Validation of the Chinese translated Activities-Specific Balance Confidence scale

OBJECTIVES: To translate contents of the Activities-Specific Balance Confidence (ABC) scale into Chinese (Cantonese), to examine the psychometric properties (internal reliability and validity) of this scale for use with Chinese older adults in Hong Kong, and to determine the level of self-perceived balance confidence of this population. DESIGN: A 2-phase exploratory study: formative qualitative research and a cross-sectional survey to establish the psychometric properties of the Chinese translated ABC (ABC-C) scale. SETTING: Community based. PARTICIPANTS: One hundred older community-dwelling subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Measurement of perceived level of confidence in maintaining balance using the ABC-C scale. This instrument contains 16 items on indoor and outdoor activities requiring different levels of balance function. RESULTS: Four of the 16 ABC-C scale items had to be modified to achieve content equivalence and cultural relevance to Hong Kong. Final test items of this scale showed high internal consistency with a Cronbach alpha coefficient of .97. The instrument was found to have excellent test-retest and very good interrater reliability with intraclass coefficients of .99 and .85, respectively. Results of a factor analysis conducted on the scale showed evidence of a coherent 1-domain structure. The mean perceived balance confidence level +/- standard deviation of 100 community-dwelling older adults in Hong Kong, performed by using the ABC-C scale, was 71.6+/-23.7. CONCLUSIONS: Results of the present study verified that the ABC-C scale is a culturally relevant, valid, and reliable tool for measuring self-perceived balance confidence in Chinese older adults. These were reflected in very good to excellent internal consistency of items, test-retest and interrater reliability, and construct validity shown.     

Development of a reliable and valid Chinese version of the diabetes empowerment scale

OBJECTIVE: To translate the Diabetes Empowerment Scale (DES) into Chinese and establish its psychometric properties among Hong Kong Chinese people. RESEARCH DESIGN AND METHODS: A two-stage study design, incorporating qualitative and quantitative components, determined the cultural equivalency and content validity of the translated scale and established the psychometric properties of the Chinese DES (C-DES) in 207 patients. RESULTS: Psychometric analysis supported the reliability and validity of the 20-item Chinese DES (C-DES-20) and five subscales: overcoming barriers (alpha = 0.89), determining suitable methods (alpha = 0.79), achieving goals (alpha = 0.78), obtaining support (alpha = 0.78), and coping (alpha = 0.76). The test-retest reliability of the intraclass correlations was satisfactory when a subsample of 20 patients was tested after a 2-week interval. There was criterion validity between the global scale and metabolic control (HbA(1c)) of respondents with type 2 diabetes (P = 0.03). CONCLUSIONS: The C-DES-20 is a reliable and valid outcome measure for patient education and psychosocial interventions among Hong Kong Chinese people with diabetes.     

Validation of the Chinese version of the EORTC colorectal cancer-specific quality-of-life questionnaire module (QLQ-CR38)

The European Organization for Research and Treatment of Cancer colorectal cancer (CRC)-specific quality-of-life questionnaire module (QLQ-CR38) assesses health-related quality of life in patients with CRC. We studied its psychometric properties and clinical validity in Hong Kong Chinese patients with CRC. The 38 items, forming functional and symptom scales, were administered to 256 Chinese patients diagnosed with CRC from a clinical oncology outpatient unit. Multitrait scaling analyses confirmed the hypothesized scale structure of the functional scales but not of the symptom scales, particularly those measuring chemotherapy side effects and gastrointestinal symptoms. The functional scales, but not the symptom scales, showed good internal consistency reliability. Convergent and divergent validity were satisfactory, as indicated by the correlations with other measures. The scales effectively differentiated between clinically distinct patient groups. As expected from a module designed to be used in conjunction with the core questionnaire, correlations between the QLQ-CR38 and the QLQ-30 are only weak to moderate. The functional scales of the Chinese version of the QLQ-CR38 show good psychometric performance and suitability for use with the QLQ-C30. Although, the results lend support to the clinical validity of the QLQ-C38, the symptom scales would benefit from further refinement to enhance their usefulness.     

Construct validation of the English version of Readiness for Interprofessional Learning Scale (RIPLS): Are Chinese undergraduate students ready for ‘shared learning’?

