvenient and the correlation between actual and perceived blood loss is poor. This study aimed to develop and validate a screening questionnaire in Spanish to identify HMB in women of reproductive age. Methods: The study consisted of two phases: the conceptual development of a set of items to discriminate between women with and without HMB and the assessment of the sensitivity and specificity of these items. Correlation of the screening tool with women's perception of the intensity of bleeding and the interference in their daily life activities was also assessed. Results: An initial set of 46 items were identified, from which 21 items were selected following the cognitive interviews. For the psychometric validation phase, 389 patients were enrolled, of whom 364 were assessable: 211 cases with Pictorial Blood loss Assessment Chart-confirmed excessive menstrual loss (EML) and 153 controls. Six items met entry criteria in the model and together yielded a sensitivity of 86.7% and specificity of 89.5% to identify cases and controls. These items were weighted according to their contribution to the final model to yield a tool that can be scored from 0 to 10 being 3 the cutoff point to diagnose EML that interferes in QoL. Conclusions: The 6-item SAMANTA questionnaire represents a valid screening tool to easily identify women with EML that interfere with QoL.

Development and Psychometric Validation of a Questionnaire to Evaluate Knowledge and Attitude Towards Medication Error Reporting Among Pharmacists

Purpose

Assessment of medication errors (ME) is crucial to improving the quality of health care. A questionnaire that can be used to explore pharmacists’ perspectives regarding ME would be very useful as part of an ongoing process of quality improvement in patient care. The aim of this study was to develop and validate a questionnaire to measure perceived causes of ME and attitude towards ME reporting among pharmacists.

Methods

The questionnaire was developed from the literature together with outcomes from focus group discussions. It was divided into two domains which are knowledge on ME and attitude towards ME reporting. Content validity index (I-CVI), exploratory factor analysis (EFA), Cronbach alpha and intraclass correlation coefficient (ICC) to assess test–retest reliability were obtained during the validation process.

Results

Overall Cronbach alpha for internal consistency was good (0.742), where subscale of the questionnaire demonstrated adequate internal consistency, with Cronbach alpha value 0.83 for knowledge and 0.70 for reporting behaviour attitude. The I-CVI showed good scores (knowledge=0.88) and (attitude=0.81), while ICC was moderately accepted with a value of 0.77. Two factors were extracted from the 16 items in EFA.

Conclusion

The questionnaire to assess knowledge on ME and attitude towards ME reporting among pharmacists is valid and reliable. It demonstrates good psychometric properties.

Evaluation of the Krio Language Version of the London Measure of Unplanned Pregnancy in Western Area, Sierra Leone

New ways of measuring pregnancy planning/intention such as the London Measure of Unplanned Pregnancy (LMUP), which recognise the complexity of the construct, are being adopted worldwide. The aim of this study was to evaluate the psychometric properties of the Krio version of the LMUP in Sierra Leone. An interviewer-administered version of the LMUP was translated into Krio and pre-tested with 12 pregnant women. Field testing involved 172 pregnant women aged 15-42, with 87 completing a re-test. Completion rates of LMUP items were 100%. LMUP scores 1-12 were captured. Reliability: the scale was internally consistent (Cronbach's alpha 0.84) and stable (weighted Kappa 0.93). Construct validity: all hypotheses were confirmed. Principal components analysis revealed five items (items 2-6) related to one construct. Mokken scaling procedure selected the same five items. Removal of item 1 (which had 97% endorsement of the ‗no contraception' response option) brought about only a very slight improvement in LMUP performance, therefore we recommend retaining all six items. The Krio LMUP is reliable, valid and suitable to use in Sierra Leone.

Evaluation of the Japanese Version of the Cancer Survivors' Unmet Needs Scale

Objective

This study aimed to evaluate the psychometric properties of the Japanese version of the Cancer Survivors' Unmet Needs (CaSUN-J) scale among cancer survivors in Japan.

Methods

The CaSUN-J was developed using standardized translation methodology. Content validity was evaluated by a group of experts, and a pilot test was conducted with a convenience sample of 10 cancer patients. A total of 183 Japanese cancer survivors completed the CaSUN-J. The internal consistency of the scale was examined with Cronbach's α. Construct validity was analyzed using correlations with the physical effects, quality of life (QoL), and age. To assess the factorial validity of the CaSUN-J, confirmatory factor analysis (CFA) was performed.

