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Christensen KS, Ammentorp J. Rasch analysis of the self efficacy (SE-12) questionnaire measuring clinical communication skills. PEC INNOVATION 2024; 4:100296. [PMID: 38872980 PMCID: PMC11169456 DOI: 10.1016/j.pecinn.2024.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024]
Abstract
Objective The aim of this study was to examine the construct validity and reliability of the Self Efficacy (SE-12) questionnaire using Rasch analysis. Methods The SE-12 was administered to Danish health care professionals prior to their participation in a communication skills training program. Analysis of fit to the Rasch model, ordering of response categories, dimensionality-testing, test for differential item functioning, test for local dependency, and calculation of reliability were used to evaluate the psychometric characteristics of the SE-12. Results In this study, 1057 respondents were analyzed. Overall, the SE-12 demonstrated an acceptable fit to the Rasch model. Response categories were appropriately ordered for all twelve items. However, items 6 (structure) and item 8 (empathy) demonstrated differential item functioning, with men being more likely to affirm the first and women the last item. Local dependency was observed between five item groups but adjusting for these improved fit indices significantly. The SE-12 exhibited high reliability with PSI ranging from 0.92 to 0.94. A transformation table converting ordinal scores to interval scores is provided. Conclusion The SE-12 demonstrates good construct validity and excellent reliability. Minor issues regarding local dependency and differential functioning require attention.Innovation: A 5-item version could be explored without compromising validity and reliability.
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Affiliation(s)
- Kaj Sparle Christensen
- Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital of Southern, Denmark, Odense
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Xing H, Liu N, Li K, Cui G, Biering-Sørensen F. Translation and validation of the Chinese self-report version of Spinal Cord Independence Measure (SCIM-SR): Rasch psychometric analysis and online application. Comput Struct Biotechnol J 2024; 24:258-263. [PMID: 38623183 PMCID: PMC11016810 DOI: 10.1016/j.csbj.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/17/2024] Open
Abstract
Spinal Cord Independence Measure (SCIM) was an important functional outcome measure specifically designed for spinal cord injury (SCI) patients, with the self-reported version of SCIM (SCIM-SR) published in 2013. This study aims to translate the SCIM-SR into Chinese, and to investigate the validity of Chinese SCIM-SR among SCI patients. This Chinese version of SCIM-SR was translated into Chinese in a standardized approach, and then filled out by a sample of patients with SCI (n = 205) within 3 days after admission. Validity of Chinese SCIM-SR was then analyzed using Rasch analysis and principal component analysis. The subscale Selfcare and subscale Mobility showed good fit to the Rasch model, with no significance found in Chi-square test results for item-trait interaction, using Bonferroni adjustment for the significant level (χ2 =18.125, P = 0.111; χ2 =33.629, P = 0.006). Mean fit residual for items and persons of each subscale were within ± 2.5. The model fit of the subscale of Respiration and Sphincter Management was not satisfactory even after deleting one item and merging two items with local dependence. However, Kaiser-Meyer-Olkin test was > 0.50 in total score and all the subscales of Chinese SCIM-SR, and P < 0.05 in the Bartlett's test. There was no differential item functioning for gender, time post injury, age, and etiology in any of the three subscales. An online version of Chinese SCIM-SR was also developed. It is concluded that the SCIM-SR in Chinese is valid for application in individuals with SCI. SCIM-SR is considered as an important tool for self-reporting functional status from SCI individuals' perspective.
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Affiliation(s)
- Huayi Xing
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Nan Liu
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Guoqing Cui
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Fin Biering-Sørensen
- Department of Clinical Medicine, University of Copenhagen, and Department of Brain- and Spinal Cord Injuries, Copenhagen University Hospital, Bodil Eskesen Center, Rigshospitalet, Copenhagen, Denmark
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Fulton JPJ, Holt JKL, Mills RJ, Young CA. Rasch analysis of the modified Fatigue Severity Scale in neuromuscular disorders and comparison between sex, age and diagnoses. Muscle Nerve 2024; 70:387-394. [PMID: 38953614 DOI: 10.1002/mus.28186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION/AIMS Fatigue is a common and debilitating symptom encountered in the neuromuscular clinic. The 7-item Fatigue Severity Scale (FSS-7) is a Rasch-modified assessment validated in inflammatory neuropathies but not across a typical neuromuscular patient population. The aim of this study was to validate this measure in neuromuscular disorders and to compare between patient sex, age and diagnoses. METHODS The modified FSS-7 was mailed to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis and descriptive statistics were performed on the Rasch converted data. RESULTS The mFSS-7 met the Rasch model expectations with an overall Chi-square probability of 0.4918, a strict unidimensional scale free from differential item functioning (DIF) that satisfied the model with substantial test-retest reliability using Lin's concordance correlation coefficient 0.71 (95% CI 0.63-0.77). A 15.7% ceiling effect was observed in this patient cohort. Post hoc analysis did not show any significant difference in fatigue between sex, age or neuromuscular diagnoses. DISCUSSION The self-completed Rasch mFSS-7 showed acceptable test-retest reliability across patients with varied disorders under follow-up in a specialist neuromuscular clinic. The ceiling effect constrains its use for those with the most severe fatigue. Future considerations could include assessment of the benefits of clinical interventions, particularly multidisciplinary team input or dedicated fatigue clinics.
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Affiliation(s)
- Joshua P J Fulton
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - James K L Holt
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Roger J Mills
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Carolyn A Young
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
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May TA, Koskey KLK, Provinzano K. Developing and Validating the Preschool Nutrition Education Practices Survey. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:545-555. [PMID: 38691080 DOI: 10.1016/j.jneb.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Validate the Preschool Nutrition Education Practices Survey. DESIGN Iterative approach combining design-based research and Standards for Educational and Psychological Testing. SETTING Los Angeles, CA and Philadelphia, PA Early Care and Education (ECE) classrooms. PARTICIPANTS Expert panel members (n = 7); ECE teachers: interviews (n = 8), pilot survey (n = 31), and final survey (n = 136). VARIABLES MEASURED Early care and education nutrition education practices used in the classroom either during class time or mealtime. ANALYSIS Qualitative content analysis was implemented for content, response process, and consequences of testing validity evidence. Rasch rating scale analysis was conducted for the response process and internal structure validity and reliability evidence. RESULTS Qualitative field-testing produced strong content, response process, and consequences of testing validity evidence to inform survey modifications. Quantitative field-testing generated a psychometrically sound, well-targeted 12-item survey on a 4-point frequency scale with excellent item and person reliability (0.97 and 0.93 respectively) and separation (5.36 and 3.77 respectively); good Rasch Principal Components Analysis findings (60.3%); and productive item fit statistics (0.50-1.50 logits). CONCLUSIONS AND IMPLICATIONS Robust validity (content, response process, consequences of testing, internal structure) and reliability evidence were demonstrated for using the Preschool Nutrition Education Practices Survey to assess ECE teachers' use of nutrition education practices. Future research is needed to examine its relationship to other variables, such as nutrition teaching efficacy, and to determine its ability to detect change in ECE nutrition education practices over time and across groups.
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Affiliation(s)
- Toni A May
- School of Education, Drexel University, Philadelphia, PA.
| | | | - Kathleen Provinzano
- Departments of Teaching, Learning, and Educational Leadership and Social Work, College of Community and Public Affairs, The State University of New York - Binghamton University, Binghamton, NY
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Fulton JPJ, Holt JKL, Mills RJ, Young CA. Rasch analysis of the Unidimensional Self-Efficacy Scale in Neuromuscular Disorders and comparison between sex, age, and diagnoses. Muscle Nerve 2024; 70:187-193. [PMID: 38695636 DOI: 10.1002/mus.28104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION/AIMS Self-efficacy reflects a person's perceptions of their capabilities for specific tasks and influences motivation and performance. The Unidimensional Self-Efficacy in Neuromuscular Disorders (USE-NM) was modified from the Multiple Sclerosis (MS) USE-MS scale and administered to patients attending a specialist neuromuscular clinic. The aim was to investigate this measure in neuromuscular disorders and to compare between patient sex, age, and diagnosis. METHODS The USE-NM was posted to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis using RUMM2030 software and descriptive statistics were performed using SPSS version 28. RESULTS One hundred and ninety-eight patients (56.1% male) grouped by age (<50; 50-59; 60-69; and >69 years) and with varied NM disorders returned the USE-NM. It did not meet the Rasch model expectations due to disordered thresholds of items 6 and 8 ("Sometimes I feel inadequate as a person because of my neuromuscular disorder" and "I feel that my social life would be better if I did not have a neuromuscular disorder"). Following item re-scoring, the modified USE-NM satisfied the Rasch model with a unidimensional scale free from differential item functioning and an overall chi-square probability of 0.146 with good reliability and validity. Post hoc nonparametric testing showed no significant difference in fatigue between sex, age, and neuromuscular diagnoses. DISCUSSION The Rasch-modified USE-NM offers a measure of self-efficacy for neuromuscular disorders encountered in a typical specialist clinic. Future considerations could be given to assessing any benefits of multidisciplinary team input, across a specialist neuromuscular service.
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Affiliation(s)
- Joshua P J Fulton
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - James K L Holt
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Roger J Mills
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Carolyn A Young
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
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Baudin C, Grimby-Ekman A, Nilsson T, Wallinius M, Andiné P. Exploratory rasch analysis of a static-99R clinical cohort assessment. PLoS One 2024; 19:e0307216. [PMID: 39024242 PMCID: PMC11257258 DOI: 10.1371/journal.pone.0307216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 07/02/2024] [Indexed: 07/20/2024] Open
Abstract
Modern test theory supplements the more prevalent classic methods for assessing test properties. However, such an assessment of the commonly used sexual recidivism risk assessment instrument, Static-99R, has yet to be attempted. This study evaluated the psychometric properties of said instrument using Rasch analysis. The clinical cohort assessed consisted of individuals with mental disorders convicted of a sexual offense (N = 146). Results showed that the original ten-item Static‑99R did not meet the Rasch model requirements, and revisions of the instrument with seven and nine items each only marginally improved performance. More reliable results could likely have been obtained with a larger, non-clinical sample and a more randomized distribution of missing data. Despite the consistently poor performance of item 3 ("Index non-sexual violence") in all three analyses, reliability was slightly improved by dichotomizing the only two polytomous items in the Static-99R; items 1 ("Age at release from index offense") and 5 ("Prior sexual offenses"). These results may be of interest considering the significant change of splitting the formerly dichotomous item 1 into four different response categories in the revision of Static-99 to Static-99R.
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Affiliation(s)
- Christian Baudin
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Anna Grimby-Ekman
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Nilsson
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Märta Wallinius
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
- Department of Clinical Sciences Lund, Evidence-Based Forensic Psychiatry, Psychiatry, Lund University, Lund, Sweden
| | - Peter Andiné
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
- Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
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Kim DeLuca E, Dalziel K, Wittenberg E, Henderson NC, Prosser LA. Selecting PedsQL items to derive the PedsUtil health state classification system to measure health utilities in children. Health Qual Life Outcomes 2024; 22:53. [PMID: 38987772 PMCID: PMC11238509 DOI: 10.1186/s12955-024-02268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND There is a lack of preference-based health-related quality of life (HRQoL) measures that consistently value health across a full range of child age groups. The PedsQL is a generic HRQoL instrument validated for children 2-18 years, but it is not preference-based. The objective of this study was to derive the PedsUtil health state classification system from the PedsQL as a basis for a preference-based HRQoL measure for children. METHODS A two-step process was used to select PedsQL items to include in the health state classification system: 1) exclude poorly functioning items according to Rasch analysis in each of the previously established seven dimensions of the PedsUtil health state classification system and 2) select a single item to represent each dimension based on Rasch and psychometric analyses, as well as input from child health experts and parents. All secondary analyses were conducted using data from the Longitudinal Study of Australian Children (LSAC). Analyses were stratified by age group (i.e., 2-5 years, 6-13 years, and 14-17 years) to represent the different developmental stages of children and to reflect the study design of the LSAC. Rasch analyses were also performed on five random subsamples for each age group to enhance robustness of results. RESULTS Twelve items were excluded from the PedsUtil health state classification system after the first step of the item selection process. An additional four items were excluded in the second step, resulting in seven items that were selected to represent the seven dimensions of the PedsUtil health state classification system: Physical Functioning ("participating in sports activity or exercise"), Pain ("having hurts or aches"), Fatigue ("low energy level"), Emotional Functioning ("worrying about what will happen to them"), Social Functioning ("other kids not wanting to be their friend"), School Functioning ("keeping up with schoolwork"), and School Absence ("missing school because of not feeling well"). CONCLUSIONS The PedsUtil health state classification system was derived from the PedsQL based on several criteria and was constructed to be applicable to children two years and older. Research is ongoing to elicit preferences for the PedsUtil health state classification system to construct the PedsUtil scoring system.
