Validity and reliability of the Norwegian version of the Ferrans and Powers Quality of Life Index

The purpose of this study was to examine the validity and reliability of the Norwegian version of the Ferrans and Powers Quality of Life Index in a sample of 131 men and women with newly diagnosed cancer. The Quality of Life Index was translated into Norwegian using a standardized international approach, including back-translation. The findings showed high internal consistency reliability for the global score (alpha = 0.93 (test)) as well as for the following domains: health and functioning (alpha = 0.88), socio-economic (alpha = 0.82), psychological/spiritual (alpha = 0.82) and family (alpha = 0.79). The test-retest reliability after 3-4 weeks was 0.78 for the global score. A factor analysis partially confirmed the different subscales. In conclusion, the Quality of Life Index was found to be reliable and had sufficient validity to be used for measuring quality of life in Norwegian cancer patients.     

Abbreviated instrument to measure hope: development and psychometric evaluation

The purpose of this research was to develop and evaluate psychometrically an abbreviated instrument to assess hope in adults in clinical settings. The Herth Hope Index (HHI), a 12-item adapted version of the Herth Hope Scale (HHS), was tested with a convenience sample of 172 ill adults. Alpha coefficient was 0.97 with a 2-week test-retest reliability of 0.91. Criterion-related validity was established by correlating the HHI with the parent HHS (r = 0.92), the Existential Well-Being Scale (r = 0.84) and the Nowotny Hope Scale (r = 0.81). Divergent validity with the Hopelessness Scale was established (r = -0.73). Construct validity was supported through the factorial isolation of three factors: (a) temporality and future; (b) positive readiness and expectancy; (c) interconnectedness. These three factors accounted for 41% of the total variance in the measure.     

Hope in newly diagnosed patients with cancer

In this study, 131 Norwegian patients with recently diagnosed cancer completed the Nowotny Hope Scale (NHS). The NHS is composed of six subscales, and both global and subscale scores were assessed. Most of the patients were found to be hopeful or moderately hopeful. The variable with the single most positive contribution to hope was whether the patient lived alone. Younger people, in particular, experienced less hope when living alone. Gender, the time elapsed since diagnosis, and treatments had no observable effect on the global hope score. However, age, education level, and type of cancer was associated with particular domains of hope.     

The Swedish version of Herth Hope Index--an instrument for palliative care

The aim of this study was to assess the reliability and validity of the Swedish version (HHI-S) of the Herth Hope Index (HHI), developed by K. Herth. The HHI-S is a 12-item Likert scale, arranged with scores from 1 to 4, where 1 is 'strongly disagree' and 4 is 'strongly agree'. The HHI-S together with the Miller Hope Scale (TMHS) and Beck's Hopelessness Scale (HS-S) were distributed to 85 adults, 40 patients with cancer in palliative care and 45 family members to patients with cancer in palliative care, recruited from four different in- and out-patient oncology clinics. The result showed an internal consistency alpha coefficient of 0.88 for the HHI-S. Concurrent criterion-related validity was assessed by correlating the HHI-S with the TMHS (r = 0.82) and the discriminant validity was assessed by correlating the HHI-S with the HS-S (r = -0.69). A varimax-rotated principal component factor analysis was performed and identified two factors; reconciliation with life situation and religiosity. Although the instrument shows sound reliability and validity, it should be used with care in clinical palliative care settings, because of linguistic, conceptual and cultural difficulties when transferring the instrument into Swedish. The result demands the work of developing an instrument measuring hope, based in the Swedish culture.     

