Performance of a New Instrument for the Measurement of Systemic Lupus Erythematosus Disease Activity: The SLE-DAS

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that affects multiple organ systems and manifests in a relapsing-remitting pattern. Consequently, it is paramount for rheumatologists to assess disease activity, identify flare-ups, and establish treatment goals for patients with SLE. In 2019, the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) was introduced as a novel tool for measuring disease activity. This tool refines the parameters of the established SLE Disease Activity Index 2000 (SLEDAI-2K) to enhance the assessment process. This review aims to provide an introduction to the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and summarizes research on its development, its comparison with existing disease activity measures, and its performance in clinical settings. Literature searches on PubMed using the keyword "SLE-DAS" were conducted, covering publications from March 2019 to September 2023. Studies that compared SLE-DAS with other SLE disease activity measurement tools were reviewed. Findings indicated that SLE-DAS consistently performs on par with, and sometimes better than, traditional measures in assessing clinically meaningful changes, patient improvement, disease activity, health-related quality of life, hospitalization rates, and disease flare-ups. The association between SLE-DAS and mortality rates among patients with SLE, however, remains to be further explored. Although SLE-DAS is a promising and potentially effective tool for measuring SLE disease activity, additional research is needed to confirm its effectiveness and broaden its clinical use.

Evaluation Tools Developed for Rett Syndrome

Rett syndrome (RTT) is a complex neurodevelopmental X-linked disorder associated with severe functional impairments and multiple comorbidities. There is wide variation in the clinical presentation, and because of its unique characteristics, several evaluation tools of clinical severity, behavior, and functional motor abilities have been proposed specifically for it. This opinion paper aims to present up-to date evaluation tools which have specifically been adapted for individuals with RTT often used by the authors in their clinical and research practice and to provide the reader with essential considerations and suggestions regarding their use. Due to the rarity of Rett syndrome, we found it important to present these scales in order to improve and professionalize their clinical work. The current article will review the following evaluation tools: (a) the Rett Assessment Rating Scale; (b) the Rett Syndrome Gross Motor Scale; (c) the Rett Syndrome Functional Scale; (d) the Functional Mobility Scale-Rett Syndrome; (e) the Two-Minute Walking Test modified for Rett syndrome; (f) the Rett Syndrome Hand Function Scale; (g) the StepWatch Activity Monitor; (h) the activPAL^TM; (i) the Modified Bouchard Activity Record; (j) the Rett Syndrome Behavioral Questionnaire; and (k) the Rett Syndrome Fear of Movement Scale. The authors recommend that service providers consider evaluation tools validated for RTT for evaluation and monitoring to guide their clinical recommendations and management. In this article, the authors suggest factors that should be considered when using these evaluation tools to assist in interpreting scores.

Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version

The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7-15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach's alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach's alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the "mobility" subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the "feeling about functioning" CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test-retest agreement was found for the total and subscale scores (ICC ≥ 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.

Immersion and Socio-Emotional Experiences During a Movie - Polish Adaptation of the Movie Consumption Questionnaires

The aim of the article is to present a description of the psychometric properties of the Polish adaptation of the Movie Consumption Questionnaires (MCQ) - Immersion and MCQ - Experience. The instrument, created by Fornerino, Helme-Guizon and Gotteland (2008) allows measuring movie consumption in terms of immersion, the intensity of emotions and the intensity of social interactions during the screening. The Polish adaptation of the tool involved two stages, whose participants were movie-goers attending screening events at a cinema (N=577). The factor structure of the adapted instrument strongly resembles that obtained in the original study (RMSEA<0.08, CFI>0.95, SRNR<0.08) and has demonstrated very good internal consistency (α>0.8, ω>0.8). Criterion validity was also verified through the use of questionnaires that examine the following: affect - PANAS-X (Fajkowska & Marszał-Wiśniewska, 2009), emotionality - HEXACO (Szarota et al., 2007) and mindfulness - Mindful Attention Awareness Scale (Skala Świadomej Obecności; Radoń, 2014). Results of the analyses suggest that the adapted scales may be used as satisfactory tools for measuring movie consumption. By the same token, they may be useful in further psychological exploration of the movie screening phenomenon, with particular regard to immersion, emotional reactions and social interactions of the viewer.

