The Fear of Pain Questionnaire-Short Form (FPQ-SF): factorial validity and psychometric properties

McNeil and Rainwater's Fear of Pain Questionnaire III (FPQ-III, 1998) is an empirically derived self-report inventory that assesses fear of three broad categories of pain: Severe, Minor, and Medical Pain. Previous exploratory and confirmatory factor analyses suggest that the original 3-factor model of the FPQ-III has a poor fit [Osman A, Breitenstein JL, Barrios FX, Gutierrez PM, Kopper BA. The Fear of Pain Questionnaire-III: further reliability and validity with nonclinical samples. J Behav Med 2002;25:155-73; Albaret MC, Sastre MTM, Cottensin A, Mullet E. The Fear of Pain Questionnaire: factor structure in samples of young, middle-aged and elderly European people. Eur J Pain 2004;8:273-81; Roelofs J, Peters ML, Deutz J, Spijker C, Vlaeyen JWS. The Fear of Pain Questionnaire (FPQ): further psychometric examination in a non-clinical sample. Pain 2005;116:339-46.]. The goals of this study were to empirically evaluate the previously proposed 3-factor models of the FPQ-III, identify and remove items that contribute to the factor instability of the FPQ-III, and evaluate potential alternative models based on a reduced item pool. A sample of 589 participants from the University of Regina and the University of Manitoba communities was randomly divided into two subsamples of approximately equal size. FPQ-III data from these subsamples were subjected to confirmatory factor analysis and an iterative combination of exploratory and confirmatory factor analyses. The initial confirmatory factor analysis revealed that none of the previous models had acceptable fit to the data. Following iterative factor analyses and item reductions, a 4-factor model with good fit to the data and invariance across gender was identified. This model comprised 20-items distributed on factors representing Severe, Minor, Injection, and Dental Pain. The total scale and subscale scores based on the 4-factor model had good internal consistency, and preliminary support for construct validity was obtained. Use of this short version of the measure--the FPQ-Short Form--is discussed and directions for future research outlined.     

Fear of movement/(re)injury in chronic pain: a psychometric assessment of the original English version of the Tampa scale for kinesiophobia (TSK)

The Tampa scale for kinesiophobia (TSK) was developed to measure fear of movement/(re)injury in chronic pain patients. Although studies of the Dutch adaptation of the TSK have identified fear of movement/(re)injury as an important predictor of chronic pain, pain-related avoidance behaviour, and disability, surprisingly little data on the psychometric properties of the original English version of the TSK are available. The present study examined the reliability, construct validity and factor structure of the TSK in a sample of chronic pain patients (n=200) presenting for an interdisciplinary functional restoration program. Consistent with prior evaluations of the Dutch version of the TSK, the present findings indicate that the English TSK possesses a high degree of internal consistency and is positively associated with related measures of fear-avoidance beliefs, pain catastrophizing, pain-related disability and general negative affect. The TSK was not related to individual differences in physical performance testing as assessed using standardised treadmill and lifting tasks. Confirmatory factor analyses suggest that the TSK is best characterized by a three-factor trait method model that includes all 17 of the original scale items and takes into account the distinction between positively and negatively keyed items. The results of the present study provide important details regarding the psychometric properties of the original English version of the TSK and suggest that it may be unnecessary to remove the negatively keyed items in an attempt to improve scale validity.     

Validation of the Dutch Version of the Breakthrough Pain Assessment Tool in Patients With Cancer

ContextEssential for adequate management of breakthrough cancer pain is a combination of accurate (re-)assessment and a personalized treatment plan. The Breakthrough Pain Assessment Tool (BAT) has been proven to be a brief, multidimensional, reliable, and valid questionnaire for the assessment of breakthrough cancer pain.ObjectivesThe aim of this study was to examine the validity and reliability of the Dutch Language version of the BAT (BAT-DL) in patients with cancer.MethodsThe BAT was forward-backward translated into the Dutch language. Thereafter, the psychometric properties of the BAT-DL were tested, that is factor structure, reliability (internal consistency and test-retest reliability), validity (content validity and construct validity), and the responsiveness to change.ResultsThe BAT-DL confirmed the two-factor structure in 170 patients with cancer: pain severity/impact factor and pain duration/medication efficacy factor. The Cronbach's alpha coefficient was 0.72, and the intraclass correlation for the test-retest reliability was 0.81. The BAT-DL showed to be able to differentiate between different group of patients and correlated significantly with the Brief Pain Inventory. In addition, the BAT-DL was capable to detect clinically important changes over time.ConclusionThe BAT-DL is a valid and reliable questionnaire to assess breakthrough pain in Dutch patients with cancer and is a relevant questionnaire for daily practice.     

