Testing the reliability and validity of the Self-Efficacy for Exercise scale

BACKGROUND: The measure for self-efficacy barriers to exercise was developed for adults and revised on the basis of quantitative and qualitative research with older adults so it would be more appropriate for that age group. OBJECTIVES: To test the reliability and validity of the Self-Efficacy for Exercise (SEE) Scale. METHODS: Initial reliability and validity testing was performed using a sample of 187 older adults living in a continuing care retirement community. The average age of the participants was 85 +/- 6.2 years, and most were White (98%), female (82%), and unmarried (80%). Face-to-face interviews were completed and included the SEE, the 12-item Short Form Health Survey (SF-12), and the Expected Outcomes and Barriers for Habitual Exercise scale. Exercise activity was based on verbal report of participation in aerobic exercise (walking, swimming, biking, or jogging). RESULTS: There was sufficient evidence of internal consistency (alpha = 0.92), and a squared multiple correlation coefficient using structural equation modeling provided further evidence of reliability (R2 ranged from 0.38 to 0.76). There was evidence of validity of the measure based on hypothesis testing: Mental and physical health scores on the SF-12 predicted efficacy expectations, and efficacy expectations predicted exercise activity. Lambda X estimates (all estimates > or = 0.81) provided further evidence of validity. CONCLUSION: Preliminary testing provided evidence for the reliability and validity of the SEE scale. Future testing of the scale needs to be done with young old adults and subjects from different socioeconomic and cultural groups.     

Model testing for reliability and validity of the Outcome Expectations for Exercise Scale

BACKGROUND: Development of a reliable and valid measure of outcome expectations for exercise appropriate for older adults will help establish the relationship between outcome expectations and exercise. Once established, this measure can be used to facilitate the development of interventions to strengthen outcome expectations and improve adherence to regular exercise in older adults. OBJECTIVES: Building on initial psychometrics of the Outcome Expectation for Exercise (OEE) Scale, the purpose of the current study was to use structural equation modeling to provide additional support for the reliability and validity of this measure. METHODS: The OEE scale is a 9-item measure specifically focusing on the perceived consequences of exercise for older adults. The OEE scale was given to 191 residents in a continuing care retirement community. The mean age of the participants was 85 +/- 6.1 and the majority were female (76%), White (99%), and unmarried (76%). Using structural equation modeling, reliability was based on R2 values, and validity was based on a confirmatory factor analysis and path coefficients. RESULTS: There was continued evidence for reliability of the OEE based on R2 values ranging from .42 to .77, and validity with path coefficients ranging from .69 to .87, and evidence of model fit (X2 of 69, df = 27, p < .05, NFI = .98, RMSEA = .07). CONCLUSION: The evidence of reliability and validity of this measure has important implications for clinical work and research. The OEE scale can be used to identify older adults who have low outcome expectations for exercise, and interventions can then be implemented to strengthen these expectations and thereby improve exercise behavior.     

Simplified scoring and psychometrics of the revised 12-item Short-Form Health Survey

The 12-item Short-Form Health Survey was developed to describe mental and physical health status of adults and to measure the outcomes of healthcare services. Based on testing of the original SF-12 with a group of older adults, a revised scoring system and measurement model of the SF-12 Health Survey was proposed. The purpose of this study was to test the reliability and validity of this revised measurement model and scoring system. Testing was done with a sample of 187 older adults in a continuing care retirement community and a sample of 211 older adults discharged from an acute care setting. There was sufficient evidence for the internal consistency of the revised SF-12 (Cronbach alpha coefficients of 0.72 to 0.89); test retest reliability (r = 0.73-0.86); reliability based on R2 values; and validity based on confirmatory factor analysis, contrasted groups, and hypothesis testing. The revised SF-12 is a valid and reliable measure that can be used with confidence to measure outcomes for older adults.     

