Development and initial validation of the Perceived Scarcity Scale

Though socio‐economic status (SES) partially explains the experience of stress and health outcomes, most research to date has relied on a small number of traditional indicators that fail to capture the full domain of socioeconomic factors. The recent reconceptualization of perceived scarcity is proposed as a subjective indicator of SES when attempting to predict both stress and health outcomes. Although a conceptualization of perceived scarcity has been advanced, a psychometrically sound scale is needed to assess the utility and scientific import of this concept. No such scale exists. Therefore, the current paper describes the development, psychometric properties, and initial validation of the Perceived Scarcity Scale (PScS). Four studies using traditional scale development processes were employed to develop (Studies 1 and 2) and provide an initial validation (Studies 3 and 4) for the PScS. Results support the existing model of perceived scarcity and indicate that the measure is valid. Moreover, the scale predicted concurrent perceived stress, as well as longitudinal ratings of perceived stress, global health, quality of life, and symptoms of depression and anxiety. The development of the new scale provides clinicians and researchers with a brief, validated measure that can assess the level of perceived scarcity individuals currently experience.     

护士人性化护理能力量表汉化及信效度检验

目的 汉化英文版护士人性化护理能力量表,旨在为准确评估我国护理人员人性化护理能力提供测评工具。 方法 严格遵循量表引进原则,采用Brislin翻译模式对英文版量表进行翻译,形成中文版护士人性化护理能力量表,并采用中文版量表调查420名临床护士,分析其信效度。 结果 中文版护士人性化护理能力量表I-CVI为0.830～1.000,S-CVI为0.937。探索性因子分析共提取5个公因子,累积方差贡献率为82.271%;验证性因子分析结果显示,χ2/df=4.124,RMSEA=0.086,NFI=0.919,IFI=0.938,TLI=0.923,CFI=0.937,此模型基本适配。量表总的Cronbach′s α系数为0.851,各维度Cronbach′s α系数为0.857～0.965;量表折半信度为0.829,各维度折半信度为0.734～0.866;量表重测信度为0.928,各维度重测信度为0.706～0.924。 结论 中文版护士人性化护理能力量表信效度良好,可用于评估中国临床护士的人性化护理能力。     

Reliability and Validity of the OMNI-Vibration Exercise Scale of Perceived Exertion

This study examined reliability and concurrent validity of the newly developed OMNI-vibration exercise scale (OMNI-VIBRO) to measure Ratings of Perceived Exertion (RPE) during vibration exercise in twenty recreationally active students (12 males and 8 females). The criterion variables were muscle activity of the Vastus Medialis (VM), Vastus Lateralis (VL), Biceps Femoris (BF), and Medial Gastrocnemius (MG) muscles, as well as accelerations (12.5, 20.2, 30.9, 36.3, 60.1, and 88.4 m·s^-2). RPE was registered during the final of each 30 s condition. Each participant attended two laboratory testing sessions. Positive linear regression coefficients (p < 0.001) were found between RPE (OMNI-VIBRO) and acceleration (r = 0.976) and muscle activity of lower-body muscles (r = 0.942). Between session (test-retest), reliability of RPE (OMNI-VIBRO) was good (ICC: 0.790. 95% CI: 0.699-0.854). Conclusions: findings provided concurrent validation of the OMNI-VIBRO to measure RPE for the active muscle and overall body in recreationally active students performing lower-body vibration exercise.

Key points

• The pictorial-verbal category scale of perception of exertion (OMNI-VIBRO) during lower body vibration exercise on a vibration platform showed good concurrent validity.
• The OMNI-VIBRO method in conjunction with WBV exercise would allow coaches, fitness professionals, or health-care personnel to assess the intensity that corresponds to the level of the vibratory stimulus.
• The OMNI-VIBRO could be a useful tool of measuring the different intensities of a vibratory-training session and altering the vibratory stimulus in a periodized fashion.

Key words: Validation, perceived exertion, vibration, EMG.     

