Design and Validation of an Observational System for Penalty Kick Analysis in Football (OSPAF)

The analysis of penalty kick has played an important role in performance analysis. The study aims are to get formal feedback on the relevance of variables for penalty kick analysis, to design and validate an observational system; and to assess experts' opinion on the optimum video footage in penalty kick analysis. A structured development process was adopted for content validity, reliability and agreement on video usage. All observational variables included in OSPAF showed Aiken's V values above the cut-off (for 5-scale V> 0.64; for 2-scale = V > 0.75; p < 0.05). Cohen's Kappa resulted in mean intra- and inter-rater reliability values of 0.90 and 0.86, respectively. It is recommended to combine at least three different viewing angles (V = 0.90; p = 0.006) with standardization of video quality (V = 0.95; p = 0.006). Changing the viewing angles may influence the observer perception (V = 0.86; p = 0.006). The aerial and pitch-level viewing angle behind the penalty taker and pitch-level viewing angle behind the goalkeeper were indicated as most appropriate for observational analysis (V = 0.97; p = 0.01). The OSPAF met all requirements of instrument validation. It may be recommended as basis of future observational systems on penalty kicks.

A catalogue of PROMs in sports science: Quality assessment of PROM development and validation

Choosing the most adequate PROM for a study is a non-trivial process. The aim of this study was to provide a catalogue with analyses of content and construct validity of PROMs relevant to research in sports science, including all published local translations. The most commonly used PROMs in sports research were selected from a PubMed search "patient reported outcome measures sports", identifying 439 articles and 194 different PROMs. Articles describing development of the 61 selected PROMs were assessed for content validity, and all articles regarding construct validity of each PROM and all published translations (in total 622 articles) were analyzed. A catalogue with assessments of the 61 PROMs was produced. The majority were of inferior validity, with few exceptions. The most common reason for this was that the PROM had not been developed by methods that ensure high content validity. Another major reason for inferior validity was that construct validity had not been secured by adequate statistical methods. In conclusion, this catalogue provides a tool for researchers to facilitate choosing the most valid PROM for studies in sports research. Furthermore, it shows for popular PROMs where further validation is needed, and for fields in musculoskeletal medicine where valid PROMs are lacking. It is suggested that a targeted effort is made to develop valid PROMs for major conditions in musculoskeletal research. The current method is easier to practice compared with assessment after COSMIN guidelines.

Engaging the Voices of Children: A Scoping Review of How Children and Adolescents Are Involved in the Development of Quality-of-Life-Related Measures

OBJECTIVES

Patient-reported outcomes are increasingly recommended to guide patient care, develop and evaluate interventions, and modify health systems. However, not enough is known about whether and how children and adolescents, as "experts" in their own health and quality of life (QoL), are being engaged in the development of instruments. Our goals in this review were (1) to identify all QoL-related instruments that have included children and/or adolescents in the development of questionnaire content, including identification of themes and items; and (2) to report how this was done; and (3) to highlight those that used qualitative methods.

METHODS

MEDLINE and Embase were searched for child- or adolescent-completed QoL-related instruments, supplemented by hand-searching of relevant reviews until 2020. Original development papers were identified and retrieved when possible, from which instrument characteristics and details of qualitative development methods were extracted.

RESULTS

We identified 445 instruments, of which 88 used qualitative methods for content development. Interviews and focus groups were the most common methods. A variety of play techniques were used to engage the child and adolescent participants. The specific criteria for the inclusion of children and adolescents (age, developmental stage, duration, and nonclinical location) varied considerably.

CONCLUSIONS

Researchers frequently involve children and adolescents in qualitative methods when developing QoL-related measures; however, there is little information about the methods used. Better reporting of methodology, improved dissemination of methods guidelines, and research into optimal ways of including children and adolescents in the process of instrument development would be useful.

Validation of the Muscle Tightness Measurement Tool

BACKGROUND AND PURPOSE

For nurses, muscle tightness is an important aspect of patient care, but no bedside tool is available that allows them to measure it. Therefore, a standardized tool that measures muscle tightness is needed. The purpose of this study was to validate a tool to measure muscle tightness.