Interprofessional education has been receiving attention as a result of research suggesting the benefits of interpersonal collaboration in healthcare. In Hong Kong, the implementation of the Interprofessional Team-based Learning programme provides implicit call to study the psychometric properties of Readiness for Interprofessional Learning Scale (RIPLS) to clarify if this is a valid measure when used in the Chinese undergraduate healthcare context. This study examines the psychometric properties of RIPLS involving predominantly Chinese undergraduate healthcare students in Hong Kong. Using within- and between-network approaches to construct validity, we investigated the applicability of English version of RIPLS among 469 predominantly Hong Kong Chinese students who have competence in the English language. These participants were from complementary health professional programmes: biomedical sciences, chinese medicine, medicine, nursing, and pharmacy, from two universities in Hong Kong. The within-network test results indicated that RIPLS had good internal consistency reliability. Results of the confirmatory factor analysis lend support to the overall factor structure of hypothesized four-factor solution although one item obtained non-significant factor loading. The between-network test also suggests that various subscales of RIPLS correlated systematically with theoretically relevant constructs: collective efficacy, team impact on quality of learning, and team impact on clinical reasoning ability. The RIPLS is a valid measure to estimate the Chinese undergraduate healthcare students’ readiness to engage in interprofessional learning.     

Distinguishing between task and contextual performance for nurses: development of a job performance scale

AIM: This paper is a report of a development and validation of a new job performance scale based on an established job performance model. BACKGROUND: Previous measures of nursing quality are atheoretical and fail to incorporate the complete range of behaviours performed. Thus, an up-to-date measure of job performance is required for assessing nursing quality. METHODS: Test construction involved systematic generation of test items using focus groups, a literature review, and an expert review of test items. A pilot study was conducted to determine the multidimensional nature of the taxonomy and its psychometric properties. All data were collected in 2005. FINDINGS: The final version of the nursing performance taxonomy included 41 behaviours across eight dimensions of job performance. Results from preliminary psychometric investigations suggest that the nursing performance scale has good internal consistency, good convergent validity and good criterion validity. CONCLUSION: The findings give preliminary support for a new job performance scale as a reliable and valid tool for assessing nursing quality. However, further research using a larger sample and nurses from a broader geographical region is required to cross-validate the measure. This scale may be used to guide hospital managers regarding the quality of nursing care within units and to guide future research in the area.     

Psychometric properties of the Chinese version of Sexual Function after Gynecologic Illness Scale (SFAGIS)

Purpose

This study aims to develop the Chinese version of the Sexual Function after Gynecologic Illness Scale (SFAGIS) and to establish its psychometric properties in Hong Kong Chinese patients with gynecological cancer.

Methods

A Chinese version of SFAGIS was developed using the Brislin model of translation and guidelines for cross-cultural adaptation of scales. The content validity and semantic equivalence were assessed by an expert panel. The translated version of SFAGIS was administered to 150 Hong Kong Chinese women with gynecological cancer to test the scale’s psychometric properties and to assess its feasibility. The convergent validity of the Chinese scale was tested by correlating it with the Chinese version of the sex relations subscale of the Psychosocial Adjustment to Illness Scale Self-Report (PAIS-SR).

Results

The average completion time for the Chinese SFAGIS was 16.2?±?6.6 min. The internal consistency of the Chinese SFAGIS was 0.93. Test–retest reliability was also high with an interclass correlation coefficient 0.76. A Pearson product–moment correlation found strong correlations among the Chinese SFAGIS and the Chinese version of the sex relations subscale of the PAIS-SR, indicating that both scales measure the same as or has a similar construct.

Conclusions

The Chinese version of SFAGIS is a reliable and valid instrument which can be used in clinical practice and research for assessing sexual function problems in Chinese patients with gynecological cancer and to identify those in need of attention.     