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Affiliation(s)
- Ellen Kim DeLuca
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
- Department of Health Management and Policy, Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Kim Dalziel
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Eve Wittenberg
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Nicholas C Henderson
- Department of Biostatistics, Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Lisa A Prosser
- Department of Health Management and Policy, Michigan School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Susan B. Meister Child Health Evaluation & Research Center, Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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Simonsen NV, Klassen AF, Rae C, Mundy LR, Poulsen L, Pusic AL, Fan KL, Sørensen JA. The WOUND-Q Function and Symptoms Scales for Chronic Lower Extremity Wounds: A Validation Study. Adv Wound Care (New Rochelle) 2024. [PMID: 38775456 DOI: 10.1089/wound.2024.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Objective: Determine the validity and reliability of the LIMB-Q scales, Function, and Symptoms in patients with chronic lower extremity wounds. Approach: Cognitive debriefing interviews with people with current or previous wounds were conducted to examine content validity. Scales were field-tested in an international sample of people with chronic lower extremity wounds sourced from an online platform (i.e., Prolific). Psychometric properties were examined using the Rasch Measurement Theory analysis. A test-retest reproducibility study was performed, and construct validity was examined. Results: Content validity was established after 10 cognitive interviews. A total of 233 people with lower extremity wounds (age 19-80 years, mean 39.3) participated in the field test. All 25 items tested demonstrated good fit to the Rasch model with ordered thresholds. One item had a fit residual outside ±2.5, but no items had significant χ2 values after Bonferroni adjustment. Reliability was high with the person separation index, Cronbach alpha, and intraclass correlation coefficient values >0.8. Strong correlations were found between the Function and Symptoms scales and EQ-5D dimensions measuring similar constructs as well as the EQ-5D global score. All hypotheses for construct validity were confirmed. Innovation: Patient-reported outcome measures are an important component of patient-centered care, as they capture the patient's perspective in a rigorous and reproducible way. Adding these two scales to the WOUND-Q provides a means to measure function and symptoms associated with lower extremity wounds. Conclusion: These new WOUND-Q scales can be used to measure outcomes important to patients with lower extremity wounds in clinical settings and research studies.
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Affiliation(s)
- Nina Vestergaard Simonsen
- Research Unit for Plastic Surgery, Department of Plastic Surgery, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lily R Mundy
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital, University of Southern Denmark, Denmark
| | - Andrea L Pusic
- Department of Surgery and Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Maryland, USA
| | - Kenneth L Fan
- Department of Plastic and Reconstructive Surgery, MedStar, MedStar Plastic and Reconstructive Surgery, Washington, USA
| | - Jens Ahm Sørensen
- Research Unit for Plastic Surgery, Department of Plastic Surgery, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Wijntjes J, Saris C, Doorduin J, van Alfen N, van Engelen B, Mul K. Improving Heckmatt muscle ultrasound grading scale through Rasch analysis. Neuromuscul Disord 2024; 42:14-21. [PMID: 39059056 DOI: 10.1016/j.nmd.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
The 4-point Heckmatt grading scale can easily be used to analyze muscle ultrasound images. The scale is used in an expanding set of muscles and neuromuscular disorders. This prompted the need for evaluation of the measurement properties of the scale in its current form. In this retrospective observational study we included muscle ultrasound images from patients who were undergoing an ultrasound exam for either clinical or research purposes. The primary outcome of this study was to investigate and improve the measurement properties of the Heckmatt scale using Rasch analysis. We investigated whether observers consistently used the 4 response categories. Data was available of 30.967 muscle ultrasound images from 1783 patients and 43 different individual muscles. In 8 of the 43 muscles, observers had difficulty to discriminate between the response categories, especially in bulbar muscles. After rescoring to a 3-point scale, the response categories were consistently used in all 43 muscles. In conclusion, a 3-point Heckmatt grading scale leads to improved accurate scoring compared to the original 4-point Heckmatt grading scale. Using the 3-point Heckmatt grading scale will not only simplify the use of the scale but also enhance its application in clinical practice and research purposes.
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Affiliation(s)
- Juerd Wijntjes
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands.
| | - Christiaan Saris
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands
| | - Jonne Doorduin
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands
| | - Nens van Alfen
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands
| | - Baziel van Engelen
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands
| | - Karlien Mul
- Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands
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Christensen KB, Packness A, Simonsen E, Brodersen J. Psychometric validation of the Danish version of the Major Depression Inventory using data from the Lolland-Falster health study (LOFUS). Nord J Psychiatry 2024; 78:392-401. [PMID: 38546419 DOI: 10.1080/08039488.2024.2333445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/08/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE The Major Depression Inventory (MDI) is a widely used self-rating depression scale commonly in primary care in Denmark. It has not been subject to robust psychometric validation in a general population setting. The aim of this study was to evaluate the psychometric measurement properties of the MDI when applied in the general population. METHODS We evaluated statistical psychometric validity using modern test theory (confirmatory factor analysis, item response theory models and Rasch measurement theory) testing local independence and differential item function across groups defined by gender, age, education, and chronic disease status. Separate analyses across different strata and across different statistical models were employed. RESULTS Regarding structural validity we consistently identified local dependence for the item two pairs (MDI2,MDI3) and (MDI4,MDI5) across strata. This result was confirmed by bifactor CFA models and item screening. We further identified substantial differential item functioning with respect to age group and with respect to chronic disease. We identified quantified the magnitude of this lack of measurement invariance. CONCLUSION The MDI is psychometrically valid in homogenous sub populations, but the disclosed evidence of local dependence means that published estimates of its reliability cannot be trusted. The lack of measurement invariance means that the instrument cannot be used to compare individuals or groups unless they are similar in terms of age group and chronic disease status.
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Affiliation(s)
- Karl Bang Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen K, Copenhagen, Denmark
| | - Aake Packness
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - John Brodersen
- Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Copenhagen, Denmark
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11
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Wijk I, Amsberg S, Johansson UB, Toft E, Hagquist C, Anderbro T. Psychometric Evaluation of the Swedish Acceptance and Action Diabetes Questionnaire: A Rasch Analysis. J Nurs Meas 2024; 32:227-240. [PMID: 37553160 DOI: 10.1891/jnm-2022-0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Background and Purpose: The Acceptance and Action Diabetes Questionnaire (AADQ) is a tool for assessing the acceptance of thoughts and emotions related to diabetes in people living with the disease. This study aimed to examine the psychometric properties of the Swedish version of AADQ (Swe-AADQ) in a sample of adults with type 1 diabetes. Methods: To examine the psychometric properties of the Swe-AADQ, the Rasch model was used. Data for 120 individuals were included. Results: The Swe-AADQ showed an acceptable fit to the Rasch model. A sufficiently high value of the separation index indicated a capacity to distinguish between different levels of acceptance in the sample. The 7-point Likert scale was reduced to three categories suggesting an improvement in the ordering of the item thresholds. Conclusions: The Swe-AADQ possesses reasonable quality in terms of reliability and validity. However, there are some deficiencies regarding the categorization of the response rating that should be addressed.
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Affiliation(s)
- Ingrid Wijk
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Susanne Amsberg
- Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Eva Toft
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine, Karolinska Institutet, Ersta Hospital, Stockholm, Sweden
| | - Curt Hagquist
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
| | - Therese Anderbro
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Rand S, Towers AM, Allan S, Webster L, Palmer S, Carroll R, Gordon A, Akdur G, Goodman C. Exploratory factor analysis and Rasch analysis to assess the structural validity of the Adult Social Care Outcomes Toolkit Proxy version (ASCOT-Proxy) completed by care home staff. Qual Life Res 2024; 33:1555-1567. [PMID: 38507142 PMCID: PMC11116179 DOI: 10.1007/s11136-024-03631-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Rasch analysis and exploratory factor analysis (EFA) were used to evaluate the structural validity of the ASCOT-Proxy measures completed by staff on behalf of older adults resident in care homes, by comparison to the ASCOT-SCT4, the measure of social care-related quality of life (SCRQoL) from which the ASCOT-Proxy was developed. METHODS EFA was conducted on the ASCOT-SCT4 and the two ASCOT-Proxy measures (Proxy-Proxy, Proxy-Resident), to determine if they retained the single factor of the original ASCOT-SCT4 measure found in samples of older community-dwelling adults. Rasch analysis was also applied to measures with a single factor structure in the EFA. RESULTS ASCOT-Proxy-Resident had a single factor structure, as did the original ASCOT-SCT4 (also, found in this analysis when completed by care home staff). The ASCOT-Proxy-Proxy had a two factor structure. Rasch analysis of ASCOT-Proxy-Resident and ASCOT-SCT4 had an acceptable model fit, internal consistency and met the assumptions of unidimensionality and local independence. There was evidence of less than optimal distinguishability at some thresholds between responses, and low frequency of rating of the 'high level needs'. CONCLUSION The ASCOT-Proxy-Resident is a valid instrument of SCRQoL for older adults resident in care homes, completed by staff proxies. Due to the two-factor structure, which differs from the original ASCOT-SCT4, we do not recommend the use of the ASCOT-Proxy-Proxy measure, although collecting data as part of the ASCOT-Proxy questionnaire may support its feasibility and acceptability. Further qualitative study of how care home staff complete and perceive the ASCOT-Proxy is encouraged for future studies.
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Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Canterbury, UK.
| | - Ann-Marie Towers
- Centre for Health Services Studies (CHSS), University of Kent, Canterbury, UK
| | - Stephen Allan
- Personal Social Services Research Unit (PSSRU), University of Kent, Canterbury, UK
| | - Lucy Webster
- Centre for Health Services Studies (CHSS), University of Kent, Canterbury, UK
| | - Sinead Palmer
- Personal Social Services Research Unit (PSSRU), University of Kent, Canterbury, UK
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Fang YY, Ackerman IN, Page R, Harris IA, Cashman K, Lorimer M, Heath E, Soh SE. Measurement Properties of the Oxford Shoulder Score and Minimal Clinically Important Changes After Primary Total Shoulder Replacement Surgery. Arthritis Care Res (Hoboken) 2024; 76:895-903. [PMID: 38258339 DOI: 10.1002/acr.25304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/19/2023] [Accepted: 01/18/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE We evaluated the measurement properties of the Oxford Shoulder Score (OSS) and estimated the minimal clinically important change (MCIC) in patients undergoing primary total shoulder replacement in Australia. METHODS Deidentified data from the Australian Orthopaedic Association National Joint Replacement Registry were used for this analysis. Pre- and 6-month postoperative OSS scores were used, with the 5-level EuroQoL quality of life instrument and shoulder pain scores used as comparators. Floor and ceiling effects, internal consistency reliability, construct validity, and responsiveness to change were evaluated using standard psychometric methods. Mean change and predictive modeling approaches (with and without adjustment for the proportion of improved patients) were used to calculate MCIC thresholds, with patient-perceived improvement after surgery as the anchor. RESULTS Preoperative OSS data were available for 1,117 patients (59% female; 90% aged ≥60 years) undergoing primary total shoulder replacement. No floor or ceiling effects were observed pre- or postoperatively. The OSS showed high internal consistency reliability (Cronbach alpha >0.89), good construct validity, and high responsiveness to change (effect size 1.88). The MCIC derived from the mean change method was 6.50 points (95% confidence interval [95% CI] 4.41-8.61). The predictive modeling approach produced an MCIC estimate of 8.42 points (95% CI 5.68-12.23) after adjustment. CONCLUSION The OSS has good measurement properties to capture pain and function outcomes after shoulder replacement procedures and is highly responsive to change. Based on robust methods, an increase in OSS scores of at least eight points can be considered as meaningful improvement after surgery from the patient's perspective.