METHODS

Using Delphi technique and quantitative design, the tool was validated in two phases. The phase 1 included 20 expert clinicians who established content validity with Lawshe's rating. In phase 2, divergent validity was established by administering the tool to one group that had muscle tightness (n = 26) and one group that did not (n = 20).

RESULTS

Findings indicate that the muscle tightness measurement tool has content and divergent validity.

CONCLUSIONS

Further tool refinement with validity and reliability studies are recommended for clinical practice.

Development of the Chinese, Malay and Tamil translations of the Positive Mental Health Instrument: Cross-cultural adaptation, validity and internal consistency

This study describes the development and validation of Chinese, Malay and Tamil translations of the Positive Mental Health Instrument (PMHI) in a general population sample in Singapore. Translations were performed using two independent forward translations followed by expert panel discussions and tested for content, construct and language appropriateness using focus group discussions. The final translated tools were field-tested among 220 residents per language using self-administered questionnaires comprising the translated PMHI and other validity measures. Missing data, floor and ceiling effects, confirmatory factor analysis (CFA), internal consistency, item response theory differential item functioning (IRT-DIF) and criterion validity were assessed. A total of 10 PMHI-Chinese items, 26 PMHI-Malay items and six response categories and six PMHI-Tamil items were modified based on expert panel and focus group discussions. PMHI had low missing data and showed negative but acceptable skewness (<2) and kurtosis (<7) for all translations, except for the PMHI-Malay "spirituality" subscale (skewness: -2.8; kurtosis: 12.5). CFA showed that all three PMHI translations fulfilled the original six-factor-higher-order structure (RMSEA = 0.05, CFI = 0.962, TLI = 0.96). Cronbach's alpha coefficients for total PMHI were 0.958, 0.954, 0.945 and 0.949 in the overall sample and the Chinese, Malay and Tamil translations, respectively. The three translations of the PMHI showed expected and significant positive (r = 0.116 to 0.663) and negative correlations (r = -0.137 to -0.574) with established measures. The findings show that the Chinese, Malay and Tamil translations of the PMHI have high internal consistency and validity in this multi-ethnic population.

Measuring Food Literacy: Progressing the Development of an International Food Literacy Survey Using a Content Validity Study

Background: The term "food literacy" is increasingly used to describe the knowledge, skills and behaviours needed to meet food needs. The aim of this research was to determine content validity for an International Food Literacy Survey. Methods: The literature was searched for existing items to form an item pool to measure the eleven components of food literacy. Expert consensus was investigated through two related online surveys. Round 1 participants were researchers who had been involved in the development of a food literacy measure (n = 18). Round 2 participants were authors of papers who had used the term (n = 85). Level of agreement was determined quantitatively using the Content Validity Index and compared to open ended qualitative comments. Results: Consensus was achieved on 119 items. Components varied in the ease with which existing validated items could be found and the number of items achieving consensus. Items related to food prepared within the home were more likely to achieve consensus. Additional issues included limited shared understanding of the scope of the term, the validity of items varying according to context and a limited health focus. Conclusions: This study provides a valuable basis upon which to progress the development of a measure.

Use of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) in X-Linked Myotubular Myopathy: Content Validity and Psychometric Performance

X-linked myotubular myopathy (XLMTM) is a life-threatening, congenital myopathy characterized by extreme hypotonia, weakness, delayed motor milestones, and respiratory failure, often resulting in pediatric mortality. This study evaluated the content validity and psychometric performance of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders as a measure of neuromuscular functioning in children with X-linked myotubular myopathy. This study was conducted in two phases. Phase I assessed the content validity of the measure for use in an XLMTM pediatric population through: literature review, clinical expert interviews, caregiver interviews, and a modified-Delphi panel among clinicians. Phase II assessed psychometric performance based on the INCEPTUS observational clinical study and the ASPIRO interventional gene therapy study, including tests of reliability (internal consistency, test-retest, and interrater), validity (construct and criterion), and responsiveness based on observational and interventional clinical trial data analyses. Data established construct validity and reliability of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders among XLMTM patients before administration of resamirigene bilparvovec, and sensitivity to study drug administration as evidenced by the significant post-administration response in ASPIRO. Findings support the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders as an appropriate neuromuscular functioning assessment in a pediatric X-linked myotubular myopathy patient population.