Review of the psychometric properties of the Diabetes Self-Efficacy Scale: Australian longitudinal study

The current paper presents the findings from the reliability and validity testing of an 18-item Diabetes Self-efficacy Scale derived from the 28-item Insulin Management Diabetes Self-efficacy Scale. Testing in the Australian context occurred at three points over 9 months. Diabetes self-efficacy is defined as the individual's judgement of confidence to carry out tasks specific to diabetes management. Data were obtained from an Australian metropolitan sample of adult, English speaking men and women with diabetes (N = 226). Participants were insulin-using and non-insulin-using. Factor analysis indicated five subscales. The data support the construct validity and reliability of the 18-item scale in terms of stability, internal consistency and item-total correlation matrices. This study provides consistent evidence that the Diabetes Self-efficacy Scale is a valid and reliable measure over time when the individual's efficacy beliefs are changing. Hence this instrument should be a useful outcome measure for educational diabetes related interventions.     

Development,reliability, and validity of the Sitting Balance Scale

The Sitting Balance Scale (SBS) measures sitting balance for frail older adults who are primarily nonambulatory. Purposes were to generate items representing different functional abilities of sitting balance, reduce the number of items to make a clinically useful tool, refine the assessment, and establish reliability and validity. The study was conducted in multiple phases, with qualitative and quantitative methodologies. Content development used nominal group process, expert narratives, and literature review. After consensus was reached on content and scoring, item reduction began. Item retention and deletion decisions were based on a combination of practical considerations during field testing, expert and experienced clinician opinion of clinical relevance, and statistical information. Item retention or deletion decisions were based in part on the internal consistency analysis of the 19-item SBS based on 256 scores, which included participants who were apparently healthy and those with pathology. We applied a decision matrix to yield the final 11-item version. The 11-item SBS demonstrated good internal consistency (α?=?0.762), intrarater rater reliability (ICC_3,1?=?0.96 to 0.99), and interrater reliability (ICC_2,1?=?0.87). On the basis of analysis of 156 scores, construct and concurrent validity were established. The SBS appears to meet the criteria required to make it a useful tool. The SBS can be used to assess sitting balance in frail individuals who are primarily nonambulatory who might exhibit floor effects for traditionally used balance measures. The SBS is the first attempt to assess lower balance abilities. Further assessment of the tool's validity with larger and varied samples is necessary.     

Development, reliability, and validity of the Sitting Balance Scale

The Sitting Balance Scale (SBS) measures sitting balance for frail older adults who are primarily nonambulatory. Purposes were to generate items representing different functional abilities of sitting balance, reduce the number of items to make a clinically useful tool, refine the assessment, and establish reliability and validity. The study was conducted in multiple phases, with qualitative and quantitative methodologies. Content development used nominal group process, expert narratives, and literature review. After consensus was reached on content and scoring, item reduction began. Item retention and deletion decisions were based on a combination of practical considerations during field testing, expert and experienced clinician opinion of clinical relevance, and statistical information. Item retention or deletion decisions were based in part on the internal consistency analysis of the 19-item SBS based on 256 scores, which included participants who were apparently healthy and those with pathology. We applied a decision matrix to yield the final 11-item version. The 11-item SBS demonstrated good internal consistency (α?=?0.762), intrarater rater reliability (ICC(3,1)?=?0.96 to 0.99), and interrater reliability (ICC(2,1)?=?0.87). On the basis of analysis of 156 scores, construct and concurrent validity were established. The SBS appears to meet the criteria required to make it a useful tool. The SBS can be used to assess sitting balance in frail individuals who are primarily nonambulatory who might exhibit floor effects for traditionally used balance measures. The SBS is the first attempt to assess lower balance abilities. Further assessment of the tool's validity with larger and varied samples is necessary.     

