Adolescent health promotion scale: development and psychometric testing

The purpose of this study was to assess the psychometric properties of a newly devised instrument, the Adolescent Health Promotion scale (AHP), a 40-item Likert-type self-report instrument used to detect unhealthy lifestyles in adolescents. Content validity was considered to be supported based on the findings of previous studies and the observations of a panel of 14 content experts. This study examined the construct validity and reliability of the instrument. The psychometric properties of the AHP, including item analysis, factor analysis, and reliability measures, were assessed based on the responses of 1,128 Taiwanese adolescents. Kaiser-Meyer-Olkin (KMO) measures and Bartlett's sphericity test showed that the samples met the criteria for factor analysis. Factor analysis yielded a six-factor instrument that explained 51.14% of the variance in the 40 items. The six factors were social support, life appreciation, health responsibility, nutritional behaviors, exercise behaviors, and stress management. The Cronbach alpha reliability coefficient for the total scale was 0.932, and alpha coefficients for the subscales ranged from 0.75 to 0.88. The results of this study indicate that the AHP has good construct validity and reliability in Taiwanese and that its use by school health nurses to assess adolescent health promotion programs is warranted.     

Development and testing of a patient‐centred care competency scale for hospital nurses

This study aimed to develop and test the psychometric soundness of a patient‐centred care competency (PCC) scale for hospital nurses. A cross‐sectional questionnaire survey was conducted among 594 nurses in two teaching hospitals (response rate 99.5%). Reliability and validity analyses were performed. The PCC scale consisted of 17 items divided into four subscales: respecting patients' perspectives (6 items), promoting patient involvement in care processes (5 items), providing for patient comfort (3 items) and advocating for patients (3 items). The Cronbach's alpha coefficient of the entire scale was 0.92, and those for the subscales were 0.85, 0.81, 0.84 and 0.80, respectively. Multitrait scaling analysis indicated that the four subscales had satisfactory convergent and discriminant validity. Significant correlations were found between total PCC scores and overall self‐ratings of patient‐centred care performance (r = 0.60, P < 0.001). The PCC scale was therefore determined to be a highly valid and reliable tool.     

Oswestry功能障碍指数评定慢性腰痛患者的效度分析

目的:探讨中文版Oswestry功能障碍指数(CODI)的效度,为临床应用提供客观依据。方法:107例慢性腰痛患者参加测试,患者根据自己情况独立完成CODI、视觉模拟评分法(VAS)和健康状况调查问卷(SF-36)3个量表。应用因子分析对CODI进行分析来检验其结构效度;应用Person相关分析计算CODI每一条目与所属领域和其他领域的相关系数来检验其内容效度和区分效度;比较CODI和VAS、CODI和SF-36的Person相关系数来检验其同期效度。结果:患者对CODI的条目8回答率较低(32.7%),没有纳入统计分析。CODI的9个条目提取出3个公因子,累计方差贡献率为76.3%;每一条目与所属领域的相关系数r=0.78—0.89(P0.05),且每一条目与所属领域的相关系数均高于该条目与其他领域的相关系数;CODI的三大领域得分和VAS评分的相关系数分别为r=0.88,0.81,0.76(P0.05);CODI的三大领域得分与SF-36各项目分值相关性r=-0.36—-0.87(P0.05)。结论:CODI具有良好的结构效度、内容效度、区分效度和同期效度,可用于慢性腰痛患者的临床评定。     

Quality of life in Polish respondents: psychometric properties of the Polish WHOQOL-Bref

The aim of this study was to examine the validity and reliability of the Polish WHOQOL - Bref in a sample of 908 respondents. The Bref is a generic quality of life (QoL) instrument designed for cross - cultural use. Correlational and multivariate analyses confirmed the relevancy of individual items and domains supporting the construct validity of the scale. Multiple regression analyses of the domain scores with two overall questions (dependent variable) showed that all four domains made a significant contribution in explaining the variance in overall QoL. The psychological domain made the strongest contribution (unstandardized B coefficient = 0.10, r2 = 0.41), followed by the social, environmental and physical domains. When overall health satisfaction was considered as the dependent variable, the physical domain contributed most strongly (unstandardized B coefficient = 0.21, r2= 0.43) followed by the psychological and environmental domains. Exploratory factor analyses resulted in a four factors solution with 24 items explaining 49.6% of the cumulative variance. Confirmatory factor analyses lended marginal support for the goodness of fit of the four-domain model. The physical domain was found to be strongest in differentiating between unhealthy and healthy subjects, followed by psychological and social domains. Acceptable internal consistency was shown with Cronbach's alpha coefficients being greater than 0.70 for all domains with the exception of the social domain. Further exploration of the scales validity and conceptual clarity need further testing in Polish and international samples.     

