Development and validation of a muscular dystrophy-specific functional rating scale

OBJECTIVE: To develop a reliable and valid new rating scale for measuring the functional impact of muscular dystrophy. DESIGN: Prospective and longitudinal investigation. SETTING: Three academic medical centres in Taiwan and the Muscular Dystrophy Association of Taiwan. MEASURES: The Brooke Scale, the Vignos Scale, the Barthel Index, muscular strength, contracture severity, and predicted forced vital capacity (FVC%). METHODS: Scale development was in three stages. In stage I, a preliminary pool of 53 items was generated from patient interviews (n = 25), literature review, existing functional rating scales and expert opinion. In stage II, these items were administered to 85 patients with muscular dystrophy. The resulting data were analysed to construct a rating scale (the Muscular Dystrophy Functional Rating Scale, MDFRS) that encompassed four unidimensional constructs: mobility, basic activities of daily living, arm function and impairment. In stage III, the measurement properties of this rating scale were assessed in 121 muscular dystrophy patients different from those examined with the preliminary instrument. RESULTS: Internal consistency reliability was excellent for all domains of the final 33-item scale, with values of Cronbach's alpha ranging from 0.84 to 0.97. Intraclass correlation coefficients for test-retest and inter-rater reliability were 0.99 for all domains of the MDFRS. The MDFRS showed moderate to high correlations with a range of functional rating scales measuring similar aspects and impairment parameters (Spearman's rho = 0.65-0.91; P < 0.001, each). Confirmatory factor analysis supported a unitary construct of the four-dimensional MDFRS. The MDFRS had small floor and ceiling effects in the study samples. Sensitivity to change was confirmed by large standardized response means for the MDFRS total score. CONCLUSIONS: The MDFRS is a reliable and valid disease-specific measure of functional status for patients with muscular dystrophy.     

Development and testing of the resistiveness to care scale

A conceptual model and objective scale for measuring resistiveness to care in individuals with advanced dementia of the Alzheimer type (DAT) were empirically generated from the perspective of nursing staff caregivers and through observation of residents with DAT. The resistiveness to care scale (RTC‐DAT) was judged to have content validity and reduced to 13 items. Quantifiable scoring procedures and methods for rating videotapes and conducting clinical observations were developed. The RTC‐DAT was tested with 68 subjects at three sites. The RTC has a range of 0–156. Initial testing provided reliability estimates of .82–.87 for internal consistency and good to excellent kappas. Criterion‐related validity with observed discomfort and construct validity by factor analysis support the RTC‐DAT. Measurement issues and recommendations for use in research are discussed. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22: 27–38, 1999.     

急性心肌梗死高危者院前延迟行为意向测评量表的编制及信效度检验

目的初步编制“急性心肌梗死高危者院前延迟行为意向测评量表”,并对其信效度进行检验,为评估急性心肌梗死高危者院前延迟倾向提供一个有效的测评工具。方法应用量表开发的综合策略,以计划行为理论作为编制量表的基本理论框架,在广泛参阅国内外相关文献资料的基础上,建立条目池,采用专家评议法和预试验法对量表条目进行筛选,形成暂定版量表,并选取哈尔滨420名急性心肌梗死高危者为研究对象进行测量,对量表的信效度进行检验。结果形成的急性心肌梗死高危者院前延迟行为意向测评量表,由6个维度组成,具体为就医决策、症状警觉、习惯反应样式、症状程度判断、阻碍就医因素、促进就医因素,量表的Cronbaeh’s a系数为0．744;其累积解释总方差的58．694％,表明量表具有良好的信效度。结论本量表具有较好的信度和效度,既可作为测评急性心肌梗死高危者院前延迟倾向的工具之一,也可为以后有针对性地进行健康教育干预提供依据。     

Assessing nursing students' basic communication and interviewing skills: the development and testing of a rating scale

This study explores the communication skills of a group of nursing students who were required to interview a simulated client as part of their studies. In order to assess the students and to improve the process of learning discrete skills, an instrument was developed and tested as part of this process. The subjects were 212 nurses enrolled in a bachelor of nursing programme, in New South Wales, Australia, who were studying a problem-based learning package the focus of which was 'alcohol early intervention'. The sub-groups within the sample included registered nurses, a significant percentage of whom had completed their basic nursing education in overseas countries. The Simulated Client Interview Rating Scale (SCIRS) was developed to assess basic humanistic communication skills as well as beginning motivational interviewing skills. The students were required to interview a simulated client and demonstrate competence in interviewing. This was assessed by the SCIRS which was completed by the students and the simulated clients. The instrument proved to be a reliable and valid means of assessing student interview technique as well as a flexible educational tool, while valuable insights into students' interviewing techniques were gained.     

Development and testing of a family nursing scale

A methodological study was conducted to test the psychometric properties of the Family Functioning, Health, and Social Support (FAFHES) Instrument to be used with families of heart patients. A total of 109 initial items were developed based on knowledge generated by three Finnish academic dissertations concerning family functioning, health, and social support provided by nurses. Data were collected from family members of 161 heart patients. Principal component analysis was performed in each of three total scales: family functioning, family health, and social support. The scales had acceptable reliability (alpha coefficients ranged from .73 to .95). Internal consistency reliability and content validity of the FAFHES have initial support. Results obtained from this study support that this instrument is ready for use in research in which the investigator wishes to measure social support associated with family functioning and the health of families of heart patients.     

