Psychometric validation of a generic health-related quality of life measure (EQ-5D) in a sample of schizophrenic patients

OBJECTIVE: The aim of this study was to evaluate the construct validity of a generic health related quality of life (HRQOL) instrument - the EQ-5D - in a sample of schizophrenic patients receiving antipsychotic treatment. Research design and methods: A total of 2128 schizophrenic patients treated with olanzapine, 417 treated with risperidone, and 112 with haloperidol responded to the EQ-5D. The study also assessed the effect of patient age, gender, and co-morbidity variables on patient's HRQOL Main outcomes measures: EQ-5D scores at the start of treatment and after 3 and 6 months of therapy were compared with results from the Clinical Global Impression (CGI) severity of illness scale and the (GAF) scale. The effect of antipsychotics and sociodemographic variables on patient's HRQOL over time was tested through a three-factor doubly multivariate repeated measures MANCOVA. RESULTS: High scores in the GAF scale and low scores in the CGI were linked with high scores on the EQ-5D scale. The correlational effects observed between the EQ-5D and the clinical indices ranged from 0.33 to 0.54. A significant effect of 'visit time' as well as an interaction of 'visit time' x drug, 'visit time' x gender, and 'visit time' x co-morbidity was observed. CONCLUSIONS: Results suggest the EQ-5D is a valid instrument capable of detecting HRQOL differences between schizophrenic patients with different degrees of severity of illness.     

Psychometric validation of a generic health-related quality of life measure (EQ-5D) in a sample of schizophrenic patients

SUMMARY

Objective: The aim of this study was to evaluate the construct validity of a generic health related quality of life (HRQOL) instrument – the EQ-5D – in a sample of schizophrenic patients receiving antipsychotic treatment.

Research design and methods: A total of 2128 schizophrenic patients treated with olanzapine, 417 treated with risperidone, and 112 with haloperidol responded to the EQ-5D. The study also assessed the effect of patient age, gender, and co-morbidity variables on patient's HRQOL

Main outcomes measures: EQ-5D scores at the start of treatment and after 3 and 6?months of therapy were compared with results from the Clinical Global Impression (CGI) severity of illness scale and the (GAF) scale. The effect of antipsychotics and sociodemographic variables on patient's HRQOL over time was tested through a three-factor doubly multivariate repeated measures MANCOVA.

Results: High scores in the GAF scale and low scores in the CGI were linked with high scores on the EQ-5D scale. The correlational effects observed between the EQ-5D and the clinical indices ranged from 0.33 to 0.54. A significant effect of ‘visit time’ as well as an interaction of ‘visit time’ x drug, ‘visit time’ x gender, and ‘visit time’ x co-morbidity was observed.

Conclusions: Results suggest the EQ-5D is a valid instrument capable of detecting HRQOL differences between schizophrenic patients with different degrees of severity of illness.     

The Twelve Promises of Alcoholics Anonymous: Psychometric measure validation and mediational testing as a 12-step specific mechanism of behavior change

Background

Empirical support for the recovery utility of 12-step mutual-help organizations (MHOs) has led to increased investigation of how such organizations confer benefit. The Twelve Promises of Alcoholics Anonymous (AA) feature prominently in 12-step philosophy and culture and are one of the few documented explications of the cognitive, affective, and behavioral benefits that members might accrue. This study investigated the psychometric properties of a measure of AA's Twelve Promises and examined whether it mediated the effect of 12-step participation on abstinence.

Method

Young adults (N = 302, M age 20.4 [1.6], range 18–25; 27% female; 95% White) enrolled in an addiction treatment effectiveness study completed assessments at intake and 3-, 6-, and 12-months post treatment including a 26-item, Twelve Promises Scale (TPS). Factor analyses examined the TPS’ psychometrics and lagged mediational analyses tested the TPS as a mechanism of behavior change.

