Development and testing of the KnowGene scale to assess general cancer genetic knowledge related to multigene panel testing

PurposeTo develop and evaluate a measure of cancer genetics knowledge relevant to multigene panel testing.MethodsThe instrument was developed using systematic input from a national panel of genetics experts, acceptability evaluation by patient advocates, and cognitive testing. Twenty-four candidate items were completed by 591 breast or gynecological patients who had undergone genetic counseling and multigene panel testing in the past 18 months. A unidimensional item response theory model was fit with a mix of 2-parameter logistic nested response (2 plnrm) and 2-parameter logistic (2 pl) items.ResultsKey domains addressing cancer genetics knowledge were found to be overlapping. Of the 24 candidate items, 8 items were removed due to poor discrimination or local dependence. The remaining 16 items had good fit (RMSEA = 0.045, CFI = 0.946) and discrimination parameters ranging from 0.49 to 1.60. The items specified as 2 plnrm distinguish between those answering incorrect versus don’t know, with discrimination ranging from 0.51 to 1.02. Information curves were highest among those with lower knowledge.ConclusionKnowGene is a rigorously developed and effective measure of knowledge after cancer genetic counseling and multigene panel testing.Practice ImplicationsMeasuring knowledge in a systematic way will inform practice and research initiatives in cancer genetics.     

Development of a questionnaire to measure heart disease risk knowledge in people with diabetes: the Heart Disease Fact Questionnaire

This paper describes a paper and pencil questionnaire that measures heart disease risk knowledge in people with diabetes. The Heart Disease Fact Questionnaire (HDFQ) is a 25-item questionnaire that was developed to tap into respondents' knowledge of major risk factors for the development of CHD. Approximately half of these items specifically address diabetes-related CHD risk factors. Based on extensive pilot data, the current study analyzed responses from 524 people with diabetes to assess the psychometric properties. The HDFQ is readable to an average 13-year old and imposes little burden. It shows good content and face validity. It demonstrates adequate internal consistency, with Kuder-Richardson-20 formula = 0.77 and good item-total correlations. Item analysis showed a desirable range in P-values. In discriminant function analyses, HDFQ scores differentiated respondents by knowledge of their own cardiovascular health, use of lipid lowering medications, health insurance status, and educational attainment, thus indicating good criterion related validity. This measure of heart disease risk knowledge is brief, understandable to respondents, and easy to administer and score. Its potential for use in research and practice is discussed. Future research should establish norms as well as investigate its test-retest reliability and predictive validity.     

The Outcome Questionnaire (OQ‐45) in a Dutch population: A cross‐cultural validation

The cross‐cultural validity of the Outcome Questionnaire (OQ) in the Dutch population has been examined by comparing the psychometric properties and equivalence in factor structure and normative scores of the Dutch OQ with the original American version. Data were collected from a university (n = 268), in a community (n = 810) and from three mental health care organizations (n = 1920). Results show that the psychometric properties of the Dutch OQ were adequate and similar to the original instrument. Some differences in equivalence were found though. In factor analysis, two additional factors were found: one consisting of social role items and another that reflected anxiety and somatic symptoms. Furthermore, normative scores were different for the Dutch and American samples, and this resulted in different cut‐off scores for estimating a clinically significant change in the Dutch population. Copyright © 2007 John Wiley & Sons, Ltd.     

The psychometric properties of the health locus of control scale with medical and surgical patients

Examined the psychometric properties of the Health Locus of Control (HLC) Scale with inpatients from medical and surgical wards (N = 111) at a Veterans Administration Medical Center. Factor analyses suggested that the two-factor solution met important criteria that involved simple structure, parsimony, and psychological meaningfulness. Factor I was comprised entirely of salient items that were internally worded, and Factor II was comprised of salient externally worded items. Item remainder correlation coefficients were calculated; the lowest value was 0.18 for item 5, and the highest value was 0.45 for items 1 and 10. Cronbach's alpha was 0.63 for the internally worded items and 0.56 for the externally worded items. The psychometric properties were considered adequate, although results were somewhat lower than those reported in the original HLC article. Clinical application of the scale with medical and surgical inpatients is discussed with particular emphasis on outcome studies.     