A structured review evaluating content validity of the Asthma Control Test, and its consistency with U.S. guidelines and patient expectations for asthma control

OBJECTIVE

To assess whether the content of the Asthma Control Test (ACT) served as a valid measure of asthma control (i.e., content validity) by mapping ACT items to the National Heart, Lung and Blood Institute (NHLBI) guideline asthma control definitions, and to language used by patients to describe their asthma.

DATA SOURCES

PubMed and EMBASE databases were used for a structured literature analysis.

STUDY SELECTIONS

Full-text, English-language articles that reported findings from qualitative studies conducted in adults, focusing on patient descriptors of asthma symptoms, impacts, or severity, were included. Pediatric studies, studies conducted in patients without asthma, and studies that did not contain qualitative data were excluded.

RESULTS

ACT items reflected all domains of asthma impairment described in the NHLBI guidelines, except pulmonary function. Following the literature review, 28 full-text publications were identified that included patient descriptors that could be mapped to ACT items. For example, per ACT Item 1, patients described having trouble at work, school, and completing household chores; and, per ACT Item 2, patients used the phrase "short of breath" to describe asthma-associated symptoms.

CONCLUSION

ACT item content corresponded well with the NHLBI guideline definitions of the impairment domain of asthma control (focused on asthma symptoms and impact), and we identified numerous examples in the literature indicating that ACT concepts and item content mirror the language patients use when discussing asthma symptoms and impact, and their degree of asthma control. This provides further evidence to support content validity of the ACT as a measure of asthma control.

Using the Brief Health Literacy Screen in Chronic Care in French Hospital Settings: Content Validity of Patient and Healthcare Professional Reports

Person-centered care has led healthcare professionals (HCPs) to be more attentive to patients' ability to understand and apply health-related information, especially those with chronic conditions. The concept of health literacy (HL) is essential in understanding patients' needs in routine care, but its measurement is still controversial, and few tools are validated in French. We therefore considered the brief health literacy screen (BHLS) for assessing patient-reported HL in chronic care settings, and also developed an HCP-reported version of the BHLS with the aim of using it as a research instrument to assess HCPs' evaluation of patients' HL levels. We assessed the content validity of the French translation of both the patient-reported and HCP-reported BHLS in chronic care within hospital settings, through cognitive interviews with patients and HCPs. We performed qualitative analysis on interview data using the survey response Tourangeau model. Our results show that the BHLS is easy and quick to administer, but some terms need to be adapted to the French chronic care settings. Health-related information was observed to be mainly communicated orally, hence a useful direction for future literacy measures would be to also address verbal HL.

The Indian Stroke Scale: Development and validation of a scale to measure participation in daily activities among patients with stroke in India

BACKGROUND

Prospects of a participation measure to be valid across cultures are debatable. Existing stroke outcome measures had been shown to have limited validity when used within Indian sociocultural contexts.

AIM

To develop and validate a patient-reported outcome measure of participation in daily activities appropriate for patients with stroke living in an Indian sociocultural context.

METHODS

The scale was developed in two phases: scale development and psychometric testing. Items were derived from a conceptual framework of participation in daily activities of patients who had experienced stroke within an Indian context. The final version of the scale consisted of 25 items. A total of 377 patients diagnosed with stroke were recruited from two tertiary care hospitals and five physiotherapy outpatient rehabilitation centers in India. Psychometric testing of the scale included investigation of internal consistency, unidimensionality, construct validity (known group and convergent validity), and test-retest reliability.

RESULTS

The scale items demonstrated good internal consistency (Cronbach's alpha = .94). Confirmatory factor analysis results showed acceptable goodness of fit. The scale has shown good construct validity and test-retest reliability (intraclass correlation coefficient = 0.80). The scale differentiated patients with low and high disability severity (mean difference = 34, 95% CI = 27 to 39) and moderately associated with physical and instrumental activities of daily living (r = 0.64, p < .001) and social participation domains of stroke impact scale (r = 0.44, p < .001) and Barthel index (r = 0.59, p < .001).