Psychometric properties of the Spanish version of the Resilience Scale

The purpose of this study is to test the reliability and validity of a Spanish translation of the Resilience Scale (RS), which was originally created in English by Wagnild and Young (1993). A team of bilingual, bicultural translators participated in the translation process to enhance the linguistic accuracy and cultural appropriateness of the Spanish translation. As part of the convenience sample of 315 women of Mexican descent who participated in the larger study, data from 147 women who preferred to read and write in Spanish were used in this analysis. The English version of the RS consists of a 17-item "Personal Competence" subscale and an 8-item "Acceptance of Self and Life" subscale for a total of 25 items. However, two items had low item-total loadings and were removed to form a modified 23-item RS. The exploratory principal components factor analysis, varimax rotation, and subsequent goodness of fit indices were ambivalent on whether a one or two-factor solution was appropriate, but the chi-square difference test clearly demonstrated that the two-factor solution of the Spanish version was more useful in explaining variance than a one-factor solution. Internal consistency reliability was estimated with Cronbach's alpha (alpha = 0.93) which was acceptable for the 23-item RS as well as its subscales. Construct validity was demonstrated by a significant positive correlation between resilience and life satisfaction (r = 0.36; p < 0.001), and a significant negative correlation between resilience and depressive symptoms (r = -0.29; p < 0.01). This analysis ultimately supports the appropriateness of the modified 23-item Spanish translation of the RS and its subscales in a sample of urban, low-income women of Mexican descent in the U.S.     

Assessing protection from suicidal risk: psychometric properties of the suicide resilience inventory

This study investigated psychometric properties of the Suicide Resilience Inventory-25 (SRI-25) in a diverse sample of 239 college students. Participants completed the SRI-25, Beck Hopelessness Scale (BHS), Suicidal Ideation Questionnaire, and the Multidimensional Scale of Perceived Social Support (MSPSS). Confirmatory factor analysis supported the 3 dimensions described by SRI-25 authors (A. Osman et al., 2004): internal protective, emotional stability, and external protective. Correlations with the BHS (r = - .68) and SIQ (r = - .67) supported the scale's validity, although the external protective subscale and MSPSS were only moderately correlated (r = .47). Overall, the SRI-25's reliability and validity support its use in suicide research. Implications for exploring young adults' resilience in the face of suicidal thoughts via clinical interview or administration of the SRI-25 are discussed as they create an opportunity to potentially infuse hope, tap into strengths, and identify avenues for positive change.     

Perceived social support,resilience and health self-efficacy among migrant older adults: A moderated mediation analysis

Migrant older adults become more disadvantaged in health due to aging and migration-related problems. This study aimed to examine the mediating role of resilience in the relationship between perceived social support and health self-efficacy, and to test whether gender moderated the mediating effect of resilience between perceived social support and health self-efficacy among migrant older adults. A total of 184 migrant older adults were recruited from five communities. Resilience played a partial mediating role in the relationship between perceived social support and health self-efficacy. Moreover, age moderated the relationship between resilience and health self-efficacy. The relationship between resilience and health self-efficacy was stronger in male older adults than female ones. These findings provide a better understanding of the effects of perceived social support and resilience on health self-efficacy, which could guide targeted interventions for community health nurses to promote health self-efficacy among migrant older adults.     

A self-assessment tool to measure older adults'Perceptions regarding physical fitness and exercise activity

The purpose of this research was to qualitatively generatively generate and psychometrically assess an instrument which assesses the self-perceived physical fitness and exercise activity levels of community-dwelling older adults and examines perceived factors which enhance or impede their exercise activity level. This research was carried out in two stages: qualitative and quantitative. Items for the instrument were generated through qualitative interviews with 23 community-dwelling older adults, 9 males and 14 females, with an age range of 63 to 82 years. From this qualitative study, 50 items were generated, representing nine categories of elements which enhance or impede physical activity. The 50 items were incorporated into a 4-point, forced-choice, Likert format instrument which was pilot tested for clarity and ease of administration with a convenience sample of community-dwelling older adults. Following the pilot testing, 41 items were retained. The 41-item instrument, entitled physical Fitness and Exercise Activity Levels of Older Adults Scale, was categorized into the following subscales: Physical Fitness, Barriers, Motivators, and Exercise Activity Levels of Older Adults Scale seems to indicate adequate validity and reliability. Correlation coefficients for the total instrument, as well as the subscales, were significantly positive for both stability and internal consistency. Results with respect to predictive validity were mixed. The physical Fitness and Motivators subscales were significant predictors of Exercise Frequency. Although the correlation between the Barriers subscale and Exercise Frequency was negative, it was non-significant.     