A new scale informed by the Reciprocal-Engagement Model for quality evaluation of genetic counselling by patients: Development and initial validation

Monitoring the quality of genetic counselling is essential to ensure appropriate provision. This study describes the development and initial psychometric validation of a novel scale for genetic counselling quality evaluation by patients. A deductive approach was taken to formulate scale items. Exploratory factor analysis with the principal axis factoring method was used to assess the scale's factor structure (n = 118). Internal consistency (Cronbach's Alpha) was also examined. Exploratory factor analysis resulted in a single overarching construct consisting of seven factors, which account for 59% of the variance explained. Items showed, in general, strong factor loadings (>0.5). Some items focused on patient satisfaction with services provision did not load onto the factors. Thus, another factor analysis was performed with these items, which resulted in one-factor. The identified factor accounted for 57% of variance explained, and communalities were strong (≥0.5) for most items. Cronbach's alpha score for the scale was 0.85, indicating high internal consistency. Factors were significantly and moderately interrelated (from r = 0.31 to r = 0.71). Further studies are needed to establish the psychometric validity of the scale.     

Concordance between the PHQ-9 and the HSCL-20 in depressed primary care patients

BACKGROUND: Two instruments commonly used in primary care research to measure depressive severity are the Patient Health Questionnaire-9 (PHQ-9) and the Hopkins Symptom Checklist-20 (HSCL-20). However, there is little information regarding the relationship between clinical information derived from these scales. The present study investigates the psychometric properties of the PHQ-9 and HSCL-20, determines the degree of instrument concordance, and describes the factor structure of the HSCL-20. METHODS: A secondary data analysis from a randomized controlled trial was performed. A total of 405 primary care patients with major depressive disorder and/or dysthymia were administered the PHQ-9 and the HSCL-20 when recruited for the study. RESULTS: Good internal consistency reliability estimates were obtained for both scales (PHQ-9 alpha=0.803; HSCL-20 alpha=0.837). All PHQ-9 inter-item and corrected item-total correlations showed that no item detracted from overall scale functioning. HSCL-20 items assessing overeating, poor appetite, and sexual interest were poorly correlated with other items and with the total scale score. A positive, moderate strength relationship was found between the instruments (r=0.54, p<0.0001). Exploratory factor analysis of the HSCL-20 yielded a six-factor structure, which accounted for almost 63% of the variance in total score. The largest contribution to common variance in the scale was provided by an "anxiety and self-reproach" factor. CONCLUSIONS: PHQ-9 and HSCL-20 total scores were moderately correlated. Although the HSCL-20 is utilized as a measure of depression severity, it may lack sufficient specificity to be an accurate reflection of depression status per se.     

Preliminary validation of an ultra‐brief version of the Penn State Worry Questionnaire

The Penn State Worry Questionnaire (PSWQ) is widely regarded as the gold standard self‐report questionnaire for pathological worry. However, the factorial structure of the scale remains contentious. We sought to determine whether a psychometrically sound brief version of the PSWQ, which avoids contentious items and yet incorporates the essential features of pathological worry, could be derived from the existing PSWQ item pool. After inspecting items of the PSWQ and the findings of previous factor analytic studies, three items were selected that capture the essence of pathological worry (i.e., high frequency, perceived uncontrollability and multiple domains of worry), according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). We then compared the psychometric properties of the 3‐item PSWQ with the full PSWQ in a sample of 225 clients attending an anxiety disorders clinic. Despite its brevity, the 3‐item PSWQ had internal consistency comparable with that of the standard PSWQ, and performed equally well with regards to convergent and discriminant validity, in screening for a generalized anxiety disorder diagnosis and in detecting change with treatment. The 3‐item ultra‐brief version of the PSWQ is quick to administer, simple to score and possesses psychometric properties very similar to the 16‐item version. Further research should confirm the psychometric properties of the 3‐item version when administered independently of the other items and assess the scale's test–retest reliability. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: ? The 3‐item version of the Penn State Worry Questionnaire (PSWQ) captures the essence of pathological worry, as defined by the Diagnostic and Statistical Manual of Mental Health Disorders (Fourth Edition). ? The 3‐item version of the PSWQ appears to have similar psychometric properties to the full, 16‐item version, and is therefore a good measure of pathological worry. ? The 3‐item PSWQ is quick to administer in time‐pressured clinical settings. ? The 3‐item PSWQ is simple to score and does not include reverse‐keyed items.     

