Chinese Breast Cancer Screening Beliefs Questionnaire: development and psychometric testing with Chinese-Australian women

Title.  Chinese Breast Cancer Screening Beliefs Questionnaire: development andpsychometric testing with Chinese-Australian women.
Aim.  This paper is a report of the development and psychometric testing of the Chinese Breast Cancer Screening Beliefs Questionnaire, a culturally sensitive questionnaire for measuring Chinese-Australian women's beliefs, knowledge and attitudes towards breast cancer and breast screening practices.
Background.  Breast cancer is the leading cause of cancer morbidity among Chinese-Australian women. They are, however, 50% less likely to participate in all types of breast examination. A valid and reliable instrument to explore the breast cancer beliefs is essential for the development of interventions to promote breast cancer screening practices.
Method.  Items for the questionnaire were drawn from a literature review and in-depth interviews. A panel of professional experts and lay women evaluated face and content validity. The instrument was translated from English to Chinese using back-translation. In 2008, a total of 292 Chinese-Australian women aged 22–78 years who were resident of Australia were included in testing the instrument. Multi-trait analysis and Cronbach's alpha were used to assess internal consistency reliability and exploratory factor analysis assessed construct validity.
Results.  The final 13-item questionnaire had satisfactory validity and internal consistency. Cronbach's alpha for the total scale was 0·76, and for the three subscales ranged from 0·70 to 0·79. Exploratory factor analysis showed that the scale reduced to three factors.
Conclusion.  Preliminary data suggest that the Chinese Breast Cancer Screening Beliefs Questionnaire is a valid, reliable and culturally sensitive instrument for the measurement of Chinese-Australian women's beliefs, knowledge and attitudes about breast cancer and breast cancer screening.     

Validation of the English and Spanish Mammography Beliefs and Attitudes Questionnaire

Breast cancer is the leading cause of cancer deaths among Hispanic women in the United States. Unfortunately Hispanic women exhibit poor mammography screening participation, are diagnosed at later stages of the disease, and have lower survival rates than non-Hispanic white women. Several cultural and psycho-social factors have been found to influence mammography screening participation among Hispanic women. We will begin by presenting the theoretical framework that grounded this research program to develop an instrument to assess factors contributing to poor mammography participation among Hispanic women. We will also summarize the early stages in the development of the English and Spanish Mammography Beliefs and Attitudes Questionnaire (MBAQ and SMBAQ) for use with low-health-literacy Mexican-American women. Next we will describe the initial psychometric testing of the MBAQ/SMBAQ, after which we will present the psychometric testing of the SMBAQ with low-health-literacy women. This will be followed by a discussion of the modification of the MBAQ and SMBAQ subscales. We'll conclude with a discussion of the instruments and share our assessment regarding the limitations of this research program, where the program stands to date, and the implications for practice and future research.     

A Spanish language version of the Health-Promoting Lifestyle Profile

The development and initial psychometric evaluation of a Spanish language version of the Health-Promoting Lifestyle Profile (HPLP) is described. The 48-item instrument was translated into Spanish and found to be culturally relevant and reliable in a pilot study. The Spanish version was then administered to a diverse but predominantly Mexican-American group of 485 Hispanics residing in metropolitan and surrounding rural areas. In a principal components factor analysis, all but one item loaded significantly on six factors similar to those isolated previously during psychometric assessment of the English language version. Those six dimensions comprise the HPLP subscales of self-actualization, health responsibility, exercise, nutrition, interpersonal support, and stress management. The six factors explained 45.9% of the variance in the measure. Second-order factor analysis yielded a single factor, interpreted as health-promoting lifestyle. The alpha reliability coefficient for the total scale was .93 and 2-week test-retest reliability was .86; alpha coefficients for the subscales ranged from .70 to .87.     

The development and testing of the Mental Health Problems Perception Questionnaire

This paper reports the development and psychometric testing of the Mental Health Problems Perception Questionnaire. This questionnaire was developed to measure the therapeutic commitment, role support and role competency of non-mental health specialist nurses (generalists) to working with patients with mental health problems who live in rural communities. The instrument was demonstrated to be valid and reliable in this population. The questionnaire was underpinned by an explicit theoretical model which facilitates an understanding of the factors that influence effective psychosocial nursing interventions with this client group.     