Results

The CaSUN-J indicated good readability and high content validity for use as an assessment tool among Japanese cancer survivors. All Cronbach's α coefficients were above the minimum acceptable criterion of ≥0.70. For construct validity, higher physical effect scores, as well as poorer QoL scores and younger patients, were significantly positively associated with higher levels of needs. CFA indicated that the five-factor structure of the CaSUN-J was a good fit to the data.

Conclusions

The CaSUN-J can serve as a valid and reliable tool to evaluate unmet needs among Japanese cancer survivors.

[Not Available]

Objective:

The aim of this study was to validate the French version of the 7-item Auditory Hallucination Rating Scale (AHRS) so as to facilitate fine-grained assessment of auditory hallucinations (AH) in native French-speaking patients with schizophrenia (SZ) in clinical settings and studies.

Method:

Patients (N = 66) were diagnosed with SZ according to the Diagnostic and Statistical Manual of Mental Disorders. The French version of the AHRS was developed using a forward–backward translation procedure. Psychometric properties of the French version of the AHRS were tested including (i) construct validity with a confirmatory one-factor analysis, (ii) internal validity with Pearson correlations and Cronbach α coefficients, and (iii) external validity by correlations with the Scale for Assessment of Positive Symptoms (SAPS-H1), the Positive and Negative Syndrome Scale (PANSS-P3; concurrent), the PANSS-Negative subscale and age of subjects (divergent), and inter-rater intraclass correlation coefficients (ICCs).

Results:

(i) The confirmatory one-factor analysis found a root mean square error of approximation (RMSEA) = 0.00, 90% confidence interval = [0.000 to 0.011], and a comparative fit index = 0.994. (ii) Correlations between AHRS total score and individual items were mostly ≥0.4. Cronbach α coefficient was 0.61. (iii) Correlations with PANSS-P3 and SAPS-H1 were 0.42 and 0.53, respectively. In a subset of participants (N = 16), ICC values were extremely high and significant for AHRS total and individual item scores (ICCs range 0.899 to 0.996)

Conclusion:

The French version of the AHRS is a psychometrically acceptable instrument for the evaluation of AH severity in French-speaking patients with SZ.

Evaluating patient-perceived control of atopic dermatitis: design, validation, and scoring of the Atopic Dermatitis Control Tool (ADCT)

Objectives: The Atopic Dermatitis Control Tool (ADCT) was designed to evaluate patient-perceived AD control and facilitate patient-physician discussion on long-term disease control.Methods: The study was performed in adult patients with AD. Development of the ADCT followed US Food and Drug Administration (FDA) guidelines on patient-reported outcome measures (PROMs). Qualitative research, including targeted literature review, interviews with clinical experts, and combined concept elicitation/cognitive debriefing with patients with AD, was conducted to provide a list of comprehensive concepts capturing AD control per physician and patient perspectives. Quantitative methods assessed psychometric properties of the instrument and defined the threshold for AD control.Results: The resulting pilot six-item ADCT, reflecting key concepts related to AD control, had 7-day recall and assessed symptoms and impacts on patients' everyday lives by severity and/or frequency. The ADCT showed good content validity (well understood by adult patients with AD), and quick completion time (<2 min). Psychometric analysis indicated no floor/ceiling effects for response distributions, particularly strong (r ≥ 0.80) inter-item correlations for the six ADCT items, robust construct validity (r > 0.50), and item-level discriminating ability (p < .03); this supported the derivation of a total score based on responses to all items. ADCT total score showed evidence of strong internal consistency reliability (Cronbach's alpha >0.80). A score ≥7 points was identified as an optimum threshold to identify patients whose AD is "not in control."Conclusions: No single validated instrument has been available to holistically evaluate patient-perceived AD control. The newly developed ADCT displays good-to-excellent content validity, construct validity, internal consistency, reliability, and discriminating ability.

Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3

CONTEXT

Cancer therapy-induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests.

OBJECTIVES

This study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer.

METHODS

The FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy. Study participants were recruited in Hiroshima University Hospital and Kagawa Breast Clinic in Hiroshima, Japan. Patients with breast cancer (N = 236) responded to the resultant assessment and Functional Assessment of Cancer Therapy-General version 4. The internal consistency and concurrent and construct validity of the FACT-Cog were examined.

