The construction and validation of the Stellenbosch Endometriosis Quality of life measure (SEQOL)

ABSTRACT

In this paper, we describe the process of construction and validation of a health-related quality of life (HRQOL) measure for patients with endometriosis. The items in the measure were initially constructed, edited and reduced using a consultative process with endometriosis experts. We then determined the test reliability, validity and factor structure of the measure by administering the measure and several other measures to 203 patients with endometriosis. The 35-item measure produced an eight-dimension factor structure. The measure and its subscales demonstrated excellent internal consistency reliability and promising validity.     

The development and validation of the body shape questionnaire

Concerns about body shape are common among young women in Western cultures, and, in an extreme form, they constitute a central feature of the eating disorders anorexia nervosa and bulimia nervosa. To date there has been no satisfactory measure of such concerns. A self-report instrument, the Body Shape Questionnaire (BSQ) has therefore been developed. The items that constitute this measure were derived by conducting semistructured interviews with various groups of women including patients with anorexia nervosa and bulimia nervosa. The BSQ has been administered to three samples of young women in the community as well as to a group of patients with bulimia nervosa. The concurrent and discriminant validity of the measure have been shown to be good. The BSQ provides a means of investigating the role of concerns about body shape in the development, maintenance, and treatment of anorexia nervosa and bulimia nervosa.     

The development and validation of the weight management support inventory

The purpose of this investigation was to develop and validate the Weight Management Support Inventory (WMSI). The WMSI assesses social support specifically for weight management. It quantifies the frequency and subjective helpfulness of supportive behaviors as well as examining four specific subtypes of support (emotional, instrumental, informational, and appraisal). The first stage of development (n=348) established the internal consistency (alpha) of the WMSI and also established the factor structure of the WMSI using confirmatory factor analysis. The second stage of development (n=237) demonstrated the construct, convergent, and discriminant validity of the WMSI. The WMSI provides a tool to allow future investigations to examine baseline levels of support for weight management and to verify changes in support via intervention. Additionally, the WMSI provides information that allows clinicians to tailor the social support component of weight management treatments to clients' individual needs.     

The development and validation of the Perceived Health Competence Scale

A sense of competence or self-efficacy is associated with many positive outcomes, particularly in the area of health behavior. A measure of a sense of competence in the domain of health behavior has not been developed. Most measures are either general measures of a general sense of self-efficacy or are very specific to a particular health behavior. The Perceived Health Competence Scale (PHCS), a domain-specific measure of the degree to which an individual feels capable of effectively managing his or her health outcomes, was developed to provide a measure of perceived competence at an intermediate level of specificity. Five studies using three different types of samples (students, adults and persons with a chronic illness) provide evidence for the reliability and validity of the PHCS. The eight items of the PHCS combine both outcome and behavioral expectancies. Results from the five studies indicate that the scale has good internal consistency and test-retest reliability. The construct validity of the scale is demonstrated through the support obtained for substantive hypotheses regarding the correlates of perceived health competence, such as health behavior intentions, general sense of competence and health locus of control.     

Back Pain and Body Posture Evaluation Instrument (BackPEI): development, content validation and reproducibility

Objectives

Following a search conducted in several databases, no instrument was found that jointly evaluates the prevalence of back pain and its associated demographic, social–economic, hereditary, behavioral and postural risk factors. Thus, the present study aims to develop the Back Pain and Body Posture Evaluation Instrument (BackPEI) for school-age children and verify its validity and reproducibility.

Methods

Twenty-one questions were elaborated to compose the BackPEI instrument, eight experts checked the content validity, and its reproducibility was tested by applying the questionnaire to 260 primary schoolchildren, at two different times with a 7-day interval.

Results

The reproducibility data for the first 20 questions, analyzed using the kappa (k) coefficient, were classified as “very good” (k > 0.8) or “good” (0.6 < k ≤ 0.8). The reproducibility data for the pain intensity question, analyzed using the Wilcoxon test and the intraclass correlation coefficients (ICC), demonstrated that there was no difference between the averages (p = 0.251) and the responses were highly correlated (ICC = 0.937) for these two tests.

Conclusions

The BackPEI constitutes a valid and reproducible instrument which is relevant for the evaluation of back pain and its associated risk factors.     

电子病案的现状及发展前景（综述）

该文阐述电子病案的进展,分析了电子病案的优势和发展中的前沿问题。尤其是对电子病案的医疗质量监控作用、安全性、法律效力、建设和维护资金以及人才等问题进行总结分析,并对完善医院电子病案系统建设进行了展望。     

The Irrational Food Beliefs Scale: development and validation

This article reports the development and validation of a measure of Irrational Food Beliefs (IFB), defined as cognitively distorted and unhealthy attitudes and beliefs pertaining to food, which is proposed to be a factor that undermines success at weight loss and maintenance. Studies 1 and 2 demonstrated that the Irrational Food Beliefs Scale (IFBS) contains ecologically valid items and is comprised of two primary factors (irrational and rational food beliefs) whose items are internally consistent. Study 3 established that irrational subscale scores were positively associated with first semester weight gain in college freshmen. In Study 4, irrational food belief scores related predictably to measures of recent weight gain, poor weight loss maintenance, and bulimic symptoms in another college sample. In addition, IFB scores were not unduly influenced by test-taking response sets, and they were positively associated with depression and phobic anxiety and negatively correlated with self-esteem and need for cognition. Study 5 revealed strong positive associations between irrational food beliefs and bulimic symptoms, as well as number of previous diets in an obese community sample. The role irrational food beliefs may play in poor weight loss outcomes and maintenance is discussed.     