Translation and validation of the Hong Kong Chinese version of the breastfeeding self-efficacy scale-short form

Healthcare providers do not have a validated instrument to measure breastfeeding self‐efficacy among Hong Kong Chinese. In this study, we sought to translate the breastfeeding self‐efficacy scale—short form (BSES‐SF) into Hong Kong Chinese and to examine the psychometric properties in a sample of 185 breastfeeding mothers. The construct validity of the translated scale was supported by confirmatory factor analysis and known group analysis. The receiver operating characteristics analysis indicated that the total score of the translated scale at 48–72 hours after delivery could be a useful diagnostic tool for identifying mothers likely to discontinue breastfeeding prematurely, before 6 months postpartum. Further research to cross‐validate the suggested cut‐off value of the scale is recommended. © 2012 Wiley Periodicals, Inc. Res Nurs Health 35:450–459, 2012     

The alcohol use disorders identification test (AUDIT): validation of an instrument for enhancing nursing practice in Hong Kong

This paper describes the psychometric analysis of the alcohol use disorders identification test (AUDIT) after it was modified for use in Hong Kong and administered to examine the patterns of hazardous and harmful drinking. The modified version of AUDIT was an 18-item instrument in which 10 items were completely adopted from the original version and 8 items were added to improve its cultural sensitivity. It was translated into Chinese and back translation was undertaken to confirm the equivalence of the Chinese and English versions. Following a pilot study the instrument was administered to 450 subjects who were recruited from two acute general hospitals, a University Health Clinic and three community health centres. The content validity was judged as adequate by a panel of five international and local experts and the instrument achieved a high reliability coefficient of 0.99 during a test-retest procedure conducted with 20 subjects. Factor analysis was performed on the responses obtained from 450 subjects which supported the construct validity of the 18-item instrument. The modified instrument had a consistently high internal consistency reliability (Cronbach's alpha=0.96-0.97) when tested in the different settings. It was found that a higher percentage of respondents from the hospitals (14.5%) drank at a hazardous or harmful levels compared to those from the community (6.2%) or the University (5.3%). The AUDIT proved a reliable and valid measure with potential applications in Chinese cultures. Early intervention and identification of 'at risk' drinking by the AUDIT is supported as a strategy to be implemented by nurses in primary and secondary health care settings in Hong Kong, where there are indications of increasing alcohol overuse.     

The Leuven Questionnaire on Patient Knowledge of Chemotherapy (L-PaKC): Instrument development and psychometric evaluation

PurposeEvidence suggests that patients who gain knowledge perform better self-care, cope better and are more satisfied. Today, up-to-date and valid instruments for evaluating patient knowledge on chemotherapy are unavailable. Hence, our aim was to develop a valid instrument to assess patients' knowledge on chemotherapy.MethodWe performed a literature review to develop a topic list for the construct. Using a triple Delphi procedure, an expert panel of nine oncologists and oncology nurses evaluated the face and content validity of the topic list and the generated items. A preliminary psychometric evaluation of 144 patients allowed to identify and remediate items having limited applicability and item validity. A convenience sample of 440 patients was used to evaluate item statistics (item difficulty), reliability (Cronbach alpha) and construct validity (exploratory factor analysis) of the final instrument.ResultsWe developed a 20-item instrument reflecting 14 relevant themes of patient knowledge on chemotherapy in 13 questions. Twelve items cover general chemotherapy aspects, eight items cover treatment-specific knowledge. Three questions are facultative and address oral chemotherapy. Content validity was excellent (CVI = 0.78–1.00). Item difficulty ranged from 0.25 to 0.95. Internal consistency was acceptable (Cronbach's alpha = 0.67). Exploratory factor analysis defined four underlying factors: general aspects of chemotherapy treatment, negative treatment-related events, information resources and intake of oral chemotherapy.ConclusionsThe Leuven Questionnaire on Patient Knowledge of Chemotherapy (L-PaKC) demonstrated good content validity and psychometric properties, permitting application in both research and practice for evaluating patient knowledge on chemotherapy.     

Content validity of the integrative medicine attitude questionnaire: perspectives of a Hong Kong Chinese expert panel