CONCLUSION

The Indian Stroke Scale has shown preliminary evidence of validity to support its use as a patient-reported outcome measure for evaluating poststroke participation in daily activities among patients with stroke in India.

How to develop a condition-specific PROM

Developing new patient-reported outcome measures (PROMs) for application in clinical studies can be necessary if an adequate PROM does not exist. For adequate measurement, it is essential that the PROM has face validity (ie, is perceived to be relevant by clinicians and researchers) and has high content validity (ie, content relevance and content coverage for the targeted patient group). The steps needed to create PROMs that possess face and content validity for a specific condition are described in this paper. Face validity is achieved by item identification and generation through literature review. Content validity is confirmed through repetitive cognitive interviews of patients from the targeted patient group in order to generate a consensus-based pilot-version of the new PROM. This qualitative process ensures that items are appropriately worded, understandable, and minimizes doubts about how items should be answered. A practical example of this process is presented, which shows the development of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a condition-specific PROM for patients with deficiency of the anterior cruciate ligament (ACL).

Content Validation of an Instrument for the Assessment of School Teachers' Levels of Knowledge of Diabetes through Expert Judgment

The objective of this study was to describe the content validation, through expert judgment, of a questionnaire for determining the level of knowledge that school teachers have of diabetes in order to design relevant educational interventions to improve the health of school-aged children. This psychometric study involved 15 experts who assessed each of the items in the instrument. The results revealed that the strength of agreement shown by the questionnaire ranged from substantial to almost perfect in its four dimensions, with the characteristics of “sufficiency” and “relevance” having the highest scores (0.982 and 0.903, respectively) based on the judgments made by the participating experts. Regarding statistical significance, the characteristics “sufficiency”, with p < 0.001, and “relevance”, with p = 0.001, were particularly relevant. The overall degree of understandability for the new version of the instrument was high (91.54%). The psychometric results obtained from validation of the “grado de conocimientos sobre diabetes en docentes del ámbito escolar” (Spanish for “level of knowledge of diabetes in school teachers”)—GCDDaE questionnaire through expert judgment and the pre-test indicate that it is recommended for use as it is both relevant and quick and easy to administer.

Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs

Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence level in patients using subcutaneous injections of bDMARDs utilized the indirect methods adapted from adherence assessment for oral medication. Aim: This study aimed to develop a questionnaire to assess adherence to the self-injectable subcutaneous bDMARDs. Methods: The development of the Subcutaneous bDMARDs Adherence Score (SCADS) involved evaluation of content validity. Literature reviews provide the basis for domain identification and item formation. Four experts evaluated the instrument by using a four-point ordinal scale with a rubric scoring on relevance, importance, and clarity of each item in measuring the overarching construct. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI) were calculated. The factor structure and internal consistency reliability of SCADS were estimated using principal component analysis (PCA) and Cronbach's alpha, respectively. Results: Both S-CVI/UA (universal agreement) and the average item-level content validity index (S-CVI/Ave) (average) for the entire instrument showed excellent criteria with a value of >0.90. Cronbach's alpha coefficient value for SCADS was 0.707 indicating good internal consistency. All items showed corrected item-total correlation coefficients above 0.244. Questionnaire items with a factor loading of 0.30 or above were considered in the final factor solution. The factor analysis resulted in 3-factor solutions, which corresponded to 66.62% of the total variance. Conclusion: The SCADS is a consistent and reliable instrument for evaluating adherence among IA patients using the subcutaneous bDMARDs. It is simple to use, yet comprehensive but still requiring further clinical and international validation.

Transcultural adaptation, content validity and reliability of the instrument 'Picture My Participation' for children and youth with and without intellectual disabilities in mainland China

BACKGROUND

'Picture My Participation' (PMP) is a validated questionnaire for assessing participation in everyday activities by children with disabilities in low and middle income countries, but it is not yet available in simplified Chinese.

AIM

To describe the cross-cultural adaptation of the simplified Chinese version of 'Picture My Participation' (PMP-C; Simplified) and explore its validity and reliability.