儿童环境健康知识和技能问卷的汉化及信效度分析

目的 汉化儿童环境健康知识问卷和儿童环境健康技能问卷，并依据项目反应理论验证其信度效度。方法 便利选取河南省某高校的316名本科护生为研究对象。运用经翻译、文化调试形成的中文版儿童环境健康知识与技能问卷进行问卷调查。基于项目反应理论的Rasch模型及评定量表模型对问卷进行评价。结果 残差主成分分析与验证性因子分析残差相关分析结果显示，2个问卷均满足单维性与局部独立性假设。知识问卷的条目信度为0.970，个体信度为0.810。技能问卷的条目信度为0.930，个体信度为0.910。知识问卷的重测信度值为0.917，技能问卷的重测信度值为0.952。儿童环境健康知识内容效度为0.960，儿童环境健康技能内容效度为1.000。2个问卷的难度设置合理，数据与模型拟合程度较为理想。结论 2个问卷具有良好的心理测量特征，可以准确测量护生的儿童环境健康知识及技能水平，并对不同水平的护生及进行适当区分。     

A case study in translation methodology using the Health-Promotion Lifestyle Profile II

Although Hispanics constitute the most rapidly growing segment of the population in the United States, they have received relatively little attention regarding factors affecting their health behaviors and influences. One such factor is the scarcity of reliable and valid Spanish-language instruments for research with this population. Researchers who attempt to translate an existing instrument into Spanish need to recognize the methodological issues involved in the translation process and psychometric testing. The purpose of this article is to describe the advantages and disadvantages of various translation methodologies, to identify statistical issues in cross-cultural research, and to provide a case study of the translation process and statistical analysis of a translated instrument. Specifically, this study looks at the development and pilot testing of a Spanish-language version of the Health-Promoting Lifestyle Profile II using a randomized convenience sample of 60 bilingual Hispanic individuals.     

Spanish Version of the Whiplash Disability Questionnaire in Adults With Acute Whiplash-Associated Disorders

ObjectiveThe purpose of this study was to develop and validate a Spanish version of the Whiplash Disability Questionnaire (WDQ) for the Spanish population with acute whiplash-associated disorder (WAD).MethodsThis was a cross-sectional questionnaire validation study. Adults with acute WAD (grade I to III) were enrolled within 3 weeks of their injury. A blinded forward and back translation of the WDQ was made from English to Spanish, and the resulting back-translation version was compared with the original. Patients with WAD completed the Spanish version of the 13-item WDQ. The developed questionnaire was assessed using psychometric statistical analysis including correlation with the numerical rating score for pain, Northwick Park Neck Pain Questionnaire, Neck Disability Index, and 36-item Short Form Health Survey.ResultsFifty-six patients completed the questionnaire, the mean age was 33.9 years (standard deviation [SD] = 10.5), and 76.8% were women. Participants were enrolled 13.9 days (SD 4.9) after the injury, with 14.3% presenting with WAD grade I and 85.7% with WAD grade II. The mean WDQ score was 62 (SD = 31). Two factors were detected, and the factor structure remained stable after translation. Positive correlations were identified between the total WDQ score and the numerical rating score, Neck Pain Questionnaire, and Neck Disability Index results, with a strong negative correlation with the 36-item Short Form Health Survey.ConclusionThe Spanish version of WDQ is psychometrically reliable and a valid instrument to measure the disability status in patients with acute WAD within the clinic.     

Measuring breast cancer and mammography screening beliefs among Chinese American immigrants

Disparities in breast cancer outcomes persist among Asian American women. Breast cancer is the most commonly diagnosed cancer among Chinese American women. This article describes the psychometric evaluation of an instrument measuring knowledge and beliefs related to breast cancer and screening among Chinese American women aged 40 or older. A sample of 100 foreign-born Chinese American women were recruited from an Asian community. Guided by the health belief model, a questionnaire was adapted from three existing questionnaires. Principal axis factoring analyses yielded a three-factor solution that accounted for 53% of the variance in the breast cancer items and a four-factor solution that accounted for 69% of the variance in the cultural items (Cronbach's alphas = .71-.89). Whereas these findings contribute to the understanding of the psychometric properties of an instrument targeted for Chinese American women, additional research is needed to evaluate its utility and efficacy for other Asian Americans.     

