Psychometric properties of an Arabic version of the fatigue severity scale in patients with stroke

Background: Post-stroke fatigue is a common symptom which needs to be assessed by a psychometrically sound tool.

Objectives: To investigate the psychometric properties of an Arabic version of the fatigue severity scale (FSS-A) in patients with stroke.

Methods: An observational, cross-sectional design was applied to 147 survivors of first-time stroke and 70 healthy participants. Internal consistency was measured by Cronbach’s α, while test-retest reliability was measured by intraclass correlation coefficients (ICCs). To assess validity, the FSS-A was correlated with the Fatigue Visual Analogue Scale (VAS-F), the Short Form 36 (SF-36) and its vitality domain (SF-36V), the stroke specific quality of life (SSQOL-A) and its energy domain (SSQOL-A-E), and the Beck Depression Inventory II (BDI-II).

Results: The FSS-A showed excellent internal consistency (Cronbach’s α = 0.934) and test-retest reliability (ICC = 0.920, 95% confidence interval (CI): 0.85–0.96). Exploratory factor analysis confirmed that the FSS-A is unidimensional. The FSS-A had high positive correlation with VAS-F, moderate positive correlation with BDI-II, high negative correlation with SSQOL-A-E and moderate negative correlations with SF-36, SF-36V, and SSQOL-A. It differentiated patients from healthy participants with a sensitivity of 78.4% and a specificity of 77.1%. The minimal detectable change with 95% CI was 1.02 (22.4%).

Conclusions: The FSS-A showed good psychometric properties suggesting its usefulness as a fatigue evaluation tool in patients diagnosed with stroke.     

Validity and reliability of an inpatient severity of psychiatric illness measure

Inpatient psychiatric severity measures are often used but few psychometric data are available. This study evaluated the psychometric properties (reliability and validity) of a measure used to assess severity of psychiatric illness among inpatients. Using the severity measure, minimally trained raters conducted retrospective patient record reviews to assess medical necessity for psychiatric hospitalization. The data analysis compared 135 civilly committed psychiatric inpatients with a heterogeneous group of 248 psychiatric inpatients at a general hospital. The severity measure showed acceptable inter-rater reliability in both populations. Two-way analysis of variance showed that the intra-class correlation coefficient for the total score was 0.65 for general hospital subjects and 0.63 for civilly committed subjects. Differences in mean scores were substantial (15 out of a possible 75 points for general hospital subjects versus 42 for civilly committed subjects, Mann-Whitney U = 562, p < 0.001). As expected, all civilly committed subjects were well above admission cut-off score of 12, versus only 64% of the general hospital patients. The measure is appropriate for retrospective severity assessment and may also be useful for pre-admission screening.     

自杀意向量表在中国高中学生中的评估——信度和效度研究

目的:尝试修订西方国家流行的自杀意向量表,并验证其在中国文化背景下高中学生群体里的信度和效度。方法:选取292名农村高中学生参加了研究。结果:自杀意向量表修订后具有较好的内部一致性信度。自杀意向量表得分与特质焦虑、绝望高度相关。结论:修订后的自杀意向量表能够适用于中国高中生人群。     

中文版心境障碍自知力量表信效度初步研究

目的:评价心境障碍自知力量表(mood disorders insight scale,MDIS)中文版的信度和效度。方法:131例符合美国精神障碍诊断与统计手册第4版心境障碍诊断标准的患者完成MDIS中文版测试,由精神科医师采用临床总体印象量表(CGI)和自知力视觉尺度量表评估其疾病严重程度和自知力;同时,家属也完成自知力视觉尺度量表。随机抽取50例患者间隔7 d后重测MDIS。计算量表Cronbach’sα系数和两次评分的相关系数,评价量表的内部一致性和1周重测信度;采用因子分析方法考评结构效度;通过MDIS评分与精神科医师及家属的自知力视觉尺度量表评分相关分析来考察效标效度;通过比较重度和轻中度疾病严重程度患者MDIS得分差异来考评实证效度。结果:1信度:MDIS量表总Cronbach’sα系数为0.81,1周重测信度系数为0.82;2效度:探索性因子分析显示MDIS符合两因子结构,贡献率达65.75%;验证性因子分析的拟合优度指数为0.900,赋范拟合指数为0.931,标准化残差均方根为0.064;3患者MDIS分值与精神科医师及家属自知力视觉尺度评分之间相关系数分别为0.74和0.59(P均0.05),与CGI评分相关系数为-0.87(P0.05)。轻中度与重度躁狂发作患者MDIS量表分值差异具有统计学意义(P0.05)。结论:MDIS中文版具有较好的信度和效度,可用于快速有效地评估心境障碍患者的自知力。     