Psychometric properties of the Swedish version of the Resilience Scale

The aim of this study was to investigate resilience in relation to age and gender, and to elucidate the underlying structure of the Swedish version of the Resilience Scale (RS). The RS, originally created by Wagnild and Young is a 25 items scale of Lickert type with possible scores ranges from 25 to 175, the higher the score, the stronger resilience. A standardized procedure was used for translation. The analysis was based on 1719 participants, 1248 women and 471 men, from eight different samples, aged from 19 to 103 years. We found that the participants estimated their resilience as relatively high. There was a significant relationship between age and resilience, for every year RS score increased with 0.134 units. There was no relation between gender and resilience. From a factor analyses five factors emerged, equanimity, meaningfulness, perseverance, existential aloneness and self-reliance reflecting the five dimensions described by Wagnild and Young. We concluded that the resilience is related to age, the older, the stronger resilience. Five underlying dimensions was identified, which can be seen as reflection of the theoretical assumptions behind the RS scale. The RS scale seems applicable to a Swedish population.     

Development and evaluation of the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes

ObjectivesThis study aims to develop the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes (DNSS-T2DM) to measure diabetes-specific support and patients’ preference as well as evaluate the construct validity and reliability of the DNSS-T2DM.MethodsA cross-sectional study was conducted in Tongzhou District, Beijing, China from July to September 2015. A total of 474 participants who had been diagnosed as type 2 diabetes by physicians and completed the DNSS-T2DM were included. The original 11-item DNSS-T2DM contains five items on nondirective support (Items 1–5) and six items on directive support (Items 6–11). There were two parallel questions for each item with one to measure the preference for support (Preference part) and the other to measure the perception of support in reality (Reality part). The final DNSS-T2DM was determined based on the results of the exploratory factor analysis (EFA). The construct validity of the final DNSS-T2DM was evaluated by the confirmatory factor analysis (CFA). The reliability was evaluated by internal consistency with Cronbach’s α coefficients.ResultsA final 7-item DNSS-T2DM loaded on 2 factors with four items representing nondirective support and three items representing directive support was determined based on the EFA. The CFA indicated a satisfactory construct validity. The internal consistency of the 7-item DNSS-T2DM as well as the nondirective support items was satisfactory with Cronbach’s α ≥ 0.70.ConclusionsOur study supported the validity and reliability of the 7-item DNSS-T2DM. Further studies on the application of the DNSS-T2DM in different settings and population are needed.     

Research Article: Resilience among women and men aged 60 years and over in Sweden and in Thailand

The purpose of this study was to compare the level of resilience of people aged ≥ 60 years in Sweden and Thailand. In a randomized sample of 422 people in Sweden and a convenience sample of 200 people in Thailand, the level of resilience was measured by using the Resilience Scale. A χ²‐analysis was used for the differences between proportions. The relationships between the background variables and the resilience scores were analyzed by using stepwise multiple linear regression. The mean scores of resilience were 144 for the Swedish participants and 146 for the Thai participants. The two samples differed in their background characteristics. The Thai participants were more likely to be women, to be widowed, and to have more children, while among the Swedish participants, more women were married and more participants were aged ≥ 80 years. Despite different background characteristics, the Swedish and the Thai participants' scores were almost the same on the Resilience Scale. More studies are necessary to address aspects of gender and ethnicity in relation to resilience.     

Preliminary psychometric testing of the Fox Simple Quality-of-Life Scale.

Although quality of life is extensively defined as subjective and multidimensional with both affective and cognitive components, few instruments capture important dimensions of the construct, and few are both conceptually congruent and user friendly for the clinical setting. The aim of this study was to develop and test a measure that would be easy to use clinically and capture both cognitive and affective components of quality of life. Initial item sources for the Fox Simple Quality-of-Life Scale (FSQOLS) were literature-based. Thirty items were compiled for content validity assessment by a panel of expert healthcare clinicians from various disciplines, predominantly nursing. Five items were removed as a result of the review because they reflected negatively worded or redundant items. The 25-item scale was mailed to 177 people with lung, colon, and ovarian cancer in various stages. Cancer types were selected theoretically, based on similarity in prognosis, degree of symptom burden, and possible meaning and experience. Of the 145 participants, all provided complete data on the FSQOLS. Psychometric evaluation of the FSQOLS included item-total correlations, principal components analysis with varimax rotation revealing two factors explaining 50% variance, reliability estimation using alpha estimates, and item-factor correlations. The FSQOLS exhibited significant convergent validity with four popular quality-of-life instruments: the Ferrans and Powers Quality of Life Index, the Functional Assessment of Cancer Therapy Scale, the Short-Form-36 Health Survey, and the General Well-Being Scale. Content validity of the scale was explored and supported using qualitative interviews of 14 participants with lung, colon and ovarian cancer, who were a subgroup of the sample for the initial instrument testing.     

