The Psychiatric Care Satisfaction Questionnaire: a reliability and validity study

Patient satisfaction can be a useful marker in evaluating the quality of psychiatric care. However, this form of measurement has been hampered by the lack of attention paid to the psychometric properties of instruments devised. The Psychiatric Care Satisfaction Questionnaire (PCSQ) was developed and tests of acceptability, validity and reliability were undertaken using 52 inpatients. Content validity was assessed by surveying psychiatrists, other mental health professionals, MIND workers and patient groups. Thirty-six (67.9%) of all mental health professionals felt that the questionnaire was a useful measure of patients' satisfaction with their care, and many comments also suggested high consensual validity. In terms of content validity, responses from patient groups indicated that the majority (63.6%) felt it to be a useful measure of patient satisfaction and 70.5% felt all the areas covered were important. Concurrent and criterion validity were also good, with high correlations with existing scales and with those on a section being significantly less satisfied on the PCSQ (F = 13.3, P = 0.0004). Test-retest reliability was adequate (Cohen's κ 0.48–0.80) and the internal consistency of the PCSQ was good, at 0.82 (Cronbach's α). The PCSQ performed well in all aspects of validity and reliability, indicating that it has good psychometric properties and can be a useful tool for measuring patient satisfaction. However, there remains the need to analyse more closely the concept of satisfaction and its determinants. Accepted: 4 June 1998     

Social Support Questionnaire among psychiatric patients with various diagnoses and normal controls

Background: Several studies have pointed to the importance of social support in influencing the onset and course of a psychiatric disorder such as schizophrenia or depression. However, only a few have studied it across groups of patients with various psychiatric diagnoses employing a standardized assessment procedure. Method: We administered the Social Support Questionnaire (SSQ); a measure of social support recommended by two recent reviews on the subject, to 1,369 psychiatric outpatients visiting the 23 psychiatric hospitals and clinics all over Japan and to 178 healthy controls recruited from among employees at a general hospital. Results: The original two-factor structure of the SSQ was confirmed and internal consistency reliability for the Number and Satisfaction subscales was satisfactory, with Cronbach's alphas above 0.85. When the SSQ scores were compared between psychiatric patients and healthy controls, it was found that the psychiatric patients in general reported significantly lower Number as well as Satisfaction scores than the healthy controls. When individual diagnostic categories were considered, almost all the diagnostic groups reported significantly lower Number scores, but only the patients with anxiety disorder, mood disorder, schizophrenia, and V codes reported significantly lower Satisfaction scores than the healthy controls. Compared with patients with other diagnoses, the schizophrenic patients stood out as reporting significantly lower Number and Satisfaction scores. Conclusion: The findings demonstrated the internal consistency reliability, factor validity, and construct validity of the SSQ among psychiatric as well as normal populations, and exemplified the feasibility of applying the SSQ as a standard measure of social support among psychiatric patients. Accepted: 8 July 1998     

A community needs assessment: the care needs assessment pack for dementia (CarenapD)—its development,reliability and validity

Objective. To develop and evaluate a multidisciplinary needs assessment tool for people with dementia living in the community and their carers. Design. The measure was developed through applying a theory of need, generating content, consultation with potential users and refinement and evaluation. Validity was established incrementally through the development process. Setting. The development and evaluation was conducted in a variety of settings, including multidisciplinary dementia community care teams, social work departments, day hospitals, and inpatient and residential care. Patients. The evaluation included community patients with a formal diagnosis of dementia (N=34) and consultation with a multidisciplinary group of potential users (N=23). The development process included inpatients with a formal diagnosis of dementia (N=157) and consultation with potential users (N=170) from a range of professions including both health and social care. Measures. Interrater reliability was assessed using the kappa statistic. Social validity was estimated using a measure developed for this purpose as part of the development process. Results. The evaluation of interrater reliability demonstrated that three-quarters of assessors agreed on at least 85% of items in the CarenapD. The kappa statistic demonstrated that agreement for 76.2% of items in the CarenapD was ‘good’ or better (ie kappa>0.75), for 12.4% of items it was ‘fair’ or ‘moderate’ (ie kappa 0.35–0.60) and for the remaining 12 (11.4%) items for which kappa could not be calculated there was low intra-item variance and high agreement (>90%). There was good evidence for social validity. Conclusions. The CarenapD is a reliable and valid multidisciplinary assessment of need for people with dementia living in the community and their carers. © 1998 John Wiley & Sons, Ltd.     