Value-Based Stroke Rehabilitation: Feasibility and Results of Patient-Reported Outcome Measures in the First Year After Stroke

Purpose

Structured application of patient-reported outcome measures (PROMs) is a key element in Value Based Healthcare. This study aimed to evaluate the feasibility of a broad set of PROMs reflecting similar patient reported health domains as proposed within the International Standard Set of Patient-Centered Outcome Measures After Stroke within the first year after stroke.

中文版精神病人刑事责任能力评定量表的信度和效度研究

目的:探讨中文版《精神病人刑事责任能力评定量表》(中文版R-CRAS)的信度和效度。方法:国内12名不同省市的资深司法精神病学鉴定专家运用R-CRAS量表采用盲法对3例犯罪嫌疑人的辨认能力或者控制能力以及刑事责任能力的评定结果进行比较。结果:量表内部一致性系数(Cronbach'sα)r=0.846。12名评定者对全量表评定的一致性系数r=0.493,一致性最差的4个条目(第10、11、14、17题)占全量表的22.22%(r=0.099~0.294,P均0.05),提示这些条目与刑事责任能力评定或许没有必然联系。12名评定者36例次评定结果:部分、小部分、大部分、完全和无刑事责任能力的分别为7(19%)、2(6%)、8(22%)、15(42%)和4(11%)例次,提示评定者根据量表对刑事责任能力评定的结果明显不同。对于12名评定者的36例次的评分转换成等级资料,进行Friedman检验(χ2=208.824,df=17)和Kendall'W协同系数检验(Kendall'W系数=0.341,χ2=208.824,df=17),显著性均P=0.000,提示量表评分标准存在随意性。多维尺度分析发现,该量表条目按其相似性和差异性可以被划分为若干不同的范畴,仅以"辨认能力"和"控制能力"不能概括他们的特征。结论:中文版R-CRAS的设计欠合理,需进一步研究改进。     

Validity and reliability of nerve and muscle ultrasound

Introduction: Nerve and muscle ultrasound has been studied in several conditions, but validity and reliability have not been assessed systematically. Methods: Nerve cross‐sectional area and muscle thickness were measured ultrasonographically at several sites in 4 cadavers, which were then dissected, and actual measurements were obtained. To assess intrarater and interrater reliability, between 3 and 5 ultrasonographers, with varying experience levels, made repeated measurements on healthy volunteers. Results: Correlation coefficients for nerve and muscle validity were >0.968 (P < 0.001), and for intrarater reliability were >0.901 (P < 0.001) for still and real‐time images. Correlation coefficients for interrater reliability were more varied, but for still images they were all significant at the P < 0.001 (0.542–0.998) level, and for real‐time images they were significant at the P < 0.05 level for half the sites (0.243–0.981). Conclusion: Overall, nerve and muscle ultrasound is a valid and reliable diagnostic imaging technique. Muscle Nerve, 2013     

A Swedish version of the 16-item Parkinson fatigue scale (PFS-16)