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Affiliation(s)
- Yi Ying Fang
- Monash University, Melbourne, Victoria, Australia
| | | | - Richard Page
- St John of God Hospital and Deakin University, Geelong, Victoria, Australia, and Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - Ian A Harris
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Kara Cashman
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Michelle Lorimer
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Emma Heath
- Monash University, Melbourne, Victoria, Australia, and South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sze-Ee Soh
- Monash University, Melbourne, Victoria, Australia
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Bennett RJ, Larsson J, Gotowiec S, Ferguson M. Refinement and Validation of the Empowerment Audiology Questionnaire: Rasch Analysis and Traditional Psychometric Evaluation. Ear Hear 2024; 45:583-599. [PMID: 38082487 PMCID: PMC11008442 DOI: 10.1097/aud.0000000000001449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/22/2023] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Empowerment is the process through which individuals with hearing-related challenges acquire and use knowledge, skills and strategies, and increase self-efficacy, participation, and control of their hearing health care, hearing solutions, and everyday lives. The aim was to refine and validate the Empowerment Audiology Questionnaire (EmpAQ), a hearing-specific measure of empowerment. This was achieved through (1) refinement via Rasch analysis (study 1), and (2) traditional psychometric analysis of the final survey structure (study 2). DESIGN In study 1, 307 adult hearing aid owners completed the initial empowerment measure (33 items) online. To inform an intended item reduction, Rasch analysis was used to assess a range of psychometric properties for individual items. The psychometric properties included analysis of individual items (e.g., response dependency, fit to the polytomous Rasch model, threshold ordering) and the whole EmpAQ (e.g., dimensionality). Item reduction resulted in a 15-item version (EmpAQ-15) and a short-form 5-item version (EmpAQ-5), validated using modern (Rasch), and traditional (Classical Test Theory) psychometric analysis (study 2). In study 2, 178 adult hearing aid owners completed the EmpAQ-15 and EmpAQ-5, alongside 5 questionnaires to measure related constructs. These included two hearing-specific questionnaires (Social Participation Restrictions Questionnaire and Self-Assessment of Communication), two general health-related questionnaires (Patient Activation Measure and World Health Organization Disability Assessment Schedule 2.0), and a general empowerment questionnaire (Health Care Empowerment Questionnaire). Modern (Rasch) and traditional psychometric analysis techniques (internal consistency, construct validity, and criterion validity) were used to assess the psychometric properties of the EmpAQ-15 and EmpAQ-5. RESULTS Rasch analysis of the initial 33-item measure of empowerment identified 18 items with high response dependency, poor fit to the Rasch model, and threshold disordering, which were removed, resulting in a long-form (EmpAQ-15) hearing-specific measure of empowerment. A short-form (EmpAQ-5) version was developed for use in the clinic setting. Validation of the two EmpAQ measures using Rasch analysis showed good item fit to the Rasch model, appropriate threshold targeting, and the existence of unidimensionality. Traditional psychometric evaluation showed that both questionnaires had high internal consistency and positive correlations with the hearing-specific questionnaires. However, in contrast with our hypotheses, correlations with general health questionnaires were stronger than with hearing-specific questionnaires; all questionnaires were correlated with the EmpAQ and in the direction hypothesized. Taken together, these findings support the construct validity of the EmpAQ-15 and EmpAQ-5. CONCLUSIONS The EmpAQ-15 and EmpAQ-5 are the first self-report measures to be developed specifically for the measurement of empowerment. The EmpAQ-15 and EmpAQ-5 were found to meet the Rasch model criteria for interval-level measurements. Traditional psychometric evaluation supports the construct validity of both measures. The EmpAQ measures have the potential to be used in both research and clinical practice to evaluate empowerment along the hearing journey. The next stage of this research will be to further validate these measures by assessing their responsiveness, minimal clinically important difference, and clinical interpretability in a clinical population.
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Affiliation(s)
- Rebecca J. Bennett
- Brain and Hearing, Ear Science Institute Australia, Perth, Australia
- Curtin enAble Institute, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
- National Acoustic Laboratories, Sydney, Australia
| | | | | | - Melanie Ferguson
- Curtin enAble Institute, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Allied Health, Curtin University, Perth, Australia
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Katori S, Himuro N, Kitai Y, Tanabe R, Ohnishi H. Cross-cultural adaptation, validity and reliability of the Japanese version of ABILHAND-kids for children with cerebral palsy using Rasch measurement model. Disabil Rehabil 2024:1-9. [PMID: 38591266 DOI: 10.1080/09638288.2024.2338201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE The aim of this study was to develop the Japanese version of the ABILHAND-Kids and to examine its psychometric properties for Japanese children with cerebral palsy (CP). METHODS The experimental version of 75 items was developed using forward-backward translation method. Parents of 137 children with CP answered it. Their responses were analyzed to successive items, and psychometric properties of the final version were investigated through the Rasch measurement model. RESULTS The Japanese version of the ABILHAND-Kids contained 22 items. It showed valid item-patient targeting, no significant floor and ceiling effects, and no differential item functioning for demographic and clinical subgroups. All items contributed to the definition of one-dimensional measure. For internal consistency, the person separation index was 0.94. For test-retest reliability, the intraclass correlation coefficients were 0.96 (95% CI: 0.92-0.98). The minimal detectable difference was calculated with a logit score of 0.79 and a total raw score of 4.50. The logit score showed a strong correlation with the Manual Ability Classification System level (ρ= -0.70) and the Gross Motor Function Classification System level (ρ= -0.62). CONCLUSIONS The Japanese version of the ABILHAND-Kids was found to be valid and reliable. It appears to be a good tool for assessing manual abilities in daily activities in children with CP.
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Affiliation(s)
- Sayaka Katori
- Department of Pediatric Rehabilitation, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yukihiro Kitai
- Department of Pediatric Neurology, Bobath Memorial Hospital, Osaka, Japan
| | - Ryo Tanabe
- Department of Pediatric Neurology, Chiba Rehabilitation Center, Chiba, Japan
| | - Hirofumi Ohnishi
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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16
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Tosun AT, Isiklar C, Yildirim M, Coskunsu DK. e-Health Literacy Status of Individuals with Multiple Sclerosis in Turkey. Telemed J E Health 2024; 30:e1166-e1171. [PMID: 37851986 DOI: 10.1089/tmj.2023.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: This research aims to compare e-health literacy of technology users and nonusers in people with multiple sclerosis (MS) and to investigate whether there are correlations between age, duration of MS, gender, marital status, and e-health total scores. Methods: This descriptive study was carried out with a web-based questionnaire. The questionnaire was sent to 300 patients with MS who were registered at Istanbul University-Cerrahpasa Medical Faculty Neurology Department. Results: A total of 156 people (mean age: 35.33 ± 10.47 years) participated in the survey. Smartphone 98.1% (n = 153) was the mostly used device. Rate of using Google and recommended websites about MS was 94.25% (n = 145) and 73.9% (n = 113), respectively. e-Health literacy of both the tablet and recommended websites users significantly differed from that of nonusers (p = 0.007 for both). Participants' e-health literacy total score was found to weakly, but significantly, correlate with their age, marital status, and education level (rho: -0.161, p = 0.044; rho: 0.172, p = 0.032; rho: -0.192, p = 0.016, respectively). Conclusions: With developments in digital technologies, it is important to identify the access status of people with MS to improve daily clinical management and implement further motor and cognitive rehabilitation. Therefore, determining the health literacy of individuals with MS and providing education on this subject will reduce the information pollution.
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Affiliation(s)
- Anıl Tekeoglu Tosun
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
| | - Cagdas Isiklar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Yildirim
- Department of Psychology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Dilber Karagozoglu Coskunsu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Fenerbahce University, Istanbul, Turkey
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Al Zoubi FM, Bussières A, Chan HW, Leung KY, Ng YY, Lau KC, Ngai SPC, Tsang SMH, Wong AYL, Thomas A. Refining and adapting the measurement properties of evidence-based practice measures for physiotherapy students. PLoS One 2024; 19:e0298611. [PMID: 38451977 PMCID: PMC10919638 DOI: 10.1371/journal.pone.0298611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE There is a lack of reliable and valid evidence-based practice (EBP) measures for physiotherapy students. This study validated EBP-student (EBP-S) measures for physiotherapy students. METHODS EBP measures developed from previous research were cross-culturally validated for use by physiotherapy students. The adapted EBP-S consisted of six measures: use of EBP, EBP activities, EBP knowledge, self-efficacy for EBP, attitudes towards EBP, and perceptions of the teaching and assessment of EBP in the curriculum. The final version was completed by physiotherapy students (n = 335). The psychometric properties for each EBP-S measure were estimated, including construct validity using Rasch model, internal consistency reliability using person separation index (PSI), test-retest reliability using intraclass correlation coefficient (ICC), and differential item functioning (DIF). RESULTS Two formative measures (use of EBP and EBP activities) were only linguistically modified for use with students. A Rasch model was applied to the other four reflective measures. For knowledge, 55% (6/11) items fit the Rasch model with chi-square fit statistic (χ2) = 34.46, p = 0.08; PSI = 0.85. For self-efficacy, 89% (8/9) items fit the Rasch model with χ2 = 25.11, p = 0.80; PSI = 0.89. For attitudes, 62% (8/13) items fit the Rasch model with χ2 = 61.49, p = 0.00; PSI = 0.71. For perception of the teaching and assessment of EBP in the curriculum, 62% (8/13) items fit the Rasch model with χ2 = 80.99, p = 0.45; PSI = 0.92. perception of the teaching and assessment of EBP in the curriculum showed DIF in three items. The ICCs ranged between 0.80 and 0.98. CONCLUSIONS The EBP-S measures were validated for physiotherapy students, including the testing of psychometric properties, which were not tested in the original studies. Further refinements should be considered for the use of the EBP-S with other groups of students or if changes are applied to the current curriculum.
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Affiliation(s)
- Fadi M. Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - André Bussières
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Hoi Wai Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Kit Yat Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Yui Yin Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Ka Chun Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Shirley P. C. Ngai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Sharon M. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Arnold Y. L. Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Aliki Thomas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
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Abberger B, Kieselbach K. Rasch analysis of the Depression, Anxiety, and Stress Scale in patients with chronic pain. J Psychosom Res 2024; 178:111597. [PMID: 38277894 DOI: 10.1016/j.jpsychores.2024.111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Questionnaires are commonly used to assess and screen pain-related, psychological symptoms in patients with chronic pain. In Germany, the "German pain questionnaire" provided by the German Pain Society used for this purpose includes the Depression, Anxiety, and Stress Scale (DASS). This study aims to analyze the DASS by fitting its data to the Rasch model to test the psychometric quality. STUDY DESIGN AND SETTING In this cross-sectional study, 932 patients with chronic pain answered the DASS. The 21-item short version was tested via Rasch analysis using the parameters threshold order, fit to the model, Differential Item Functioning, unidimensionality and reliability. RESULTS The Rasch analysis results showed a low reliability, misfitting items, Differential Item Functioning or multidimensionality. It was necessary to remove items from the subscales to improve fit to the Rasch model. A revised depression subscale of the DASS-21 was the only scale that achieved all the required psychometric parameters. The summation of all items to a total scale was not supported. CONCLUSION More research is required on somatic free measurement of psychological symptoms in patients with chronic pain. The results demonstrate that the development of a new instrument or a revision of existing instruments for screening of psychological symptoms in chronic pain are needed.