Quality of paediatric rehabilitation from the parent perspective: validation of the short Measure of Processes of Care (MPOC-20) in the Netherlands

OBJECTIVE: In the present study we aim to assess the reliability and validity of the 20-item version of the Dutch Measure of Processes of Care (MPOC). DESIGN: The reliability, concurrent validity, predictive validity and construct validity of the Dutch MPOC-20 were determined. A subset of MPOC-20 data was extracted from a large Dutch MPOC (56-item version) database. SUBJECTS: Participants were 405 mothers and 22 fathers of children aged 1-18 years recruited through nine paediatric rehabilitation centres in the Netherlands. MAIN MEASURES: The participants filled out the MPOC-20 items, the Client Satisfaction Questionnaire (CSQ), and two additional questions about satisfaction with services and the amount of stress they experienced. RESULTS: The internal consistency analyses (alphas 0.75-0.87) and the test-retest analyses (intraclass correlation coefficients (ICCs) 0.78-0.91) showed that the Dutch MPOC-20 is a reliable tool. The concurrent validity of the Dutch MPOC-20 was confirmed by positive correlations between MPOC-20 scale scores and the CSQ (r 0.39-0.69), and between MPOC-20 scale scores and an overall satisfaction variable (r 0.37-0.66). The predictive validity of the Dutch MPOC-20 was supported by moderately negative correlations between MPOC-20 scores and a stress variable (r -0.27 to -0.44). The construct validity of the Dutch MPOC-20 was confirmed by significant scale intercorrelations (r 0.41-0.84) and a factor analysis. CONCLUSIONS: The 20-item version of the MPOC (Dutch MPOC-20) is a reliable and valid measure of the family-centredness of paediatric rehabilitation.     

Measuring the symptom experience of Chinese cancer patients: a validation of the Chinese version of the memorial symptom assessment scale

The purpose of this study was to translate the Memorial Symptom Assessment Scale (MSAS) into Chinese and evaluate the psychometric properties of this version. The original MSAS is a 32-item, patient-rated measure that was developed to assess common cancer-related physical and psychological symptoms with respect to frequency, intensity, and distress. In this study, a two-phase design was used. Phase I involved iterative forward-backward translation, testing of content validity (CVI) and a pretest. Phase II established the psychometric properties of the Chinese version MSAS (MSAS-Ch). Results showed that the MSAS-Ch achieved content relevancy CVI of 0.94 and semantic equivalence CVI of 0.94. Pretesting was performed in 10 cancer patients, and the results revealed adequate content coverage and comprehensibility of the MSAS-Ch. A convenience sample of 370 patients undergoing cancer therapy or at the early post-treatment stage was recruited for psychometric evaluation. Confirmatory factor analysis confirmed the construct validity of the MSAS-Ch, with a good fit between the factor structure of the original version and our present sample data (goodness-of-fit indices all above 0.95). The internal consistency reliability of subscales and total MSAS-Ch was moderately high, with Cronbach alpha coefficients ranging from 0.79 to 0.87. The test-retest intraclass correlation results for the subscale and total MSAS-Ch ranged from 0.68 to 0.79. The subscale scores of MSAS-Ch were moderately correlated with the scores on various validation measurements that assessed psychological distress, pain, and health-related quality of life (r = 0.46-0.65, P < 0.01), confirming that they were measurements of similar constructs. The validity of the construct validity was also supported by comparing the MSAS-Ch scores for subpopulations that varied clinically. Inpatients and patients with poorer performance status scored higher on the MSAS-Ch subscale and total scores than outpatients and patients with higher performance status (P < 0.05). Our study shows that the MSAS-Ch has adequate psychometric properties of validity and reliability, and can be used to assess symptoms during cancer therapy and at the early post-treatment stage in Chinese-speaking patients.     