Hagell P, Rosblom T, Pålhagen S. A Swedish version of the 16‐item Parkinson fatigue scale (PFS‐16).
Acta Neurol Scand: 2012: 125: 288–292.
© 2011 John Wiley & Sons A/S. Background – The PFS‐16 is a 16‐item fatigue scale for Parkinson’s disease (PD) developed in the UK. However, documented translations and psychometric evaluations are sparse. Aim – To translate the PFS‐16 into Swedish and conduct initial testing of its psychometric properties. Methods – Following translation, the PFS‐16 was administered twice (2 weeks apart) to 30 people with PD (18 men; mean age/PD duration, 60/6.4 years). The PFS‐16 uses five response categories (1 = strongly disagree, 5 = strongly agree), and the total score is the mean over item scores (1–5; 5 = more fatigue). An alternative, dichotomised scoring method has also been suggested (total score, 0–16; 16 = more fatigue). Scaling assumptions, floor/ceiling effects, reliability, and correlations with other variables including the generic fatigue scale Functional Assessment of Chronic Illness Therapy – Fatigue scale (FACIT‐F) were tested. Results – Scaling assumptions were generally supported for the original scoring [range of mean (SD) item scores, 2.1–3.3 (1–1.4); corrected item‐total correlations, ≥0.40], but not for dichotomised scoring [range of mean (SD) item scores, 0.1–0.6 (0.3–0.5); corrected item‐total correlations, ≥0.16]. Reliabilities were ≥0.88. Floor effects were absent (original scoring) and >23% (dichotomised scoring); there were no ceiling effects. Correlations with other variables followed expectations (e.g. ?0.88 with FACIT‐F scores). Conclusions – These observations support the psychometric properties of the Swedish PFS‐16, but cautions against dichotomised scoring.     

smRSq量表在部分中国脑卒中人群中信度和效度的初步研究

目的研究简化版的mRS(smRSq)在部分中国脑卒中人群中的信度和效度。方法研究对象为120例脑卒中患者,随机产生配对的测评者,进行smRSq、传统mRS、NIHSS 3个量表的评价,进而计算测评者之间的信度和同时效度。结果对于smRSq量表的测评者之间的信度,总的一致性为85%,κ=0.81(95%CI:0.74~0.89),κw=0.92(95%CI:0.82~0.95)。对于mRS量表的测评者之间的信度,总的一致性为77%,κ=0.71(95%CI:0.61~0.80),κw=0.86(95%CI:0.81~0.91)。对于smRSq和mRS两个量表一致性,总的一致性为69%,κ=0.61(95%CI:0.51~0.72),κw=0.82(95%CI:0.77~0.87)。对于同时效度,smRSq量表和NIHSS评分之间相关性分析发现,其Spearman's相关系数为0.68(P0.001)。结论 smRSq量表在评估中国脑卒中功能结局具有较高的价值。     

Validity and reliability of a scale to assess fatigue

A visual analogue scale to evaluate fatigue severity (VAS-F) was developed and tested in a sample of 75 healthy individuals and a sample of 57 patients undergoing medical evaluation for sleep disorders. The scale consists of 18 items related to fatigue and energy, has simple instructions, and is completed with minimal time and effort. The VAS-F compares favorably with the Stanford Sleepiness Scale and the Profile of Mood States, and its internal consistency reliabilities are high. Healthy subjects demonstrated significant differences between their evening and morning scores on the VAS-F, while sleep-disordered patients did not.     

Validity and Reliability of a Korean Version of the National Institutes of Health Stroke Scale

Background and Purpose

The National Institutes of Health Stroke Scale (NIHSS) is a clinical assessment tool that is widely used in clinical trials and practice to evaluate stroke-related neurological deficits. The aim of this study was to determine the validity and reliability of the Korean version of the NIHSS (K-NIHSS) for evaluating Korean stroke patients.

Methods

The K-NIHSS was translated and adapted with regard to cultural and linguistic peculiarities. To examine its content validity, we quantified the Content Validity Index (CVI), which was rated by 11 stroke experts. The validity of the K-NIHSS was assessed by comparison with the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRS), and the Barthel Index. The reliability of the K-NIHSS was evaluated using the unweighted kappa statistics for multiple raters and an intraclass correlation coefficient (ICC).

Results

The CVI of the K-NIHSS reached 0.91-1.00. The median K-NIHSS score at baseline was 3 (interquartile range, 2-7), and the mean±SD score was 6.0±6.6. The baseline K-NIHSS had a significantly negative correlation with the GCS at baseline and the Barthel Index after 90 days. The K-NIHSS also had a significantly positive correlation with the mRS after 90 days. Facial paresis and dysarthria had moderate interrater reliability (unweighted kappa, 0.41-0.60); kappa values were substantial to excellent (unweighted kappa, >0.60) for all the other items. The ICC for the overall K-NIHSS score was 0.998. The intrarater reliability was acceptable, with a median kappa range of 0.524-1.000.

Conclusions

The K-NIHSS is a valid and reliable tool for assessing neurological deficits in Korean acute stroke patients.     