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Affiliation(s)
- Birgit Abberger
- Interdisciplinary Pain Center, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
| | - Kristin Kieselbach
- Interdisciplinary Pain Center, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
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Nielsen CM, Lauridsen HH, Østergaard SD, Kølbæk P. Structural validity of the 5-item World Health Organization Well-being Index (WHO-5) in patients with schizophrenia spectrum disorders. J Psychiatr Res 2024; 170:387-393. [PMID: 38215649 DOI: 10.1016/j.jpsychires.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND When monitoring the severity and impact of schizophrenia spectrum disorders, a measure of subjective well-being should ideally accompany measures of symptom severity and medication side effects. The self-reported 5-item World Health Organization Well-being Index (WHO-5) is a brief, generic, and widely used measure of subjective well-being. However, the structural validity of the WHO-5, namely, whether the individual item scores can be combined to produce a meaningful total score, has not been examined among patients with schizophrenia spectrum disorders. METHOD Utilizing data from 399 Danish patients with schizophrenia spectrum disorders attending the Psychiatric Services of the Central Denmark Region, we employed Rasch analysis to examine the structural validity (i.e., unidimensionality, overall fit to the Rasch model, and differential item functioning) of the WHO-5. RESULTS The WHO-5 was found to be unidimensional with no differential item functioning for age, sex, or inpatient/outpatient status. However, in the initial analysis, some misfit to the Rasch model, partially caused by the disordering of response categories, was evident. In adjusted analyses in which the item response categories 2 (Less than half of the time) and 3 (More than half of the time) were merged, overall fit to the model was improved. CONCLUSIONS When two item response categories were merged, the Danish version of the WHO-5 was found to be structurally valid for patients with schizophrenia spectrum disorders. This suggests that the WHO-5 holds promise as a measure of subjective well-being in this patient population.
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Affiliation(s)
- Cecilie Marie Nielsen
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Søren Dinesen Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Pernille Kølbæk
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.
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Kangwanrattanakul K, Krägeloh CU. Psychometric evaluation of the WHOQOL-BREF and its shorter versions for general Thai population: confirmatory factor analysis and Rasch analysis. Qual Life Res 2024; 33:335-348. [PMID: 37906345 DOI: 10.1007/s11136-023-03521-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Rasch analysis was employed to validate the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and its existing shorter versions in the general Thai population. METHODS 1200 respondents were randomly selected to complete the questionnaire. Confirmatory factor analysis (CFA) was employed to test the structure of the WHOQOL-BREF and its shorter versions with the random sub-sample of 900 respondents, while Rasch analysis was performed with a random sub-sample of 300 respondents. RESULTS The CFA confirmed the factor structure of WHOQOL-BREF and its shorter versions. The Rasch analysis revealed that the WHOQOL-BREF, when a four-domain structure was tested using a subtest approach, achieved acceptable model fit to the Rasch model and met the expectations of unidimensionality with high reliability (PSI = 0.87). Individual domain models were also unidimensional, but reliability of the 3-item social domain was inadequate. While the 8-item EUROHIS-QOL-8 and 5-item WHOQOL-5 achieved an overall acceptable fit and met the expectations of unidimensionality, the reliability of the WHOQOL-5 was below the acceptable threshold (PSI = 0.66). Reliability of the EUROHIS-QOL-8 was satisfactory (PSI = 0.79). CONCLUSIONS The WHOQOL-BREF is a valid instrument for use in the Thai general population, both as a total score as well as individual subscales. Rasch analysis also supports the use of EUROHIS-QOL-8, but the WHOQOL-5 lacks good reliability. While the reliability of the EUROHIS-QOL-8 is sufficiently high for between-group analysis, the Thai WHOQOL-BREF total score can also be used for within-participant analyses. Rasch investigation with a more varied health conditions of general Thai samples or patient groups is encouraged for future studies.
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Affiliation(s)
- Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, 20131, Chonburi, Thailand.
| | - Christian U Krägeloh
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
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Ndosi M, Almeida C, Dawson J, Dures E, Greenwood R, Bromhead A, Guly C, Stern S, Hill C, Mackie S, Robson JC. Validation of a patient-reported outcome measure for giant cell arteritis. Rheumatology (Oxford) 2024; 63:181-189. [PMID: 37144946 PMCID: PMC10765151 DOI: 10.1093/rheumatology/kead201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/10/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVES GCA is systemic vasculitis manifesting as cranial, ocular or large vessel vasculitis. A prior qualitative study developed 40 candidate items to assess the impact of GCA on health-related quality of life (HRQoL). This study aimed to determine final scale structure and measurement properties of the GCA patient reported outcome (GCA-PRO) measure. METHODS Cross-sectional study included UK patients with clinician-confirmed GCA. They completed 40 candidate items for the GCA-PRO at times 1 and 2 (3 days apart), EQ-5D-5L, ICECAP-A, CAT-PROM5 and self-report of disease activity. Rasch and exploratory factor analyses informed item reduction and established structural validity, reliability and unidimensionality of the final GCA-PRO. Evidence of validity was also established with hypothesis testing (GCA-PRO vs other PRO scores, and between participants with 'active disease' vs those 'in remission') and test-retest reliability. RESULTS The study population consisted of 428 patients: mean (s.d.) age 74.2 (7.2), 285 (67%) female; 327 (76%) cranial GCA, 114 (26.6%) large vessel vasculitis and 142 (33.2%) ocular involvement. Rasch analysis eliminated 10 candidate GCA items and informed restructuring of response categories into four-point Likert scales. Factor analysis confirmed four domains: acute symptoms (eight items), activities of daily living (seven items), psychological (seven items) and participation (eight items). The overall scale had adequate Rasch model fit (χ2 = 25.219, degrees of freedom = 24, P = 0.394). Convergent validity with EQ5D-5L, ICECAP-A and Cat-PROM5 was confirmed through hypothesis testing. Internal consistency and test-retest reliability were excellent. CONCLUSION The final GCA-PRO is a 30-item, four-domain scale with robust evidence of validity and reliability in measuring HRQoL in people with GCA.
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Affiliation(s)
- Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Celia Almeida
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jill Dawson
- Nuffield Department of Population Health (HSRU), University of Oxford, Oxford, UK
| | - Emma Dures
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rosemary Greenwood
- NIHR Research Design Service South West, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Alison Bromhead
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Catherine Guly
- Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Steve Stern
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Catherine Hill
- Discipline of Medicine, The University of Adelaide, Adelaide, Australia
- Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Joanna C Robson
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Doi K, Mane SA, Hattori Y, Sakamoto S, Sonezaki S, Saeki Y. Rasch analysis of the carpal tunnel syndrome instrument. J Hand Ther 2024; 37:118-129. [PMID: 37586990 DOI: 10.1016/j.jht.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 06/30/2023] [Accepted: 07/19/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The carpal tunnel syndrome instrument (CTSI) is the most widely used patient-reported outcome measure (PROM) in carpal tunnel syndrome (CTS). However, CTSI is an ordinal-type questionnaire and might have caused misinterpretations of the PROM between surgical outcomes of CTS (Camitz and extra/open carpal tunnel release). PURPOSE This study aims to convert the CTSI to an interval scale using Rasch analysis (RA) and evaluate the outcome differences between the original and transformed scales. STUDY DESIGN Prospective control study. METHODS Four hundred twenty-four patients with 567 CTSs had been interviewed for CTSI perioperatively and treated with either endoscopic/open carpal tunnel release or Camitz tendon transfer. Each CTSI was analyzed for dimensionality, fit statistics, and a transformation of the ordinal-to-interval scale by RA. We compared the two groups perioperative scores of three CTSI versions (original 11-item, modified 8-item, and transformed 8-item). RESULTS Based on the RA, the original CTSI was not unidimensional. We identified two dimensions. After removing misfit items, the perioperative course of each score by three versions of each dimension was compared (Repeated 2-factor analysis of variance). The transformed interval scales of CTSI provided different assessments of score changes from the ordinal scale of CTSI analyses. CONCLUSIONS Original CTSI consisted of ordinal scale items that yielded different conclusions than scores converted to interval scale by Rasch analysis. CTSI should convert into an interval scale after reclassifying dimensionality by Latent Factor Analysis and removing misfit items.
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Affiliation(s)
- Kazuteru Doi
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan.
| | - Satish A Mane
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan
| | - Yasunori Hattori
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan
| | - Sotetsu Sakamoto
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan
| | - Shichoh Sonezaki
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan
| | - Yuji Saeki
- Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi-prefecture, Japan
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Morville AL, Wagman P, Håkansson C. A Rasch analysis of the Danish version of the occupational balance questionnaire (OBQ11). Scand J Occup Ther 2024; 31:2327356. [PMID: 38498981 DOI: 10.1080/11038128.2024.2327356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND OBQ11 was developed in a Swedish context. To evaluate occupational balance, accurate self-rating instruments in the native language are needed. AIM The aim was to investigate the measurement properties of the Danish version of OBQ11, using the Rasch analysis. METHOD Data for the analysis of the Danish version of OBQ11 (OBQ11-DK) was gathered online, and all full data records (n 366) were included in the analysis. RESULTS Three items showed non-significant marginal under- or overfit, suggesting a degree of misfit between the data and the Rasch model. Unidimensionality was not reached, though, since the proportion of persons with different estimates were more than 5% and thus the OBQ11-DK cannot be said to assess a person's perception of occupational balance. CONCLUSION The present version of the OBQ11-DK shows the need for further development and testing and is not tested for test/retest or in clinical samples. The results and small number of items may after modifications and further studies make it feasible to implement OBQ11-DK into settings where the measuring of occupational balance is needed.
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Affiliation(s)
- Anne-Le Morville
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petra Wagman
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Lund University, Medicon Village, Lund, Sweden
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24
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Ståhl C, Karlsson E, Wenemark M, Sandqvist J, Årestedt K. The Social Insurance Literacy Questionnaire (SILQ): Development and Psychometric Evaluation. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10159-7. [PMID: 38159124 DOI: 10.1007/s10926-023-10159-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE For clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory. METHODS The development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020. RESULTS Overall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively. CONCLUSION This study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties.
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Affiliation(s)
- Christian Ståhl
- Division of Education and Sociology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
| | - Elin Karlsson
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marika Wenemark
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Unit for Public Health and Statistics, East Region, Linköping, Sweden
| | - Jan Sandqvist
- Division of Prevention, Department of Health, Medicine and Caring Sciences, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Kalmar, Kalmar County, Sweden
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Mehta SP, Ellis AP, Meadows S, Lu S, Bullock M, Oliashirazi A. Rasch Analysis of Joint Replacement Version for Hip Disability and Osteoarthritis Outcome in Individuals With Advanced Osteoarthritis of Hip Awaiting Total Hip Arthroplasty Surgery. Arch Phys Med Rehabil 2023; 104:2084-2091. [PMID: 37290491 DOI: 10.1016/j.apmr.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/20/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The objective of this study was to examine measurement properties of the Joint replacement version for Hip Disability and Osteoarthritis Outcome Score (HOOS-JR) using Rasch analysis in patients with osteoarthritis of hip (HOA). DESIGN Cross-sectional clinical measurement SETTING: Patient outcomes database at a tertiary care hospital PARTICIPANTS: Convenience sampling of patients with HOA scheduled for total hip arthroplasty (N=327) OUTCOME MEASURES AND ANALYSIS: The data for pre-surgery assessments for patients with HOA were extracted from an existing database. Variables extracted included HOOS-JR scores, demographic information (age, sex), health-related data, and anthropometric variables. The assumptions of Rasch model such as the test of fit, fit residuals, ordering of item thresholds, factor structure, DIF, internal consistency and Pearson separation index were examined for the HOOS-JR scores. RESULTS The HOOS-JR showed adequate overall fit to the Rasch model, logically ordered response thresholds, no floor or ceiling effects, and high internal consistency (Cronbach's alpha of 0.91). The HOOS-JR did not satisfy the assumption of unidimensionality, albeit the violation of this assumption was marginal (6.12% over 5%). Person-item threshold distribution (difference between person and item means were equal to 0.92 which was less than 1 logit unit) confirmed that the HOOS-JR scores were well targeted. CONCLUSIONS Given that the violation of unidimensionality for HOOS-JR was marginal, we recommend further studies to validate this finding. Results broadly support the use of HOOS-JR for assessing hip health in patients with HOA.