The psychometric quality and clinical usefulness of three pain assessment tools for elderly people with dementia

In view of the need for valid, reliable, and clinically useful scales to assess pain in elderly people with dementia, this study evaluated the psychometric properties of translated versions of the PAINAD, PACSLAC, and DOLOPLUS-2 scales. In an observational study design, two raters simultaneously assessed the nursing home residents (n=128) for pain during influenza vaccination and care situations. The PACSLAC was valued as the most useful scale by nurses. Cronbach's alpha was high (>.80) for the total scale at T2 and T3 and adequate for the 'Facial expression' and 'Social/personality/mood' subscales. IC scores for the 'Activity/body movement' and 'Physiological indicators/eating/sleeping changes/vocal behaviors' subscales were low. It demonstrated good validity and reliability, although the scale should be further refined. This refinement should increase homogeneity. The PAINAD showed good psychometric qualities in terms of reliability, validity, and homogeneity (alpha ranged .69-.74 at T2 and T3) (except for the 'Breathing' item). The PAINAD scale had lower scores for clinical usefulness in this sample. The Dutch version of the DOLOPLUS-2 was considered more difficult to use but showed acceptable psychometric qualities in terms of the issues assessed, except for the 'psychosocial reactions' subscale. IC of the DOLOPLUS were adequate for the total scale (alpha ranged .74-.75) and almost all subscales (alpha ranged .58-.80). Findings of this study provide evidence of validity and reliability of the three pain assessment scales. Now that a pain scale is available, future studies also need to focus on its implementation in nursing practice.     

Translation,cross-cultural adaptation,and psychometric properties of the Brazilian Portuguese version of the DiAbeTes Education Questionnaire (DATE-Q)

BackgroundThe DiAbeTes Education Questionnaire (DATE-Q) is a self-administered tool developed to evaluate disease-related knowledge and to assess knowledge of five core components of rehabilitation programs: physical exercise, diet, psychosocial well-being, disease self-management, and complications.ObjectiveTo translate and cross-culturally adapt into Brazilian Portuguese, and to test the psychometric properties of the DATE-Q for its use in Brazil.MethodsThe process of translation and cross-cultural adaptation consisted of five steps: translation into Brazilian Portuguese, synthesis of translation, back translation, expert committee, and pilot test of pre-final version. The pre-final version was applied to a sample of 30 patients with diabetes. Psychometric properties (internal consistency, reliability, construct validity, and ceiling and floor effects) of the final version of the Brazilian Portuguese version of the DATE-Q were tested in a sample of 200 adults with diabetes.ResultsThere was no conceptual divergence between the original and the translated versions. Ten (50%) items of the DATE-Q were culturally adapted. Internal consistency (Cronbach’s alpha coefficient = 0.6), reliability (intraclass correlation coefficient = 0.5), and construct validity (correlation between Diabetes Knowledge Scales and DATE-Q total scores: ρ = 0.7; P < 0.001) were confirmed. Ceiling or floor effects were not identified. The highest scoring item was about healthy eating. The average time for completion of the DATE-Q was 5 min and 51 s, and the completion rate was 100% for all items.ConclusionThe Brazilian Portuguese version of the DATE-Q showed adequate psychometric properties, and results suggested that the tool can be used to assess disease-related knowledge in adults with diabetes in Brazil.     

Construct and criterion validity of the DUFS and DEFS⁴ in Lithuanian patients with coronary artery disease

Background Fatigue has become an important symptom in clinical diagnosis and clinical trials among subjects with cardiovascular diseases and disease‐specific fatigue scales were developed in a Dutch and English version. Objective Various questionnaires for measuring fatigue have been developed, but currently no validated questionnaire targeted at subjects with cardiovascular disease and heart failure exists in the Lithuanian language. Methods Despite the rigor of the exploratory factor analysis and analyses of the psychometric properties of the disease‐specific Dutch Fatigue Scale and the Dutch Exertion Fatigue Scale (DUFS–DEFS) we adopted a confirmatory approach considered as the gold standard method for the evaluation of construct validity in psychometric inventories. To test the criterion validity of the DUFS and DEFS structural equation modelling was employed with the widely used and validated Multidimensional Fatigue Inventory (MFI). Results The a priori specification of a hypothesized five‐factor model of the MFI‐20 and a two‐factor model of the DUFS and DEFS appeared to have a good fit to the data in Lithuanian patients. The hypothesized model of the criterion validity of the DUFS and DEFS had a good fit and classes of disease severity showed statistically significant and clinically relevant differences on fatigue scores. Conclusion The construct validity and criterion validity of the DUFS and DEFS were confirmed in a Lithuanian sample of cardiac patients. The construct validity of the MFI was also supported and this fatigue measure can be used in Lithuanian settings of clinical practice and research.     