BACKGROUND: Although the Integrative Medicine Attitude Questionnaire (IMAQ) is a validated instrument developed in the United States for measuring allopathic physicians' attitudes toward complementary and alternative medicine, little is known about attitudes among western-trained doctors in other societies, particularly in the Far East. In Hong Kong, cultural and historical forces have created a unique environment for integration. Thus, consideration of such forces suggests that direct use of the original IMAQ for assessing attitudes of allopathic physicians' views on Traditional Chinese Medicine (TCM) in Hong Kong would be inappropriate. This hypothesis was tested using content validity judgment and local experts' opinions, to assess the three domains of IMAQ: "holism," "introspection and doctor-patient relationship," and "effectiveness of integrative treatment." METHOD: Standard content validity establishment methodologies were followed. An 8-member panel (4 with TCM and 4 with allopathic medicine backgrounds) was convened to assess the content validity of a modified Hong Kong TCM specific IMAQ. Experts were provided with explicit instructions on how to evaluate the content validity of individual items, and the instrument as a whole, both quantitatively and qualitatively. RESULT: Of 28 items, 12 items of the modified IMAQ were content validity adequate (Content Validity Index (CVI) > 0.70 and kappa > 0.4). Seven items were considered content invalid and removed. The overall CVI and kappa of the instrument were 0.71 and 0.09, respectively, indicating the need to modify 9 marginally valid items that remained in the questionnaire. Qualitative expert comments were used for the revision. CONCLUSION: The process of validation showed that it would be inappropriate for the U.S.-derived IMAQ to be used without modification in Hong Kong. Most of the content valid items were in the "effectiveness of integrative treatment" domain, which reflected the influence of the evidence-based TCM movement on the experts' judgment.     

Home Healthcare Nurses' Job Satisfaction Scale: refinement and psychometric testing

AIMS: This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. BACKGROUND: Numerous scales have been developed to measure nurses' job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. METHODS: A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's alpha internal consistency reliability coefficients. The data were collected in 2003. RESULTS: Nine factors contributing to home healthcare nurses' job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0.4. Cronbach's alpha coefficients for each of the nine subscales ranged from 0.64 to 0.83; the alpha for the global scale was 0.89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0.79, indicating good criterion-related validity. CONCLUSIONS: The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.     

Translation,Cross-Cultural Adaptation,and Psychometric Properties of the Chinese Version of the Surgical Fear Questionnaire

PurposeTo translate the Surgical Fear Questionnaire into Chinese, to culturally adapt, and test the validity and reliability of the Chinese version of the Surgical Fear Questionnaire.DesignThe translation and cultural adaptation process followed Sousa's guidelines, including the evaluation of this scale by the selected participants and content validity measurement by experts. A cross-sectional design was employed to the psychometric properties evaluation phase.MethodsA convenience sample of 336 participants from three hospitals was recruited between July 2019 and December 2019. Internal consistency reliability, construct validity, and convergent validity with the Hospital Anxiety and Depression Scale were analyzed.FindingsConfirmatory and exploratory factor analyses of the Chinese version of the Surgical Fear Questionnaire yielded a two-factor solution, with each factor comprised of four items, which were the same as the original English scale. The Chinese version showed a moderate correlation with the two domains of the Hospital Anxiety and Depression Scale. Cronbach's alpha and McDonald's Omega in the present sample showed excellent internal consistency.ConclusionsThe Chinese version of the Surgical Fear Questionnaire is a reliable and valid instrument to assess the fear before surgical procedures under general anesthesia.     

The validity and reliability of the World Health Organization Mental Disorders Checklist for use in a telehealth clinic in Hong Kong

This research aimed to test the validity and reliability of the 'World Health Organization Mental Disorders Checklist' for use in a telehealth clinic in Hong Kong. The Checklist adopted four subscales: (i) depression; (ii) anxiety; (iii) alcohol use disorders; and (vi) functioning and disablement, and was translated from English into Chinese. It was validated by a panel of five experts to confirm its content validity (content validity index = 0.98) and cultural appropriateness in Hong Kong. The reliability of the checklist was supported by the findings of a test-retest procedure (Pearson correlation = 0.66-0.88, P < 0.01), internal consistency reliability (Cronbach's alpha = 0.54-0.83), and interrater reliability (Kendall's coefficient of concordance = 0.58-1.00, P < 0.01) involving a sample of 197 subjects from one telehealth clinic in Hong Kong.     

Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in Cantonese-Speaking Chinese Patients