RESULTS

The Cronbach's alphas of the four FACT-Cog subscales, namely, CogPCI, CogOth, CogPCA, and CogQOL, were 0.95, 0.73, 0.93, and 0.88, respectively. The item-to-domain correlations ranged from 0.211 to 0.920. Most of the FACT-Cog subscales were significantly correlated with other subscale and total scores (r = 0.133-0.425). Structural equation modeling was barely acceptable (χ2 = 1361.8, df = 489, P < 0.001; goodness of fit index = 0.731, adjusted goodness of fit index = 0.691, comparative fit index = 0.848, root-mean-square error of approximation = 0.087).

CONCLUSION

The Japanese version of the FACT-Cog is a valid and reliable self-report measure of the cognitive function of patients with breast cancer. Its utility to clinicians and researchers in measuring the cognitive concerns of patients with cancer in Japan will serve as a further test of its validity.

Pregnancy Planning among Female Sex Workers in Uganda: Evaluation of the Psychometric Properties of the London Measure of Unplanned Pregnancy

The aim of the study was to evaluate the psychometric properties of the London Measure of Unplanned Pregnancy (LMUP) among female sex workers (FSWs) in Uganda. The LMUP was translated into Luganda and adapted for use with FSWs and underwent cognitive testing and two field tests. From the final Luganda LMUP, three other language versions were created (Acholi, Lugisu and Runyakole), and preliminary field test data were collected. Final data were collected from 819 FSWs attending the 'Most at Risk Population Initiative' clinics. The Luganda field testing showed that there were no missing data, the scale was well targeted, Cronbach's alpha was 0.82, weighted Kappa was 0.78, measurement was unidimensional, and all construct validity hypotheses were met. Likewise, with the Acholi, Lugisu, and Runyankole translations, field testing showed that there were no missing data, the scales were well targeted, Cronbach's alpha were<0.70, and measurement was unidimensional. We concluded that the Luganda LMUP is a valid and reliable tool for assessing pregnancy planning among FSWs in Uganda and that the Acholi, Lugisu, and Runyankole versions of the LMUP also had good initial psychometric properties.

Psychometric Evaluation of the Nursing Outcome "Pain: Adverse Psychological Response" in Patients With Chronic Pain

PURPOSE

To culturally adapt into Spanish and validate the outcome "Pain: Adverse psychological response" (code 1306) in patients with chronic pain.

METHODS

A three-stage study was conducted: (a) translation and cultural adaptation, (b) content validation, and (c) clinical validation.

FINDINGS

The Spanish version of the outcome "Pain: Adverse psychological response" has high content validity ( 0.91). Fourteen indicators were organized into two factors. This version offers good reliability in both inter-observer agreement (kappa = 0.72) and internal consistency (alpha = 0.89).

CONCLUSIONS

The Spanish adaptation of "Pain: Adverse psychological response" is a reliable and valid instrument for the measurement of emotional aspects of chronic pain.

IMPLICATIONS FOR NURSING PRACTICE

The Spanish adaptation of this outcome offers nurses a set of structured indicators to measure the adverse emotional impact of chronic pain.

Validation of the French Version of the Integrated Palliative Care Outcome Scale

CONTEXT

The Integrated Palliative care Outcome Scale (IPOS) is a widely used tool for assessing patient needs in palliative care.

OBJECTIVES

The aim of this study was to provide a validated version of the patient and staff IPOS for French-speaking Switzerland (IPOS-Fr) and assess its psychometric properties.

METHODS

The validation took place in 12 palliative care units and mobile teams. At baseline (T1) and three days later (T2), patients' general health status, palliative care needs (IPOS-Fr), and quality of life (McGill Quality of Life Scale-Revised) were assessed by patients and staff.

RESULTS

We included 173 patients (mean age: 68.8; 92 women; 85% oncologic disease). IPOS internal consistency was high for the total score (0.69 and 0.71). Staff-patient interrater agreement was good to moderate for 13 items (intraclass correlations >0.516). Results indicated strong correlations between IPOS-Fr and McGill Quality of Life Scale-Revised for the total score (-0.623 at T1) and the psychological domain (Item 11: -0.601 at T1; Item 13: -0.633 at T2). Regarding sensitivity to change, there was a significant difference between T1 and T2 for patients with an improved health condition (z = -2.326; P = 0.020).

CONCLUSION

IPOS-Fr has fair to good validity, especially with regard to interrater agreement and construct validity, is sensitive to positive change, and has good interpretability and acceptability for patients and staff. IPOS-Fr is not optimal in terms of internal consistency and structure when using subscale scores, except for the emotional subscale.