Development and psychometric testing of the infant colic scale.

Novice researchers, when confronted with a clinical problem they want to study, are admonished by more experienced researchers to search the literature for an instrument that already has established reliability and validity, fits the problem of study, or that can be easily adapted. Sometimes, however, there is no such instrument available so the researcher has to develop a new instrument. The purpose of this article is to describe the steps required to develop and psychometrically test a new instrument. A new instrument, the Infant Colic Scale, is used as an example.     

成年人健康自我管理能力测评量表的编制及信度和效度检验

目的编制成年人健康自我管理能力测评量表,检验其信度和效度,为评估成年人健康自我管理能力提供一个有效的测评工具。方法本研究是在前期研究的基础上,选取哈尔滨和福州1205名成年人为研究对象,应用暂定版量表进行施测,并对量表的信效度进行检验。结果形成的成年人健康自我管理能力测评量表由3个分量表,7个维度和38个条目组成;其累积解释总方差的59．039％,量表具有良好的信、效度。结论本量表具有较好的信度和效度,既可作为测评成年人健康自我管理能力的工具之一,也可为以后有针对性地进行健康教育干预提供依据。     

缺氧量化评分表的设计与应用研究

目的探索一种无创的辅助判断肺心病患者缺氧程度的评分方法.方法①以急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)为框架,自行设计肺心病患者缺氧量化评分表,对67例肺心病患者缺氧的状况进行评分.②将评分结果与动脉血气分析进行对比分析,找出其相关性.结果评分与pH值、动脉血氧分压(PaO2)、动脉氧饱和度(SaO2)呈高度负相关,评分与二氧化碳分压(PaCO2)呈高度正相关(P＜0.01).结论缺氧评分表虽然不能替代血气分析,但可作为一种无创手段用以辅助判断肺心病患者缺氧程度,从而减少患者因多次穿刺造成的痛苦,特别是对那些无条件行血气分析的基层医疗单位,运用此表可起到判断患者缺氧程度的目的,有一定的临床意义.     

Investigating rating scale category utility

Eight guidelines are suggested to aid the analyst in investigating whether rating scales categories are cooperating to produce observations on which valid measurement can be based. These guidelines are presented within the context of Rasch analysis. They address features of rating-scale-based data such as category frequency, ordering, rating-to-measure inferential coherence, and the quality of the scale from measurement and statistical perspectives. The manner in which the guidelines prompt recategorization or reconceptualization of the rating scale is indicated. Utilization of the guidelines is illustrated through their application to two published data sets.     

护士职业嵌入量表的编制及信效度检验

目的 初步编制适用于我国文化背景的护士职业嵌入评估量表并对其进行信效度检验.方法 以嵌入性理论作为编制量表的基本理论框架,通过文献查阅、开放式问卷调查和半结构式访谈初步拟定量表条目库,经过专家评定形成护士职业嵌入量表初稿.采用方便取样法进行3次取样.用第1次预测样本（n=368）和第2次预测样本（n=306）进行项目分析和探索性因素分析,用正式施测样本（n=372）进行验证性因素分析及信度和效标效度检验.从正式施测样本中抽取55名护士间隔2周后重测.以离职倾向量表作为效标.结果 护士职业嵌入量表共18个条目,由匹配、联结和牺牲3个维度构成,累积贡献率为55.321％;验证性因素分析表明量表的模型拟合较好,x2/df=2.563,RMR=0.048,TLI=0.914,CFI=0.925.量表得分与离职倾向得分呈负相关.量表的内部一致性Cronbach α系数为0.917,3个维度的α系数为0.800～0.834.总量表的重测信度为0.890,3个维度的重测信度为0.732～0.873.结论 本研究编制的护士职业嵌入量表信效度指标较好,可作为国内护士职业嵌入的测评工具.     

护理活动评估量表的介绍

ICU是危重病人集中监护治疗的场所,日益得到医院管理者的重视,随之ICU护士人力资源的配置也成为当今护理管理的一个热点[1].护士是卫生服务系统的中坚力量,护理服务的质量直接关系到病人的预后及生活质量,包括死亡率、致残率、副反应和照顾成本.国际卫生部门和护理监督部门、北美护理学会声明在世界范围内都存在护士尤其是ICU护士短缺的现象,而由一个有效的工具测量护理工作量是解决这个问题的基本步骤[2].     

护理活动评估量表的介绍

ICU是危重病人集中监护治疗的场所,日益得到医院管理者的重视,随之ICU护士人力资源的配置也成为当今护理管理的一个热点。护士是卫生服务系统的中坚力量,护理服务的质量直接关系到病人的预后及生活质量,包括死亡率、致残率、副反应和照顾成本。国际卫生部门和护理监督部门、北美护理学会声明在世界范围内都存在护士尤其是ICU护士短缺的现象,