主观社会隔离量表的汉化及信效度检验

目的 为测评老年人主观社会隔离感引进、验证适用性工具。方法 基于Beaton翻译原则对英文版主观社会隔离量表进行翻译、回译和跨文化调适,形成中文版主观社会隔离量表。采用方便抽样法,选取武汉市3个社区432名老年人进行调查,检验量表的信效度。结果 中文版主观社会隔离量表包括3个维度、9个条目。探索性因子分析共提取3个公因子,累积方差贡献率为56.475%,验证性因子结果显示χ2/df=2.194、RMSEA=0.074、SRMR=0.058、CFI=0.962、TLI=0.943;量表Cronbach′s α为0.776;量表的重测信度为0.792;量表内容效度指数为1.000。结论 中文版主观社会隔离量表具有良好的信效度,可用于评估老年人的主观社会隔离程度。     

Posttraumatic Mental and Physical Health Correlates of Forgiveness and Religious Coping in Military Veterans

This study assessed mental and physical health correlates of dispositional forgiveness and religious coping responses in 213 help-seeking veterans diagnosed with PTSD. Controlling for age, socioeconomic status, ethnicity, combat exposure, and hostility, the results indicated that difficulty forgiving oneself and negative religious coping were related to depression, anxiety, and PTSD symptom severity. Difficulty forgiving others was associated with depression and PTSD symptom severity, but not anxiety. Positive religious coping was associated with PTSD symptom severity in this sample. Further investigations that delineate the relevance of forgiveness and religious coping in PTSD may enhance current clinical assessment and treatment approaches.     

Measurement Invariance of the Perceived Stress Scale and Latent Mean Differences across Gender and Time

Measurement invariance of the 2‐factor model of the Perceived Stress Scale—10‐item version (Cohen & Williamson, 1988) was tested across men and women at two time points and in the combined total sample over a 2‐year time frame (n = 871). Measurement invariance results indicated that the scale measured the latent factors, stress and counter‐stress, equivalently in men and women and over time. With measurement invariance demonstrated, differences in latent means were tested. Results indicated that men had lower levels of frequencies of stressors, and at one time point, higher levels of counter‐stress, when compared with women. When examining change in frequencies of stressors and counter‐stress over 2 years with the combined male and female sample, stressors remained stable, yet counter‐stress increased over time. These findings may aid in the interpretation of results when examining stressors and counter‐stress in clinical samples where one would expect stress to increase, whereas positive psychological states decrease. Copyright © 2012 John Wiley & Sons, Ltd.     

The Essential Resilience Scale: Instrument Development and Prediction of Perceived Health and Behaviour

Further advancement in stress and health research calls for better tools to assess resilience. In this study, we developed the Essential Resilience Scale (ERS) and investigated the association between ERS scores and several health and behaviour measures. We developed the ERS with an operationalized definition of resilience—an individual's capability to anticipate, be flexible with and bounce back from three types of traumatic and adverse events (physical, emotional and social). The 15‐item ERS was assessed using survey data from a diverse sample (n = 238, aged 18–45 years, 76 rural‐to‐urban migrants, 85 rural residents, 77 urban residents) recruited in Wuhan, China. Results showed a high reliability of the ERS (α = 0.94). Confirmatory factor analysis demonstrated a satisfactory fit of the proposed second‐order ERS measurement model (goodness‐of‐fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.06, chi‐square/df = 1.75). Multivariate regression analysis indicated that ERS scores significantly predicted perceived health status, stress, anxiety, depression and cigarette smoking after controlling for important covariates. Findings of this study indicate high reliability and validity of the scale and its potential use in advancing stress and health research. Further studies are implied to provide additional support for the ERS and its relations with other health outcomes. Copyright © 2015 John Wiley & Sons, Ltd.     

Assessment of Subjective Perceived Exertion at the Anaerobic Threshold with the Borg CR-10 Scale