Validity and reliability of the albanian version of the nursing professional values scale (NPVS-3)

IntroductionThe Nurses Professional Values Scale-3 (NPVS-3) is a psychometric instrument derived from the American Nurses Association Code. The validation of the scale for Albania will assist in assessing the level of professional values in students and the effectiveness of the national curriculum in integrating those values in nursing education.AimThis study aims to test the psychometric properties of the Albanian version of the NPVS-3.MethodsThis is a methodological cross-sectional study. Data was collected in 2020, from March to September, through an electronic survey. The inclusion criteria were: an Albanian national and a student registered in the Bachelor program of the nursing departments from the university.The questionnaire was translated and back-translated and submitted for evaluation by an experts committee. The validity of the items was determined by the Content Validity Index, the construct validity of the scale was estimated by Confirmatory Factor Analysis and Cronbach's alpha was calculated for each construct to assess the internal consistency reliability.ResultsThe convenient sample consisted of 105 nursing students. The results indicates an adequate content validity and internal structure of the scale. The Cronbach's alpha calculated supports the three-factor structure of the scale based on the domains of Caring, Professionalism and Activism.DiscussionValidation of the Albanian version of the NPVS-3 followed all the required procedures and confirmed the psychometric integrity of the instrument.     

The nursing incivility scale: development and validation of an occupation-specific measure

This article describes the development of the Nursing Incivility Scale (NIS), which is designed to assess hospital nurses' experiences with incivility according to specific sources-physicians, coworkers, patients, and direct supervisors. The NIS was developed using focus groups with nurses at a hospital in the midwestern United States and validated during a second survey administered to 163 hospital nurses. Exploratory factor analysis revealed that the NIS items grouped according to a priori scale construction. All subscales showed acceptable reliability and demonstrated acceptable convergent and discriminant validity with other variables. The results indicate that the NIS has good psychometric qualities and can be used by hospitals and health care administrators to assess the prevalence of incivility.     

Les caractéristiques psychométriques du Questionnaire de douleur de Saint-Antoine en consultation d’algologie chez les personnes atteintes de cancer

Purpose

The purpose of this study was to assess the psychometric characteristics of the French Saint-Antoine Pain Questionnaire (Long-Form and Short-Form) in cancer patients consulting for pain-relief.

Method

71 patients completed the pain intensity measures and the long and short versions of the Saint-Antoine Pain Questionnaire (QDSA-LF and QDSA-SF) at the Claudius-Regaud Institut in Toulouse. Demographic and medical information about patients was collected. Several psychometric analyses were considered. Convergent and divergent validity were assessed using Pearson’s correlation coefficient. Construct validity was measured by Principal Component Analysis. The internal consistency was estimated using coefficient alpha. The stability was measured using correlations over time.

Results

The results show that the psychometric analyses are acceptable (convergent and divergent validity, construct validity, internal consistency and stability). The psychometric qualities of both versions of the QDSA are satisfactory and comparable to results from studies carried out in other countries on cancer patients.

Conclusion

This study shows that the QDSA is an important and useful tool for measuring pain because it includes investigation of sensory and emotional aspects and goes beyond a simple measurement of intensity.     

Psychometric testing of the Arabic version of the Patient Health Questionnaire among adolescent refugees living in Jordan

Refugee youth living in Arab countries have disproportionately higher rates of depression due to the effects of displacement and trauma which makes screening a priority for early intervention. The Patient Health Questionnaire for Adolescents (PHQ‐A) is a reliable and valid scale to assess mental health issues, but its psychometric properties in Arabic refugee populations are unknown. This was a cross‐sectional study conducted between March and Mid‐April 2018, among Arabic refugee adolescents aged 13–18 years living in the Baqa'a United Nations Relief and Works Agency refugee camp in Jordan, to generate an Arabic‐language version of the questionnaire and to test its psychometric properties among adolescent refugees. Five hundred and ninety‐one adolescents completed the PHQ‐A in Arabic. Using SPSS and AMOS version 25, exploratory and confirmatory factor analyses were conducted and Cronbach's alpha coefficient was computed to assess construct validity and instrument reliability. Multivariate logistic regression analyses assessed the discriminant validity of the PHQ‐A. Although exploratory factor analysis identified the nine items from the original version and explained only 37% of the variance, confirmatory factor analysis supported the one‐factor structure of the PHQ‐A. Cronbach's alpha coefficient for the scale was 0.82 and ranged from 0.79 to 0.81 for each item. The Arabic translated version of the Patient Health Questionnaire for Adolescents showed acceptable psychometric properties for use as a screening tool for depression in Arabic adolescent refugees.     