Validation of the Knowledge of Genome Sequencing (KOGS) scale in cancer patients

IntroductionThe Knowledge of Genome Sequencing (KOGS) questionnaire was recently developed to measure knowledge of genomic sequencing (GS), with preliminary psychometric data supporting its reliability and validity. The aim of this study was to test the reliability and validity of the KOGS in a larger sample, and to confirm its utility in a cancer setting.MethodsThe Genetic Cancer Risk in the Young (RisC) study recruits participants with a personal history of cancer, to investigate heritable cancer causes and future cancer risk using germline GS. Participants (n = 261) in a psychosocial substudy of RisC completed a questionnaire after consent to RisC but before GS, including the KOGS, the Intolerance of Uncertainty Scale, the Chew health literacy scale and items assessing demographic and disease variables. Confirmatory factor analysis (CFA), Cronbach alpha and correlational analyses were undertaken.ResultsThe CFA testing a single-factor model yielded a good model fit, χ2/df = 2.43, comparative fit index (CFI) = 0.97, root mean square error of approximation (RMSEA) = 0.07 and weighted mean root square (WRMR) = 1.03. Factor loadings of all items were above 0.60 and ranged between.66 and.93. The single factor score demonstrated excellent internal consistency (α = 0.82). KOGS scores were significantly associated with health literacy (r = 0.23, p < .001), having a university education [t(258) = ?4.53, p < .001] and having a medical or science background [t(259) = ?3.52, p < .001] but not with speaking a language other than English at home, time since diagnosis, previous genetic counselling/testing or intolerance of uncertainty.DiscussionThis study confirmed a single-factor structure for the KOGS, and its reliability and validity in a cancer population. Associations with measures of health literacy and education were significant and positive as expected, supporting the KOG’s construct validity. Previous genetic counselling may not be sufficient to provide specific knowledge of GS.     

Psychometric Properties of the Cambridge Depersonalization Scale in Puerto Rico

Depersonalization experiences have been studied in the United States and Europe, but there is a dearth of investigations with Latino populations. In the current study we examined the psychometric properties of the Spanish version of the Cambridge Depersonalization Scale (CDS) in 300 adult individuals from the community and compared the results with those reported previously with non-Latino clinical populations. Discrepant findings have been reported with respect to the factor structure of the CDS. We performed exploratory and confirmatory factor analyses on the CDS items and compared our results with published analyses on other populations. Results revealed that the psychometric properties of the CDS, such as reliability, seem adequate, although the factor structure of the CDS seems to be inconsistent across studies. We selected a 4-factor solution that was most parsimonious and best fit our data. Furthermore, we obtained a moderate, statistically significant relationship (r = .64, p = .001) between the CDS and the Dissociative Experiences Scale. Our results, utilizing a nonclinical sample of Puerto Rican adults, suggest that depersonalization experiences can be reliably measured in a Latino and Spanish-speaking population.     