肝癌初诊手术患者的希望水平及其与社会支持、应对方式的相关性

目的了解肝癌初诊手术患者的希望水平,并探讨社会支持、应对方式与肝癌初诊手术患者希望水平间的关系。方法采用社会支持量表、医学应对问卷、Herth希望量表对230例肝癌初诊手术患者进行问卷调查,运用Pearson相关分析、构建结构方程模型对三者之间的关系进行分析。结果共纳入209例患者,希望水平评分为(37.16±3.39)分,中等希望水平者78例(37.3%),高等希望水平者131例(62.7%)。社会支持及各维度、应对方式维度中的面对、回避与希望水平呈显著正相关(P<0.01或P<0.05),应对方式维度中的屈服与希望水平呈负相关(P<0.01)。屈服应对方式在社会支持与希望水平之间的部分中介效应显著(β=0.05,P<0.05),中介效应占总效应的10%。结论大多数肝癌初诊手术患者希望水平处于高等水平,社会支持对肝癌初诊手术患者希望水平既存在直接影响,也通过屈服应对的中介效应对患者希望水平发挥间接影响作用。     

Applicability,validity, and reliability of the Piper Fatigue Scale in postpolio patients

OBJECTIVE: To identify a scale that is potentially applicable for measuring the fatigue in postpolio patients and to evaluate its validity and reliability in this population. DESIGN: Interview survey of 64 individuals with postpolio syndrome and 25 healthy controls of similar age range, with retest in a subset of postpolio patients. The sample was recruited from a postpolio support group, a postpolio clinic, and the general community. Subjects completed the Piper Fatigue Scale, the Beck Depression Inventory, and the Chalder Fatigue Questionnaire during the interview. RESULTS: Face and content validity of the Piper Fatigue Scale was established by a team of experts and by a group of postpolio patients. The postpolio subjects had significantly higher Piper Fatigue Scale scores than the healthy control subjects (P < 0.001), demonstrating extreme groups validity. Convergent validity was shown with a strong positive correlation between Piper Fatigue Scale scores and Chalder Fatigue Questionnaire scores (r = 0.80). Reliability was also demonstrated with the Piper Fatigue Scale's high internal consistency (alpha = 0.98) and strong test-retest agreement (intraclass correlation coefficient = 0.98). CONCLUSIONS: The Piper Fatigue Scale is a valid and reliable tool for measuring postpolio fatigue. This scale may be useful in other studies of postpolio fatigue, including those gauging the effectiveness of various treatments for this fatigue.     

Psychometric properties of the Herth Hope Index in adolescents and young adults with cancer

The Herth Hope Index (HHIndex), originally developed for adults, was examined for appropriateness in two studies of adolescents and young adults with cancer-those at various stages of treatment (N = 127) and those newly diagnosed (N = 74). The internal consistency reliability (Cronbach's alpha) of the index was .84 and .78, respectively, in the two samples. Construct validity was supported by discriminant correlations in the moderate to low range between the HHIndex and measures of uncertainty in illness and symptom distress, and by moderate convergent correlations with measures of resilience (self-esteem, self-confidence, and self-transcendence) and quality of life (index of well-being). A four-step factor analysis procedure was done, and confirmatory factor analysis suggested that a one-factor solution best fit the data in this population. Findings indicate that the HHIndex is a reliable measure of hope in adolescents and young adults with cancer. Evidence of discriminant and convergent validity in measuring hope in adolescents and young adults with cancer was also generated. Further exploration of the HHIndex factor structure in adolescents and young adults is needed.     

Development of an instrument to measure hope

The purpose of this study was to develop an instrument to measure hope in adults and to evaluate its psychometric properties. A 40-item Miller Hope Scale (MHS) was developed based on critical elements of hope revealed in a comprehensive review of the literature and on an exploratory study of hope in persons who survived a critical illness. The instrument was critiqued by measurement and content experts, and content validity was established. The MHS was pretested on 75 subjects. The refined instrument was next evaluated using 522 healthy adults. The intent was to establish norms on the instrument before using it on ill subjects. The range of scores on the MHS is 40 to 200, with high scores indicating high hope. Mean hope score for this healthy sample was 164.46 (SD = 16.31). A leptokurtic curve, skewed to the left, was noted in these responses. As expected, the instrument detected high hope in individuals who were screened to have no physical or mental health problems. The internal consistency alpha coefficient was .93 with a 2-week test-retest reliability of .82. Criterion-related construct validity was established by correlating the MHS to the Psychological Well-Being Scale, r = .71, the Existential Well-Being Scale, r = .82, and a 1-item hope self-assessment, r = .69. Divergent validity with the Hopelessness Scale was established, r = -.54. Maximum likelihood factor analysis with oblimin rotation resulted in a three-factor solution: I, Satisfaction with Self, Others, and Life; II, Avoidance of Hope Threats; and III, Anticipation of a Future.     