The Coping Strategies Task: Assessment of Coping in Schizophrenia

Abstract

The current study presents the: 1) conceptual development of a preliminary measure, the Coping Strategies Task (CST), for assessing coping-related cognition in a group of long-term, hospitalized individuals with schizophrenia-spectrum disorders; and 2) preliminary reliability and validation data of the CST. The CST was designed for persons with severe and persistent mental illness, and study participants included thirty-three individuals in comprehensive psychiatric rehabilitation. Reliability analyses revealed that the CST and its subscales demonstrated adequate reliability, although one subscale (Behavioral Reaction) demonstrated less robust split-half and test-retest reliabilities. Concurrent validity was evaluated by analyzing the relationship between the CST and measures of stress, observed behavior, and neurocognition. Correlational analyses revealed that coping attributions, as measured by the CST, were associated with perceived stress, observed behavior, and executive functioning. These preliminary data suggest that the CST could become a valid, clinically useful coping measure in order to further inform psychiatric rehabilitation.     

Psychometric properties of the K-SADS-P in an Israeli adolescent inpatient population

Seventy adolescent admissions to a psychiatric unit were evaluated with a Hebrew translation of the Schedule for Affective-Disorders and Schizophrenia for School-Aged Children (K-SADS-P). Interrater and test-retest reliability and mother-child agreement were evaluated for diagnoses, symptom clusters, and 20 affective symptoms. K-SADS diagnoses were also compared with 3-month unit evaluation diagnoses as a measure of consensual validity. The reliability of assessing psychosocial functioning was additionally examined. Reliability and validity of diagnoses were high and reliability of symptoms and syndromes was good to excellent. Mother-child agreement faired less well on all measures. The use of semistructured interviews and DSM-III criteria in an Israeli adolescent psychiatric setting are discussed.     

Corticosteroidpsykose med Kristusforestilling hos kvinne

Abstract

Introduction: Aggression has been linked to several psychiatric disorders. None of the available instruments validated in Mexico is able to classify aggression as impulsive or premeditated. The Impulsive/Premeditated Aggression Scale (IPAS) is a self-report instrument designed to characterize aggressiveness as predominately impulsive or premeditated. Objective: The aim of the study was to determine the validity and reliability of the IPAS in a sample of Mexican psychiatric patients. Method: A total of 163 patients diagnosed with affective, anxiety or psychotic disorder were included. A principal-component factor analysis was performed to obtain construct validity of the IPAS impulsive and premeditated aggression subscales; convergent validity as well as internal consistency of subscales were also determined. Results: The rotated matrix accounted for 33.4% of the variance. Significant values were obtained for convergent validity and reliability of the IPAS subscales. Conclusion: The IPAS is an adequate instrument, which might be used to differentiate the type of aggressive behavior in Mexican psychiatric patients.     

Validation psychométrique d’une échelle française d’auto-stigmatisation auprès d’un échantillon de patients souffrant de troubles mentaux : la Self-Stigma Scale-Short (SSS-S)

ObjectivesThe Self-Stigma Scale - Short (SSS-S) is a 9 item questionnaire designed to measure the degree of self-stigma of individuals from various minority groups. It consists of a cognition score, an affect score and a behaviour score. The aim is to validate this scale in French in the context of psychiatric patients.MethodsThe SSS-S has been translated and then back-translated and approved by its authors. A total of 96 patients were assessed using this questionnaire as well as the Self-Stigma Paradox Scale (PaSS-24), the Generalized Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, the Beck Hopelessness Scale, the abbreviated version of the Stigma Scale (KSS-S) and the Overall Quality of Life of the WHOQOL scale. Internal validity, reliability as well as convergent validity were evaluated.ResultsThe results indicated a good fit of the original three-factor model, a good reliability and a good convergent validity of all KSS-S scores.ConclusionsThe SSS-S is a rapidly completed generic tool with good psychometric properties with a population of psychiatric patients.     

