Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers

OBJECTIVE: To develop and test a new instrument to assess environmental barriers encountered by people with and without disabilities by using a questionnaire format. DESIGN: New instrument development. SETTING: A rehabilitation hospital and community. PARTICIPANTS: Two convenience samples: (1) 97 subjects, 50 with disabilities and 47 without disability, and (2) 409 subjects with disabilities from spinal cord injury, traumatic brain injury, multiple sclerosis, amputation, or auditory or visual impairments. In addition, a population-based sample in Colorado of 2269 people (mean age, 44 y; 57% men) with and without disabilities. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Item development; factor structure; test-retest, subject-proxy and internal consistency reliability; content, construct, and discriminant validity; and subscale and abbreviated version development. RESULTS: Panels of experts on disability developed items for the Craig Hospital Inventory of Environmental Factors (CHIEF). The instrument measured the frequency and magnitude of environmental barriers reported by individuals. Five subscales were derived from factor analysis measuring (1) attitudes and support, (2) services and assistance, (3) physical and structural, (4) policy, and (5) work and school environmental barriers. The CHIEF total score had high test-retest reliability (intraclass correlation coefficient [ICC]=.93) and high internal consistency (Cronbach alpha=.93), but lower participant-proxy agreement (ICC=.62). Significant differences were found in CHIEF scores among groups of people with known differences in disability levels and disability categories. CONCLUSIONS: The CHIEF has good test-retest and internal consistency reliability with evidence of content, construct, and discriminant validity resulting from its development strategy and psychometric assessments in samples of the general population and among people with a variety of disabilities.     

Reliability and validity of the self-assessment of occupational functioning.

OBJECTIVE: Two studies examined the reliability and validity of the Self-Assessment of Occupational Functioning (SAOF), a 23-item self-assessment of perceptions of strengths, and weaknesses relative to occupational functioning, grounded in the Model of Human Occupation. METHOD: The first study examined the test-retest reliability of the SAOF, and involved 37 college students without disabilities who completed the SAOF twice. The second study, which involved 39 young persons hospitalized with psychiatric disorders, examined internal consistency reliability of the SAOF, and examined correlations between SAOF scores and composite scores on the Self-Perception Profile, a widely used measure of perceived competence. In addition, data from both studies were combined to examine the ability of the SAOF to discriminate between the college students without disabilities and the young persons with psychiatric disorders. RESULTS: Kappa and intraclass correlation coefficients (ICCs) were used to examine test-retest reliability and Cronbach's alpha was used to examine internal consistency. Acceptable levels of test-retest (ICCs) and internal consistency (Cronbach's alpha) reliability were found for the subscale and total scores of the SAOF. However, test-retest reliability (kappa) was lower than desirable for many of the individual SAOF items. The young persons with psychiatric disorders had lower item, subscale, and total scores on the SAOF than did the college students without disabilities. In addition, a discriminant analysis predicting group membership (college students without disability vs. young persons with psychiatric disorder) correctly classified 76.6% of the participants based on the four subscale scores of the SAOF. CONCLUSION: The SAOF has the potential to be a reliable and valid clinical assessment; however, additional research is needed.     

护士对护士处方权信念和态度量表的编制与信效度研究

目的:编制护士对护士处方权的信念和态度量表,并评价其信效度,为评估护士对护士处方权的信念和态度提供有效的测量工具。方法:参考Patel编制的护士对护士处方权态度问卷和文献综述,形成条目池,经专家函询及预调查,形成原始量表。采用方便抽样法,选取全国7个省、1个自治区的13所医院共368名护士对量表进行调查,并进行探索性因子分析和信效度检验。结果:量表共有27个条目4个维度:感知护士处方权的益处、对行使护士处方权的自我效能、感知行使护士处方权时的障碍、感知护士处方权的需求。探索性因子分析产生的4个公因子累积变异贡献率为68.24%,各条目的因子载荷为0.498~0.905。总量表与每个维度的相关系数为0.62~0.83,内容效度指数(S-CVI)为0.921,重测信度为0.808,Cronbach′sα系数为0.902。结论:本研究编制的量表信效度良好,适用于评价护士对护士处方权的信念和态度。     

Test-retest reliability and internal consistency of the Quebec-French version of the Survey of Pain Attitudes

OBJECTIVE: To determine the test-retest reliability and internal consistency of the Quebec-French version of the Survey of Pain Attitudes (QAD/F-SOPA). DESIGN: Measurement of test-retest reliability (2-wk interval) and internal consistency. SETTING: Five rehabilitation settings that offer services to chronic pain patients. PARTICIPANTS: Convenience sample of 69 Francophone adults (having either French as the mother tongue or a good mastery of French) with musculoskeletal pain for a minimum of 6 months and stable pain condition during the test-retest interval. INTERVENTIONS: Completion of the QAD/F-SOPA twice within a 2-week interval. MAIN OUTCOME MEASURES: Test-retest reliability (Pearson r , 2-tail paired t test, P <.001) and internal consistency (Cronbach alpha at time 1). RESULTS: Fifty-six subjects completed the QAD/F-SOPA on both occasions. Except for the disability subscale, the r values fell between 0.7 and 0.9 (high correlation). For the paired t test, all subscales (except for control and medication) had a P value greater than .05, confirming their test-retest stability. All subscales showed satisfactory internal consistency estimates (0.7-0.9) except for the harm (.67) and disability (.64) subscales. CONCLUSIONS: Globally, the QAD/F-SOPA has good reliability and validity properties and meets the prerequisites for use for clinical and research purposes. The disability subscale shows weaker properties; further studies would help determine how it could be improved.     