Sleep Beliefs Scale (SBS) and circadian typology

The aim of this work was to present the Sleep Beliefs Scale (SBS), a 20-item reviewed version of the Sleep Hygiene Awareness by Lacks and Rotert. We also examined for the first time the influence of circadian typology in sleep beliefs. Voluntary and unpaid psychology students participated in the study (n = 510; 182 men and 328 women), from Italy and Spain, aged between 18 and 33 (22.80 +/- 4.14 years). The mean score of SBS was 13.05 (SD = 3.46; range 2-20) in the total sample, with a distribution positive skewness to high score (correct beliefs) (Z = 1.82; P = 0.003). The internal consistency was good (Cronbach's alpha = 0.714) and factor analysis extracted three factors labelled 'Sleep-incompatible behaviours' (eight items), 'Sleep-wake cycle behaviours' (seven items) and 'Thoughts and attitudes to sleep' (five items). Circadian typology influences the total score and that of the three factors, as well the majority of the items that compose the SBS. The morning-type showed the best scores, the evening-type the worst, and the neither-type the medium scores. Moreover, in the men sample, the differences between circadian typology groups were higher than in the women sample. The SBS showed good psychometric properties; however, further studies in other countries, with clinical and non-student samples, and more aged subjects are needed so as to validate this psychometric instrument. The circadian typology is an individual difference that presented significant relationships with the sleep beliefs, the possibility of the evening-type being a risk factor for a worse sleep hygiene, and the maintenance of sleep problems such as insomnia may all be investigated in depth in future research.     

Does the easy–difficult item measure attitude or perceived behavioural control?

Objective In order to determine if easy–difficult item measures attitude or perceived behavioural control (PBC), we used structural equation modelling of 10 cross‐sectional data sets. Design Cross‐sectional design was used. Method. Ten studies that examined health‐related behaviours and used the theory of planned behaviour as a theoretical framework were analysed. Samples totalling N = 4,552 participants were employed. All studies involved multi‐item measures of attitude (Aact) and PBC items derived from pilot testing. Results Confirmatory factor analysis confirmed the discriminant validity of Aact and PBC. Structural equation modelling of relevant path indicated that in three studies, easy–difficult item is an indicator of both Aact and PBC. In the other seven studies, easy–difficult item belongs to PBC. The indexes of meta‐analysis suggest that overall, easy–difficult item is an indicator of PBC. Conclusion. Findings from 10 studies converged toward the conclusion that the easy–difficult item is an indicator of perceived PBC. However, since the easy–difficult item is sometimes classified as both Aact and PBC, and only the perceived difficulty dimension of PBC captures a significant increment in the variance of intention, it appears important to develop and validate a set of items devoted to measure the perceived difficulty dimension adequately.     

The reliability and validity of the positive and negative perfectionism scale

Background: It has been debated if perfectionism is both positive and negative. This debate will more likely be resolved with scales that distinguish between positive and negative perfectionism, but currently there is limited psychometric information on these scales. Methods: This study examined the reliability and construct validity of the Positive and Negative Perfectionism Scale (PANPS) in three groups: A clinical sample with anxiety disorders and depression (n = 40), athletes (n = 111), and college students (n = 101). Results: There were two correlated factors of positive and negative perfectionism found on a confirmatory factor analysis although the solution was a poor fit. A subsequent exploratory factor analysis (EFA) produced a solution that was consistent with this interpretation. The negative perfectionism subscale demonstrated good internal consistency, and moderate to strong correlations with all subscales of the Multidimensional Perfectionism Scale (FMPS). The positive perfectionism subscale had significant correlations with concern over mistakes and personal standards on the FMPS in all groups. The positive perfectionism subscale also had a significant, moderate correlation with depressive symptoms in the clinical group, which does not support the scale being associated with positive adjustment. Conclusion: The results indicate that the PANPS is not an adequate measure of positive and negative perfectionism.     