精神疾病病耻感量表维吾尔文版在维吾尔族精神分裂症患者中信度和效度的研究

目的:检测精神疾病病耻感量表维吾尔(维)文版(SSMI-U)在新疆维吾尔(维)族精神分裂症患者的信度及效度。方法:对中文版精神疾病病耻感量表进行翻译并修订成维文版;随机选取118例门诊及住院维族精神分裂症患者评估;2周后随机抽取其中60例患者进行重测。结果:SSMI-U克朗巴赫α系数为0.801,评定者一致性组内相关系数(r)=0.995(95%CI:0.949~0.990);重测信度r=0.750(P0.001)。结论:SSMI-U在新疆维族精神分裂症患者具有良好的信度与效度。     

Validity and reliability of the Dysfunctional Behaviour Rating Instrument

The objective of this study was to examine the reliability and validity of the Dysfunctional Behaviour Rating Instrument (DBRI) in cognitively impaired older adults living in the community. A total of 184 adults with suspected cognitive impairment received a standardized history, physical examination and work-up that included the Standardized Mini-Mental State Examination. Caregivers scored a DBRI Behaviour Problem Checklist (BPC) and Lawton Scale for each patient. The reliability of the DBRI, measured by an intraclass correlation coefficient, was 0.75. The correlation coefficient between the DBRI and the BPC total score was 0.71. The correlations between the DBRI and the cognitive, activities of daily living and self-care domain scores of the BPC were lower (0.66, 0.38 and 0.26 respectively). The DBRI is a specific, reliable and valid caregiver-reported measure of dysfunctional behaviour in cognitively impaired elderly living in the community.     

Validity and reliability of the Intelligibility in Context Scale: European Portuguese version

The purpose of the study was to evaluate the validity, reliability, sensitivity and specificity of the European-Portuguese version of the Intelligibility in Context Scale (ICS-EP).

Seventy-six children (age: M = 60.6, SD = 8.1 months), 25 having a parent or teacher concern about how they talked and 51 with no concern, were assessed with the phonetic-phonological test (TFF-ALPE) to calculate the following severity measures: percentage of phonemes correct (PPC), percentage of consonants correct (PCC), and percentage of vowels correct (PVC). Parents also filled out a questionnaire about their child’s development (e.g. concern about how the child talks). The ICS was then completed by parents to estimate their children’s intelligibility with different communicative partners.

The results showed that item-level scores were different according to communicative partners. The mean ICS score for the whole sample was 4.5 (SD = 0.6), showing that children were “usually” to “always” intelligible. The ICS had excellent internal consistency (α = 0.96). Children with parental concern about their speech presented significantly lower mean scores (M = 3.91, SD = 0.59) than children without parental concerns (M = 4.78, SD = 0.36). There was a positive correlation between the ICS scores and PPC (r = .655), PCC (r = .654), and PVC (r = .588). A simple linear model was also obtained between the ICS mean score and the severity measures analyzed. High values were obtained for sensitivity (0.80) and specificity (0.84), using a cut-off point of 4.36.

We conclude that the ICS-EP has good psychometric properties, suggesting it to be a valid tool for estimating children’s intelligibility when talking with different communicative partners. Therefore, this version of the ICS can be used as a screening measure for children’s speech intelligibility.     

Validity and reliability of the CAPE: a self-report instrument for the measurement of psychotic experiences in the general population

OBJECTIVE: General population longitudinal cohort studies have demonstrated the prognostic validity of self-reported psychotic experiences, but data on reliability and cross-validation with interview-based measures of these experiences are sparse. This study tested the reliability and validity of the Community Assessment of Psychic Experiences (CAPE42). METHOD: At baseline, the CAPE42 was used to measure the subclinical psychosis phenotype in a general population sample (n = 765). At follow-up (mean interval: 7.7 months), the Structured Interview for Schizotypy, Revised (SIS-R), the Brief Psychiatric Rating Scale (BPRS), and the CAPE42 were administered (n = 510). RESULTS: Baseline self-reported dimensions of psychosis were specifically and independently associated with their equivalent interview-based dimension at follow-up (standardized effect sizes of 0.4-0.5) and with their equivalent self-reported measure (standardized effect sizes of 0.6-0.8). CONCLUSION: The results indicate that self-reported dimensions of psychotic experiences in general population samples appear to be stable, reliable and valid.