The development and validation of the Physical Appearance Comparison Scale-Revised (PACS-R)

The Physical Appearance Comparison Scale (PACS; Thompson, Heinberg, & Tantleff, 1991) was revised to assess appearance comparisons relevant to women and men in a wide variety of contexts. The revised scale (Physical Appearance Comparison Scale-Revised, PACS-R) was administered to 1176 college females. In Study 1, exploratory factor analysis and parallel analysis using one half of the sample suggested a single factor structure for the PACS-R. Study 2 utilized the remaining half of the sample to conduct confirmatory factor analysis, item analysis, and to examine the convergent validity of the scale. These analyses resulted in an 11-item measure that demonstrated excellent internal consistency and convergent validity with measures of body satisfaction, eating pathology, sociocultural influences on appearance, and self-esteem. Regression analyses demonstrated the utility of the PACS-R in predicting body satisfaction and eating pathology. Overall, results indicate that the PACS-R is a reliable and valid tool for assessing appearance comparison tendencies in women.     

The development and validation of the primary care satisfaction survey for women.

Assessing patient satisfaction with health care is becoming an integral component of quality monitoring in health care systems, but existing tools typically were developed to minimize differences related to gender. This paper reports the development and psychometric properties of a new survey instrument to measure women's satisfaction with their primary care. A multisite, cross-sectional validation survey of 1,202 women receiving care in primary care settings in Michigan, North Carolina, and Pennsylvania was conducted. Item response theory (IRT) and factor analysis methods were used to identify three scales in the Primary Care Satisfaction Survey for Women (PCSSW): Communication, Administration and Office Procedures, and Care Coordination and Comprehensiveness. Internal consistency reliability is reported, as well as convergent validity in relation to two generic measures (Medical Outcomes Study [MOS] Visit Satisfaction and Consumer Assessment of Health Plans Survey [CAHPS] overall quality rating); discriminant validity in relation to groups expected to have differing satisfaction levels based on previous literature; predictive validity in relation to behavioral intentions; and explanatory power in overall satisfaction ratings. The 24-item PCSSW may be self-administered or conducted by telephone and may be used in studies to evaluate or improve the quality of primary care for women.     

The development and validation of the Concise Outpatient Department User Satisfaction Scale.

OBJECTIVE: To develop and validate a concise scale for measuring outpatient satisfaction suitable across specialties and cultures. DESIGN: & SETTING: Item generation adopted a concept-driven approach, and 10 candidate items were administered together with a battery of validation items and scales in a cross-sectional survey at a government-aided Chinese medicine specialized outpatient department in Hong Kong. PARTICIPANTS: About 344 consenting patients or their accompanying caregivers were recruited upon their first visit at the clinic and interviewed one month thereafter. RESULTS: The overall response rate was 79%. After deleting one item (physician's manner and attitude) for its redundancy suggested by interitem correlations, exploratory factor analysis yielded two factors, General Service and Case Physician, explaining 75% of variance of the remaining nine items. The internal consistency coefficients of the whole scale and the two subscales were higher than 0.90. Criterion-related validity was supported by high correlations with three anchor items, overall satisfaction, intended future reutilization, and recommendation to others (r = 0.38-0.85). Significant correlations with compliance and negative affects provided preliminary evidence for construct validity. CONCLUSION: The psychometric properties of the resulting 9-item scale supported its usefulness in measuring outpatient satisfaction. Further validation studies in various specialties and countries are suggested to make future cross-cultural comparisons possible.     

Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish

Purpose

The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment 19-item questionnaire developed in the UK to measure foot pain and disability. This study aimed at conducting cross-cultural adaptation and validation of the MFPDI for use in Spain.

Methods

Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures were followed in the MFPDI adaptation into Spanish. The cross-cultural validation involved Rasch analysis of pooled data sets from Spain and the UK.

Results

Spanish data set comprised 338 patients, five used in the adaptation phase and 333 in the cross-cultural validation phase, mean age (SD) = 55.2 (16.7) and 248 (74.5 %) were female. A UK data set (n = 682) added in the cross-cultural validation phase; mean age (SD) = 51.6 (15.2 %) and 416 (61.0 %) were female. A preliminary analysis of the 17-item MFPDI revealed significant local dependency of items causing significant deviation from the Rasch model. Grouping all items into testlets and re-analysing the MFPDI as a 3-testlet scale resulted in an adequate fit to the Rasch model, χ ² (df) = 15.945 (12), p = 0.194, excellent reliability and unidimensionality. Lack of cross-cultural invariance was evident on the functional and personal appearance testlets. Splitting the affected testlets discounted the cross-cultural bias and satisfied requirements of the Rasch model. Subsequently, the MFPDI was calibrated into interval-level scales, fully adjusted to allow parametric analyses and cross-cultural data comparisons when required.