中文版创伤后应激障碍诊断量表在震后受灾人群中的适用性

目的研究中文版创伤后应激障碍诊断量表(PDS-C)在震后受灾人群中的适用性。方法选取震后受灾人群(有效n=125)进行PDS-C问卷测试,再进行项目分析、信度分析、区分效度分析以及验证性因素分析。结果各题与除该题外的问卷总分相关系数范围为0.267~0.689。问卷Cronbach's alpha为0.891,子量表Cronbach's alpha范围为0.722~0.811。验证性因素分析的拟合指数为:χ2/df=1.261,RMSEA=0.046,FMIn=1.139,F0=0.236,ECVI=1.8。问卷总分对生活领域不同受损程度可以进行区分(F=12.875,P0.01)。结论中文版PDS问卷具有良好的心理测量学属性。     

Disclosing genetic risk for coronary heart disease: effects on perceived personal control and genetic counseling satisfaction

We investigated whether disclosure of coronary heart disease (CHD) genetic risk influences perceived personal control (PPC) and genetic counseling satisfaction (GCS). Participants (n = 207, age: 45–65 years) were randomized to receive estimated 10‐year risk of CHD based on a conventional risk score (CRS) with or without a genetic risk score (GRS). Risk estimates were disclosed by a genetic counselor who also reviewed how GRS altered risk in those randomized to CRS+GRS. Each participant subsequently met with a physician and then completed surveys to assess PPC and GCS. Participants who received CRS+GRS had higher PPC than those who received CRS alone although the absolute difference was small (25.2 ± 2.7 vs 24.1 ± 3.8, p = 0.04). A greater proportion of CRS+GRS participants had higher GCS scores (17.3 ± 5.3 vs 15.9 ± 6.3, p = 0.06). In the CRS+GRS group, PPC and GCS scores were not correlated with GRS. Within both groups, PPC and GCS scores were similar in patients with or without family history (p = NS). In conclusion, patients who received their genetic risk of CHD had higher PPC and tended to have higher GCS. Our findings suggest that disclosure of genetic risk of CHD together with conventional risk estimates is appreciated by patients. Whether this results in improved outcomes needs additional investigation.     

A validity and reliability study of the coping self‐efficacy scale

Objectives. Investigate the psychometric characteristics of the coping self‐efficacy (CSE) scale, a 26‐item measure of one's confidence in performing coping behaviors when faced with life challenges. Design. Data came from two randomized clinical trials (N1 = 149, N2 = 199) evaluating a theory‐based Coping Effectiveness Training (CET) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness. Methods. The 348 participants were HIV‐seropositive men with depressed mood who have sex with men. Participants were randomly assigned to intervention and comparison conditions and assessed pre‐ and post‐intervention. Outcome variables included the CSE scale, ways of coping, and measures of social support and psychological distress and well‐being. Results. Exploratory (EFA) and confirmatory factor analyses (CFA) revealed a 13‐item reduced form of the CSE scale with three factors: Use problem‐focused coping (6 items, α = .91), stop unpleasant emotions and thoughts (4 items, α = .91), and get support from friends and family (3 items, α = .80). Internal consistency and test–retest reliability are strong for all three factors. Concurrent validity analyses showed these factors assess self‐efficacy for different types of coping. Predictive validity analyses showed that residualized change scores in using problem‐ and emotion‐focused coping skills were predictive of reduced psychological distress and increased psychological well‐being over time. Conclusions. The CSE scale provides a measure of a person's perceived ability to cope effectively with life challenges, as well as a way to assess changes in CSE over time in intervention research.     

A short scale to evaluate supervision and supervisor competence—The SE-SC8

There is an urgent need for instruments to evaluate supervisor competence. The current study describes the development of the SE-SC8, an eight-item version of a previously published Supervision Evaluation and Supervisory Competence scale that has adequate reliability and validity. The current study analysed data from the sample (N = 142) used in the initial validation of the full scale to identify the best set of items for a short scale before testing the scale's psychometric properties in a new study (N = 122). The SE-SC8 demonstrated good reliability and adequate convergent and divergent validity. The SE-SC8 has two overall items respectively measuring supervisor effectiveness and supervision satisfaction and six items that represent supervisory competencies, namely, (1) Openness, Caring and Support, (2) Supervisor's Knowledge and Expertise as Therapist, (3) Supervision Planning and Management, (4) Goal-Directed Supervision, (5) Restorative Competencies, and (6) Insight into and Management of Therapist–Client Dynamics and Reflective Practitioner Competencies. As with other subjective ratings, SE-SC8 scores should be supplemented by other assessments for a holistic appraisal of supervisor competence.     