Validity and reliability of the Italian Constipation Assessment Scale

Constipation is a common problem among oncology patients and requires careful assessment. Use of validated instruments is important to improving its management. The aim of this study was to validate the Italian translation of the Constipation Assessment Scale (CAS). To test construct validity, patients and apparently healthy adults were asked to complete the CAS. The results indicated that there was a significant difference between the median CAS of the patient group and that of the apparently healthy group. Test-retest reliability was very high (r=0.96; P=0.0001), and the internal consistency as assessed by Cronbach's alpha was 0.768. These findings suggest that the Italian CAS can be used in clinical practice to document the presence and severity of constipation in cancer patients. However, further studies should be conducted in a larger sample of patients to confirm the results.     

The Norwegian version of the chronic obstructive pulmonary disease self‐efficacy scale (CSES): a validation and reliability study

Scand J Caring Sci; 2010; 24; 600–609
The Norwegian version of the chronic obstructive pulmonary disease self‐efficacy scale (CSES): a validation and reliability study The aim of this study was to evaluate the feasibility, internal consistency and face and construct validity of the Norwegian version of the Chronic Obstructive Pulmonary Disease Self‐Efficacy Scale (CSES). The CSES was translated into Norwegian according to standard procedures for forward and backward translation, and administered to 100 patients with chronic obstructive pulmonary disease (COPD) (51% men, mean age 66.1 years, range 42–82) prior to their participation in an outpatient pulmonary rehabilitation programme. The CSES‐N (translated version) consists of 34 items comprising five subscales describing negative affect, intense emotional arousal, physical exertion, weather/environment and behavioural risk factors. Each scale ranges from 1 to 5, with higher scores indicating better self‐efficacy. For validation purposes, we measured lung function (FEV₁, FEV₁% predicted) and exercise capacity (ISWT), and administered the St. George’s Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS). A pilot study confirmed that the CSES‐N was clear, understandable and easy to self‐administer. Cronbach’s alpha was 0.98 for the total score (0.80–0.96 for subscales). Results showed small to medium negative correlations between all CSES‐N scales and anxiety, depression (HADS), physical activity, psychosocial impact of disease and total health status (SGRQ) (?0.20 to ?0.49). Small or negligible negative correlations between different CSES‐N scales and respiratory symptoms (SGRQ) (?0.03 to ?0.23) were found. Any correlations among exercise capacity, lung function and different socio‐demographic variables (age, gender and education) and CSES‐N were also small or negligible (0.00 to 0.23). This study shows acceptable feasibility, internal consistency and face and construct validity for the CSES‐N in a sample of Norwegian COPD patients.     

Self-perceived burden in cancer patients: validation of the Self-perceived Burden Scale

Although caregiver burden has been studied extensively, cancer patients' self-perceived burden on caregivers has been an understudied phenomenon. The purpose of this cross-sectional study was to validate the Self-perceived Burden Scale, a 10-item self-report instrument designed to measure chronically ill patients' experience of burden. Participants were 106 cancer patients (site nonspecific) receiving active cancer treatments at a university cancer center. Factor analysis results indicated that a 9-item version of the scale consisted of a single factor and had good reliability (alpha = .938). Convergent validity was demonstrated with global quality of life (r = -0.546, P < .001), physical well-being (r = -0.547, P < .001), emotional well-being (r = -0.549, P < .001), functional well-being (r = -0.404, P < .001), financial satisfaction (r = -0.284, P = .001), and depression (r = 0.414, P <.001). Tests of divergent validity indicated that the Self-perceived Burden Scale was independent of age, number of people living in the household, disease site, cancer treatment, and sociofamilial well-being. Findings indicate that the Self-perceived Burden Scale may be a useful instrument to assess patients' perceptions of burden on their caregivers. Further studies of the role of patient burden in psychosocial well-being and global quality of life, including validation of the Self-perceived Burden Scale on a larger study sample, are warranted.     