METHODS

A cross-sectional study using convenience sampling was conducted using PMP-C (Simplified) with structured interviews supported by pictures for children and youth with and without intellectual disabilities (ID) in mainland China. The validity of the PMP-C (Simplified) was demonstrated by face validity and content validity while the reliability was evaluated for internal consistency and test-retest reliability.

RESULTS

Five items were slightly modified and eight pictures were revised to improve their fit with the culture of mainland China. All the items in PMP-C (Simplified) had excellent content validity, and face validity. The internal consistency, reliability coefficient and test-retest reliability of the subscale attendance for children and youth with and without ID were excellent.

CONCLUSION

Preliminary evidence of the content validity of PMP-C (Simplified) items and reliability of the subscale attendance for use with children and youth in mainland China has been gathered. However, psychometric properties in terms of construct validity for the whole instrument and reliability for the engagement subscale need further exploration.

On the Practical Consequences of Misfit in Mokken Scaling

Mokken scale analysis is a popular method to evaluate the psychometric quality of clinical and personality questionnaires and their individual items. Although many empirical papers report on the extent to which sets of items form Mokken scales, there is less attention for the effect of violations of commonly used rules of thumb. In this study, the authors investigated the practical consequences of retaining or removing items with psychometric properties that do not comply with these rules of thumb. Using simulated data, they concluded that items with low scalability had some influence on the reliability of test scores, person ordering and selection, and criterion-related validity estimates. Removing the misfitting items from the scale had, in general, a small effect on the outcomes. Although important outcome variables were fairly robust against scale violations in some conditions, authors conclude that researchers should not rely exclusively on algorithms allowing automatic selection of items. In particular, content validity must be taken into account to build sensible psychometric instruments.

Content Validity of Parental Stressor Scale: Pediatric Intensive Care Unit (PSS:PICU)

Around 10% to 42% of parents suffer from post-traumatic stress disorder following child's Pediatric Intensive Care Unit (PICU) admission. What is needed is an understanding of factors associated with parental stress at the beginning of the PICU admission to guide strategies to prevent the development of stress-related morbidity. Only one measure exists to assess sources of PICU-related parental stress, the Parental Stressor Scale: Pediatric Intensive Care Unit (PSS:PICU). However, this scale has not been modified in over 30 years. The purpose of this study is to examine the content validity and descriptive statistics of the PSS:PICU, propose initial refinements of the scale based on interviews and quantitative analyses, and identify threats to validity in this measure using a convergent parallel mixed methods design. Three validity threats were identified: construct underrepresentation, construct-irrelevant variance, and item redundancy. Suggested scale refinements were to delete 17, revise 7, retain 15, and add 16 items for future testing.

Assessing the Palliative and End-of-Life Care Education-Practice-Competence Triad in Intensive Care Units: Content Validity, Feasibility, and Reliability of a New Tool

BACKGROUND

To date, a comprehensive, psychometrically robust instrument to assess palliative and end-of-life (PEOL) care education, practice, and perceived competence among intensive care unit (ICU) nurses does not exist.

OBJECTIVE

To examine content validity and reliability of a proposed instrument to assess the PEOL care education-practice- competence triad among ICU nurses.

METHODS

An international modified e-Delphi and a cross-sectional pilot questionnaire survey. The Delphi involved 23 panelists from 11 countries. The pilot study involved 40 staff nurses and 3 nurse managers from 3 adult ICUs in a randomly selected hospital in Egypt. An instrument was developed and judged for content validity by international panelists, and then pretested in a pilot study, where data were collected at 2 time points using self-administered questionnaires, followed by cognitive interviews. Test-retest reliability was examined using intraclass correlation (ICC), standard error of measurement (SEM), and repeatability coefficient (RC).

RESULTS

The panelists confirmed content validity of the proposed instrument, and staff nurses confirmed its comprehensibility. At the level of the instrument's total scores, the lowest ICC was .9 (95% confidence interval: .8-.9); and the highest SEM and RC were 4.8 and 13.3, respectively.