The purpose of this study was to evaluate the anaerobic threshold (AT) with a graphic visual method for estimating the intensity of ventilatory and metabolic exertion and to determine the ratings of perceived exertion (RPE) on the Borg CR-10 scale during a continuous ramp type exercise test (CT-R). Forty healthy, physically active and sedentary young women (age 23.1 ± 3.52 years) were divided into two groups according to their fitness level: active group (AG) and sedentary group (SG) and were submitted to a CT-R on a cycloergometer with 20 to 25 W/min increments. Shortly before the end of each one-minute period, the subjects were asked to rate dyspnea (RPE-D) and leg fatigue (RPE-L) on the Borg CR-10 scale. After the AT was determined with the graphic visual method, the score that the volunteers gave on the Borg CR10 scale was verified. Data were analyzed using the Mann-Whitney and Spearman correlation tests with the significance level set at 5%. The mean ratings of RPE-L and RPE-D at the AT level were not significantly different between groups (p > 0.05). Significant correlations were found between VO₂, heart rate (HR), power output and RPE for both groups. The muscular and respiratory RPE, according to the Borg CR-10 scale, were correlated with the AT, suggesting that scores close to 5, which correspond to a “strong” perception, may be used as parameters for quantifying aerobic exercise intensity for active and sedentary individuals. The similar perception of exercise intensity, which corresponded to the AT of different individuals, makes it possible to prescribe exercise at an intensity equivalent to the AT by means of the RPE.

Key points

• Interest in quantitative and systematic determination of the AT is growing, however, qualitative studies measure the AT by perceived exertion, are still unsubstantial.
• Borg CR-10 scale is a category scale with ratio properties consisting of numbers related to verbal expressions, which allows rate comparison between intensities as well as a determination of intensity levels.
• Scores close to 5 expressed on the Borg CR-10 scale, which correspond to a “strong” perception, may be used as parameters for quantifying the aerobic exercise intensity of both active and sedentary women.

Key words: Rating of perceived exertion, anaerobic threshold, exercise test     

Operational Stress and Correlates of Mental Health Among Joint Task Force Guantanamo Bay Military Personnel

Military personnel deployed to Joint Task Force Guantanamo Bay (JTF‐GTMO) faced numerous occupational stressors. As part of a program evaluation, personnel working at JTF‐GTMO completed several validated self‐report measures. Personnel were at the beginning, middle, or end of their deployment phase. This study presents data regarding symptoms of posttraumatic stress disorder, alcohol abuse, depression, and resilience among 498 U.S. military personnel deployed to JTF‐GTMO in 2009. We also investigated individual and organizational correlates of mental health among these personnel. Findings indicated that tenure at JTF‐GTMO was positively related to adverse mental health outcomes. Regression models including these variables had R² values ranging from .02 to .11. Occupation at JTF‐GTMO also related to mental health such that guards reported poorer mental health than medical staff. Reluctance to seek out mental health care was also related to mental health outcomes. Those who reported being most reluctant to seek out care tended to report poorer mental health than those who were more willing to seek out care. Results suggested that the JTF‐GTMO deployment was associated with significant psychological stress, and that both job‐related and attitude‐related variables were important to understanding mental health symptoms in this sample.     

Patient Health Questionnaire-9 in Spinal Cord Injury: An Examination of Factor Structure as Related to Gender

Background/Objective: Despite the attention depression after spinal cord injury (SCI) has received, research and clinical practice have been hampered by inadequate emphasis on reliable and valid measurement. Assessment of symptoms in persons with SCI is challenged by the presence of “transdiagnostic” symptoms and unexamined effects of gender. The objective of this study was to examine the factor structure of the Patient Health Questionnaire-9 (PHQ-9; the 9-item depression scale of the Patient Health Questionnaire) and determine whether the structure replicates across gender.

Methods: A total of 1,168 women and men were matched on level/completeness of SCI, follow-up year, and age to create 584 pairs. Exploratory factor analysis examined 1- and 2-factor models and congruence in 2 randomly split half samples to establish congruence of the factor solution and replication across gender.

Results: The 1- and 2-factor solutions fit the structure of the items accounting for 41 % to 51 % of original item variance. Congruence between random samples was uniformly high for the 1-factor solution (r = 0.791-0.948) but variable for the 2-factor solution. Although congruence was high for the combined sample and men (r= 0.90-0.97 and 0.71-0.94, respectively), it was variable for women (r= 0.29-0.85).

Conclusions: Although there was support for the 1-factor structure of the PHQ within and between sexes, the low congruence between sexes and within women for the 2-factor structure indicates potentially important differences about how certain symptoms may be experienced or interpreted differently by men and women with SCI. Future research should focus on where sexes diverge in cognitive, affective, and somatic dimensions of depressive symptoms and whether sex-specific or sex-neutral measures are warranted.     