Results

Robust principal axis factoring extraction with Varimax rotation revealed a 2-factor solution explaining 45–58% of the variance across three administrations (“Psychological Wellbeing” = 26–39%; “Freedom from Craving = 17–21%); internal consistency was high (alpha = .83–.93). Both factors were found to increase in relation to greater 12-step participation, but significant mediation was found only for the Freedom from Craving factor explaining 21–34% of the effect of 12-step participation in increasing abstinence.

Conclusions

The TPS shows potential as a conceptually relevant, and psychometrically sound measure and may be useful in helping elucidate the extent to which the Twelve Promises emerge as an independent benefit of 12-step participation and/or explain SUD remission and recovery.     

Development and validation of a questionnaire to measure moral distress in community pharmacists

International Journal of Clinical Pharmacy - Background Pharmacists work within a highly-regulated occupational sphere, and are bound by strict legal frameworks and codes of professional conduct....     

加强医患沟通技巧以建立和谐的医患关系

医患关系是医疗实践中最基本的人际关系,医患关系的协调与否在医疗卫生系统实践活动的展开及良性进展中起到重要的作用。在医疗工作中,提高医护人员的自身素质,掌握沟通的技巧,本着诚信、尊重、同情、耐心的原则与患者进行沟通。良好的医患沟通,对及时化解医患之间的误解和矛盾,减少医患纠纷和医疗事故的发生也起着关键作用     

[Translated article] Design and validation of a scale to measure adherence to oral antineoplastic drugs

ObjectiveDesign and validate a scale to measure adherence to oral antineoplastic drugs. The availability of a simple, validated tool that can be applied to routine care will make it possible to detect and identify non-adherence in order to establish strategies to improve adherence and optimize the quality of healthcare services.MethodValidation study of the scale designed to assess adherence to antineoplastic drugs in a sample of outpatients who collect their medication in two Spanish hospitals. Its validity and reliability will be analyzed, based on a previous qualitative methodology study, using classical test theory and Rasch analysis. We will examine its performance, item fit, response structure and person fit to the predictions of the model, as well as dimensionality, item-person reliability, the appropriateness of the level of difficulty of the items to the sample, and the differential performance of the items according to gender.     

Use of simulated patients to assess the clinical and communication skills of community pharmacists

Objective To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Setting Community pharmacies in the southwest of England during 2007. Method Two simulated patient (‘mystery shopper’) scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John’s Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Main outcome measure Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. Results 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Conclusion Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.     

Development and initial validation of a measure of motives for pregaming in college students

Objective

Pregaming (i.e., drinking alcohol prior to going out) is a common and risky drinking practice on college campuses. Yet, little is known about what motivates students to pregame as no motives measure exists specifically targeting pregaming. The current study describes the development and initial validation of a measure to assess motives for pregaming and to evaluate associations between these motives and pregaming behavior.

Method

In a multi-stage process using three different college samples, both qualitative (i.e., focus groups) and quantitative methods were used to derive the Pregaming Motives Measure (PGMM). After initial item generation (Stage I: N = 43, 74% male) and refinement with exploratory factor analysis (Stage II: N = 206, 61% male), a confirmatory factor analysis was performed to establish the structure of the PGMM (Stage III: N = 321, 34% male). The pattern of associations of the derived factors, pregaming behavior, and general drinking motives was explored to provide evidence for initial construct validity. Last, the indirect effect of pregaming motives on alcohol problems via pregaming behavior was assessed.

Results

Findings indicated that the PGMM differed both in content from general drinking motives and that the PGMM items generated load on factors labeled Inebriation/Fun, Instrumental, and Social Ease. Moreover, the Inebriation/Fun and Instrumental motives were significantly associated with pregaming behavior. PGMM motives also both directly and indirectly predicted alcohol-related consequences.

Conclusions

Findings corroborate other data on pregaming, suggesting that this behavior may be driven by desires for quick inebriation and conviviality and related to problems only via increased drinking. The PGMM offers targeted assessment of pregaming and other social drinking behavior that can lead to deleterious outcomes.     