Communication Capacity Scale and Agitation Distress Scale to measure the severity of delirium in terminally ill cancer patients: a validation study.

Although valid measurement of the severity of terminal delirium is of great importance in palliative care settings, existing instruments have considerable limitations. In order to quantify patients' communication capacity and agitated behaviour, two new operational observer-rating scales, the Communication Capacity Scale (Communication Scale) and Agitation Distress Scale (Agitation Scale), were validated. Thirty terminally ill cancer patients diagnosed with delirium were evaluated simultaneously by two palliative care physicians blinded to each other's coding using the Communication Scale and Agitation Scale. In addition, the Memorial Delirium Assessment Scale (MDAS), Delirium Rating Scale (DRS) and Sedation Scale were rated by one researcher. Both scales achieved high internal consistency and inter-rater reliability with Cronbach's alpha coefficients of 0.91 and 0.96, and Cohen's kappa values on each item of 0.72-1.00. The principal components analysis resulted in the emergence of only one component for each scale. The total score on the Communication Scale was highly associated with that of the MDAS (rho = 0.78), Sedation Scale (rho = 0.86), and cognitive items from the MDAS and DRS (rho = 0.83). The whole score on the Agitation Scale was significantly correlated with that of the DRS (rho = 0.61) and agitation items from the MDAS and DRS (rho = 0.61). In conclusion, the Communication Scale and Agitation Scale have acceptable reliability and validity to quantify patients' communication capacity and agitation symptoms of terminally ill cancer patients with delirium.     

Development of a brief assessment scale for caregivers of the medically ill

Studies have documented high degrees of burden and negative outcomes for caregivers. The present study sought to develop a brief instrument for caregiver burden. An item pool was administered to 102 caregivers of patients with chronic illnesses (cancer, 55%; neurological, 15%; psychiatric 12%), along with measures of caregiver burden and quality of life. Item reduction was accomplished through content review and factor analysis. This yielded a 14-item Brief Assessment Scale for Caregivers (BASC) and an eight-item subscale measuring negative personal impact (NPI). Cronbach's alpha was 0.70 for the BASC and 0.80 for the NPI. Construct validity was confirmed by appropriate patterns of intercorrelation with other measures of caregiver burden. Higher burden was found for caregivers expected to have higher levels of distress (adult children caring for parents, P<0.005; female caregivers, P=0.035). These results support the validity of the BASC as a brief instrument for caregiver burden.     

Development and refinement of an instrument to measure hope

This article describes the development and psychometric evaluation of a measure designed to evaluate hope in adults, the Herth Hope Scale, which was completed by 180 cancer patients, 185 well adults, 40 well elderly and 75 elderly widow(er)s. The alpha reliability coefficients for the total scale ranged from .75 to .94 with a three-week test-retest reliability of .89 to .91. A negative correlation (r = -.69) was found between the Herth Hope Scale and the Beck Hopelessness Scale. The multidimensionality of the construct was supported through the factorial isolation of three subscales: temporality and future, positive readiness and expectancy, and interconnectedness. These three factors accounted for 58% of the total variance in the measure. With refinement, this measure should enable exploration of the antecedents and correlates of hope in diverse adult populations. Further, hope enhancing strategies could be identified and examined for their ability to alter hope states.     

The memorial symptom assessment scale: modified for use in understanding family caregivers' perceptions of cancer patients' symptom experiences

The purpose of this study was to determine whether the Memorial Symptom Assessment Scale (MSAS) could serve as a feasible, reliable, and valid tool for use in assessing the reports of 98 family caregivers (FC) on the symptom experiences of advanced stage cancer patients. The MSAS consists of subscales that describe psychological symptom distress (PSYCH), physical symptom distress (PHYS), and global symptom distress (Global Distress Index [MSAS-GDI]). The majority of FCs was able to respond to 32 MSAS symptom items; however, the greatest difficulty in FC responding occurred on the 'sexual interest' item. The mean PSYCH score was 1.42 (SD=0.83), the mean PHYS score was 0.96 (SD=0.67), and the mean MSAS-GDI was 1.46 (SD=0.24). Internal consistency was high in the PHYS (alpha=0.84), PSYCH (alpha=0.82), and MSAS-GDI (alpha=0.84) subscales. The average item-scale correlation ranged between r=0.50 and 0.60, indicating that the items were moderately to strongly correlated with the respective total subscales. The average inter-item correlation ranged between r=0.30 and 0.45, indicating that the items were moderately correlated with each other on the respective subscales. Good to excellent intraclass correlations (ICC) with patients' ordinal ratings support the concurrent validity and utility of the PHYS and MSAS-GDI subscales in FC populations who care for cancer patients in the home setting. Depending on the symptom, a range of slight to substantial Kappa values on dichotomous PHYS and PSYCH items, and fair ICC values on the ordinal PSYCH subscale provide questionable validity in FC populations caring for cancer patients.     