Psychometric Properties of Darryl,a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children

Objective To examine the reliability and validity of Darryl, a cartoon-based measure of PTSD symptoms and a screening tool for identifying children and adolescents with a PTSD diagnosis. Method Exposure to community violence, PTSD symptoms and diagnostic status were assessed in a sample of 49 children and adolescents at an urban outpatient psychiatry clinic. Results Darryl has good internal consistency for the full scale and adequate reliability for each DSM-IV PTSD symptom cluster. Darryl correlates significantly (r = 0.64, P < 0.001) with the most frequently used measure for assessing PTSD in children (CPTSD-RI). As a screening tool, Darryl has excellent sensitivity and specificity in relationship to the KID-SCID. Conclusions In comparison to other child PTSD measures, Darryl has comparable or better psychometric properties and assesses PTSD symptoms in a more developmentally appropriate manner, especially in the domain of community violence. The value of Darryl as a screening tool remains preliminary given the limited number of diagnosed cases of PTSD in the study sample. Full scale efforts at replication are warranted.     

The Personality Organization Diagnostic Form (PODF): A Preliminary Report on Its Validity and Interrater Reliability

This research provides empirical support to the Personality Organization Diagnostic Form (PODF; Diguer & Normandin, 1996), which is a measure that operationalizes Kernberg's (1996) model of personality organizations. The goals of this study were to examine the PODF's interrater reliability and validity. Results confirmed that reliability ranged from good to excellent. Factor analysis showed that items tended to regroup according to the model, which contributes to the validity of the PODF. Internal consistency, reliability, and correlations with psychiatric severity also indicate moderate to good construct validity. Several suggestions are made to improve the measure, such as adding neurotic items and having Likert-scale items.     

The development,validity, and reliability of the auditory vocal hallucination rating scale questionnaire (AVHRS-Q)

Purpose

The Auditory Vocal Hallucination Rating Scale Questionnaire (AVHRS-Q) is a short self-report measure assessing several characteristics of auditory vocal hallucinations (AVH) that was derived from a validated clinical interview (the auditory vocal hallucination rating scale; AVHRS). This study investigated the internal reliability, convergent validity, and divergent validity of the AVHRS-Q using two clinical samples.

Methods

In sample I, 32 psychiatric patients with AVH were recruited from an academic hospital service and assessed with the AVHRS and the AVHRS-Q. Data for sample II were retrospectively retrieved from a pseudonymised Routine Outcome Monitoring (ROM) database collected in the context of mental healthcare at the same academic hospital service. Data from 82 psychiatric patients with AVH were retrieved, who completed the AVHRS-Q, and measures of psychological distress (the Outcome Questionnaire; OQ-45, and the Symptom Checklist; SCL-90) and quality of life (the Manchester Short Assessment of Quality of Life; MANSA).

Results

The AVHRS-Q showed good internal consistency in both samples. Severity scores of the AVHRS-Q were strongly correlated to the severity scores of the AVHRS (r = 0.90, p < 0.01). The AVHRS-Q and AVHRS did not differ in the identification of mild and severe voice-hearers [X² (1, N = 32) = 15.71]. AVHRS-Q severity scores had moderate correlations with measures of psychological distress (OQ-45, r = 0.43, p < 0.01; SCL-90, r = 0.50, p < 0.05) and quality of life (MANSA, r = − 0.22, p < 0.01).