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Affiliation(s)
- Saurabh P Mehta
- Physical Therapy Program, East Tennessee State University, Johnson City, TN; Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV.
| | | | | | - Steve Lu
- School of Rehabilitation Science, McMaster University, Hamilton, Canada; Roth McFarlane Hand and Upper Limb Centre, St Joseph's Health Care London, London, Canada
| | - Matthew Bullock
- Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV
| | - Ali Oliashirazi
- Dept. of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV
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Skogestad IJ, Kottorp A, Larsson P, Moen TM, Gay CL, Borge CR, Lerdal A. Development and evaluation of the Norwegian Fatigue Characteristics and Interference Measure (FCIM) for stroke survivors: cognitive interviews and Rasch analysis. Qual Life Res 2023; 32:3389-3401. [PMID: 37468806 PMCID: PMC10624711 DOI: 10.1007/s11136-023-03477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE There is need for a comprehensive measure of post-stroke fatigue with sound measurement properties. This study aimed to develop the Norwegian Fatigue Characteristics and Interference Measure (FCIM) and assess its content validity, structural validity, and internal consistency. METHOD This study consisted of three steps: (1) an expert panel developed version 1.0 of the Norwegian FCIM, (2) its content validity was assessed in cognitive interviews with stroke patients (N = 15), (3) a convenience sample of stroke patients (N = 169) completed an online questionnaire with the FCIM, Fatigue Severity Scale, and sociodemographic information; validity and reliability were assessed using Rasch analysis. RESULTS FCIM version 1.0 included a 10-item characteristics subscale, a 20-item interference subscale, and two pre-stroke fatigue items. The cognitive interviews revealed content validity issues, resulting in two interference items being removed and five items being flagged but retained for Rasch analysis (version 2.0). Rasch analysis led to removal of four items from the characteristics subscale and six more from the interference subscale. The final six-item characteristics subscale and 12-item interference subscale (version 3.0) both showed adequate fit to the Rasch model with indications of unidimensionality and local independence. The interference subscale had a high person separation index. No significant differential item function (DIF) was found in relation to gender, but one item demonstrated DIF in relation to age. CONCLUSION The cognitive interviews and Rasch analysis demonstrated that the Norwegian version of the FCIM has high content validity, structural validity, and internal consistency. Future research should assess its construct validity, reliability, and responsiveness.
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Affiliation(s)
- Ingrid Johansen Skogestad
- Medical Department, Lovisenberg Diaconal Hospital, Oslo, Norway.
- Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Petra Larsson
- Surgical Department, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Caryl L Gay
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Family Health Care Nursing, University of California, San Francisco, USA
| | - Christine Råheim Borge
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway
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Upenieks L, Ryan BM, Carson HJ. When a bad day at the golf course is a bad day at the office: occupational stressors, institutional supports, and the mental health of NCAA golf coaches. Front Sports Act Living 2023; 5:1286965. [PMID: 38098650 PMCID: PMC10719948 DOI: 10.3389/fspor.2023.1286965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
This study examined the mental health of NCAA collegiate golf coaches. Utilizing the person-environment fit theory and previous literature on coaches' well-being, this study examined four outcomes among 48 participants, namely: depressive and anxiety symptoms, burnout, and job turnover intentions. Results suggested that coaching stressors (e.g., administrative tasks, practice plans, pressure to win) only associate with greater burnout. More consistent evidence showed that workplace stress (e.g., lack of control and autonomy, poor work-family balance) associated with higher levels of all outcomes. Finally, greater perceived organizational support had a beneficial association with each outcome. The findings of the current study suggest golf coaches are at risk of mental health problems because of the stressors of this job. Taken as a whole, athletic departments, coaches, and student-athletes must reconsider norms that overemphasize performance and underemphasize self-care and work-life balance.
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Affiliation(s)
| | | | - Howie J. Carson
- Moray House School of Education and Sport, The University of Edinburgh, Edinburgh, United Kingdom
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28
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Rasmussen SE, Aaby A, Søjbjerg A, Mygind A, Maindal HT, Paakkari O, Christensen KS. The Brief Health Literacy Scale for Adults: Adaptation and Validation of the Health Literacy for School-Aged Children Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7071. [PMID: 37998302 PMCID: PMC10671482 DOI: 10.3390/ijerph20227071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
The Health Literacy for School-Aged Children (HLSAC) is a brief, generic instrument measuring health literacy among school-aged children. Given its brevity and broad conceptualization of health literacy, the HLSAC is a potentially valuable measuring instrument among adults as well. This validation study aimed to adapt the HLSAC questionnaire to an adult population through assessment of content validity and subsequently determine the structural validity of the adapted instrument, the Brief Health Literacy scale for Adults (B-HLA). The content validity of the HLSAC was assessed through interviews with respondents and experts, and the structural validity of the adapted instrument (B-HLA) was evaluated using Rasch analysis. The content validity assessment (n = 25) gave rise to adjustments in the wording of five items. The B-HLA demonstrated an overall misfit to the Rasch model (n = 290). Items 6 and 8 had the poorest individual fits. We found no signs of local dependency or differential item functioning concerning sex, age, education, and native language. The B-HLA demonstrated unidimensionality and ability to discriminate across health literacy levels (PSI = 0.80). Discarding items 6 or 8 resulted in an overall model fit and individual fit of all items. In conclusion, the B-HLA appears to be a valid and reliable instrument for assessing health literacy among adults.
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Affiliation(s)
- Stinne Eika Rasmussen
- Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.S.); (A.M.); (K.S.C.)
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.A.); (H.T.M.)
| | - Anna Aaby
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.A.); (H.T.M.)
| | - Anne Søjbjerg
- Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.S.); (A.M.); (K.S.C.)
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.A.); (H.T.M.)
| | - Anna Mygind
- Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.S.); (A.M.); (K.S.C.)
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.A.); (H.T.M.)
| | - Olli Paakkari
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014 Jyväskylä, Finland;
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.S.); (A.M.); (K.S.C.)
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; (A.A.); (H.T.M.)
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Yunus NA, Sturgiss E, Soh SE. Validation of the Universal Measure of Bias-Fat (UMB Fat) among Malaysian health practitioners using Rasch analysis. Obes Res Clin Pract 2023; 17:477-484. [PMID: 38042691 DOI: 10.1016/j.orcp.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/01/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE This study aimed to evaluate the structural validity of the Universal Measures of Bias - Fat (UMB Fat) among Malaysian healthcare practitioners using Rasch analysis. METHODS Data from a cross-sectional survey of 268 public and private doctors and allied health practitioners in Peninsular Malaysia were used for this analysis. Using Rasch analysis, overall model fit and item fit of the summary UMB Fat and domain scores were examined, together with unidimensionality, response threshold ordering, internal consistency, measurement invariance, and item targeting. RESULTS Data showed overall misfit to the Rasch model for both the summary UMB Fat score and domain scores. Whilst unidimensionality was observed for the domain scores, this was not evident for the summary score where multiple local dependencies were present. Disordered thresholds were observed for the response format, in which the majority improved with modification. Suboptimal targeting was also detected with an uneven distribution of items at the upper and lower end of the logit scale for the summary and domain scores. Despite this, excellent internal consistency reliability was observed (person separation index: 0.76-0.89), and no measurement invariance was detected. CONCLUSION The Rasch model supports reporting of the UMB Fat domain scores but not the summary score. Several issues related to local dependencies and response format were identified that could benefit from refining the UMB Fat to improve measurement accuracy, particularly when used by healthcare practitioners in Asian countries.
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Affiliation(s)
- Nor Akma Yunus
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia; Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Sze-Ee Soh
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Davies E, Liddiard S, McConn-Palfreyman WJ, Parker JK, Cameron LJ, Williams JM. Anxiety and Depression in British Horseracing Stud and Stable Staff Following Occupational Injury. Animals (Basel) 2023; 13:3337. [PMID: 37958092 PMCID: PMC10649171 DOI: 10.3390/ani13213337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Horseracing has identified several factors influencing staff wellbeing; however, the relationship between injury, anxiety, and depression is yet to be established. This study investigated anxiety and depression scores and their association to pain management, coping, and help-seeking behaviour in injured British horseracing staff. An online retrospective survey was completed by 175 participants, identifying injury prevalence, coping strategies, occupational risk factors, and Hospital Anxiety and Depression Scale (HADS) scores. Analysis identified 65.14% (n = 114) of staff reported anxiety scores above the threshold (≥8) and 59.52% (n = 104) of staff reported depression scores ≥8. Median anxiety and depression scores were higher for staff who viewed their employer as unhelpful (anxiety p = 0.001; depression p = 0.020). Heightened anxiety and depression were associated with an increased likelihood to use pain medication to manage at work, including non-steroidal anti-inflammatory drugs (NSAID's), alcohol, nicotine, and prescription drugs (p < 0.05). Implications for staff wellbeing is evident; anxiety and depression risks are high following injury, which may influence help-seeking behaviour, perceived job security, and coping mechanisms. This paper suggests it is vital to continue to investigate poor mental health and injury in racing staff and the implications for equine welfare.
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Affiliation(s)
- Emma Davies
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK (L.J.C.); (J.M.W.)
| | - Sophie Liddiard
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK (L.J.C.); (J.M.W.)
| | | | - John K. Parker
- Sport Department, Hartpury University, Gloucestershire GL19 3BE, UK;
| | - Lorna J. Cameron
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK (L.J.C.); (J.M.W.)
| | - Jane M. Williams
- Equine Department, Hartpury University, Gloucestershire GL19 3BE, UK (L.J.C.); (J.M.W.)
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Feng S, McDaniel S, Van de Winckel A. Finding functionality: Rasch analysis of the Functionality Appreciation Scale in community-dwelling adults in the US. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1222892. [PMID: 37849959 PMCID: PMC10577199 DOI: 10.3389/fresc.2023.1222892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023]
Abstract
Introduction The Functionality Appreciation Scale (FAS) measures an individual's appreciation for the functions their body can perform, regardless of the individual's physical limitations. Prior studies reported on internal consistency, test-retest reliability, convergent validity, and exploratory or confirmatory factor analyses, but Rasch analysis has not yet been performed to evaluate the structural validity of the FAS. Methods We recruited community-dwelling adults at the Minnesota State Fair and through contact lists of participants identifying interest in research done in the Brain Body Mind Lab (University of Minnesota). Community-dwelling adults with spinal cord injury (SCI) completed the FAS over Zoom. We analyzed the FAS using Rasch Measurement Theory, which produced the following outputs: item, and person fit, targeting, unidimensionality, person separation reliability (PSR), local item dependence (LID), principal component analysis of residuals (PCAR), and differential item functioning (DIF). Results We recruited 567 participants (average age 52.15 ± 17.5 years, 63.84% women), among which 14 adults with SCI. After rescoring 3 items and deleting 1 item, the FAS had good person and item fit (except item 4). The PCAR and subsequent paired t-tests (3.53%) confirmed the unidimensionality of the scale. There was no DIF and only one item pair had LID (item 5-6). PSR was 0.75, reflecting a capacity to differentiate groups of people with high or low functionality appreciation levels. However, there was a significant ceiling effect (28.04%) and the person mean location was 3.06 ± 2.07 logits, indicating the FAS is too easy for community-dwelling adults in the US. Discussion The 6-item Rasch-based FAS demonstrated unidimensionality, good item fit (except item 4) and person fit, but the FAS will require more difficult items to be added to improve the targeting of the scale, and better reliability.