Development and validation of a measure and a model of general practitioner attitudes toward collaboration with pharmacists

BackgroundCollaboration between general practitioners (GPs) and community pharmacists has been shown to be effective in improving patient outcomes. However, little is known about GP attitudes toward collaborating with their pharmacist counterparts and variables that influence this interprofessional collaboration.ObjectivesTo develop and validate, in the context of primary care in Australia 1) an instrument to measure GP attitudes toward collaborating with pharmacists and 2) a model that illustrates how GP attitudes (and other variables) influence GP-pharmacist collaborative behavior.MethodsThe “Attitudes Toward Collaboration Instrument for GPs” (ATCI-GP) was developed to measure GP attitudes toward GP-pharmacist collaboration based on existing literature and qualitative interviews with GPs and community pharmacists. The ATCI-GP and a previously validated behavioral measure “Frequency of Interprofessional Collaboration Instrument for GPs” (FICI-GP) were included in a survey and administered to a sample of 1145 GPs in 12 divisions of general practice across Australia. Principal component analysis (PCA) was used to assess the structure of the ATCI-GP. Structural equation modeling was used to determine how attitudes (measured by the ATCI-GP) and other variables, influence collaborative behavior (measured by the FICI-GP).ResultsThree hundred and seventy-six surveys were completed and returned for a response rate of 33%. PCA of the ATCI-GP suggested a two factor (“interactional and practitioner determinants” and “role for pharmacist in medication management”) solution accounting for 66.2% of the variance. The model for GP-pharmacist collaboration demonstrated adequate fit (χ²/df = 2.27, CFI = .99, RMSEA = .060, 90% CI [.052–.069]). Factors found to predict collaboration included: 1) Interactional and practitioner determinants 2) environmental determinants and 3) GP perception of the pharmacists' role in medication management.ConclusionsThe study provides evidence for the validity of the ATCI-GP for measuring GP-pharmacist collaboration from the GPs perspective and supports a model for collaboration in which collaborative behavior is influenced by a number of variables.     

Development and psychometric validation of a novel measure of sensory expectancies associated with E-cigarette use

IntroductionE-cigarette dependence measures largely focus on e-cigarette use (“vaping”) that is linked to nicotine use, and measures assessing sensory aspects of vaping that may influence use (e.g., taste) are limited in scope. Thus, we developed the novel Sensory E-cigarette Expectancies Scale (SEES).MethodsIn Summer 2017, 610 adult e-cigarette users (48.7% male, 84.9% White, 37.41[±12.15] years old) completed an online survey that included 23 SEES items. Psychometric analyses included evaluating latent structure, internal consistency, measurement invariance, mean differences, and test-criterion relationships.ResultsFactor analyses supported a 9-item, 3-subscale structure (taste/smell, pleasure/satisfaction, vapor cloud production). Subscales evidenced internal consistency and scalar invariance by sex, race, smoking status (current/not), vaping status (daily/not), e-liquid nicotine content (yes/no), and device type (cig-a-likes/vape-pens/Advanced Personal Vaporizers [APVs]/Mods). Women and daily e-cigarette users reported stronger SEEs for taste/smell and pleasure than their counterparts. Non-white participants reported stronger SEEs for cloud production than White participants. Cig-a-like users reported the weakest SEEs for taste/smell and weaker SEEs linked to cloud production than APV/mod users. SEES scores evidenced convergence with nicotine dependence (mean r = .36). Finally, SEES scores predicted vaping frequency and habitual vaping concurrently and incrementally beyond nicotine dependence.ConclusionsThe SEES evidenced good psychometric properties, suggesting that the measure can be used to assess sensory vaping expectancies in adults. Importantly, SEES scores indicated that sensory expectancies are related, yet distinct, from nicotine dependence. Future research should evaluate how SEEs relate to product characteristic preferences and patterns of vaping including the development and maintenance of addiction.     