Conclusions

The AVHRS-Q demonstrated good reliability, convergent validity, and divergent validity, suggesting it can be applied in both clinical and research settings for a quick and reliable assessment of AVH.

     

Reliability and validity of the korean version of the childhood trauma questionnaire-short form for psychiatric outpatients

Objective

The Childhood Trauma Questionnaire (CTQ) is perhaps the most widely used and well-studied retrospective measure of childhood abuse or neglect. This study tested the initial reliability and validity of a Korean translation of the Childhood Trauma Questionnaire (CTQ-K) among non-psychotic psychiatric outpatients.

Methods

The CTQ-K was administered to a total of 163 non-psychotic psychiatric outpatients at a university-affiliated training hospital. Internal consistency, four-week test-retest reliability, and validity were calculated. A portion of the participants (n=65) also completed the Trauma Assessment Questionnaire (TAQ), the Impact of Events Scale-Revised, and the Dissociative Experiences Scale-Taxon.

Results

Four-week test-retest reliability was high (r=0.87) and internal consistency was good (Cronbach''s α=0.88). Each type of childhood trauma was significantly correlated with the corresponding subscale of the TAQ, thus confirming its concurrent validity. In addition, the CTQ-K total score was positively related to post-traumatic symptoms and pathological dissociation, demonstrating the convergent validity of the scale. The CTQ-K was also negatively correlated with the competence and safety subscale of the TAQ, confirming discriminant validity. Additionally, we confirmed the factorial validity by identifying a five-factor structure that explained 64% of the total variance.

Conclusion

Our study indicates that the CTQ-K is a measure of psychometric soundness that can be used to assess childhood abuse or neglect in Korean patients. It also supports the cross-cultural equivalence of the scale.     

The Reliability and Validity of Kiddie‐Schedule for Affective Disorders and Schizophrenia ‐ Present and Life‐time Version ‐ Persian Version

Background: The validity and reliability of a Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia‐Present and Lifetime Version (K‐SADS‐PL‐P) was evaluated. Method: The K‐SADS‐PL‐P was administered to 102 inpatients (mean age = 15.3 yrs, SD = 1.81) in a child and adolescent psychiatric ward. The psychometric properties were evaluated in comparison to the results of clinical diagnosis. Results: The K‐SADS‐PL‐P showed good‐to‐excellent concurrent validity in diagnosing current major disorders. Test‐retest reliabilities of most of the current diagnoses were also good to excellent. Conclusion: The Persian version of the K‐SADS‐PL provides reliable and valid youth psychiatric diagnoses.     

The Equity Perception Scale – Intellectual Disability Services (EPS-IDS): Evaluating the reliability and validity of a new measure

Abstract

Background?The aim of this paper was to evaluate the reliability and validity of the Equity Perception Scale – Intellectual Disability Services (EPS-IDS), a detailed measure of staff equity perceptions in services for people with intellectual disability (ID). The EPS-IDS contains 3 relationship indices that assess staff relationships with their employing organisation, their co-workers, and service users.

Method?Postal questionnaires were used to collect quantitative data from a purposive sample of ID service staff.

Results?The EPS-IDS was found to have good internal consistency reliability. The overall test–retest reliability of the measure, however, was found to be less satisfactory. With the exception of the co-worker relationship index, the EPS-IDS indices were found to have promising validity.

Conclusions?The findings from the study suggest that the EPS-IDS shows some promise as a measure of the equity perceptions of ID service staff. Further refinements to the relationship indices, however, may be required.     