Development of the Japanese version of the Depression Literacy Scale

BACKGROUND

Depression is a major social concern in Japan. It is therefore necessary to develop a scale in Japanese that can assess depression literacy.

AIMS

The present study aimed to develop the Japanese version of the Depression Literacy Scale (D-Lit-J), and examined its validity and reliability.

METHODS

Three groups were administered the D-Lit-J, including 117 first-year university English literature students, 112 first-year medical school students, and 53 psychiatrists. Among these, 112 (95.7%), 112 (100%), and 29 subjects (54.7%) returned completed questionnaires, respectively. The total D-Lit-J scores were compared between the three groups to assess known-group validity, and internal reliability was examined by calculating Cronbach's alpha coefficients. Medical students were asked to complete the questionnaire a second time, 3 weeks later (11 students did not respond), to assess the test-retest reliability using the intra-class correlation coefficient.

RESULTS

The total D-Lit-J scores (mean ± SD) were 7.61 ± 4.18, 9.51 ± 4.37, and 17.7 ± 3.15, for English literature students, medical students, and psychiatrists, respectively, and there were significant differences between the three groups (p < .05). The Cronbach's alpha coefficients ranged from .800 to .834 in all students, and was .764 in psychiatrists, revealing a good internal consistency. The intra-class correlation coefficient of the scale was .769.

CONCLUSIONS

The D-Lit-J showed a credible known-group validity, with good internal and test-retest reliabilities. Additional studies with a greater variety of subjects and that examine concurrent or discriminant validity will be necessary in the future.

Developing a scale measuring the doctor-patient relationship in China from the perspective of doctors

OBJECTIVES

The doctor-patient relationship is usually measured in line with patient needs and demands. This study aimed to develop a scale measuring such a relationship from the perspective of doctors.

METHODS

A draft scale was developed and adapted to the hospital context of China based on several existing scales, with an intention to measure how medical doctors view and manage their relationship with patients beyond episodic clinical encounters. Two rounds of Delphi consultations involving 14 experts were conducted to seek their consensus on the inclusion and descriptions of items. This resulted in a 19-item scale measuring four domains of the relationship. The scale was validated through a survey of 1,712 medical doctors selected from 27 public hospitals in Heilongjiang province of China. The internal consistency of the scale was assessed using Cronbach's α coefficients of the four domains. Confirmatory factor analyses were performed to test the construct validity of the scale. Linear regression analyses were performed to assess the known-group validity of the scale.

RESULTS

The scale measures four domains. The Cronbach's α of the scale reached an acceptable level, ranging from 0.61 to 0.78 for its four domains. Good fitness of data into the four-domain structure of the scale was confirmed by the confirmatory factor analysis. Known-group differences were demonstrated in the regression analyses.

CONCLUSION

The doctor-patient relationship scale developed in this study is a psychometrically valid tool assessing how medical doctors view and manage their relationship with patients in the hospital setting in China.

Psychometric Properties of a Healthcare Provider Burden Scale: Preliminary Results

Measures are lacking of the clinical burden that healthcare providers perceive in treating chronic conditions. This study presents a preliminary psychometric evaluation of a novel self-report measure of provider burden in the treatment of chronic pain. Data for eight burden items were available from vignette studies examining the effects of patient pain severity and medical evidence on clinical burden and judgments for chronic pain. Participants (N = 922) were 109 physicians and 813 non-physicians, all acting in the role of physician (232 community members without chronic pain, 105 community members with chronic pain, and 476 American Chronic Pain Association members with chronic pain). Factor analyses of burden items yielded one-factor solutions in all samples, with high factor loadings and adequate explained variance. Internal consistency reliability was uniformly high (≥ .87). Burden scores were significantly higher among physicians compared to non-physicians; non-physician groups did not differ on any burden score. Significant correlations of burden score with indicators of psychosocial complications in patient care supported scale validity. Burden score was not associated with gender, age, or education. Results provide initial support for the psychometric properties of a Healthcare Provider Burden Scale (HPBS). Research utilizing larger and representative healthcare provider groups is needed.

Spontaneous space closure following the extraction of the first permanent mandibular molar

Aim

The aim of this study was to determine the prognostic factors, such as the developmental stage of second permanent molar (SPM), the angulation of SPM, and presence/absence of the third molar associated with the spontaneous space closure after the mandibular first permanent molars (FPM) extraction.