Development and preliminary validation of the Menopause Symptoms Treatment Satisfaction Questionnaire (MS-TSQ)

OBJECTIVE: The Menopause Symptoms Treatment Satisfaction Questionnaire, an eight-item questionnaire with a 4-week recall period, was developed to assess women's satisfaction with treatment for symptoms associated with menopause. We describe the development and initial testing of the scale. DESIGN: Following standard instrument-development procedures, focus groups were conducted with menopausal women experiencing hot flushes to generate potential constructs. Multiple items were drafted to address each construct. An iterative process of cognitive testing, item revision, and item reduction was followed to identify the most appropriate items and optimal response scales. The psychometric validation of the questionnaire used data collected through a multicenter, randomized, double-blind, placebo-controlled study including 543 postmenopausal women. Psychometric analyses were conducted to explore potential item reduction and to address questionnaire scaling and scoring. Internal consistency reliability, construct validity, and discriminant validity of the new scale were also examined. RESULTS: The questionnaire includes items addressing the control of daytime and nighttime hot flushes; effects of treatment on sleep, mood, libido, and cognition; medication tolerability; and overall satisfaction. Correlation analyses indicated that the items are related to each other without being overly redundant and that the item set is best described using a one-factor model. The subsequent scale score demonstrated sound internal consistency reliability, strong construct validity, and good discriminant validity. CONCLUSIONS: The results of the development and initial validation are favorable. It is expected that the questionnaire will prove to be a worthwhile tool for assessing women's satisfaction with treatment for menopausal symptoms.     

The Sleep Disturbance Scale for Children (SDSC) Construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence

SUMMARY To attempt a categorization of sleep disorders in children, we developed a 27 item Likert-type rating scale (Sleep Disturbance Scale for Children: SDSC) and assessed the psychometric properties was developed. The scale was distributed to the mothers of 1304 children (1157 controls, mean age 9.8y; 147 sleep disorder subjects, mean age 9.2y, composed of four clinical groups: Insomnia 39 subjects, Hypersomnia 12 subjects, Respiratory disturbances during sleep 25 subjects and Parasomnias 71 subjects). The internal consistency was high in controls (0.79) and remained at a satisfactory level in sleep disorder subjects (0.71); the test/retest reliability was adequate for the total (r = 0.71) and single item scores. The factor analysis (variance explained 44.21%) yielded six factors which represented the most common areas of sleep disorders in childhood and adolescence. Enuresis was the only item with a factor loading lower than 0.40 and with a low inter-item correlation and was therefore eliminated, resulting in a final scale of 26 items. The re-evaluation of the sample, using the factor scores, supported the validity and the discriminating capacity of the scales between controls and the four clinical groups. The correlation between factor scores corroborated the hypothesis that childhood sleep disturbances are not independent entities nor do they cluster into different groupings related to each other. The SDSC appears to be a useful tool in evaluating the sleep disturbances of school-age children in clinical and non-clinical populations.     

A comparison of the 27‐item and 12‐item intolerance of uncertainty scales

The 27‐item Intolerance of Uncertainty Scale (IUS) has become one of the most frequently used measure of Intolerance of Uncertainty. More recently, an abridged, 12‐item version of the IUS has been developed. The current research used clinical (n = 50) and non‐clinical (n = 56) samples to examine and compare the psychometric properties of both versions of the IUS. The two scales showed good internal consistency at both the total and subscale level and had satisfactory test‐retest reliability. Both versions were correlated with worry and trait anxiety and had satisfactory concurrent validity. Significant differences between the scores of the clinical and non‐clinical sample supported discriminant validity. Predictive validity was also supported for the two scales. Total scores, in the case of the clinical sample, and a subscale, in the case of the non‐clinical sample, significantly predicted pathological worry and trait anxiety. Overall, the clinicians and researchers can use either version of the IUS with confidence, due to their sound psychometric properties.