Development of a brief screen for violence risk (V-RISK-10) in acute and general psychiatry: An introduction with emphasis on findings from a naturalistic test of interrater reliability

Most violence risk assessment scales were originally developed for use in forensic settings at the time of discharge or release of patients into the community after long-term treatment. However, there is a considerable need for specialized, brief and structured risk assessment tools to inform risk decisions in short-term psychiatric treatment. The present study reports on research findings from the development and implementation of the violence risk screening-10 (V-RISK-10) in two acute psychiatric settings in Norway. The 10-item screen is easy to use, time-saving and may be used for screening of violence risk during hospital stay and after discharge into the community. Prospective validation studies of the screen concerning inpatient and post-release community violence have been conducted. Although data analyses are not yet complete, preliminary findings indicate that the screen has good predictive validity. This suggests that the screen is a promising tool in short-term acute psychiatric settings. However, the importance of reliability in mental health data and tests is well recognized, and a screen with good predictive validity is not worth much if clinicians are unable to agree on the scoring of one and the same patient. In this article we report results from a naturalistic interrater reliability investigation that involved 25 mental health professionals and 73 acute psychiatric patients. V-RISK-10 scoring was accomplished by two raters for each patient. The interrater reliability value for total scores was acceptable. Variations pertaining to the individual V-RISK-10 item, patient characteristics and rater characteristics are discussed.     

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective

Background In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire – Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. Methods People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. Results A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40‐item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self‐determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P < 0.000, P < 0.01 and P < 0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α = 0.79). Conclusions Initial validity tests indicated that the Chinese Quality of Life Questionnaire – Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.     

The TOM Test: A New Instrument For Assessing Theory of Mind in Normal Children and Children with Pervasive Developmental Disorders

This article describes a first attempt to investigate the reliability and validity of the TOM test, a new instrument for assessing theory of mind ability in normal children and children with pervasive developmental disorders (PDDs). In Study 1, TOM test scores of normal children (n = 70) correlated positively with their performance on other theory of mind tasks. Furthermore, young children only succeeded on TOM items that tap the basic domains of theory of mind (e.g., emotion recognition), whereas older children also passed items that measure the more mature areas of theory of mind (e.g., understanding of humor, understanding of second-order beliefs). Taken together, the findings of Study 1 suggest that the TOM test is a valid measure. Study 2 showed for a separate sample of normal children (n = 12) that the TOM test possesses sufficient test–retest stability. Study 3 demonstrated for a sample of children with PDDs (n = 10) that the interrater reliability of the TOM test is good. Study 4 found that children with PDDs (n = 20) had significantly lower TOM test scores than children with other psychiatric disorders (e.g., children with Attention-deficit Hyperactivity Disorder; n = 32), a finding that underlines the discriminant validity of the TOM test. Furthermore, Study 4 showed that intelligence as indexed by the Wechsler Intelligence Scale for Children was positively associated with TOM test scores. Finally, in all studies, the TOM test was found to be reliable in terms of internal consistency. Altogether, results indicate that the TOM test is a reliable and valid instrument that can be employed to measure various aspects of theory of mind.     

Development of the Psychiatric Nurse Job Stressor Scale (PNJSS)

Aims: The aim of the present study was to develop a tool, the Psychiatric Nurse Job Stressor Scale (PNJSS), for measuring the stress of psychiatric nurses, and to evaluate the reliability and validity of the PNJSS. Methods: A total of 302 psychiatric nurses completed all the questions in an early version of the PNJSS, which was composed of 63 items and is based on past literature of psychiatric nurses' stress. Results: A total of 22 items from four factors, ‘Psychiatric Nursing Ability’, ‘Attitude of Patients’, ‘Attitude Toward Nursing’ and ‘Communication’, were extracted in exploratory factor analysis. With regard to scale reliability, the item–scale correlation coefficient was r = 0.265–0.570 (P < 0.01), the Cronbach alpha coefficient was 0.675–0.869, and the test–retest correlation coefficient was r = 0.439–0.771 (P < 0.01). With regard to scale validity, the convergent validity of the ‘job stressor’ scale was r = 0.172–0.420 (P < 0.01), and the predictive validity of the ‘job reaction’ scale was r = 0.201–0.453 (P < 0.01). The compatibility of the factor model to the data was 1.750 (χ²/d.f., 343.189/196, P < 0.01), the goodness of fit index was 0.910, the adjusted goodness of fit index was 0.883, the comparative fit index was 0.924, and the root mean square error of approximation was 0.050. Conclusions: The PNJSS has sufficient reliability and validity as a four‐factor structure containing 22 items, and is valid as a tool for evaluating psychiatric nurse job stressors.     