Material and Methods

A total of 177 mandibular SPMs were evaluated in this cross-sectional study. The prognostic factors determining successful space closure such as SPM developmental stage, SPM angulation, and presence/absence of the third molar were evaluated.

Results

The mean age of the patients at the time of extraction of SPM was 9.4 years and post-extraction assessment at the time of the study was 12.7 years. Of the total 177 mandibular SPMs, 36 SPMs (20.3%) were at Demirjian stage D, 63 (35.6%) at stage E, 60 (34%) at stage F, 18 (10.1%) at stage G. 18 SPMs (10.1%) had distal angulation, 23 SPMs (13.0%) had mesial angulation and 136 SPMs (76.9%) had upright angulation. At the time of radiographic assessment, 79.1% of the mandibular quadrants showed evidence of third molar formation. Of the 177 mandibular SPMs, 93 (52.5%) exhibited successful space closure in the mandibular arch.

Conclusions

There is no statistical significance between the chronological age and the developmental stage of the mandibular SPM with regard to the successful spontaneous space closure at the time of the dental extraction of FPMs. The presence of the mandibular third molar may be a consideration for spontaneous space closure in the mandibular arch.

A self-applied valid scale for rapid tracking of household food insecurity among pregnant women in Sri Lanka

Rapid household food insecurity (HFI) tracking has been identified as a priority in the context of the COVID-19 pandemic and its aftermath. We report the validation of the Latin American and Caribbean Food Security Scale (Escala Latinoamericana y Caribena de Seguridad Alimentaria [ELCSA]) among pregnant women in Sri Lanka. The eight-item adult version of the ELCSA was translated from English to Sinhala and Tamil. Cognitive testing (on 10 pregnant women and five local experts) and psychometric validation of the self-administered HFI tool were conducted among pregnant women (n = 269) attending the special clinics of the Rajarata Pregnancy Cohort (RaPCo) in Anuradhapura in February 2020. We assessed the psychometric properties and fit using a one parameter logistic model (Rasch model analysis) using STATA Version 14 and WINSTEP software Version 4.3.4. Concurrent validity was tested using psychological distress. The scale was internally consistent (Cronbach's alpha = 0.79) and had a good model fit (Rasch items infit statistic range: 0.85 to 1.07). Item 8 ('did not eat for the whole day') was removed from the model fit analysis, as it was not affirmed by respondent. Item severity scores ranged from -2.15 for 'not eating a diverse diet' to 4.43 for 'not eating during the whole day'. Concurrent validity between HFI and psychological distress was confirmed (r = 0.15, p < 0.05). The self-applied version of ELCSA-pregnancy in Sri Lanka (ELCSA-P-SL) is a valid and feasible valid tool. We recommend it to track HFI among pregnant women in lower income countries during the COVID-19 pandemic.

The Digital Stressors Scale: Development and Validation of a New Survey Instrument to Measure Digital Stress Perceptions in the Workplace Context

This article reports on the development of an instrument to measure the perceived stress that results from the use and ubiquity of digital technology in the workplace. Based upon a contemporary understanding of stress and a set of stressors that is a substantial update to existing scales, the Digital Stressors Scale (DSS) advances the measurement of digital stress. Initially, 138 items were constructed for the instrument and grouped into a set of 15 digital stressors. Based on a sample of N = 1,998 online questionnaires completed by individuals representative of the US employed population, the scale was refined using exploratory factor analyses (EFA) and PLS-SEM. The resulting and final scale consists of ten stressor categories reflective of one higher-order construct and a total of 50 items. Through a nomological network that includes important outcome variables of digital stress (emotional exhaustion, innovation climate, job satisfaction, user satisfaction) it was then demonstrated that the DSS provides substantial explanatory power, particularly related to emotional exhaustion and user satisfaction. Thus, the DSS constitutes a state-of-the-art self-report instrument to measure the extent of distress appraisal related to digital technologies in the workplace and helps to explain further how and why information and communication technologies can lead to adverse outcomes in individuals, thereby providing the starting point for job related organizational interventions.

The multidimensional attitudes scale towards persons with disabilities (MAS) - a Polish adaptation (MAS-PL)

OBJECTIVE

The aim of this study was to create a Polish adaptation of the Multidimensional Attitudes Scale toward Persons with Disabilities (MAS) by performing a statistical psychometric analysis in a sample of Polish students.