智谋在初诊乳腺癌患者知觉压力与抑郁间的中介效应

目的 探讨智谋在初诊乳腺癌患者知觉压力与抑郁间的作用机制,为乳腺癌患者的心理干预提供参考。 方法 于2018年5月—11月采用智谋量表、中文版知觉压力量表及汉密尔顿抑郁量表,对河南省某三级甲等医院的510例初诊乳腺癌患者进行调查。 结果 知觉压力、抑郁与智谋呈负相关,知觉压力与抑郁呈正相关（P<0.01）;智谋在知觉压力与抑郁间的中介效应为0.203,占总效应的36.8%。 结论 智谋是初诊乳腺癌患者知觉压力与抑郁间的中介变量,医护人员应关注乳腺癌患者的智谋水平,对新确诊患者积极进行智谋水平的评估,以便采取干预措施减少其压力、降低其抑郁水平。     

Exploratory factor analysis of the Cancer Problems in Living Scale: a report from the American Cancer Society's Studies of Cancer Survivors

People diagnosed with cancer face a variety of problems, which can impact their quality of life (QoL). Identifying these problems is an important part of understanding how people adjust to cancer. This study identified the underlying factor structure of the Cancer Problems in Living Scale (CPILS), a 29-item measure of the problems that cancer survivors may face. Exploratory factor analysis was applied to data from 5155 cancer survivors included in the American Cancer Society's Study of Cancer Survivors-I (SCS-I), a national, population-based study of survivors of 10 different types of cancer. Results of the factor analysis identified four factors in the CPILS: 1) physical distress (PD) (Cronbach's alpha=0.84); 2) emotional distress (ED) (Cronbach's alpha=0.87); 3) employment/financial (EF) problems (Cronbach's alpha=0.78); and 4) fear of recurrence (FR) (Cronbach's alpha=0.84). The convergent and divergent validity of the factors is demonstrated by correlations with relevant measures of physical and emotional functioning. The four valid and reliable factors demonstrate the utility of the CPILS in both clinical and research settings. The emergence of a separate factor for FR shows that this is a unique aspect of the cancer survivor experience, distinct from general ED.     

The Norwegian version of the Quality of Life Scale (QOLS-N). A validation and reliability study in patients suffering from psoriasis

The aim of this study was to adapt, validate, and test for reliability the Quality of Life Scale in Norwegian (QOLS-N) for patients suffering from psoriasis. Two hundred and eighty-two patients with psoriasis were included in the study. Self-reported health was measured using the SF-36. Disease severity was also measured in 95 patients using the Psoriasis Area and Severity Index (PASI). The reliability of the QOLS-N was computed using the internal consistency reliability (Cronbach's alpha) and the test-retest reliability test. Face and content validity and construct discriminant ability of the QOLS-N were assessed. The results indicated that the QOLS-N has highly satisfactory rates of test-retest reliability (r = 0.83) and internal consistency reliability (alpha 0.86). As expected, the QOLS-N had a lower correlation with physical health (r = 0.24, p < 0.000) and self-reported symptoms (r = -0.20, p < 0.001), and a higher correlation with mental health (r = 0.52, p < 0.000). The correlation with disease severity was not significant (-0.06). The results reported in the present paper are in accordance with those derived in other validation studies. The QOLS-N seems to be a reliable and valid measure of global quality of life in patients suffering from psoriasis.