Development and validation of an instrument to measure physicians' attitudes toward the clinical pharmacist's role

A scale to measure physicians' attitudes toward clinical pharmacy was developed and validated. Based on physician-clinical pharmacist interactions, statements were written and edited into tentative subscales. A preliminary test resulted in a reduction in the number of items and subscales. The final field test, based on responses from 166 physicians, after factor analysis, yielded 23 items in 5 subscales, with a scale reliability of 0.94. As additional measures of validity, physicians' responses showed significant differences in attitudes between subscales and differences by specialty. Differences also were demonstrated by physician status and age. No differences were shown by amount of exposure to clinical pharmacists. Reliability and validity of the scale have been supported and additional research into the concurrent validity of the scale is suggested.     

Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index

BACKGROUND: Patient-based symptom assessments are necessary to evaluate the effectiveness of medical treatments for gastroparesis. AIM: To summarize the development and measurement qualities of the Gastroparesis Cardinal Symptom Index (GCSI), a new measure of gastroparesis-related symptoms. METHODS: The GCSI was based on reviews of the medical literature, clinician interviews and patient focus groups. The measurement qualities (i.e. reliability, validity) of the GCSI were examined in 169 gastroparesis patients. Patients were recruited from seven clinical centres in the USA to participate in this observational study. Patients completed the GCSI, SF-36 Health Survey and disability day questions at a baseline visit and again after 8 weeks. Clinicians independently rated the severity of the patients' symptoms, and both clinicians and patients rated the change in gastroparesis-related symptoms over the 8-week study. RESULTS: The GCSI consists of three sub-scales: post-prandial fullness/early satiety, nausea/vomiting and bloating. The internal consistency reliability was 0.84 and the test-re-test reliability was 0.76 for the GCSI total score. Significant relationships were observed between the clinician-assessed symptom severity and the GCSI total score, and significant associations were found between the GCSI scores and SF-36 physical and mental component summary scores and restricted activity and bed disability days. Patients with greater symptom severity, as rated by clinicians, reported greater symptom severity on the GCSI. The GCSI total scores were responsive to changes in overall gastroparesis symptoms as assessed by clinicians (P = 0.0002) and patients (P = 0.002). CONCLUSION: The findings of this study indicate that the GCSI is a reliable and valid instrument for measuring the symptom severity in patients with gastroparesis.     

The 12 Step Affiliation and Practices Scale: Development and initial validation of a measure assessing 12 step affiliation

Objective

Research on instruments designed to measure endorsement of 12 step beliefs and practices among individuals with substance use disorders is virtually nonexistent. The goal of this study was to examine the psychometric properties of a novel instrument called the 12 Step Affiliation and Practices Scale (TSAPS) using a sample of young adults receiving 12 step-based residential treatment for alcohol and drug dependence.

Method

As part of a naturalistic treatment outcome study, 300 young adults receiving residential treatment completed the TSAPS and several other assessments during and after treatment. Analyses of the TSAPS examined its factor structure, internal consistency, sensitivity to change over time, and convergent and predictive validity.

Results

A maximum likelihood estimation factor analysis using oblique rotation produced 4 factors accounting for 61.16% of the variance. Internal consistency was very high and scores on the TSAPS significantly increased across the course of treatment. Convergent validity was demonstrated by relationships with scales of treatment attitudes, twelve step expectancies and commitment to sobriety. Predictive validity was also found, as evidenced by a relationship between total TSAPS score at 3 months post-treatment and percent of abstinent days at 6 months post-treatment.

Conclusions

The TSAPS shows promise as a psychometrically sound, internally reliable measure of 12 step affiliation and practices among individuals with substance dependence.     

Development and validation of an instrument to measure professional self‐perception and job satisfaction of Portuguese community pharmacists

□ A questionnaire was developed to assess job satisfaction and professionalism, and sent to a stratified randomised sample of Portuguese community pharmacists □ The ratio of male to female between owner and employee groups was roughly equal, indicating little sex bias between these groups □ Job satisfaction and career satisfaction items could not be differentiated in the sample □ Combined job and career satisfaction scores showed significant differences between male and female pharmacy owners and employees, with the female pharmacy owner group showing the highest job and career satisfaction score