Patient Health Questionnaire-9 in Spinal Cord Injury: An Examination of Factor Structure as Related to Gender

Background/Objective:

Despite the attention depression after spinal cord injury (SCI) has received, research and clinical practice have been hampered by inadequate emphasis on reliable and valid measurement. Assessment of symptoms in persons with SCI is challenged by the presence of “transdiagnostic” symptoms and unexamined effects of gender. The objective of this study was to examine the factor structure of the Patient Health Questionnaire-9 (PHQ-9; the 9-item depression scale of the Patient Health Questionnaire) and determine whether the structure replicates across gender.

Methods:

A total of 1,168 women and men were matched on level/completeness of SCI, follow-up year, and age to create 584 pairs. Exploratory factor analysis examined 1- and 2-factor models and congruence in 2 randomly split half samples to establish congruence of the factor solution and replication across gender.

Results:

The 1- and 2-factor solutions fit the structure of the items accounting for 41% to 51% of original item variance. Congruence between random samples was uniformly high for the 1-factor solution (r = 0.791–0.948) but variable for the 2-factor solution. Although congruence was high for the combined sample and men (r = 0.90–0.97 and 0.71–0.94, respectively), it was variable for women (r = 0.29–0.85).

Conclusions:

Although there was support for the 1-factor structure of the PHQ within and between sexes, the low congruence between sexes and within women for the 2-factor structure indicates potentially important differences about how certain symptoms may be experienced or interpreted differently by men and women with SCI. Future research should focus on where sexes diverge in cognitive, affective, and somatic dimensions of depressive symptoms and whether sex-specific or sex-neutral measures are warranted.     

Expression Level of Hepatoma-Derived Growth Factor Correlates with Tumor Recurrence of Esophageal Carcinoma

Background Hepatoma-derived growth factor (HDGF) is thought to play an important role in the development and progression of carcinomas. In the present study, association of HDGF expression with recurrence and prognosis of esophageal carcinoma (EC) was examined. Methods HDGF expression in 111 patients with EC (101 men and 10 women) with ages ranging from 38 to 82 (median, 61) years was analyzed by immunohistochemistry. Samples in which >90% of tumor cells exhibited nuclear and cytoplasmic HDGF immunoreactivity at levels greater than or equal to what is observed in the endothelial cells were regarded as HDGF expression level 1, and others as HDGF expression level 0. Results Thirty-seven of 111 patients showed level 1 HDGF expression. There was no correlation between HDGF expression and other clinicopathologic factors. Patients with level 1 expression showed poorer disease-free and overall survival (P < .05 for both) compared with those with level 0 expression. HDGF expression was an independent prognostic factor for patients with early (pT1–2) stage of the disease, but not for those with advanced (pT3–4) stage. Conclusions HDGF expression level was shown to be a prognostic factor for EC.     

Factor structure and predictive utility of the Binge Eating Scale in bariatric surgery candidates

BackgroundScreening for binge eating before bariatric surgery is a component of the recommended clinical practice for bariatric surgery candidates. The Binge Eating Scale (BES) is 1 of the most commonly used self-report measures of eating behaviors in preoperative evaluations; however, the factor structure of this measure has not been evaluated in the bariatric population. The aims of the present study were to report the mean, standard deviation, and reliability of the BES for patients seeking bariatric surgery; to evaluate the 2-factor structure of the BES using confirmatory factor analysis; and to investigate the association between the BES and its factors with surgical weight loss. The setting was an academic medical center.MethodsA total of 530 patients completed the BES as a component of their psychological evaluation before undergoing Roux-en-Y gastric bypass surgery.ResultsApproximately one third of patients reported at least mild to moderate binge eating, with 9% of patients reporting severe binge eating on the BES. The BES demonstrated good internal consistency. The results of the confirmatory factor analysis indicated that a 2-factor structure, consisting of feelings/cognitions related to binge eating and behavioral manifestations of binge eating, was the best fit to the data. Nonsignificant correlations were found between the BES and its 2 factors with short-term postoperative weight loss.ConclusionThe BES measures 2 aspects of binge eating in bariatric surgery candidates, feelings/cognitions and behavioral manifestations of binge eating. Consideration of these factors in patients presenting for bariatric surgery could allow for a more detailed understanding of binge eating in this population.     