CONCLUSIONS

The PEOL Care Index is a comprehensive, comprehensible, content valid, and reliable instrument to assess the PEOL care education-practice-competence triad among ICU nurses. Construct and criterion validities need to be confirmed in future studies. Applicability of the PEOL Care Index in different settings and cultures needs to be examined.

Preliminary test-retest reliability of the Wheelchair Satisfaction Questionnaire

PURPOSE

Economic realities in lower-and-middle-income countries (LMICs) present an increased need for outcome measures for wheelchair efficacy, as these measures enable optimized use of funds. As the provision level of wheelchairs is low in these areas, and many wheelchairs are inappropriate for their intended users, use of funds based on evidence is especially necessary. The Wheelchair Satisfaction Questionnaire (WSQ) was designed to be a snapshot of a wheelchair user's level of satisfaction with their wheelchair. The WSQ is comprised of 16 visual analogue scale questions. Each question includes an option for a qualitative explanatory comment. The current study examined initial test-retest reliability of the WSQ.

MATERIALS AND METHODS

The WSQ was administered twice to the same set of wheelchair users who were secondary students at a school for students with disabilities. A demonstration was given to the participants to explain how to mark the analogue scale. Participants were instructed to answer each item honestly and without peer input. A one-week time span separated test and retest. Scores for both sessions were entered into SPSS. An interclass coefficient of 0.70 or above indicates acceptable test-retest reliability.

RESULTS

The ages of participants ranged from 13 to 24, with a mean age of 17.86 years. Sixty-five participants completed the questionnaire fully in both test and retest and were included in this study. A high degree of reliability was found between scores from both tests. The interclass coefficient was r(63) = .863, p = .01, indicating statistically significant agreement between test and retest.

CONCLUSION

The results support the WSQ as a reliable measure, confirming the WSQ as a reliable tool for user feedback on wheelchair function. Because the WSQ is designed to provide user feedback with enough granularity to give data on particular aspects of wheelchair structure and function, data can facilitate repair and modifications to wheelchair parts. Studies using the WSQ to assess specific wheelchair types could indicate consistent patterns of user satisfaction and dissatisfaction, revealing relevant design issues. The WSQ is designed to give wheelchair users a voice that can empower user centred modification and design changes to facilitate improved health, opportunity, and social interaction.Implications for RehabilitationResults from the WSQ could enable manufacturers to utilize user feedback to improve the design of wheelchairs for use in LMIC's, and providers could be better-informed in the selection of wheelchair types for specific environments.The WSQ could provide immediate user feedback to inform wheelchair modification and selection to best serve a particular user.The WSQ could be used in clinical settings over time to collect longitudinal data from wheelchair users, which could identify the most commonly perceived reasons for user dissatisfaction in a particular clinical setting.

A Qualitative Study to Assess the Content Validity of the 24-Hour Migraine Quality of Life Questionnaire in Patients with Migraine

Objective

A concept elicitation, cognitive debriefing, and usability study was undertaken to: (1) explore migraine symptoms and day‐to‐day impacts; (2) determine the comprehensiveness and comprehensibility of the previously developed 24‐Hour Migraine Quality of Life Questionnaire electronic patient‐reported outcome (24‐Hr MQoLQ ePRO) items, and the appropriateness and understanding of the recall period, response options, and instructions; and (3) assess the usability on an electronic hand‐held device.

Methods

Eleven United States English‐speaking people with episodic migraine were recruited to participate in one‐on‐one interviews, which followed methods appropriate for concept elicitation, cognitive debriefing, and usability testing. Interviews were audio‐recorded, transcribed, and analyzed following the constant comparative method.

Results

Participants had a mean age of 42 years, and 8 were female. Through spontaneous mention or probing, all concepts of the 24‐Hr MQoLQ ePRO were endorsed by a majority of the participants. Cognitive interviewing confirmed the 24‐Hr MQoLQ ePRO instructions were clear, meaningful, and important to assess as symptoms and day‐to‐day impacts experienced as a result of migraine. Overall impressions of the ePRO device were overwhelmingly favorable, and the ePRO device was preferred to paper and pencil by all participants. Participant responses regarding the level of headache pain that would be acceptable in order to continue to go about daily activities ranged from 3 to 6, on a scale of 0 to 10, with 0 being “no headache” and 10 being “the worst headache.”