MATERIAL AND METHODS

The study included 540 person (82.0% of students and 18.0% of workers), whose attitudes towards the disabled were measured with the Polish version of the MAS (MAS-PL). Mean age of respondents was 24.72 years (SD = 5.7), with a significant majority of women (n = 455, 84.3%). Data was collected during university classes and via an online survey.

RESULTS

Factor analysis yielded a three-factor structure of the MAS-PL, including affective, cognitive, and behavioural domains, which explained almost 45% of the total variance. Further factor-based solutions increased this percentage only slightly (0.8).

CONCLUSIONS

The Polish version of the MAS scale (MAS-PL) has been developed and presented as a reliable instrument for studying the attitudes of Poles towards people with disabilities. The scale can be used as a preliminary assessment tool when creating educational programmes, including those for training and social Policy, as well as assessing the effectiveness of programmes. Studies with the use of the MAS-PL will allow comparisons of research findings conducted with the use of MAS scales in other English-speaking (original/English MAS) or Spanish-speaking (Spanish MAS) populations and German (G-MAS), Korean (MAS-K), Serbian (Serbian MAS), Turkish (Turkish MAS) and French populations (French MAS autism).

A measurement scale to assess responsive feeding among Cambodian young children

The caregiver-child interaction during mealtime, which refers to responsive feeding (RF), influences child's dietary intake. In Cambodia, given the level of malnutrition, getting better knowledge of RF among young children is essential, but to do so, using an appropriate assessment tool is necessary. We aim to develop and to validate a measurement tool to assess RF in two different situations (before and after an intervention) among children 6-23 months old. This research is part of a larger trial assessing the impact of nutrition education combined or not with the provision of complementary foods on child nutritional status. The "Opportunistic Observation Form" from the Process for the Promotion of Child Feeding package was used to collect data on RF through direct observations of child's meal episodes. Data were used to define an initial scale composed of four constructs and 15 indicators. Confirmatory factor analyses (CFA) and Hancock and Mueller's H reliability indices were computed to assess the validity and reliability of the scale. The final tool was applied to baseline and endline data. At baseline, the sample included 243 pairs and, at endline, 248 pairs. The final scale included two latent constructs (RF and active feeding) that comprise three indicators for active feeding and five for RF. Criteria for fit indices of CFA were met for both constructs though better at baseline. Reliability coefficients were above 0.80 for each construct at baseline and endline. This research proposes a scale that could be used to assess active feeding and RF. Further validation is warranted in different contexts.

Norm and Deviance-Seeking Personal Orientation Scale (NDPOS) Adapted to the Organisational Context

Deviance theory introduces a behavioural view on constructive and destructive deviance to explain how an individual's intent can harm or improve organisational well-being. However, to our knowledge, no scale exists that evaluates the personal orientation aspect of deviance and normativity. This article discusses the creation of the Norm and Deviance-Seeking Personal Orientation Scale (NDPOS). To create this scale, we studied the psychometric properties of the instrument using data from French workers. NDPOS exploratory analysis indicated a 12-item scale composed of four factors: normative conformity, normative rule adequacy, deviant performance seeking, and deviant proactivity seeking. Confirmatory factor analysis corroborated the factorial structure in four sub-scales. Convergent and discriminant validity indicated that deviant dimensions were positively related to expressing voice, cognitive flexibility, and deviant behaviours, whereas normativity dimensions were negatively or not related to these behaviours. Furthermore, opposite relations between the conformity construct and the four factors were observed. Practical implications and suggestions for the development of future research on constructive deviance theory are discussed.

Scale matters: a survey of the concepts of scale used in spatial disciplines

Scale is a critical factor when studying patterns and the processes that cause them. A variety of approaches have been used to define the concept of scale but confusion and ambiguities remain regarding scale types and their definitions. The objectives of this study were therefore (1) to review existing types and definitions of scale, and (2) to systematically investigate the ambiguities in scale definitions and to determine the applicability of the various scale types and definitions. Through a comprehensive literature review, we identified seven types of scales and designed a survey for the seven definitions of scale and interviewed 150 scientists. The results show that the more cartography related types of scale are relatively well known while the more abstract dimensions are less known and are most ambiguous. Based on graphical examples, participants were asked which spatial scales are most relevant for their work. Surprisingly, composite objects such as a forest stand were most relevant followed by individual objects such as single trees and, lastly, more generalized categorizes or meta-objects such as "forested area". We have drawn some conclusions that will help to clarify the different types of scale in regard to their practical use.