Vascular Endothelial Growth Factor and Soft Tissue Sarcomas: Tumor Expression Correlates With Grade

Introduction: Vascular endothelial growth factor (VEGF), an endothelial–specific mitogen overexpressed in various epithelial malignancies is thought to be a potent regulator of angiogenesis. We hypothesized that some soft tissue sarcomas, due to their high propensity for hematogenous metastases (1) would overexpress VEGF, (2) that the degree of expression may represent a significant biologic predictor for disease-specific survival, and (3) that recurrent tumor would express as high or higher VEGF compared with the primary tumor.Methods: Selected paraffin-embedded tissue of surgical specimens from 79 patients with soft tissue sarcomas, treated between 1989 and 1995 were stained with a rabbit polyclonal anti-VEGF antibody at a concentration of 2 g/ml. Slides were assessed for VEGF expression as high or low by two investigators blinded to the clinicopathologic data. Twelve patients had VEGF expression of their primary tumors, and their recurrent tumors were compared. The Fishers exact test assessed for differences in VEGF expression; survival analyses were performed according to the methods of Kaplan and Meier.Results: Seventy-eight percent (29 of 37) of patients who died of disease had high VEGF expression. However, VEGF expression was not an independent predictor of either overall or disease-free survival. Tumor grade correlated with VEGF expression significantly. For the low-grade tumors, 7 of 13 expressed low VEGF, whereas for high-grade tumors, 53 of 66 expressed high VEGF (P = .016). Seven of the 12 paired tumor samples expressed identical VEGF immunostaining.Conclusions: The majority of high-grade soft tissue sarcomas in this study have high intensity VEGF expression. This finding may provide useful information on individual soft tissue sarcomas and offer the basis for therapeutic and biologic targeting in high-risk patients using anti-angiogenesis strategies. However, in our analysis, after accounting for tumor grade, VEGF does not seem to be an independent predictor of clinical outcome.Presented at the 53rd Annual Cancer Symposium of the Society of Surgical Oncology Poster Session, New Orleans, Louisiana, March 16-19, 2010434_2001_Article_260.     

Confirmatory Factor Analysis of the Perceived Stress Scale‐4 in a Community Sample

Although the Perceived Stress Scale (PSS) is among the most widely used measures of perceived stress, it has only recently begun to be tested in independent psychometric validation studies, and the four‐item version of the PSS (PSS‐4) (the briefest version of this measure) has never undergone testing to examine and confirm the originally proposed structure. To address this paucity of research, the present study (a) tested the structure of the PSS‐4 in the first confirmatory factor analysis of the instrument and (b) tested for item‐level gender differences in the PSS that have been demonstrated in other versions of this scale. Results indicated that the PSS four‐item measure does not fit its proposed model. Additionally, score differences were observed for one item across genders. Copyright © 2014 John Wiley & Sons, Ltd.     

Factor analysis of the Mayo-Portland Adaptability Inventory: Structure and validity

Principal components (PC) factor analysis of the Mayo Portland Adaptability Inventory (MPAI) was conducted using a sample of outpatients (n=189) with acquired brain injury (ABI) to evaluate whether outcome after ABI is multifactorial or unifactorial in nature. An eight factor model was derived which explained 64.4% of the total variance. The eight factors were interpreted as representing Activities of Daily Living, Social Initiation, Cognition, Impaired Self awareness Distress, Social Skills Support, Independence, Visuoperceptual, and Psychiatric, respectively. Validation of the Cognition factor was supported when factor scores were correlated with various neuropsychological measures. In addition, 117 patient self rating total scores were used to evaluate the Impaired Self awareness Distress factor. An inverse relationship was observed, supporting this factor's ability to capture the two dimensional phenomena of diminished self awareness or enhanced emotional distress. A new subscale structure is suggested, that may allow greater clinical utility in understanding how ABI manifests in patients, and may provide clinicians with a better structure for implementing treatment strategies to address specific areas of impairment and disability for specific patients. Additionally, more precise measurement of treatment outcomes may be afforded by this reorganization.     