Conclusions

The 24‐Hr MQoLQ ePRO is content‐valid and appropriate for inclusion in future acute treatment for migraine studies designed to measure the symptoms and health‐related quality of life of migraine.

Validation of a Sensor-Fitted Simulator for Upper Airway Examination

OBJECTIVE

To validate a simulator for upper airway examination, fitted with sensors, for use as an academic tool for learning how to conduct examination of the upper airway and for evaluation of that learning.

STUDY DESIGN

Validation study.

SETTING

Undergraduate medical education.

SUBJECTS AND METHODS

A group of 18 fifth-year medical students and another of 6 otorhinolaryngology specialists conducted 6 examinations each with the simulator. To investigate concurrent validity, we calculated the correlation between damage scores provided by the simulator and damage assessment by a specialist. To evaluate construct validity, we compared both groups with regard to damage scores, technical procedure, and time spent. To examine content and face validity, we used questionnaires based on a 5-point Likert scale.

RESULTS

For concurrent validity, the correlation between the simulator's damage scores and the specialist's damage assessment was high: Spearman's ρ was 0.828 (P < .001). For construct validity, the group of students differed from the group of specialists in damage scores (P = .027) and in technical procedures (P < .001) but not in time spent. For content validity, all questionnaire statements were scored highly, and both groups had similar average scores. For face validity, the group of specialists considered the simulator to be realistic, and all statements on the questionnaire were rated with at least 4/5.

CONCLUSION

Concurrent, construct, content, and face validity have been demonstrated for a sensor-fitted simulator for upper airway examination, which is therefore accurate enough to be used as an academic tool for learning and evaluation of learning.

Validity and Reliability of the New Basic Functional Assessment Protocol (BFA)

The global evaluation of motion patterns can examine the synchrony of neuromuscular control, range of motion, strength, resistance, balance and coordination needed to complete the movement. Visual assessments are commonly used to detect risk factors. However, it is essential to define standardized field-based tests that can evaluate with accuracy. The aims of the study were to design a protocol to evaluate fundamental motor patterns (FMP), and to analyze the validity and reliability of an instrument created to provide information about the quality of movement in FMP. Five tasks were selected: Overhead Squat (OHS); Hurdle Step (HS); Forward Step Down (FSD); Shoulder Mobility (SM); Active Stretching Leg Raise (ASLR). A list of variables was created for the evaluation of each task. Ten qualified judges assessed the validity of the instrument, while six external observers performed inter-intra reliability. The results show that the instrument is valid according to the experts' opinion; however, the reliability shows values below those established. Thus, the instrument was considered unreliable, so it is recommended to repeat the reliability process by performing more training sessions for the external observers. The present study creates the basic functional assessment (BFA), a new protocol which comprises five tasks and an instrument to evaluate FMP.

How do physiotherapists understand and interpret the "Pain Attitudes and Beliefs Scale"? A cognitive interview study

Background: The Pain Attitudes and Beliefs Scale (PABS) for physiotherapists aims to differentiate between clinicians' biomedical and biopsychosocial treatment orientations regarding nonspecific low back pain (LBP). Objective: To study the content validity of the Norwegian PABS by following international guidelines: exploring its relevance, comprehensibility and comprehensiveness. Methods: Cognitive interviews were performed using the Three-Step Test Interview, consisting of think-aloud techniques, retrospective probing and in-depth interviews. Eleven Norwegian physiotherapists with a diversity of professional backgrounds participated. Results: The participants encountered little difficulty in completing the PABS. All items were deemed relevant and important but five items had ambiguous formulations which can easily be handled. The biomedical subscale appeared to be a comprehensive representation of biomedical treatment orientation. The biopsychosocial subscale was found to lack items concerning cognitive behavioral aspects of LBP management, such as patient education, therapeutic alliance, shared decision making and graded exposure. Conclusions: This study provides empirical evidence that the Norwegian version of the PABS-PT is relevant and comprehensible, provided some minor adjustments. The biopsychosocial subscale, however, lacks comprehensiveness, as it is not able to capture important aspects of contemporary biopsychosocial best practice care. Measurement of biopsychosocial treatment orientation may therefore be incomplete.

