Psychometric properties of a Korean version of the summary of diabetes self-care activities measure

Background

The summary of diabetes self-care activities (SDSCA) questionnaire is one of the most widely used self-report instruments for measuring diabetes self-management in adults.

Objectives

This study aimed to examine the psychometric properties of a Korean version of the SDSCA questionnaire.

Methods

The 11-item English version of the SDSCA was translated into Korean following the standard translation methodology. The questionnaire was administered to 208 patients with type 2 diabetes. Exploratory and confirmatory factor analyses (EFA and CFA) were carried out for construct validity. Content validity index (CVI), internal consistency and a diabetes management self-efficacy scale (DMSES) were assessed.

Results

The CVI of a Korean version of the SDSCA was .83. The EFA yielded a 9-item measure with a four factor solution with the same labels for original scales. The results of CFA showed the goodness of fit in the 9-item Korean SDSCA version (SDSCA-K). The internal consistency of SDSCA-K was moderate (Cronbach's α = .69) and the positive correlation between the SDSCA-K and the DMSES was identified.

Conclusion

The current study provides the initial psychometric properties of SDSCA-K modified to 9 items and supports SDSCA-K as a reliable and valid measure of diabetes self-management in Korean patients.     

Psychometric properties of the self-care of chronic illness inventory in Chinese older adults with multiple chronic conditions

Background

Existing self-care measures for the Chinese population are specific to single chronic conditions. No generic self-care measures exist for the Chinese population with multiple chronic conditions.

Objectives

To test the structural validity, concurrent validity and reliability of the Self-care of Chronic Illness Inventory (SC-CII) in Chinese older adults with multiple chronic conditions.

Methods

This cross-sectional study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline. A diverse sample of Chinese older adults with multiple chronic conditions (n = 240) was recruited. Structural validity was assessed with confirmatory factor analysis. Concurrent validity was investigated with hypotheses testing of the relationships between perceived stress, resilience and self-care. Reliability was assessed with Cronbach's alpha and McDonald's omega. Finally, a simultaneous confirmatory factor analysis was conducted to test the general model with all items and all three subscales.

Results

Confirmatory factor analysis supported the two-factor structure of the self-care maintenance and self-care management subscales and the one-factor structure of the self-care monitoring subscale. Concurrent validity was supported by the significant negative correlation (r ranged from −0.18 to −0.38, p < .01) with perceived stress and the significant positive correlation (r ranged from 0.31 to 0.47, p < .01) with resilience. Reliability estimates ranged from 0.77 to 0.82 across the three subscales. The simultaneous confirmatory factor analysis did not support the more general model with the combined set of items.

Conclusion

The SC-CII is valid and reliable for Chinese older adults with multiple chronic conditions. Future cross-cultural assessment should be conducted to investigate the measurement equivalence of the SC-CII in individuals from Western and Eastern cultural groups.

Implications for practice

With the increasing number of older adults in China who are living with multiple chronic conditions and the call for culturally tailored self-care interventions, this self-care measure can be used in geriatric primary care settings, long-term facilities and homes to improve the understanding and practice of self-care in older Chinese adults.     

Psychometric properties of the HIV-Related Fatigue Scale.

The HIV-Related Fatigue Scale (HRFS) was developed to address the specific aspects of fatigue experienced by people who are HIV-positive and are not measured in any commonly used fatigue scale. The necessity for a new scale was determined after analysis of a qualitative study to explore HIV-related fatigue in which it was found that HIV-related fatigue has components related to intensity, circumstances, and consequences that must be included in the measurement of fatigue for this population. The HRFS has 56 items, most of which are on a 1-to-10 scale, drawn from five existing fatigue scales and the data from this qualitative study. The items were deemed content valid, easy to understand, and not fatiguing to complete by people with HIV-related fatigue. Cronbach's alpha for the entire tool was .94; internal consistency for each of the three preliminary subscales is reported as well. Test-retest reliability was moderate at r = .43. Further testing needs to be done, but the HRFS has the potential to be a valuable addition to the measurement of fatigue in seropositive persons.     

Psychometric evaluation of the personal lifestyle questionnaire for adolescents.