Factors influencing the access to prenatal care by Hispanic pregnant women

PURPOSE: To explore factors influencing the access to prenatal care among Hispanic pregnant women living in the United States. DATA SOURCES: A convenience sample of 46 Hispanic migrant pregnant women was interviewed over a 12-month period using a set of five open-ended questions. CONCLUSIONS: The ability of the health care providers to communicate in Spanish, as well as the availability of culturally sensitive prenatal care were the main factors influencing the willingness of Hispanic women to access to prenatal care. IMPLICATIONS FOR PRACTICE: With the Hispanic population increasing in the United States, there is a need to provide culturally appropriate health care for that population; prenatal care is one of the areas of health care in demand. This study supports the findings in the literature and provides nurse practitioners a deeper understanding of the needs of Hispanic women needing prenatal care.     

Nursing students' attitudes about home health nursing

In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.     

Cultural sensitivity education for nurses: a pilot study

Health professionals need to be responsive to changing demographics, especially the growing Hispanic American population. This pilot project explored the effect that an education program about selected Hispanic health beliefs and practices had on nurses who provide care to this population. Seven white registered nurses employed at a small, rural health department completed a 10-item, researcher-designed instrument, termed the Lee Cultural Sensitivity Tool: Hispanic Version, before and after an educational intervention. Findings showed that the intervention increased knowledge of selected Hispanic health beliefs and practices.     

Beyond translation ... cultural fit

Reaching non-English-speaking families, the economically disadvantaged, and those who are disproportionately represented in disease and injury statistics is challenging. This article describes the process of making a questionnaire developed in English, culturally appropriate for low-income, monolingual, Mexican and Mexican American mothers. The questionnaire, guided by the Health Belief Model, assesses maternal childhood injury health beliefs and was originally used with a 96% African American, English-speaking sample in the Eastern United States. Two research assistants from the target population worked with the non-Hispanic, bilingual investigator to redesign the questionnaire's language and presentation and to collect data. Sixty monolingual Latina mothers participated in the study to determine the internal consistency of the 42-item Spanish language Maternal Childhood Injury Health Belief Questionnaire (MCIHB). Cronbach's alpha coefficients ranged from .76 (Benefits subscale) to .90 (Consequences subscale).     

Turkish adaptation of the parental health beliefs scale

AIM: This paper reports an adaptation of the English version of the Parental Health Beliefs Scale for use with Turkish parents and an evaluation of its psychometric properties. BACKGROUND: As a profession, nurses are particularly concerned with cross-cultural influences that affect the health beliefs of populations. Although the international literature describes questionnaires and specific scales in health promotion and health beliefs, adequate Turkish-language instruments are scarce. Therefore, suitable instruments need to be developed or adapted for the Turkish parents. METHOD: This was a psychometric study. A convenience sample (n=257) was recruited in 2003 from parents who attended a primary healthcare centre in Erzurum, Turkey. Translation and back-translation of the original English instrument and content validation by an expert panel were the first two steps. The third step was psychometric testing of the adapted instrument to establish internal consistency, inter-item correlation and construct validity. Data were collected using the Parental Health Beliefs Scale. Socio-demographic data were also collected. The investigators visited the centre every workday, and interviewed the samples. The parents read and self-completed the questionnaire. FINDINGS: Content validity procedure resulted in a final scale that consisted of 20 items. Cronbach's alpha was 0 x 75. Factor analysis yielded three factors related to chance, internality and powerful others. CONCLUSION: Although acceptable levels of reliability and validity of the Turkish version of the Parental Health Beliefs Scale for parents were reached, cultural factors appeared to play a role in the applicability of the scale. Further validation research is therefore needed before the scale can be recommended for use in nursing research and practice.     

Childbirth Self‐Efficacy Inventory: psychometric testing of the Spanish version

Title. Childbirth Self‐Efficacy Inventory: psychometric testing of the Spanish version. Aim. This paper is a report of a study of the psychometric properties of the Spanish version of the Childbirth Self‐efficacy Inventory. Background. Enhancing the confidence of women in their ability to cope with pain in labour is a key element of effective childbirth education programs. The Childbirth Self‐efficacy Inventory is a suitable instrument for testing hypotheses about the development of self‐efficacy for childbirth. Analysing its psychometric properties in the light of Bandura’s Self‐Efficacy Theory is relevant for the validation of the instrument. Methods. Translation and back‐translation of the questionnaire took place in 2002 using a pilot sample of 12 women. The study was conducted using a sample of 146 childbearing women recruited from different national healthcare centres in Spain during the last 6 months of 2003. The psychometric study was carried out using the Statistical Package for Social Sciences. Results. Principal components analysis supported the ability of the Self‐Efficacy Inventory to distinguish between outcome and self‐efficacy expectancies. Internal Consistency Reliability of the Inventory was found adequate. Previous knowledge was identified as the most important factor influencing the confidence of a woman to coping with labour. Conclusion. Results are consistent with previous findings, and contribute to give support to the reliability and validity of the Inventory. The findings provide an additional and useful insight into practical ways of enhancing a woman’s confidence to coping with childbirth: self‐efficacy can be strengthened through persuasion by healthcare professionals, childbirth educators, and family and friends who offer support to the pregnant woman.     