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Affiliation(s)
- Sarah Feng
- Breck School, Golden Valley, MN, United States
| | | | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
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Michael NG, Bobevski I, Georgousopoulou E, O'Callaghan CC, Clayton JM, Seah D, Kissane D. Unmet spiritual needs in palliative care: psychometrics of a screening checklist. BMJ Support Palliat Care 2023; 13:e170-e176. [PMID: 33262122 DOI: 10.1136/bmjspcare-2020-002636] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/27/2020] [Accepted: 11/10/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND While studies in palliative care use measures of spirituality and religious belief, there have been few validation studies of a screening tool that identifies unmet spiritual needs. METHODS A multidisciplinary research team developed and examined the usefulness, reliability and validity of a 17-item Spiritual Concerns Checklist (SCC) as a screening tool for unmet spiritual needs. A cohort of patients recruited from three palliative care services in Sydney and Melbourne, Australia completed anonymous questionnaires. Factor structure and item response theory were used to examine its properties; concurrent validity employed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12). RESULTS Among 261 patients, while only 15% directly sought spiritual care, nearly 62% identified at least one spiritual concern. Existential needs (fear of the dying process 32%; loss of control 31%), regret (20%), need for forgiveness (17%), guilt (13%), loss of hope (13%) and meaning (15%) were prominent concerns. Eleven concerns were present for more than 10% of the participants and 25% of religiously orientated participants expressed >4 concerns. The 17-item SCC was unidimensional, with satisfactory reliability. Concurrent validity was evident in the reduced sense of meaning and peace on the FACIT-Sp-12. CONCLUSION This preliminary Rasch analysis of the newly developed SCC has demonstrated its usefulness, reliability and validity. Our findings encourage refinement and ongoing development of the SCC with further investigation of its psychometric properties in varying populations.
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Affiliation(s)
- Natasha G Michael
- Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, Victoria, Australia
- University of Notre Dame Australia, School of Medicine, Sydney, NSW, Australia
| | - Irene Bobevski
- Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, Victoria, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | | | - Clare C O'Callaghan
- Supportive, Psychosocial and Palliative Care Research Department, Cabrini Health, Melbourne, Victoria, Australia
- Palliative Care Service St Vincent's Hospital Melbourne, VIC, Australia, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Josephine M Clayton
- Centre for Learning & Research in Palliative Care, Hammond Care, Greenwich Hospital, Sydney, NSW, Australia
- The University of Sydney Northern Clinical School, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Davinia Seah
- University of Notre Dame Australia, School of Medicine, Sydney, NSW, Australia
- Sacred Heart Health Service, St. Vincent's Hospital Sydney, Sydney, NSW, Australia
| | - David Kissane
- University of Notre Dame Australia, School of Medicine, Sydney, NSW, Australia
- Sacred Heart Health Service, St. Vincent's Hospital Sydney, Sydney, NSW, Australia
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Panthagani J, O'Donovan C, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston AK, Moore DJ, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for future clinical trials in adult patients with optic neuritis. Eye (Lond) 2023; 37:3097-3107. [PMID: 36932161 PMCID: PMC10022552 DOI: 10.1038/s41433-023-02478-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/09/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE To search for and critically appraise the psychometric quality of patient-reported outcome measures (PROMs) developed or validated in optic neuritis, in order to support high-quality research and care. METHODS We systematically searched MEDLINE(Ovid), Embase(Ovid), PsycINFO(Ovid) and CINAHLPlus(EBSCO), and additional grey literature to November 2021, to identify PROM development or validation studies applicable to optic neuritis associated with any systemic or neurologic disease in adults. We included instruments developed using classic test theory or Rasch analysis approaches. We used established quality criteria to assess content development, validity, reliability, and responsiveness, grading multiple domains from A (high quality) to C (low quality). RESULTS From 3142 screened abstracts we identified five PROM instruments potentially applicable to optic neuritis: three differing versions of the National Eye Institute (NEI)-Visual Function Questionnaire (VFQ): the 51-item VFQ; the 25-item VFQ and a 10-item neuro-ophthalmology supplement; and the Impact of Visual Impairment Scale (IVIS), a constituent of the Multiple Sclerosis Quality of Life Inventory (MSQLI) handbook, derived from the Functional Assessment of Multiple Sclerosis (FAMS). Psychometric appraisal revealed the NEI-VFQ-51 and 10-item neuro module had some relevant content development but weak psychometric development, and the FAMS had stronger psychometric development using Rasch Analysis, but was only somewhat relevant to optic neuritis. We identified no content or psychometric development for IVIS. CONCLUSION There is unmet need for a PROM with strong content and psychometric development applicable to optic neuritis for use in virtual care pathways and clinical trials to support drug marketing authorisation.
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Affiliation(s)
| | - Charles O'Donovan
- School of Immunology and Microbiology, King's College London, London, UK.
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham Biomedical Research Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - Susan Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR, Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Alastair K Denniston
- Institute of Inflammation and Ageing, and Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - David J Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tasanee Braithwaite
- School of Immunology and Microbiology, King's College London, and The Medical Eye Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
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Rozental A, Forsström D, Johansson M. A psychometric evaluation of the Swedish translation of the Perceived Stress Scale: a Rasch analysis. BMC Psychiatry 2023; 23:690. [PMID: 37736719 PMCID: PMC10515233 DOI: 10.1186/s12888-023-05162-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Stress reflects physical and psychological reactions to imposing demands and is often measured using self-reports. A widely-used instrument is the Perceived Stress Scale (PSS), intended to capture more general aspects of stress. A Swedish translation of the PSS is available but has not previously been examined using modern test theory approaches. The aim of the current study is to apply Rasch analysis to further the understanding of the PSS' measurement properties, and, in turn, improve its utility in different settings. METHODS Data from 793 university students was used to investigate the dimensionality of different version of the PSS (14, 10, and 4 items) as well as potential response patterns among the participants. RESULTS The current study demonstrates that the PSS-14 has two separate factors, divided between negatively worded items (perceived stress) and positively worded items (perceived [lack of] control), although with only the negative subscale exhibiting good reliability. Response patterns were analyzed using Differential Item Functioning, which did not find an influence of gender on any of the items, but for age regarding the positive subscale (items 6 and 9). The PSS-10 also demonstrated adequate reliability for the negative subscale, but the PSS-4 was not deemed suitable as a unidimensional scale. CONCLUSIONS Based on the results, none of the versions of the PSS should be used by sum-scoring all of the items. Only the negative items from the PSS-14 or PSS-10 can be used as unidimensional scales to measure general aspects of stress. As for different response patterns, gender may nevertheless be important to consider, as prior research has found differences on several items. Meanwhile, content validity is discussed, questioning the relevance of anger and being upset when measuring more general aspects of stress. Finally, a table to convert the PSS-7 (i.e., negative items) ordinal sum scores to interval level scores is provided.
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Affiliation(s)
- Alexander Rozental
- Department of Psychology, Uppsala University, Uppsala, Sweden.
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Solna, Sweden.
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
| | - David Forsström
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Solna, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Magnus Johansson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Solna, Sweden
- RISE Research Institutes of Sweden, Division Safety and Transport, Measurement Science and Technology, Stockholm, Sweden
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Bobevski I, Kissane DW, Desroches J, De Simone A, Henry M. Validation of the Canadian Version of the Shame and Stigma Scale for Head and Neck Cancer Patients. Curr Oncol 2023; 30:7553-7565. [PMID: 37623029 PMCID: PMC10453664 DOI: 10.3390/curroncol30080548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
Cancers of the head and neck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person's self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients' progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French- and English-speaking head and neck cancer patients. Data from 254 patients from two major Canadian hospitals were analysed. The existing four-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test-retest reliability. Rasch analysis suggested scale improvement by removing two misfitting items and two items with differential functioning between French- and English-speaking patients. The final 16-item scale version was an adequate fit with the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions.
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Affiliation(s)
- Irene Bobevski
- School of Medicine, University of Notre Dame Australia, Darlinghurst, NSW 2010, Australia;
- Department of Psychiatry, School of Clinical Sciences, Monash Health and Monash University, Clayton, VIC 3168, Australia
| | - David W. Kissane
- School of Medicine, University of Notre Dame Australia, Darlinghurst, NSW 2010, Australia;
- Department of Psychiatry, School of Clinical Sciences, Monash Health and Monash University, Clayton, VIC 3168, Australia
| | - Justin Desroches
- Faculty of Medicine, McGill University, Montreal, QC H3A 0G4, Canada; (J.D.)
| | - Avina De Simone
- Faculty of Medicine, McGill University, Montreal, QC H3A 0G4, Canada; (J.D.)
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada
- Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Tennant A, Küçükdeveci AA. Application of the Rasch measurement model in rehabilitation research and practice: early developments, current practice, and future challenges. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1208670. [PMID: 37529206 PMCID: PMC10387545 DOI: 10.3389/fresc.2023.1208670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023]
Abstract
The application of the Rasch measurement model in rehabilitation is now well established. Both its dichotomous and polytomous forms provide for transforming ordinal scales into interval-level measures, consistent with the requirements of fundamental measurement. The growth of applying the model in rehabilitation spans 30 years, during which both the protocol has steadily developed and several software packages have emerged that provide for analysis, together with the "R" language that has an increasing set of codes for applying the model. This article reviews that development and highlights current practice requirements, including those for providing the relevant information for the methods, and what is expected of the analysis. In addition, this provides a worked example and looks at the remaining issues and current developments of its application.
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Affiliation(s)
- Alan Tennant
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Ayse A. Küçükdeveci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ankara University, Ankara, Turkey
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Caselli S, Sabattini L, Cattaneo D, Jonsdottir J, Brichetto G, Pozzi S, Lugaresi A, La Porta F. When 'good' is not good enough: a retrospective Rasch analysis study of the Berg Balance Scale for persons with Multiple Sclerosis. Front Neurol 2023; 14:1171163. [PMID: 37409022 PMCID: PMC10318536 DOI: 10.3389/fneur.2023.1171163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/07/2023] Open
Abstract
Background The Berg Balance Scale (BBS) is one of the most used tools to quantify balance in Persons with Multiple Sclerosis, a population at high risk of falling. Aim To evaluate the measurement characteristics of the BBS in Multiple Sclerosis through Rasch analysis. Design Retrospective study. Setting Outpatients in three Italian Rehabilitation centers. Population Eight hundred and fourteen persons with Multiple Sclerosis able to stand independently for more than 3 s. Methods The sample (N = 1,220) was split into one validating (B1) and three confirmatory subsamples. Following the Rasch analysis performed on B1, the item estimates were exported and anchored to the three confirmatory subsamples. After obtaining the same final solution across all samples, we studied the convergent and discriminant validity of the final BBS-MS using the EDSS, the ABC scale, and the number of falls. Results The base analysis on the B1 subsample failed the monotonicity, local independence, and unidimensionality requirements and did not fit the Rasch model. After grouping locally dependent items, the BBS-MS fitted the model (χ28 = 23.8; p = 0.003) and satisfied all requirements for adequate internal construct validity (ICV). However, it was mistargeted to the sample, given the striking prevalence of higher scores (targeting index 1.922) with a distribution-independent Person Separation Index sufficient for individual measurements (0.962). The B1 item estimates were anchored to the confirmatory samples with confirmation of adequate fit (χ2 = [19.0, 22.8], value of ps = [0.015, 0.004]) and satisfaction of all ICV requirements for all subsamples. The final BBS-MS directly correlated with the ABC scale (rho = 0.523) and inversely with EDSS (rho = -0.573). The BBS-MS estimates significantly differed across groups according to the pre-specified hypotheses (between the three EDSS groups, between the ABC cut-offs, distinguishing 'fallers' vs. 'non-fallers', and between the 'low' vs. 'moderate' vs. 'high' levels of physical functioning; and, finally, between 'no falls' vs. 'one or more falls'). Conclusion This study supports the internal construct validity and reliability of the BBS-MS in an Italian multicentre sample of persons with Multiple Sclerosis. However, as the scale is slightly mistargeted to the sample, it represents a candidate tool to assess balance, mainly in more disabled people with an advanced walking disability.