The purpose of this study was to provide evidence of validity for the Personal Lifestyle Questionnaire (PLQ), a measure of positive health practices, in a sample of 222 adolescents ages 15-21. Using a priori criteria, it was found that a two-factor solution, resulting from a principal components analysis with an orthogonal rotation, best represented the factor structure of the PLQ for adolescents. Of the two factors, only Factor I demonstrated an acceptable coefficient alpha reliability; this factor was labeled General Health Practices. Evidence of construct validity for the total PLQ was provided by two statistically significant correlations found between the scale and the theoretically relevant variables of perceived health status and symptom patterns. Contrary to expectation, dependency was not related to positive health practices. A post hoc analysis indicated that Factor I correlated significantly with perceived health status and symptom patterns. The results support the use of Factor I, consisting of 13 items, as a measure of general health practices with adolescents.     

Psychometric properties of the Post-Fall Index

Evaluation and prevention of falls begin with a thorough understanding of their occurrence. Post-fall assessment (PFA) tools should be available to sufficiently guide nursing staff in identification of all possible causes. Absence of empirically tested PFA tools led to the development of the Post-Fall Index (PFI). Developed and validated in three phases, a 76-item PFI was first tested for content validity by national experts. Next, it was tested for feasibility with registered nurses practicing in nursing homes. Last, it was piloted with a sample of 30 falls by older residents of a skilled nursing unit in a continuing care retirement community. Review of data from these 30 falls provided the item analysis. Reflective of evidenced-based guidelines, a 30-item PFI emerged, containing essential items causing falls. Although lengthier than incident reports, its comprehensiveness was deemed of higher value. Large absolute agreement of items (70%-100%) indicates good interrater reliability. The PFI is valid, reliable, and feasible and has clinical utility for the secondary prevention of falls.     

Psychometric evaluation of the Hemodialysis Stressor Scale

This report updates the psychometric information available on the Hemodialysis Stressor Scale. The tool is a 29-item scale that rates the incidence and severity of stressors associated with hemodialysis treatment of end-stage renal disease. Six items are classified as physiologic stressors and 23 as psychosocial stressors. Alpha homogeneity coefficients achieved acceptable standards for reliability. Content validity is demonstrated by the varied sources used to ascertain pertinent items for the scale. Construct validity of the scale was investigated by factor analysis (N = 174). A two-factor solution to evaluate the validity of the physiological-psychosocial dichotomy showed insufficient support for this simplistic dichotomous classification of hemodialysis stressors. A subsequent unrestricted factor solution to explore the multidimensionality of the scale yielded eight factors, but only three were significant, so a three-factor solution was subjected to rotation. The content of the 6 physiological and 9 psychosocial items loading significantly on Factor I characterized this factor as psychobiological; Factor II consisted of 12 psychological and social stressors; Factor III pertained to 8 dependency and restriction stressors. The three-factor solution was seen as the best-fitting solution with this particular data set because it was conceptually clear, informative, and parsimonious.     

Psychometric evaluation of the Writing-To-Learn Attitude Survey

The Writing-To-Learn Attitude Survey (WTLAS) was developed to measure the effects of using writing-to-learn activities in the classroom, but adequate psychometric data have not been reported for the measure. Using the pretest scores from 149 basic and RN-to-BSN nursing students enrolled in a Nursing Management and Leadership course, the reliability and validity of the WTLAS were evaluated. The initial 30-item measure demonstrated acceptable reliability, but the item intercorrelations suggested revision of the subscales was appropriate. After exploratory factor analyses, the WTLAS was revised to 21 items and consists of two factors: Apprehensions about Writing Abilities and Perceived Benefits of Writing-To-Learn Activities. Both subscales possess acceptable internal consistency reliability and conceptually sound, significant correlations with a separate measure of writing apprehension. The revised WTLAS appears to have adequate psychometric properties for further use in the evaluation of students' perceptions of writing-to-learn activities.     

Psychometric properties of the Suicidal Behaviors Questionnaire

In order to assess the reliability and validity of Cole's (1988) four-item version of the Suicidal Behaviors Quesionnaire (SBQ), 57 clinical outpatients completed it and the Reasons for Living Inventory (RFL), and 86 undergraduates completed it and the Scale for Suicide Ideation (SSI). Two weeks later, 30 undergraduates completed the SBQ again. Cronbach alphas were moderate (clinical sample = .75; nonlinical sample = .80). Test-retest correlations were also significant (r = 95). The SBQ and SSI were significantly correlated (r =.69). The SBQ and RFL were also significantly correlated (r = -.34), although modestly. In view of its moderate to strong reliability, its construct and fact validity, its ease of administration and scoring, and its brevity, the SBQ is recommended as a brief screening instrument for suicidiality for researchers and clinicians.     