Composition Factor Analysis and Factor Invariance of the Physical Appearance State and Trait Anxiety Scale (PASTAS) in Sports and Non-Sports Practitioner Mexican Adolescents

The purpose of the present study was to adapt and validate the Physical Appearance State and Trait Anxiety Scale (PASTAS) for Mexican adolescents, verifying the factor invariance by sports and non-sports practitioners. A sample of 930 Mexican adolescents (46.0% females), aged 11-15 years old, voluntarily participated in the study. A total of 415 participants regularly played sports in a club and/or regularly participated in sports competitions and 515 were non-sports practitioners. The adolescents filled out the trait version of the PASTAS questionnaire, which was previously translated and adapted for Mexican-speaking adolescents following the International Test Commission guidelines. The results of the confirmatory factor analyses showed an adequate measurement model for the original two-factor structure (e.g., GFI = 0.913; RMSEA = 0.078; CFI = 0.943). The internal consistency of the two dimensions was excellent (α and Ω = 0.92-0.93). Additionally, the results of the factorial invariance analyses showed an appropriate fit of the two-structure model (e.g., GFI = 0.96; CFI = 0.98; RMSEA = 0.04) among both sports and non-sports practitioners. The proposed trait version of the PASTAS questionnaire adapted to a Mexican-speaking population shows adequate psychometric properties among Mexican adolescents. The Mexican version of the PASTAS questionnaire supports the original two-factor structure (i.e., factor related to the body weight and factor not related to body weight) among adolescents. Additionally, the factorial invariance analyses support the equivalence of the two-factor structure among both sports and non-sports practitioners.Key points

• The proposed trait version of the PASTAS questionnaire adapted to Mexican-speaking population shows adequate psychometric properties among Mexican adolescents.
• The Mexican version of the PASTAS questionnaire supports the original two-factor structure (i.e., factor related to the body weight and factor not related to body weight) among adolescents.
• Factorial invariance analyses support the equivalence of the two-factor structure among both sports and non-sports practitioners.

Key words: Body image, validity, reliability, psychometric properties, athletes, teenagers     

The Role of Military Social Support in Understanding the Relationship Between PTSD,Physical Health,and Healthcare Utilization in Women Veterans

Posttraumatic stress disorder (PTSD) is a significant predictor of both poorer physical health and increased health care utilization, whereas adequate social support is associated with better physical health and less health care utilization. However, research has not previously examined the simultaneous effects of PTSD and social support on health and health care utilization. This study examined both the independent and interactive effects of PTSD and a particular type of social support (postactive‐duty social support from military friends) on self‐reported physical health and number of Veterans Health Administration (VHA) visits in the last year. These relationships were examined in a representative, national sample of 3,524 women veterans who completed telephone interviews as part of the National Survey of Women Veterans in 2008–2009. Regression analyses were conducted using these cross‐sectional data to examine main effects of PTSD and military social support on physical health and VHA utilization and their interaction. Screening positive for PTSD was associated with poorer health (B = ?3.19, SE = 1.47) and increased VHA utilization (B = 0.98, SE = 0.16), whereas greater military social support was associated with better health (B = 0.97, SE = 0.44) and less frequent VHA utilization (B = ?0.15, SE = 0.05). Neither moderation model was significant, such that military social support behaved in a similar way regardless of PTSD status.     

资源护士工作压力源和心理健康水平的调查研究

目的 了解资源护士工作的主要压力源,以帮助护理管理者及资源护士正确认识并设法减轻工作压力,从而提高其工作效率和护理质量.方法 采用问卷调查法和对照研究,对某三级甲等医院38名资源护士和40名普通专科护士的工作压力源和心理状况进行调查并比较.结果 资源护士与普通专科护士在患者护理、时间分配及工作量、管理及人际关系、护理专业及工作、工作环境及仪器设备的评分及压力源总均分存在显著性差异(均P＜0.05).资源护士SCL-90评分与普通护士相比,除了强迫和人际关系敏感因子外,其他因子评分及SCL-90总均分比较,差异有显著性意义(均P＜0.05).结论 资源护士在工作中面临较多压力源,其心理健康不客忽视.建议从管理角度为资源护士创造条件以减少工作压力源,并进行相应的心理训练.