The Finnish Clinical Outcome in Routine Evaluation Outcome Measure: psychometric exploration in clinical and non-clinical samples

The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consistency and convergent validity of the Finnish CORE-OM scores. Translation of the CORE-OM from English to Finnish was undertaken according to recommended protocols. Psychometric exploration was conducted in two samples: psychiatric patients (N?=?201) and non-clinical participants (N?=?209). Participation was voluntary and involved completion of all scales. Convergent validity was tested in terms of the mean score differences between clinical and non-clinical samples and correlations against the Beck Depression Inventory (BDI) and the Symptom Checklist (SCL-90). Among the clinical sample, all domains showed good or acceptable internal reliability. In the non-clinical sample, the alphas of domains were good or acceptable, with only the alphas of the Risk domain registering as low. There were no marked gender or age effects. CORE-OM scores correlated strongly with both the BDI and SCL-90, particularly in patients’ data. Some possible effects of Finnish language were found. The Finnish translation of the CORE-OM is psychometrically sound and can be recommended for use in Finnish mental health and clinical settings. However, further investigation in larger and different samples will clarify the generalizability its psychometric properties. Clinical services are encouraged to contribute to the creation of a collaborative Finnish CORE practice research network.     

A video-based balance measure for people with intellectual disability

Abstract

Background?Many standardised balance measures are unsuitable for people who are unable to comprehend test requirements. We report on the development, administration, interrater reliability, and concurrent validity of a video-based balance measure for people with intellectual disability called the Balance Scale for Persons with Intellectual Disabilities.

Method?Video recordings of 25 people performing 7 common motor tasks, identified from stakeholder consultation, were made, and rated using standardised scoring criteria. Concurrent validity, assessed against the Tinetti Gait and Balance Instrument and the modified Gait Abnormality Rating Scale (GARS-M), and interrater reliability of the scale was evaluated with 19 physiotherapists.

Results?Scores suggested no ceiling or floor effects. Excellent interrater reliability (ICC?=?.9) was demonstrated. Concurrent validity was good against the Tinetti (ρ?=?.98) and the GARS-M (ρ?=??.87). Issues around lighting for video-recording and lack of steps or stairs in the home setting were encountered.

Conclusion?The new measure may be useful in trials assessing the effectiveness of interventions aimed at improving the balance capabilities of people with intellectual disability.     

Psychometric properties of the BASIS-24© (Behaviour and Symptom Identification Scale–Revised) Mental Health Outcome Measure

Objective. Outcome measurement in mental health services is an area of considerable clinical interest and policy priority. This study sought to assess the Behaviour and Symptom Identification Scale-24 (BASIS-24©), a brief, patient self-reported measure of psychopathology and functioning, in a UK sample, including establishing population norms for comparative purposes. Methods. Participants were 588 adults recruited from psychiatric inpatient, outpatient and primary care settings; and 630 adults randomly sampled from primary care lists who completed the BASIS-24©, and the Brief Symptom Inventory (BSI) at two time points. Results. BASIS-24© demonstrated adequate reliability (coefficient α values for combined clinical sample across subscales ranged from 0.75 to 0.91), validity and responsiveness to change (effect size for change of the BASIS-24© was 0.56 compared with 0.48 for BSI Global Severity Index). Population norms were established for the general population and adult in-patients (at in-take). The scale proved straightforward to complete across clinical settings. Variable rates of questionnaire distribution across clinical settings highlighted the ongoing challenge of incorporating outcome measures in clinical settings. Conclusion. BASIS-24© is a brief, easily administered, self-complete measure of mental well-being and functioning that adequately meets the requirements of reliability, validity and responsiveness to change required of an outcome measure.