How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries

A health system's ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among researchers in measuring motivation within health worker surveys. However, there is currently limited guidance on how to conceptualize and approach measurement and how to validate or analyse motivation data collected from health worker surveys, resulting in inconsistent and sometimes poor quality measures. This paper begins by discussing how motivation can be conceptualized, then sets out the steps in developing questions to measure motivation within health worker surveys and in ensuring data quality through validity and reliability tests. The paper also discusses analysis of the resulting motivation measure/s. This paper aims to promote high quality research that will generate policy relevant and useful evidence.

Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales

OBJECTIVES

Ascertaining the quality of life (QoL) in people with dementia is important for evaluating service outcomes and cost-effectiveness. This paper identifies QoL measures for people with dementia and assesses their properties.

METHOD

A systematic narrative review identified articles using dementia QoL measures. Electronic databases searched were AMED, CINAHL, EMBASE, Index to Theses, IBSS, MEDLINE, PsycINFO, Sociological Abstracts, and Web of Science. All available years and languages (if with an English language abstract) were included.

RESULTS

Searches yielded 6806 citations; 3043 were multiple duplicates (759 being true duplicates). Abstracts were read; 182 full papers were selected/obtained, of which 126 were included as relevant. Few measures were based on rigorous conceptual frameworks. Some referenced Lawton's model (Dementia Quality of Life [DQOL] and Quality of Life in Alzheimer's Disease [QOL-AD]), though these tapped part of this only; others claimed relationship to a health-related QoL concept (e.g. DEMQOL), though had less social relevance; others were based on limited domains (e.g. activity, affect) or clinical opinions (Quality of Life in Late-Stage Dementia [QUALID]). Many measures were based on proxy assessments or observations of people with dementia's QoL, rather than their own ratings. The Bath Assessment of Subjective Quality of Life in Dementia (BASQID) was developed involving people with dementia and caregivers, but excluded some of their main themes. All measures were tested on selective samples only (ranging from community to hospital clinics, or subsamples/waves of existing population surveys), in a few sites. Their general applicability remains unknown, and predictive validity remains largely untested.

CONCLUSION

The lack of consensus on measuring QoL in dementia suggests a need for a broader, more rigorously tested QoL measure.

Measurement scale influences in the evaluation of sight-word reading interventions

Working with elementary students with disabilities, we used alternating treatment designs to evaluate and compare the effects of 2 computer-based flash card sight-word reading interventions, 1 with 1-s response intervals and another with 5-s response intervals. In Study 1, we held instructional time constant, applying both interventions for 3 min. Although students completed 6 learning trials per word during each 1-s session and 2 trials per word during each 5-s session, results showed similar acquisition rates for 1-s and 5-s words. During Study 2, we held learning trials constant (3 per word) and allowed instructional time to vary. When we measured learning using cumulative instructional sessions, the interventions appeared to cause similar increases in acquisition rates. When the same learning data were measured and plotted using cumulative instructional seconds, all participants showed greater learning rates under the 1-s intervention. Discussion focuses on how measurement scales can influence comparative effectiveness studies.

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.

Psychometric properties of the self-assessment of nursing informatics competencies scale

The objective of this study was to examine the factor structure, internal consistency reliability, and responsiveness of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS). Combined BS/MS nursing students (N=336) completed the 93-item scale, which was based upon published and locally-developed nursing informatics competency statements. Exploratory principal component analysis with oblique promax rotation extracted five factors comprising 30 items that explained 63.7% of the variance: clinical informatics role (alpha=.91), basic computer knowledge and skills (alpha=.94), applied computer skills: clinical informatics (alpha=.89), nursing informatics attitudes (alpha=.94), and wireless device skills (alpha=.90). Scale responsiveness was supported by significantly higher factor scores following an informatics course. This study provided preliminary evidence for the factor structure, internal consistency reliability and responsiveness of the 30-item SANICS. Further testing other samples is recommended.

Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services

Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.