Development of the Family Nursing Practice Scale

This article describes the development and testing of the Family Nursing Practice Scale (FNPS). This self-report questionnaire is designed to measure perceived changes in family nursing practice including attitudes toward working with families, critical appraisal of their family nursing practice and reciprocity in the nurse-family relationship. Categories were derived from a needs assessment, competence as effective application of knowledge and skill and theoretical foundations for family assessment and intervention. Psychometric testing (content, construct validity, internal consistency, and test-retest reliability) was undertaken with 140 psychiatric nurses in Hong Kong. Practice appraisal and nurse-family relationships accounted for 56.4% of the variance. Cronbach's alpha reliability coefficients were .88 and .73 for the two subscales, respectively, and .86 for the scale overall. Test-retest reliability ranged from .62 to .93 on the individual items. The results provide preliminary evidence of the reliability and validity of the FNPS. The instrument provides quantitative and qualitative evaluation components.     

Psychometric properties of the Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in patients with neck pain

OBJECTIVE: To examine selected psychometric properties of these instruments in a cohort of patients with mechanical neck pain. DESIGN: Cohort design of 78 subjects completing self-report measures of pain, disability, and the Fear-Avoidance Beliefs Questionnaire Work (FABQW) and Physical Activity (FABQPA) subscales, as well as the Tampa Scale of Kinesiophobia (TSK) at baseline and a 2-day follow-up. Intraclass correlation coefficients were used to calculate test-retest reliability, and Cronbach's alpha was used to calculate internal consistency. Concurrent validity was analyzed between the FABQPA, FABQW, TSK, pain, and disability using Pearson correlation coefficients and hierarchical linear regression modeling. RESULTS: The FABQPA and FABQW subscales exhibited substantial test-retest reliability, whereas the TSK exhibited moderate reliability. Internal consistency was high for all measures. The FABQW subscale was the only measure that significantly contributed to the regression model for both pain and disability in this group of patients with neck pain. CONCLUSIONS: Whereas the reliability and internal consistency of all measures ranged between moderate and substantial, the results of this study suggest weaker relationships between measures of fear and avoidance beliefs and pain/disability among patients with mechanical neck pain than has been reported among patients with low-back pain.     

Headache Disability Inventory (HDI): Short-term Test-Retest Reliability and Spouse Perceptions

We have reported previously that the 25-item Headache Disability Inventory has good internal consistency reliability, robust long-term (2 month) test-retest stability, and good construct validity. We conducted further investigations to evaluate the short-term (1 week) test-retest reliability and spouse perceptions of patients' self-perceived headache disability. The short-term test-retest reliability of the Headache Disability Inventory was excellent. Additionally, the spouse and patients' perceptions of the patient's headache disability generally were congruent, although we observed instances where the differences were marked.     

Psychometric evaluation of 'The 25-item Sex after MI Knowledge Test' in a Swedish context

The patients' sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of 'The 25-item Sex after MI Knowledge Test' in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients' National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test-retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test-retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.     

Validity and reliability of the Turkish Migraine Disability Assessment (MIDAS) questionnaire

OBJECTIVES: The aim of this study is to assess the comprehensibility, internal consistency, patient-physician reliability, test-retest reliability, and validity of Turkish version of Migraine Disability Assessment (MIDAS) questionnaire in patients with headache. BACKGROUND: MIDAS questionnaire has been developed by Stewart et al and shown to be reliable and valid to determine the degree of disability caused by migraine. DESIGN AND METHODS: This study was designed as a national multicenter study to demonstrate the reliability and validity of Turkish version of MIDAS questionnaire. Patients applying to 17 Neurology Clinics in Turkey were evaluated at the baseline (visit 1), week 4 (visit 2), and week 12 (visit 3) visits in terms of disease severity and comprehensibility, internal consistency, test-retest reliability, and validity of MIDAS. Since the severity of the disease has been found to change significantly at visit 2 compared to visit 1, test-retest reliability was assessed using the MIDAS scores of a subgroup of patients whose disease severity remained unchanged (up to +/-3 days difference in the number of days with headache between visits 1 and 2). RESULTS: A total of 306 patients (86.2% female, mean age: 35.0 +/- 9.8 years) were enrolled into the study. A total of 65.7%, 77.5%, 82.0% of patients reported that "they had fully understood the MIDAS questionnaire" in visits 1, 2, and 3, respectively. A highly positive correlation was found between physician and patient and the applied total MIDAS scores in all three visits (Spearman correlation coefficients were R= 0.87, 0.83, and 0.90, respectively, P <.001). Internal consistency of MIDAS was assessed using Cronbach's alpha and was found at acceptable (>0.7) or excellent (>0.8) levels in both patient and physician applied MIDAS scores, respectively. Total MIDAS score showed good test-retest reliability (R= 0.68). Both the number of days with headache and the total MIDAS scores were positively correlated at all visits with correlation coefficients between 0.47 and 0.63. There was also a moderate degree of correlation (R= 0.54) between the total MIDAS score at week 12 and the number of days with headache at visit 2 + visit 3, which quantify headache-related disability over a 3-month period similar to MIDAS questionnaire. CONCLUSION: These findings demonstrated that the Turkish translation is equivalent to the English version of MIDAS in terms of internal consistency, test-retest reliability, and validity. Physicians can reliably use the Turkish translation of the MIDAS questionnaire in defining the severity of illness and its treatment strategy when applied as a self-administered report by migraine patients themselves.