The relationship between TV/computer time and adolescents' health-promoting behavior: a secondary data analysis

Television and computers provide significant benefits for learning about the world. Some studies have linked excessive television (TV) watching or computer game playing to disadvantage of health status or some unhealthy behavior among adolescents. However, the relationships between watching TV/playing computer games and adolescents adopting health promoting behavior were limited. This study aimed to discover the relationship between time spent on watching TV and on leisure use of computers and adolescents' health promoting behavior, and associated factors. This paper used secondary data analysis from part of a health promotion project in Taoyuan County, Taiwan. A cross-sectional design was used and purposive sampling was conducted among adolescents in the original project. A total of 660 participants answered the questions appropriately for this work between January and June 2004. Findings showed the mean age of the respondents was 15.0 +/- 1.7 years. The mean numbers of TV watching hours were 2.28 and 4.07 on weekdays and weekends respectively. The mean hours of leisure (non-academic) computer use were 1.64 and 3.38 on weekdays and weekends respectively. Results indicated that adolescents spent significant time watching TV and using the computer, which was negatively associated with adopting health-promoting behaviors such as life appreciation, health responsibility, social support and exercise behavior. Moreover, being boys, being overweight, living in a rural area, and being middle-school students were significantly associated with spending long periods watching TV and using the computer. Therefore, primary health care providers should record the TV and non-academic computer time of youths when conducting health promotion programs, and educate parents on how to become good and healthy electronic media users.     

Preliminary Validation of Subjective Anchor Scales for Worry and Rumination

This research is a preliminary validation of two single-item visual analogue scales. The worry visual analogue scale (WVAS) and the rumination visual analogue scale (RVAS) are self-report measures developed to track state changes in worry and rumination. Each of these scales uses an idiographic anchor sheet, enabling each participant to quantify their personal scale of worry or rumination. We compared ratings on the WVAS and RVAS with self-report measures of trait worry and rumination as well as other constructs administered concurrently in two separate studies. In study 1 we compared results within an unselected undergraduate sample. In study 2 we compared results within a community-based sample of individuals with generalized anxiety disorder (GAD), individuals with GAD comorbid with unipolar depressive disorders, and healthy controls. Results from both studies indicate the WVAS is a reliable state-level measure of worry with acceptable discriminant and convergent validity. Results for the RVAS showed similar reliability and convergent validity but lacked as much discriminant validity. This difference is possibly due to all experimental groups having comorbid anxiety, which is associated more with worry than rumination. Regression analyses indicate the WVAS predicts trait-level anxiety measures more strongly than measures of depression and beyond the predictive ability of the RVAS. The RVAS predicts measures of depression more strongly than it does measures of anxiety but is not consistently a stronger predictor of depression than the WVAS. These findings suggest worry and rumination are distinct regulatory constructs. In study 2, participants with GAD, and GAD comorbid with unipolar depressive disorders, scored significantly higher than healthy controls in worry and rumination. The internal reliability of the measures is reported.     

Assessing health-related quality of life in adolescents: some psychometric properties of the first Norwegian version of KINDL

The study presented in this paper is part of a larger Norwegian investigation among adolescents, where the overall aim is to develop methods to promote their quality of life (QoL), to discover risk factors or threats to adolescents' well-being, and finally to prevent the negative effects of such factors. An adequate generic health-related quality of life (HR-QoL) measure is therefore needed. However, only a limited number of well validated instruments that measure HR-QoL in adolescents exist, and to date only a few has been translated into Norwegian. The purpose of this study was therefore to examine some psychometric properties of the first Norwegian version of a simple, generic, German HR-QoL questionnaire for adolescents, KINDL. The instrument consists of 24-items, distributed in six subscales, which correspond to six domains of adolescents' HR-QoL. Based on a sample of 239 healthy adolescents, the internal consistency reliability is satisfactory for both the total scale and the subscales of 'Self-esteem and Family', fairly good for the 'Emotional' subscale, but lower for the subscales 'Physical', 'Friends' and 'School'. Factor analyses, which concerns construct validity, yielded interpretable solutions. The factor solutions at item level were interpreted to be in line with the original subscales, while factor analysis at subscale level indicated that a common QoL core is involved. To conclude, the Norwegian version of KINDL appears, in general, to be a psychometrically acceptable method of measuring HR-QoL in healthy adolescents. However, the alpha-values of some of the subscales are not optimal, and these scales should be used with caution in research and profession. Still KINDL-N is considered suitable for screening purposes in the public health area and especially within school-health care.