Psychometric evaluation of the Energy Conservation Strategies Survey

OBJECTIVE: To examine the internal consistency and test-retest reliability of the Energy Conservation Strategies Survey (ECSS), a tool that was specifically designed to determine if people with multiple sclerosis who attended the six-week energy conservation course actually implemented the strategies taught to them. DESIGN: The instrument ECSS was administered at six weeks and seven weeks post intervention to evaluate the test-retest reliability, while data from six weeks post intervention were utilized to assess the internal consistency of the ECSS. SETTING: Community locations in Illinois and Minnesota, USA. SUBJECTS: Data from 53 participants with multiple sclerosis living in the community were utilized for the psychometric study. MEASURES: Energy Conservation Strategies Survey. RESULTS: The internal consistency of 0.92 reveals that all the items are consistent with each other and measure a single construct. Inferential analyses using intraclass correlation coefficient indicates good test-retest reliability (intraclass correlation coefficient (ICC) = 0.79). CONCLUSION: Findings of the study suggest that the ECSS exhibits high internal consistency and good test-retest reliability. The study implies that the ECSS could be valuable in measuring changes in behaviour over time among people with multiple sclerosis after the completion of the six-week energy conservation course provided by occupational therapists.     

Psychometric evaluation of the Hendrich Fall Risk Model

AIMS: The aim of this paper is to report a psychometric evaluation of the Hendrich Fall Risk Model. BACKGROUND: Thoroughly developed and tested instruments for assessment of fall risk are needed to identify patients at risk of falling, to enable the implementation of preventative measures. METHOD: Data from 1977 patients/residents in 45 nursing homes and 7197 patients from 47 hospitals were evaluated in a cross-sectional survey. The internal consistency of the Hendrich Fall Risk Model was examined using the Kuder-Richardson Test. The dimensions of the model were revealed by exploratory factor analysis and the Care Dependency Scale was used to investigate construct validity. Using Spearman Rho the sum of weighted items was correlated with the sum of unweighted items to obtain information about the practicability of a weighted total score. The study was carried out in 2003. RESULTS: The internal consistency of the model was not high (alpha = 0.54). Additionally, factor analysis showed that the model had more than one dimension. The correlation between the fall risk model and Care Dependency Scale was quite high for hospital patients and the total group (Spearman Rho = -0.71 or -0.76 respectively, P < 0.01) and medium for nursing home residents (Spearman Rho = -0.51, P < 0.01). The total scores of the weighted and unweighted items correlated highly (Spearman Rho = 0.96, P < 0.01). CONCLUSIONS: The use of this risk model is not recommended for nursing homes. For hospitals, we advise the use of unweighted items.     

Psychometric evaluation of the Drug Avoidance Self-Efficacy Scale

Purpose: The aim of this study was to adapt the Drug Avoidance Efficacy Scale, and to assess the validity and reliability of the scale in Turkish adolescents.

Methods: This is a psychometric study. The number of students who were recruited was twenty times the number of scale items. A convenience sample of 320 undergraduate students was recruited from a university in Turkey.

Result: Principal component analysis identified one factor. The factor loadings of the items were ranged 0.41–0.91. The internal reliability coefficient was 0.70 for the scale. It was also found that the scale explained 73.1% of the total variance.

Conclusion: According to the results of this study, it may be statedthat this study provides evidence for the Drug Avoidance Self-Efficacy Scale’s validity and reliability.     

Psychometric properties of the pressure to move scale in relocated american older adults: further evaluation

The number of elders who relocate to retirement communities is increasing exponentially, and their ability to exercise free choice, personal control, and autonomy has been associated with relocation adjustment and positive outcomes in regard to physical, emotional, and social well-being. Although a measure of relocation controllability (the degree of personal control associated with the move) exists, there is limited evidence of its psychometric adequacy. This study tested the reliability and validity of the Pressure to Move Scale (PTMS). A convenience sample of 104 American elders who relocated to six Northeast Ohio retirement communities was recruited. Study participants completed the nine-item PTMS and two validation measures during structured interviews. Cronbach's alpha was .71. Homogeneity was supported by item-to-total correlations between .30 and .70, except for two items. Deletion of the item asking about the elder's first impression of relocation improved the alpha to .74. The PTMS was correlated in the expected direction with positive cognitions (r = -.37, p < .01) and relocation adjustment (r = -.62, p < .01), indicating convergent validity. Factor extraction generated three factors, the first reflecting "internal" control factors and the second reflecting "external" control factors; a third factor, containing two items with low item-to-total correlations, reflected another level of "external" control. With preliminary evidence of its reliability and validity, this scale can be a useful tool for screening for pressure to move or involuntary relocation among older adults so that negative outcomes associated with relocation can be prevented through tailored interventions.     