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Affiliation(s)
- Serena Caselli
- Unità Operativa Complessa di Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | | | - Davide Cattaneo
- LaRiCE lab (Gait and Balance Disorders Laboratory), Don Gnocchi Foundation IRCCS, Milan, Italy
| | - Johanna Jonsdottir
- LaRiCE lab (Gait and Balance Disorders Laboratory), Don Gnocchi Foundation IRCCS, Milan, Italy
| | | | - Stefania Pozzi
- DATER Riabilitazione Ospedaliera, Azienda USL di Bologna, Bologna, Italy
| | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Blackwood J, Carpentier S, Deng W, Van de Winckel A. Preliminary Rasch analysis of the multidimensional assessment of interoceptive awareness in adults with stroke. PLoS One 2023; 18:e0286657. [PMID: 37267348 DOI: 10.1371/journal.pone.0286657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/21/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE The Multidimensional Assessment of Interoceptive Awareness (MAIA) measures interoceptive body awareness, which includes aspects such as attention regulation, self-regulation, and body listening. Our purpose was to perform a preliminary validation of the MAIA in adults with stroke using Rasch Measurement Theory. METHODS The original MAIA has 32 items that measure interoceptive sensibility, which is an aspect of body awareness. We performed a preliminary analysis with Rasch Measurement Theory to evaluate the unidimensionality and structural validity of the scale. We investigated overall fit to assess unidimensionality, person and item fit, person separation reliability, targeting, local item dependence, and principal components analysis of residuals. RESULTS Forty-one adults with chronic stroke (average 3.8 years post-stroke, 13 women, average age 57±13 years) participated in the study. Overall fit (χ 2 = 62.26, p = 0.26) and item fit were obtained after deleting 3 items and rescoring 26 items. One participant did not fit the model (2.44%). There were no floor (0.00%) or ceiling effects (0.00%). Local item dependence was found in 42 pairs. The person separation reliability was 0.91, and the person mean location was 0.06±1.12 logits. CONCLUSIONS The preliminary structural validity of the MAIA demonstrated good targeting and reliability, as well as unidimensionality, and good item and person fit in adults with chronic stroke. A study with a larger sample size is needed to validate our findings.
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Affiliation(s)
- Jena Blackwood
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sydney Carpentier
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Wei Deng
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
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Ab Manaf N, Sa’at NH, A Rahim NAA, Kamaruddin SNAA, Abdullah SS, Omar K. Assessing wellbeing: Profiling and socioeconomic status of Kenyir Lake side community, Malaysia. Heliyon 2023; 9:e16399. [PMID: 37303545 PMCID: PMC10250571 DOI: 10.1016/j.heliyon.2023.e16399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
The Kenyir Lake side community offers numerous advantages to the local community. However, the problems of backwardness and poverty have been identified as the government's main challenges in its efforts to develop the community and maximise the advantages. Therefore, this study was conducted to identify the Kenyir Lake community's profile and assess its well-being. The study was conducted in three sub-districts near Tasik Kenyir, namely Kuala Berang, Hulu Telemong, and Jenagor, with a total of 510 respondents, who are heads of households (HOH). This study was carried out using a quantitative approach using questionnaire with a simple random sampling method. The findings of this study offered demographic profiling and discovered nine indicators of well-being, namely 1) Life Achievement, 2) Health Level, 3) Family Relationship, 4) Community Relationship, 5) Spiritual Level, 6) Safety Level and Social Problems, 7) Income or Finance, 8) Basic Facilities, and 9) Communication Technology. The study found that most respondents are satisfied with their lives now compared to 10 years ago. This study will help many parties to develop the Kenyir Lake Side Community, starting from the local authorities to the highest administration in the country.
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Affiliation(s)
- Norhayati Ab Manaf
- Institute of Tropical Biodiversity and Sustainable Development, University Malaysia Terengganu, Terengganu, Malaysia
| | - Nor Hayati Sa’at
- Faculty of Business, Economics and Social Development, University Malaysia Terengganu, Terengganu, Malaysia
| | | | | | - Siti Salina Abdullah
- Faculty of Business, Economics and Social Development, University Malaysia Terengganu, Terengganu, Malaysia
| | - Khatijah Omar
- Institute of Tropical Biodiversity and Sustainable Development, University Malaysia Terengganu, Terengganu, Malaysia
- Faculty of Business, Economics and Social Development, University Malaysia Terengganu, Terengganu, Malaysia
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Tobler S, Köhler K, Sinha T, Hafen E, Kapur M. Understanding Randomness on a Molecular Level: A Diagnostic Tool. CBE LIFE SCIENCES EDUCATION 2023; 22:ar17. [PMID: 36862800 PMCID: PMC10228260 DOI: 10.1187/cbe.22-05-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/24/2023] [Accepted: 02/03/2023] [Indexed: 06/02/2023]
Abstract
Undergraduate biology students' molecular-level understanding of stochastic (also referred to as random or noisy) processes found in biological systems is often limited to those examples discussed in class. Therefore, students frequently display little ability to accurately transfer their knowledge to other contexts. Furthermore, elaborate tools to assess students' understanding of these stochastic processes are missing, despite the fundamental nature of this concept and the increasing evidence demonstrating its importance in biology. Thus, we developed the Molecular Randomness Concept Inventory (MRCI), an instrument composed of nine multiple-choice questions based on students' most prevalent misconceptions, to quantify students' understanding of stochastic processes in biological systems. The MRCI was administered to 67 first-year natural science students in Switzerland. The psychometric properties of the inventory were analyzed using classical test theory and Rasch modeling. Moreover, think-aloud interviews were conducted to ensure response validity. Results indicate that the MRCI yields valid and reliable estimations of students' conceptual understanding of molecular randomness in the higher educational setting studied. Ultimately, the performance analysis sheds light on the extent and the limitations of students' understanding of the concept of stochasticity on a molecular level.
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Affiliation(s)
- Samuel Tobler
- Professorship for Learning Sciences and Higher Education and
| | - Katja Köhler
- Department of Biology, ETH Zurich, 8092 Zurich, Switzerland
| | - Tanmay Sinha
- Professorship for Learning Sciences and Higher Education and
| | - Ernst Hafen
- Department of Biology, ETH Zurich, 8092 Zurich, Switzerland
| | - Manu Kapur
- Professorship for Learning Sciences and Higher Education and
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Rotonda C, Guillemin F, Conroy T, Alleyrat C, Lefevre B, Soudant M, Tarquinio C. Validation and optimization of the French Generic Adherence for Chronic Diseases Profile (GACID-P) using classical test and item response theory. Health Qual Life Outcomes 2023; 21:49. [PMID: 37226180 DOI: 10.1186/s12955-023-02130-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/11/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The Generic Adherence for Chronic Diseases Profile is a French generic scale (GACID-P) developed to measure adherence in several disease areas such as cardiology, rheumatology, diabetes, cancer and infectiology. METHOD We aimed to study the measurement invariance of the Generic Adherence for Chronic Diseases Profile by an item response model, optimize the new instrument version from item response model and qualitative content analyses results, and validate the instrument. The metric properties of the optimized version were studied according to classical test theory and item response model analysis. RESULTS A sample of 397 patients consulting at two French hospitals (in diabetes, cardiology, rheumatology, cancerology and infectiology) and in four private practices was recruited; 314 (79%) patients also completed the questionnaire 15 days later. Factor analyses revealed four dimensions: "Forgetting to take medication", "Intention to comply with treatment", "Limitation of risk-related consumer habits" and "Healthy lifestyle". The item response model and content analyses optimized these four dimensions, regrouping 32 items in four dimensions of 25 items, including one item conditioned on tobacco use. The psychometric properties and scale calibration were satisfactory. One score per dimension was calculated as the sum of the items for the dimensions "Forgetting to take medication" and "Intention to comply with treatment" and as a weighted score according to the item response model analysis for the two other dimensions because of differential item functioning found for two items. CONCLUSION Four adherence profile scores were obtained. The instrument validity was documented by a theoretical approach and content analysis. The Generic Adherence for Chronic Diseases Profile is now available for research targeting adherence in a broad perspective.
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Affiliation(s)
- Christine Rotonda
- Université de Lorraine, Centre Pierre Janet, Metz, F-57000, France.
- Université de Lorraine, APEMAC, équipe EPSAM, Metz, F-57000, France.
| | - F Guillemin
- CHRU Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, F-54000, France
- Université de Lorraine, APEMAC, équipe MICS, Nancy, F-54000, France
| | - T Conroy
- Université de Lorraine, APEMAC, équipe MICS, Nancy, F-54000, France
- Institut de Cancérologie de Lorraine, Department of Medical Oncology, Vandoeuvre- lès-Nancy, F-54519, France
| | - C Alleyrat
- CHRU Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, F-54000, France
| | - B Lefevre
- Institut de Cancérologie de Lorraine, Department of Medical Oncology, Vandoeuvre- lès-Nancy, F-54519, France
- CHRU-Nancy, Université de Lorraine, Service des Maladies Infectieuses et Tropicales, Nancy, F-54000, France
| | - M Soudant
- CHRU Nancy, Inserm, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, F-54000, France
| | - C Tarquinio
- Université de Lorraine, Centre Pierre Janet, Metz, F-57000, France
- Université de Lorraine, APEMAC, équipe EPSAM, Metz, F-57000, France
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Agergaard AS, Comins JD, Siersma V, Malmgaard-Clausen NM, Couppe C, Hjortshoej MH, Olesen JL, Magnusson SP. Assessment of the Psychometric Properties of the Danish VISA-P. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:5291949. [PMID: 38654908 PMCID: PMC11022774 DOI: 10.1155/2023/5291949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2024]
Abstract
Purpose The objective of the current study was to conduct a rigorous assessment of the psychometric properties of the Victorian Institute of Sports Assessment-patellar tendinopathy (VISA-P). Methods Rasch analysis, confirmatory factor analysis (CFA), and multivariable linear regression were used to assess the psychometric properties of the VISA-P questionnaire in 184 Danish patients with patellar tendinopathy who had symptoms ranging from under 3 months to over 1 year. A group of 100 healthy Danish persons was included as a reference for known-group validation. Results The analyses revealed that the 8-item VISA-P did not fit a unidimensional model, yielded at best a 3-factor model, and exhibited differential item functioning (DIF) across healthy subjects versus people with patellar tendinopathy. Conclusion VISA-P in its present form does not satisfy a measurement model and is not a robust scale for measuring patellar tendinopathy. A new PROM for patellar tendinopathy should be developed and appropriately validated, and meanwhile, simple pain scoring (e.g., numeric rating scales) and functional tests are suggested as more appropriate outcome measures for studies of patellar tendinopathy.
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Affiliation(s)
- Anne-Sofie Agergaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jonathan D. Comins
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nikolaj M. Malmgaard-Clausen
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Couppe
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Mikkel H. Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jens L. Olesen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - S. Peter Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
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Alfaro-Díaz C, Esandi N, Pueyo-Garrigues M, Canga-Armayor N, Forjaz MJ, Rodriguez-Blazquez C, Canga-Armayor A. Psychometric Evaluation of the Spanish Families Importance in Nursing Care: Nurses' Attitudes Scale Through Classical Test Theory and Rasch Analysis. JOURNAL OF FAMILY NURSING 2023; 29:179-191. [PMID: 36647194 DOI: 10.1177/10748407221148083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.
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Affiliation(s)
- Cristina Alfaro-Díaz
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Nuria Esandi
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - María Pueyo-Garrigues
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | | | | | - Ana Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
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Christensen KS, Sparle-Christensen M. Comparing the construct validity of the Patient Health Questionnaire (PHQ-9) and the Major Depression Inventory (MDI) using Rasch analysis. J Affect Disord 2023; 333:44-50. [PMID: 37084961 DOI: 10.1016/j.jad.2023.04.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE The Patient Health Questionnaire (PHQ-9) and the Major Depression Inventory (MDI) are psychometric instruments frequently used for depression diagnosis and monitoring in primary care settings. The goal of this study was to assess and compare the construct validity of the PHQ-9 and the MDI using Rasch analysis. METHODS The PHQ-9 and the MDI were distributed in random ordering (first or last) to a waiting room sample of Danish primary care patients. Analysis of fit to the Rasch model, ordering of response categories, dimensionality-testing, test for differential item functioning, test for local dependency, and calculation of reliability indices were used to evaluate the psychometric characteristics of the instruments. RESULTS A sample of 281 persons (18-87 years, 72 % females) responded to both instruments. Reliability was acceptable for PHQ-9 (PSI 0.80) and excellent for MDI (PSI 0.88). Both instruments demonstrated fit to the Rasch model after rescoring of all items. Dimensionality testing supports that both instruments are unidimensional. Indication of local dependency was observed for PHQ-9 item 2&6 and MDI item 1&4. No indication of differential item functioning regarding age, gender or ordering of instruments was found. CONCLUSION The PHQ-9 and the MDI both demonstrate measurement problems. Modifying individual items and reducing the number of response categories in both instruments could potentially improve their measurement capabilities. Study findings do not provide a conclusive indication of which instrument has superior operating characteristics.