Content Validation through Expert Judgement of an Instrument on the Nutritional Knowledge, Beliefs, and Habits of Pregnant Women

The aim of this study was to conduct content validation through expert judgement of an instrument which explores the nutritional knowledge, beliefs, and habits during pregnancy. This is a psychometric study in which 14 experts participated in the evaluation of each of the questionnaire items, which were divided into two blocks according to the characteristics of sufficiency, clarity, coherence, and relevance. Fleiss’ κ statistic was used to measure strength of agreement. A pre-test with 102 participants was conducted to measure the degree of understandability of the instrument. The strength of agreement obtained for each of the dimensions was almost perfect. For each pair of experts, strength of agreement ranged between substantial and almost perfect. Sufficiency was the characteristic of the questionnaire that obtained the highest values in the two blocks, and was also the most statistically significant (p < 0.001). Coherence was the most statistically significant characteristic in the first block (p = 0.030). Clarity was the most statistically significant characteristic in the second block (p = 0.037). The wording of five of the twenty original items was corrected. The new version of the instrument attained a high degree of understandability. The results suggest that the instrument is valid and may therefore be applied.

Functioning in schizophrenia: a Delphi study covering the perspective of physiotherapists

PURPOSE

This qualitative study explores the barriers, personal characteristics/resources, and environmental factors that experienced physiotherapists identify as relevant in the assessment and treatment of persons living with schizophrenia, and whether the identified aspects are represented in the International Classification of Functioning, Disability and Health Core Sets for schizophrenia.

METHODS

A three-round Delphi study with physiotherapists was conducted between April and July 2018. In the first round, participants had to list all the aspects they considered to be relevant when assessing and/or treating individuals with schizophrenia, and they were asked six open-ended questions. Their responses were linked to categories. In the second and third rounds, physiotherapists had to judge whether each category/personal factor was relevant for describing functioning in schizophrenia.

RESULTS

Thirteen of 22 eligible physiotherapists from eight countries responded to the first round, and 10 completed all three rounds. Eighty-two (84.5%) of the 97 categories in the Comprehensive Core Set for schizophrenia and all 25 categories in the Brief Core Set were considered relevant. A total of five categories were additionally identified.

CONCLUSIONS

The barriers, personal characteristics/resources, and environmental factors from the physiotherapists' perspective have been identified. The results largely confirm the content validity of the Core Sets for schizophrenia.Implications for rehabilitationThis study shows which barriers, personal characteristics/resources, and environmental factors in persons with schizophrenia are relevant from physiotherapists' perspective and should be integrated in the rehabilitation process.The content validity of the Comprehensive and Brief Core Sets for schizophrenia is largely supported from the physiotherapists' perspective and therefore could be used in the assessment of functioning in persons with schizophrenia.The Comprehensive and Brief ICF Core Sets for schizophrenia could be used to plan and assess multidisciplinary rehabilitation interventions.

“DLQI Seems to be ‘Action’, and Skindex-29 Seems to be ‘Emotion’”: Qualitative Study of the Perceptions of Patients with Psoriasis or Eczema on Two Common Dermatology-specific Quality of Life Measures

Little is known about which quality of life measure best captures the lived experience of people with a chronic skin condition. The purpose of this study was to explore patients’ views on the Dermatology Life Quality Index (DLQI) and Skindex-29. Participants were adults (n = 28) with a diagnosis of eczema or psoriasis who completed the DLQI and the Skindex-29 before being interviewed about the content and format of these questionnaires. Interviews were analysed using content analysis. Participants were generally satisfied with length and layout of both questionnaires. However, the majority preferred the Skindex-29 for its ease of understanding, use of a longer recall period and incorporation of items on a variety of emotions. Participants reported both questionnaires failing to incorporate important aspects of their lives, for instance impact on professional relationships. Participants voiced limitations in both measures but overall felt Skindex-29 better captured their lived experience.