Reliability and validity of the Dutch version of the inventory of traumatic grief (ITG)

The psychometric properties of the Dutch version of the Inventory of Traumatic Grief (ITG) were investigated in two studies with bereaved adults who had suffered the loss of a first-degree relative. In Study 1, exploratory factor analysis indicated that the items of the ITG clustered together into one underlying factor. In addition, the internal consistency of the ITG and its short-term temporal stability were found to be high. In Study 2 it was found that the ITG exhibited adequate discriminative, concurrent, and construct validity. Furthermore, an ITG cutoff score for a diagnosis of traumatic grief was determined, with a sensitivity of 86% and a specificity of 76%, providing evidence in favor of the predictive validity of the ITG.     

The Strain of Care for Delirium Index: a new instrument to assess nurses' strain in caring for patients with delirium

This study evaluated content validity, internal consistency and construct validity of the Strain of Care for Delirium Index (SCDI), a newly constructed instrument to measure the strain nurses experience in caring for patients with delirium. Content validity, evaluated by eight experts, reduced the initial pool of items from 38 to 28. Using a convenience sample of 190 nurses, Cronbach's alpha for the 28-item version was 0.88. Using non-linear principal components analysis another eight items were eliminated and a four-factor structure was identified. The proportion of variance explained by the remaining 20 items was 61.51%. Preliminary psychometric evaluation of the SCDI supported content validity, internal consistency and construct validity; however additional psychometric evaluation is warranted.     

Development and psychometric evaluation of the Psychiatric In-patients Comfort Scale (PICS)

ObjectiveTo develop and evaluate the psychometric characteristics of the Psychiatric In-patients Comfort Scale (PICS) in hospitalized psychiatric patients.MethodsThe items of the PICS were drawn from a literature review, existing comfort instruments, suggestions made by experts, and interviews on perceived comfort with 18 hospitalized patients. A pilot study was performed with the first version of the scale, containing 98 items, in a sample of 49 patients. This process resulted in a 51 -item version. Internal consistency, construct validity, and concurrent validity were measured in a second sample of 273 patients.ResultsData analysis, factor analysis, and reliability analysis resulted in a 38-item version. The factor analysis indicated a 3-factor structure: relief, ease and transcendence, which explained 38.64% of the total variance. The comfort dimensions correlated positively with well-being and with positive experiences of suffering and negatively with the remaining dimensions of suffering, supporting concurrent validity. Cronbach's α coefficient of the total PICS-38 was 0.89, and the subscales ranged from 0.75 to 0.90.ConclusionBased on psychometric properties, the PICS is a valid and reliable tool that can be used by nurses to assess comfort in hospitalized psychiatric patients. The items are conceptually grouped in three factors corresponding to the states of relief, ease and transcendence of the comfort structure proposed by Kolcaba.     

Psychometric assessment of the Adult-Adolescent Parenting Inventory in a sample of low-income single mothers

The Adult-Adolescent Parenting Inventory (AAPI) is a 32-item inventory widely used to identify adolescents and adults at risk for inadequate parenting behaviors. It includes four subscales representing the most frequent patterns associated with abusive parenting: (a) Inappropriate Expectations; (b) Lack of Empathy; (c) Parental Value of Corporal Punishment; and (d) Parent-Child Role Reversal. Although it has been used in a variety of samples, the psychometric properties of the AAPI have not been examined in low-income single mothers. The purposes of this study were to: (a) examine the reliability and validity of the Adult-Adolescent Parenting Inventory (AAPI) in a sample of 206 low-income single mothers; (b) assess the mother's risk for inadequate parenting by comparing their AAPI subscale scores with normative subscale scores on the AAPI; (c) assess the construct validity of the AAPI by testing the hypothesis that mothers with lower AAPI scores have a higher level of depressive symptoms and lower self-esteem in comparison to mothers with higher AAPI scores; and (d) determine whether the 4-factor structure proposed by Bavolek (1984) could be replicated. AAPI scores indicated these mothers were at high risk for child abuse when compared with normative data for parents with no known history of abuse. Higher risk for abusive parenting was associated with a higher level of depressive symptoms, less education, and unemployment. The subscales, Inappropriate Expectations and Parental Value of Corporal Punishment demonstrated poor internal consistency with Cronbach's alphas of .40 and .54, respectively. Hypothesis testing supported the construct validity of the AAPI. Bavolek's 4-factor structure was not supported. A 19-item modified version of the AAPI with three dimensions was identified. This modified version of the AAPI may provide a more efficacious tool for use with low-income single mothers.