Acceptance of chronic pain has become an important concept in understanding and predicting that chronic pain sufferers can remain engaged with meaningful aspects of life. Assessment of acceptance has been facilitated by the development of Chronic Pain Acceptance Questionnaire (CPAQ). In this study, we aimed to test the reliability and validity of translated Chinese version of CPAQ to use this important tool in the future management of Hong Kong Chinese patients with chronic nonmalignant pain. Content validity was established by consensus formed among a panel of 5 experts in clinical psychology and pain specialty during the process of forward and backward translations. Test-retest reliability was examined by completing the Chinese CPAQ twice, 2 weeks apart, by 54 patients. A total of 224 Chinese patients with chronic nonmalignant pain attending our cluster multidisciplinary pain clinic were asked to complete a battery of psychometric instruments in Chinese, including an intake form for demographic data, Hospital Anxiety and Depression Score (HADS), Medical Outcome Study Short Form 36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Self-Efficacy Questionnaire (PSEQ). Analysis results showed that Chinese CPAQ had good test-retest reliability (intraclass correlation coefficient, 0.79) and internal consistency reliability (Cronbach α = 0.79). The Chinese CPAQ score was significantly correlated to anxiety, depression, pain catastrophizing, pain self-efficacy, and physical and psychosocial disability. Scree plot and Principal Components Factor analysis confirmed the same 2-factor construct as the original English CPAQ. Construct validity of the Chinese CPAQ can therefore be supported. In conclusion, the Chinese CPAQ is a reliable clinical assessment tool with valid construct for acceptance measurement in our heterogeneous Chinese patients sample with chronic nonmalignant pain.

Perspective

This article confirms the reliability and validity of a Chinese version of the CPAQ. The Chinese CPAQ can then be used by pain clinicians caring for Chinese chronic pain patients worldwide for acceptance-based psychometric assessment as well as therapies.     

Reliability and validity of the Korean version of Kidney Disease Quality of Life instrument (KDQOL-SF)

Although the Kidney Disease Quality of Life instrument (KDQOL-SF), which was designed to measure the comprehensive quality of life in patients with end stage renal disease, has been tested and widely administered in many other counties, it has not yet been translated, validated and reported for Korea. The primary purpose of this study was to validate a Korean version of KDQOL-SF and to evaluate its psychometric properties. The study subjects were 164 patients with hemodialysis or continuous ambulatory peritoneal dialysis in university dialysis centers in Korea. In order to investigate the reliability, test-retest reliability and internal consistency reliability were assessed. Both test-retest reliability and internal consistency reliability were found to be high. In order to investigate the construct validation, all the items of the SF-36 scales, an established generic QOL measures, were compared with an overall health rating scale in kidney disease-targeted scale. They found to be highly correlated with each other. Moreover, overall health rating scale was significantly correlated with symptoms/problems, effects of kidney disease, burden of kidney disease, cognitive function (p < 0.001), and quality of social interaction (p < 0.05). These results suggest that the Korean version of KDQOL-SF satisfies its reliability and validity in Korean patients with hemodialysis or continuous ambulatory peritoneal dialysis. This questionnaire provides important and clinically valuable information for understanding the health related quality of life in the Korean patients with dialysis.     

Development and psychometric evaluation of the Psychiatric In-patients Comfort Scale (PICS)

ObjectiveTo develop and evaluate the psychometric characteristics of the Psychiatric In-patients Comfort Scale (PICS) in hospitalized psychiatric patients.MethodsThe items of the PICS were drawn from a literature review, existing comfort instruments, suggestions made by experts, and interviews on perceived comfort with 18 hospitalized patients. A pilot study was performed with the first version of the scale, containing 98 items, in a sample of 49 patients. This process resulted in a 51 -item version. Internal consistency, construct validity, and concurrent validity were measured in a second sample of 273 patients.ResultsData analysis, factor analysis, and reliability analysis resulted in a 38-item version. The factor analysis indicated a 3-factor structure: relief, ease and transcendence, which explained 38.64% of the total variance. The comfort dimensions correlated positively with well-being and with positive experiences of suffering and negatively with the remaining dimensions of suffering, supporting concurrent validity. Cronbach's α coefficient of the total PICS-38 was 0.89, and the subscales ranged from 0.75 to 0.90.ConclusionBased on psychometric properties, the PICS is a valid and reliable tool that can be used by nurses to assess comfort in hospitalized psychiatric patients. The items are conceptually grouped in three factors corresponding to the states of relief, ease and transcendence of the comfort structure proposed by Kolcaba.     