Conclusions

Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions.     

神经生长因子及其受体与子宫内膜异位症疼痛机制

子宫内膜异位症是严重影响妇女身心健康的妇科常见病。其主要症状是盆腔疼痛,但其机制至今仍然不清。近年研究发现,神经生长因子(NGF)通过与神经细胞受体结合,促使神经细胞增殖、分化,在诱导神经肽的表达和释放的同时增加感觉神经元的数量,对子宫内膜异位症的疼痛及痛觉过敏起重要作用。就NGF及其受体在子宫内膜异位症疼痛发生机制的相关研究做文献综述。     

神经生长因子及其受体与子宫内膜异位症疼痛机制

子宫内膜异位症是严重影响妇女身心健康的妇科常见病。其主要症状是盆腔疼痛,但其机制至今仍然不清。近年研究发现,神经生长因子(NGF)通过与神经细胞受体结合,促使神经细胞增殖、分化,在诱导神经肽的表达和释放的同时增加感觉神经元的数量,对子宫内膜异位症的疼痛及痛觉过敏起重要作用。就NGF及其受体在子宫内膜异位症疼痛发生机制的相关研究做文献综述。     

survivin 在子宫内膜异位症中的作用

survivin 是近年新发现的一种凋亡抑制蛋白,与细胞分裂、增殖有关,在胚胎组织和恶性肿瘤中表达,但在正常成年人的分化组织一般不表达或弱表达。子宫内膜异位症（EMs）虽为良性疾病,却具有侵袭、种植和复发等“恶性”生物行为。研究表明,survivin 蛋白的抗凋亡功能在EMs发生和发展中可能起着重要作用,现概述其生物学特点及在EMs中的作用。     

survivin在子宫内膜异位症中的作用

survivin是近年新发现的一种凋亡抑制蛋白,与细胞分裂、增殖有关,在胚胎组织和恶性肿瘤中表达,但在正常成年人的分化组织一般不表达或弱表达。子宫内膜异位症(EMs)虽为良性疾病,却具有侵袭、种植和复发等恶性生物行为。研究表明,survivin蛋白的抗凋亡功能在EMs发生和发展中可能起着重要作用,现概述其生物学特点及在EMs中的作用。     

The development and validation of the food craving acceptance and action questionnaire (FAAQ)

Research has suggested that mindfulness and acceptance may be important factors in the development, maintenance and treatment of both obesity and eating disorders. However, very few scales exist that apply constructs of acceptance and mindfulness to eating behavior. A measure of acceptance about food related thoughts would be especially beneficial in investigating links between acceptance and problematic eating, and in better understanding mechanisms of action of effective treatments for obesity and eating disorders. The Food Acceptance and Awareness Questionnaire (FAAQ) was developed to measure acceptance of urges and cravings to eat or the extent to which individuals might try to control or change these thoughts. The FAAQ is a self-report questionnaire made up of ten items each rated on a seven-point Likert scale (1 = very seldom true to 6 = always true). Higher scores indicate greater acceptance of motivations to eat. The FAAQ was given to a sample of 463 undergraduate students along with several other measures of eating behavior and other psychological variables. Concurrent associations with variables theorized to be closely linked (Eating Attitudes Test, EAT; the Dutch Eating Behavior Questionnaire, DEBQ; body mass index, BMI) and not very closely linked (the Depression Anxiety Stress Scale, DASS) were evaluated in order to indicate the new scale's convergent and divergent validity. These results demonstrated highly significant correlations with these measures in the expected direction, with stronger correlations for the theoretically-consistent variables than the theoretically-inconsistent variables. Exploratory factor analyses confirmed a structural two-factor model. Factor 1 seems to measure one's ability to regulate eating despite urges and cravings, and Factor 2 seems to measure desire to maintain internal control over eating thoughts. The FAAQ was also administered to a separate sample of 29 overweight or obese women enrolled in a weight loss program, and found to be predictive of weight loss. Taken together, results suggest that the FAAQ is a psychometrically sound instrument which might be a valuable tool for assessing acceptance of food related thoughts and urges.     

The Case of the Bleeding Colon

Pulse steroid regimens, early tapering to alternate-day treatment, and careful use of supplemental immunesuppression with cytotoxic drugs offer strategies for improving the therapeutic index of corticosteroid management.     

The Case of the Bleeding Gut

The NCI's Surveillance, Epidemiology, and End Results (SEER) Program has been collecting and analyzing data on cancer incidence and survival in the United States for more than a decade. Surveys show that data from selected, relatively small population centers accurately reflect nationwide trends. Variations among ethnic groups are often substantial.