Psychometric properties of the California Critical Thinking Tests

The evaluation of critical thinking, as with any other measure, must employ instruments that meet appropriate psychometric standards. Therefore, the purpose of this study was to investigate the psychometric properties of the two California Critical Thinking Tests. Two samples of undergraduate students enrolled in a southern comprehensive university took the California Critical Thinking Skills Test (TST) and the California Critical Thinking Dispositions Inventory (TDI). A portion of the participants, who were nursing students, were retested on the TST and TDI two weeks after the initial testing. Some participants also completed the Watson-Glaser Critical Thinking Appraisal (WGCTA). In both samples the TST had neither sufficient psychometric properties to assess individual abilities nor sufficient stability reliability. In particular, the analysis subscale of the TST demonstrated exceptional weakness in all administrations. In contrast, the TDI demonstrated very good reliability estimates in all administrations of the test. The data did not conform to the subscale structure during factor analysis. Whereas the TST needs further refinement, the TDI demonstrated sufficient reliability for use in attitudinal research.     

Psychometric properties of the non-communicating children's pain checklist-revised

The non-communicating children's pain checklist (NCCPC) has displayed preliminary validity and reliability for measuring pain in children with severe cognitive impairments (Dev Med Child Neurol 42 (2000) 609). This study provides evidence of the psychometric properties of a revised NCCPC (NCCPC-R) with a larger cohort of children. Caregivers of 71 children with severe cognitive impairments (aged 3-18) conducted observations of their children using the NCCPC-R during a time of pain and a time without pain. Fifty-five caregivers completed a second set of observations. The score results on the NCCPC-R were: internally consistent, significantly related to pain intensity ratings provided by caregivers, consistent over time, sensitive to pain, and specific to pain. Analyses of children's individual scores indicated up to 95% of their scores were consistent. Receiver operating characteristic curves suggest a score of 7 or greater on the NCCPC-R as indicative of pain in children with cognitive impairments, with 84% sensitivity and up to 77% specificity. These results provide evidence of NCCPC-R having excellent psychometric properties.     

Psychometric properties of the Swedish Diabetes Empowerment Scale

OBJECTIVE: This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe-DES-23). RESEARCH DESIGN AND METHODS: A convenience sample of 195 patients with type 1 and type 2 diabetes completed the Swe-DES-23 questionnaire. To establish discriminant validity, Swe-DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, inter-item correlations were calculated. Internal consistency was tested by the use of the Crohnbach-alpha coefficient. RESULTS: The factor analysis resulted in four factors (empowerment subscales) with eigenvalues >1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self-awareness, stress management and readiness to change showed Crohnbach-alpha values ranging from 0.68 to 0.91. Patients with good self-reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales. CONCLUSIONS: The SWE-DES-23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment-based education programmes. Further testing is needed to shorten the questionnaire.     

Psychometric properties of an International Classification of Functioning, Disability and Health (ICF)-oriented, adaptive questionnaire for the assessment of mobility, self-care and domestic life.

OBJECTIVE: Development of an adaptive, International Classification of Functioning, Disability and Health (ICF)-oriented patient questionnaire on mobility and self-care based on an item response theory model (MOSES questionnaire). METHODS: Using item reconstruction rules, items were developed for the ICF chapters "mobility", "self-care" and "domestic life". The resulting instrument, together with other instruments (SF-36, Short Musculoskeletal Function Assessment Questionnaire (SMFA), MacNew, Functional Independence Measure (FIM), Barthel) was presented to 549 patients with musculoskeletal disease, 212 patients with cardiac disease and 258 neurological rehabilitation patients in rehabilitation clinics in Germany. RESULTS: The MOSES questionnaire includes 58 items on 12 scales and fulfills the requirements of the 1-parameter item response theory model (Rasch model). The results indicate good reliability and high construct validity and sensitivity to change of the instrument. In the construction and selection of items, ICF contents that include complex processes of evaluation, and which presuppose skills that are not acquired prior to the individual learning process, were omitted due to a lack of unidimensionality. CONCLUSION: The successful implementation of the concept of applying rules to ICF categories in formulating the items of a patient questionnaire showed that the goal of a theory-driven measurement of activities using the ICF is feasible. The results of the project also raise questions as to the homogeneity of the contents of some ICF categories.