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Affiliation(s)
- Kaj Sparle Christensen
- Research Unit for General Practice, Aarhus, Denmark; Department of Public Health, Aarhus University, Denmark.
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Jayaram M, Wang C, Yoon AP, Wang L, Chung KC. Using Rasch Analysis to Evaluate the Psychometric Properties of the Brief MHQ in Patients with Traumatic Finger Amputations. J Hand Surg Asian Pac Vol 2023; 28:225-234. [PMID: 37120305 DOI: 10.1142/s2424835523500248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Background: Digit amputations affect 45,000 Americans each year and are associated with substantial healthcare expenditures and loss of wages. Few patient-reported outcome measures (PROMs) are validated in patients with digit amputations. The brief Michigan Hand Outcomes Questionnaire (bMHQ) is a 12-item PROM used in several hand conditions. However, its psychometric properties have not been investigated in patients with digit amputations. Methods: The reliability and validity of the bMHQ was investigated using Rasch analysis. Data were collected from the Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) study. Participants were divided into replantation and revision amputation cohorts and then further separated into single-digit amputation (excluding thumb), thumb-only amputation and multiple-digit amputation (excluding thumb) subgroups. Each of the six subgroups were analysed for item fit, threshold ordering, targeting, differential item functioning (DIF), unidimensionality and internal consistency. Results: All treatment groups demonstrated high unidimensionality (Martin-Löf test = 1) and internal consistency (Cronbach's α > 0.85). The bMHQ is not a reliable PROM in individuals with single-digit or multiple-digit amputations. The aesthetics, satisfaction and two-handed activities of daily living (ADLs) items had the poorest fit to the Rasch model across all categories. Conclusions: The bMHQ is not well-suited for measuring outcomes in patients with digit amputations. We recommend clinicians use more comprehensive assessment tools, such as the complete MHQ, to measure outcomes in these complex patient populations. Level of Evidence: Level III (Diagnostic).
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Affiliation(s)
- Mayank Jayaram
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Chang Wang
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Lu Wang
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Chan APC, Guan J, Choi TNY, Yang Y, Wu G, Lam E. Improving Safety Performance of Construction Workers through Learning from Incidents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4570. [PMID: 36901580 PMCID: PMC10002101 DOI: 10.3390/ijerph20054570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Learning from incidents (LFI) is a process to seek, analyse, and disseminate the severity and causes of incidents, and take corrective measures to prevent the recurrence of similar events. However, the effects of LFI on the learner's safety performance remain unexplored. This study aimed to identify the effects of the major LFI factors on the safety performance of workers. A questionnaire survey was administered among 210 construction workers in China. A factor analysis was conducted to reveal the underlying LFI factors. A stepwise multiple linear regression was performed to analyse the relationship between the underlying LFI factors and safety performance. A Bayesian Network (BN) was further modelled to identify the probabilistic relational network between the underlying LFI factors and safety performance. The results of BN modelling showed that all the underlying factors were important to improve the safety performance of construction workers. Additionally, sensitivity analysis revealed that the two underlying factors-information sharing and utilization and management commitment-had the largest effects on improving workers' safety performance. The proposed BN also helped find out the most efficient strategy to improve workers' safety performance. This research may serve as a useful guide for better implementation of LFI practices in the construction sector.
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Affiliation(s)
- Albert P. C. Chan
- Shenzhen Research Institute of the Hong Kong Polytechnic University, Shenzhen 518057, China
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 999077, China
| | - Junfeng Guan
- Shenzhen Research Institute of the Hong Kong Polytechnic University, Shenzhen 518057, China
| | - Tracy N. Y. Choi
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 999077, China
| | - Yang Yang
- Shenzhen Research Institute of the Hong Kong Polytechnic University, Shenzhen 518057, China
- Department of Building and Real Estate, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 999077, China
| | - Guangdong Wu
- School of Public Policy and Administration, Chongqing University, Chongqing 400044, China
| | - Edmond Lam
- College of Professional and Continuing Education, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 999077, China
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Balogun NA, Adeleke FA, Abdulrahaman MD, Shehu YI, Adedoyin A. Undergraduate students' perception on e-learning systems during COVID-19 pandemic in Nigeria. Heliyon 2023; 9:e14549. [PMID: 36945348 PMCID: PMC10010051 DOI: 10.1016/j.heliyon.2023.e14549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Covid-19 has forced many educational institutions to adopt e-learning as an alternative to physical classroom learning. However, the concern of critical stakeholders in higher educational institutions on the adoption and usage of e-learning system, especially in the developing countries continue to increase recently, due to various challenges facing the sector. This study investigates perception of undergraduate students in University of Ilorin, Nigeria on use of e-learning systems during Covid-19 pandemic. Specifically, this study sought to identify factors that influence the use of e-learning systems, investigates the perception of students on the quality of e-learning systems used, assesses the attitude of their lecturers towards the use of the e-learning system during the pandemic. A three stage sampling techniques including purposive, random and proportionate were employed with a total number of 333 students as respondents using a quantitative research approach. The analysis of the data collected was done using descriptive statistics including mean. The results of the study revealed that e-learning system use among University of Ilorin students is high, but highly influenced by the decision of the school management to employ e-learning system as only approach for teaching during the pandemic. It further revealed that the perception of students on the quality of system used is high, while their lecturers' attitude towards the use of e-learning facilities is positive. The study concluded that adoption of e-learning system for continue education during Covid-19 pandemic was a success at the University of Ilorin. It however suggested a blended learning approach (virtual and face-to-face) and recommended more investment from educational stakeholders to sustain e-learning beyond Covid-19 period.
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Affiliation(s)
| | | | | | - Yahaya Isah Shehu
- Department of Computer, Shehu Shagari University of Education, Sokoto, Nigeria
| | - Adeyinka Adedoyin
- Department of Information Technology, University of Ilorin, Ilorin, Nigeria
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Mayo NE, Aubertin-Leheudre M, Mate K, Figueiredo S, Fiore JF, Auais M, Scott SC, Morais JA. Development of a Frailty Ladder Using Rasch Analysis: If the Shoe Fits. Can Geriatr J 2023; 26:133-143. [PMID: 36865407 PMCID: PMC9953502 DOI: 10.5770/cgj.26.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background The current measurement approach to frailty is to create an index of frailty status, rather than measure it. The purpose of this study is to test the extent to which a set of items identified within the frailty concept fit a hierarchical linear model (e.g., Rasch model) and form a true measure reflective of the frailty construct. Methods A sample was assembled from three sources: community organization for at-risk seniors (n=141); colorectal surgery group assessed post-surgery (n=47); and hip fracture assessed post-rehabilitation (n=46). The 234 individuals (age 57 to 97) contributed 348 measurements. The frailty construct was defined according to the named domains within commonly used frailty indices, and items drawn to reflect the frailty came from self-report measures. Performance tests were tested for the extent to which they fit the Rasch model. Results Of the 68 items, 29 fit the Rasch model: 19 self-report items on physical function and 10 performance tests, including one for cognition; patient reports of pain, fatigue, mood, and health did not fit; nor did body mass index (BMI) nor any item representing participation. Conclusion Items that are typically identified as reflecting the frailty concept fit the Rasch model. The Frailty Ladder would be an efficient and statistically robust way of combining results of different tests into one outcome measure. It would also be a way of identifying which outcomes to target in a personalized intervention. The rungs of the ladder, the hierarchy, could be used to guide treatment goals.
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Affiliation(s)
- Nancy E. Mayo
- Department of Medicine, McGill University, Montreal, QC,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC,School of Physical and Occupational Therapy, McGill University, Montreal, QC
| | - Mylène Aubertin-Leheudre
- Département des Sciences de l’activité physique, Faculté des Sciences, Université du Québec à Montréal, Montréal, QC,Centre de recherche de l’institut universtaire de Gériatrie de Montréal, Montréal, QC
| | - Kedar Mate
- Department of Medicine, McGill University, Montreal, QC
| | - Sabrina Figueiredo
- Health Care Quality Program, The George Washington University, School of Medicine and Health Sciences, Washington, DC
| | - Julio Flavio Fiore
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC,Department of Surgery, McGill University, Montreal, QC,Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal, QC
| | - Mohammad Auais
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON
| | - Susan C. Scott
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC
| | - José A. Morais
- Department of Medicine, McGill University, Montreal, QC,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC
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Deng W, Carpentier S, Van de Winckel A. Physical body experiences questionnaire simplified for active aging (PBE-QAG): Rasch validation. PLoS One 2023; 18:e0280198. [PMID: 36763606 PMCID: PMC9916545 DOI: 10.1371/journal.pone.0280198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/22/2022] [Indexed: 02/11/2023] Open
Abstract
PURPOSE To validate the Physical Body Experiences Questionnaire simplified for Active aGing (PBE-QAG) with Rasch Measurement Theory. PBE-QAG measures body awareness during physical activity. METHODS Community-dwelling adults were recruited at the Minnesota State Fair, Highland Fest, and in the Brain Body Mind Lab (University of Minnesota). They completed demographic, clinical, and behavioral questionnaires and the PBE-QAG, which has 12 items, with scoring options ranging between 0 (totally true) and 4 (totally false). A lower total PBE-QAG score on reflects better body awareness. We validated the structural validity of PBE-QAG in community-dwelling older adults, and in community-dwelling adults (18-99 years of age). We also performed a pilot structural validity in community-dwelling adults with chronic stroke. We evaluated item and person fit, targeting, unidimensionality, person separation reliability, differential item functioning for demographic and clinical characteristics, principal component of residuals, and local item dependence. RESULTS We obtained unidimensionality and item fit after deleting and rescoring items in older adults (n = 133), adults (n = 530), and adults with chronic stroke (n = 36). In community-dwelling adults, 7 participants did not fit the model (1.13%). There was minimal floor (5.28%), no ceiling effect (0.00%), and no local item dependence or differential item functioning. The person mean location was -1.77±1.22 logits. CONCLUSIONS PBE-QAG demonstrated good item and person fit, but the targeting is off. Therefore, the current version of PBE-QAG is not recommended for use in community-dwelling adults. We encourage further validation of PBE-QAG by adding more difficult items. We also recommend evaluating the PBE-QAG in a larger group of adults with stroke.
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Affiliation(s)
- Wei Deng
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sydney Carpentier
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
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50
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Farzad M, MacDermid J, Rassafiani M. Factor structure of Participation Behavioural Questionnaire (PBQ) in patients with hand injuries. PLoS One 2023; 18:e0267872. [PMID: 36662736 PMCID: PMC9858033 DOI: 10.1371/journal.pone.0267872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Participation is considered a critical outcome of successful rehabilitation and should be evaluated. OBJECTIVE We aimed to evaluate the structural validity of the Participation Behaviour Questionnaire (PBQ) in people with hand injuries. METHODOLOGY The PBQ contains 30 items that measure participation as conceptualized in the ICF. PBQ was developed with Rasch analysis to measure participation in hand injured. A sample of 404 patients with hand injuries and a mean age of 37 (16.0) participated and was randomly split for exploratory and confirmatory factor analysis (EFA/CFA). RESULTS Both EFA and CFA confirmed a four factor-solution. These factors were named: Social Participation and Interpersonal Relationships, Autonomy and Role, Subjective Satisfaction with Participation, Recreational, Sport, and Leisure Time. The value of Cronbach's alpha was 0.96 for the total scale and >0.85 for each subscale. CONCLUSIONS The structural validity of the PBQ was confirmed using both EFA and CFA. The PBQ measures four dimensions of participation.
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Affiliation(s)
- Maryam Farzad
- School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, Ontario, Canada
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada
- Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Joy MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario, Canada
- Rehabilitation Science McMaster University, Hamilton, ON, Canada
| | - Mehdi Rassafiani
- Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
- Paediatric Neurorehabilitation Research Centre, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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