The development and psychometric evaluation of the Clinicians' Attitudes towards Responding and Escalating care of Deteriorating patients scale

BackgroundValidated measures of ward nurses' safety cultures in relation to escalations of care in deteriorating patients are lacking.ObjectivesThis study aimed to develop and evaluate the psychometric properties of the Clinicians' Attitudes towards Responding and Escalating care of Deteriorating patients (CARED) scale for use among ward nurses.MethodsThe study was conducted in two phases: scale development and psychometric evaluation. The scale items were developed based on a systematic literature review, informant interviews, and expert reviews (n = 15). The reliability and validity of the scale were examined by administering the scale to 617 registered nurses with retest evaluations (n = 60). The factor structure of the CARED scale was examined in a split-half analysis with exploratory and confirmatory factor analyses. The internal consistency, test–retest reliability, convergent validity, and known-group validity of the scale were also analysed.ResultsA high overall content validity index of 0.95 was obtained from the validations of 15 international experts from seven countries. A three-factor solution was identified from the final 22 items: ‘beliefs about rapid response system’, ‘fears about escalating care’, and ‘perceived confidence in responding to deteriorating patients’. The internal consistency reliability of the scale was supported with a good Cronbach's alpha value of 0.86 and a Spearman-Brown split-half coefficient of 0.87. An excellent test–retest reliability was demonstrated, with an intraclass correlation coefficient of 0.92. The convergent validity of the scale was supported with an existing validated scale. The CARED scale also demonstrated abilities to discriminate differences among the sample characteristics.ConclusionsThe final 22-item CARED scale was tested to be a reliable and valid scale in the Singaporean setting. The scale may be used in other settings to review hospitals' rapid response systems and to identify strategies to support ward nurses in the process of escalating care in deteriorating ward patients.     

Evaluation of the Morse Fall Scale: applicability in Chinese hospital populations

BACKGROUND: Patient falls have been identified as a significant health problem in the general hospital patient population. The Morse Fall Scale (MFS) is an individualized criterion-referenced assessment tool designed for measuring the likelihood of patient falls in hospitals. Despite the scale has demonstrated high validity and reliability in the previous researches, this study is to provide additional validity tests to determine the applicability in the Chinese hospital population. OBJECTIVES: To examine the predictive power of the MFS to predict patient falls. To conduct reliability tests on internal consistency, item analysis, inter-rater and test-retest reliability. DESIGN: The study was a cross-sectional study. SETTINGS: The medical and geriatric units of three rehabilitation hospitals in Hong Kong participated in the study. PARTICIPANTS: A convenience sample of 954 Chinese patients was recruited sequentially upon admission in the hospital ward units. They ranged in age from 17 to 100 years, with a mean of 70.2 years. METHODS: The patients were assessed for fall risk using the MFS on admission. Data was collected on the number of patients who fell rather than the number of falls. RESULTS: The scale had a sensitivity of 31% and a specificity of 83% when the cut-off point was determined at 45. The field test demonstrated excellent inter-rater reliability with an ICC value of 0.97 (95%CI 0.94-0.98). Repeatability was high with an ICC of 0.98 (95% CI 0.98-0.99). The evaluation revealed a low Cronbach's alpha coefficient and a low to moderate item-to-scale correlation. CONCLUSIONS: The evidence collected in this study has shown both the positive and negative aspects of using the MFS in assessing the fall risk of Chinese patients during rehabilitation. The discriminative validity and internal consistency reliability provide researchers and clinicians with a major step in further developing or modifying the scale.     

Development and psychometric evaluation of the Dialysis patient-perceived Exercise Benefits and Barriers Scale

Background

Perceptions of exercise benefits and barriers affect exercise behavior. Because of the clinical course and treatment, dialysis patients differ from the general population in their perceptions of exercise benefits and barriers, especially the latter. At present, no valid instruments for assessing perceived exercise benefits and barriers in dialysis patients are available.

Objectives

Our goal was to develop and test the psychometric properties of the Dialysis patient-perceived Exercise Benefits and Barriers Scale (DPEBBS).

Methods

A literature review and two focus groups were conducted to generate the initial item pool. An expert panel examined the content validity. Then, 269 Chinese hemodialysis patients were recruited by convenience sampling. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed.

Results

The expert panel determined that the content validity index was satisfactory. The final 24-item scale consisted of six factors explaining 57% of the total variance in the data. Confirmative factor analysis supported the six-factor structure and a higher-order model. Cronbach's alpha was 0.87 for the total scale, and 0.84 for test-retest reliability.

Conclusion

The DPEBBS was a valid and reliable instrument for evaluating dialysis patients’ perceived benefits and barriers to exercise. The application value of this scale remains to be investigated by increasing the sample size and evaluating patients undergoing different dialysis modalities and coming from different regions and cultural backgrounds.