Reliability and validity of the Overeating Tension Scale

This study presents the development and testing of the Overeating Tension Scale. Overeating tension was defined operationally as the total discrepancy score resulting from differences between subjects' ratings of actual and desired feelings before overeating. The 32-item Overeating Tension Scale, derived from Apter's Reversal Theory, measures reported overall tension and motivation-specific tension. The scale initially included 48 items, six items for each of eight motivational states. After two instrument development studies (N = 373, N = 208), items were refined and reduced to a total of 32, or four for each of eight motivational states. The final version of the instrument was tested in two additional studies (N = 330, N = 130) that provided evidence to support the internal consistency reliability of the Overeating Tension Scale. There was support for construct validity using contrasted groups (overweight and normal weight subjects), convergent validity, and factor analysis.     

Development and testing of the Resilience Factors Scale for Thai adolescents

Abstract   The growing body of knowledge related to resilience supported the need for the development of an instrument that can be used to assess resilience factors, that is, individual protective factors, but to date, no established instrument for Thai adolescents exists. The purposes of this study were to develop and test the psychometric properties of the Resilience Factors Scale for Thai adolescents. Derived from the resilience theory of Grotberg and a literature review, 27 items compose the scale. The content validity was evaluated by five experts. The construct, contrast-group, and predictive validity, as well as the internal reliability, were evaluated with a multistage random sample of 638 tenth-to-twelfth graders in four high schools in Bangkok, Thailand. An exploratory factor analysis in the final step indicated that the scale consists of six components with 25 items. Evidence of validity and reliability was obtained. This scale has demonstrated good psychometric properties and has provided an objective tool for assessing the resilience factors of Thai adolescents.     

Validation of the Pain Resilience Scale in a Chronic Pain Sample

Psychosocial factors that protect against negative outcomes for individuals with chronic pain have received increased attention in recent years. Pain resilience, or the ability to maintain behavioral engagement and regulate emotions as well as cognitions despite prolonged or intense pain, is one such factor. A measure of pain-specific resilience, the Pain Resilience Scale, was previously identified as a better predictor of acute pain tolerance than general resilience. The present study sought to validate this measure in a chronic pain sample, while also furthering understanding of the role of pain resilience compared with other protective factors. Participants with chronic pain completed online questionnaires to assess factors related to positive pain outcomes, pain vulnerability, pain intensity, and quality of life. A confirmatory factor analysis confirmed the 2-factor structure of the Pain Resilience Scale previously observed among respondents without chronic pain, although one item from each subscale was dropped in the final version. For this chronic pain sample, structural equation modeling showed that pain resilience contributes unique variance to a model including pain acceptance and pain self-efficacy in predicting quality of life and pain intensity. Further, pain resilience was a better fit in this model than general resilience, strengthening the argument for assessing pain resilience over general resilience.

Psychometric properties of the positive thinking skills scale among college students

Suicide continues to be in the top leading causes of death among college students. Positive thinking has been linked to increasing health outcomes and decreasing the effects of stress. The psychometric properties of the 8-item Positive Thinking Skills Scale (PTSS) has not been tested in American college students. The study used resilience as the theoretical framework. In 131 students, internal consistency and construct validity was supported. The Cronbach's alpha of 0.86 and significant correlation with measures of suicide resilience, perceived social support, and self-esteem demonstrated good reliability and validity. The findings of the study provide directions for future suicide prevention efforts.