Development and Validation of the Migraine-Specific Quality of Life Questionnaire

This paper describes the development and validation of a migraine-specific quality-of-life instrument that is capable of measuring health-related quality-of-life impairments attributed to migraine. Item selection, item reduction, and pretesting and finalization of items during the instrument development phase resulted in a total of 16 questions which were incorporated into the Migraine-Specific Quality of Life Questionnaire (Version 1:0) (©1992 Glaxo Wellcome Inc). Three meaningful dimensions were hypothesized: Role Function-Restrictive, Role Function-Preventive, and Emotional Function. In the instrument validation phase, the Migraine-Specific Quality of Life Questionnaire was mailed to 1109 migraine patients, providing a response rate of 45% (n=458). Initial psychometric evaluation of the questionnaire indicated that it possessed adequate reliability with Cronbach's alpha for the three dimensions ranging between 0.70 to 0.85. The Migraine-Specific Quality of Life Questionnaire possessed adequate content and criterion validity. All but three items satisfied the test of construct validity. In conclusion, the Migraine-Specific Quality of Life Questionnaire has acceptable psychometric properties and can be used to estimate the effect of migraine and its treatment on the patient's health-related quality of life.     

Selection of quality-of-life measures for a prevention trial: a psychometric analysis

Quality-of-life (QoL) outcomes have become increasingly important in the evaluation of health interventions. The objective of the present study was to determine which of three generic QoL instruments was most suitable for use in an 8-year nutritional primary prevention trial. We compared the Duke Health Profile, the Nottingham Health Profile, and the Short Form Health Survey Questionnaire (SF36). We conducted the comparison in two stages: (1) a statistical analysis of data from a pilot study (n = 963) comparing the psychometric properties of the three instruments; and (2) an assessment of the practicality of the tools. With regard to psychometric properties, convergent validity was comparable for the three scales, and the correlation with Global Health Assessment ranged from 0.24 to 0.72. Discriminant validity was best for the SF36, with a difference between scores in healthy subjects and those with chronic disease in the range of 4.4 to 15.8 (scores could range from 0 to 100, where 100 indicates perfect health). Reproducibility was good for all three instruments, with a test-retest intraclass correlation coefficient of over 0.60 for most dimensions. DHP and SF36 performed best in terms of responsiveness. We judged the practicality of the three tools as satisfactory. We chose the SF36 for its high responsiveness. We also selected the Duke Health Profile for its practicality and favorable psychometric properties.     

Health-Promoting Lifestyles of English-Speaking and Spanish-Speaking Mexican-American Migrant Farm Workers

This study was conducted with 62 Mexican-American migrant farm workers at four different sites in northern Illinois. An established English and a newly developed pilot Spanish version of the health-promoting lifestyle profile was used. The concept of health-promoting lifestyle appeared to be culturally relevant to study participants. English-speaking migrant workers scored significantly lower than Spanish-speaking workers on the dimensions of self-actualization, exercise, and stress management. Patterns of scores among both groups were highest in self-actualization and interpersonal support, and lowest in health responsibility and exercise. Further research in health-promoting behaviors with all cultural groups and socioeconomic levels of society will contribute to achievement of the World Health Organization's goal, health for all by the year 2000.     

Questionnaire development to predict mammography intention among women in southeastern Louisiana

This article summarizes the development and psychometric analysis of the Thoughts About Mammography (TAM) questionnaire to predict mammography intention using the Theory of Planned Behavior (TPB). Key themes, obtained from elicitation interviews (N = 45), were categorized, ranked and extracted for item construction. Initial pilot testing supported test-retest reliability (alpha = .85 to .97), internal consistency (alpha = .67 to .91), and content validity (0.86-1.00). After pilot testing, the TAM was administered to 302 rural women in southeastern (SE) Louisiana. The instrument was internally consistent (alpha = 0.77 to 0.92), construct valid (alpha = .18 to .64), and predicted 24% of the variance of mammography intention. The TAM adequately demonstrated reliability and validity to measure mammography intention in rural southeastern Louisiana women.