The De-Escalating Aggressive Behaviour Scale: development and psychometric testing

Title.  The De-Escalating Aggressive Behaviour Scale: development and psychometric testing.
Aim.  This paper is a report of a study to develop and test the psychometric properties of a scale measuring nursing students' performance in de-escalation of aggressive behaviour.
Background.  Successful training should lead not merely to more knowledge and amended attitudes but also to improved performance. However, the quality of de-escalation performance is difficult to assess.
Method.  Based on a qualitative investigation, seven topics pertaining to de-escalating behaviour were identified and the wording of items tested. The properties of the items and the scale were investigated quantitatively. A total of 1748 performance evaluations by students (rater group 1) from a skills laboratory were used to check distribution and conduct a factor analysis. Likewise, 456 completed evaluations by de-escalation experts (rater group 2) of videotaped performances at pre- and posttest were used to investigate internal consistency, interrater reliability, test–retest reliability, effect size and factor structure. Data were collected in 2007–2008 in German.
Findings.  Factor analysis showed a unidimensional 7-item scale with factor loadings ranging from 0·55 to 0·81 (rater group 1) and 0·48 to 0·88 (rater group 2). Cronbach's alphas of 0·87 and 0·88 indicated good internal consistency irrespective of rater group. A Pearson's r of 0·80 confirmed acceptable test–retest reliability, and interrater reliability Intraclass Correlation 3 ranging from 0·77 to 0·93 also showed acceptable results. The effect size r of 0·53 plus Cohen's d of 1·25 indicates the capacity of the scale to detect changes in performance.
Conclusion.  Further research is needed to test the English version of the scale and its validity.     

Chinese Breast Cancer Screening Beliefs Questionnaire: development and psychometric testing with Chinese-Australian women

Title.  Chinese Breast Cancer Screening Beliefs Questionnaire: development andpsychometric testing with Chinese-Australian women.
Aim.  This paper is a report of the development and psychometric testing of the Chinese Breast Cancer Screening Beliefs Questionnaire, a culturally sensitive questionnaire for measuring Chinese-Australian women's beliefs, knowledge and attitudes towards breast cancer and breast screening practices.
Background.  Breast cancer is the leading cause of cancer morbidity among Chinese-Australian women. They are, however, 50% less likely to participate in all types of breast examination. A valid and reliable instrument to explore the breast cancer beliefs is essential for the development of interventions to promote breast cancer screening practices.
Method.  Items for the questionnaire were drawn from a literature review and in-depth interviews. A panel of professional experts and lay women evaluated face and content validity. The instrument was translated from English to Chinese using back-translation. In 2008, a total of 292 Chinese-Australian women aged 22–78 years who were resident of Australia were included in testing the instrument. Multi-trait analysis and Cronbach's alpha were used to assess internal consistency reliability and exploratory factor analysis assessed construct validity.
Results.  The final 13-item questionnaire had satisfactory validity and internal consistency. Cronbach's alpha for the total scale was 0·76, and for the three subscales ranged from 0·70 to 0·79. Exploratory factor analysis showed that the scale reduced to three factors.
Conclusion.  Preliminary data suggest that the Chinese Breast Cancer Screening Beliefs Questionnaire is a valid, reliable and culturally sensitive instrument for the measurement of Chinese-Australian women's beliefs, knowledge and attitudes about breast cancer and breast cancer screening.     

Reliability and validity of the caregiver quality of life index‐cancer (CQOLC) scale in Turkish cancer caregivers

Aims and objectives. The aim of this study was to translate the Caregiver Quality of Life Index‐Cancer into Turkish and test the reliability and validity of the Turkish version of the Caregiver Quality of Life Index‐Cancer in Turkey. Background. Cancer is a chronic illness that affects the entire family and deteriorates the quality of life of cancer caregivers. The Caregiver Quality of Life Index‐Cancer is a widely used instrument to measure quality of life in cancer caregivers. Therefore, identifying and increasing quality of life benefits of cancer caregivers. Design. Methodological research design. Method. This study describes the translation process of The Caregiver Quality of Life Index‐Cancer into Turkish and testing its reliability and validity on quality of life in cancer caregivers. The questionnaire was translated using a back‐translation technique. The statistical analysis was carried out using Cronbach’s alpha to test the internal consistency of the Caregiver Quality of Life Index‐Cancer scale while confirmatory and exploratory factor analyses were carried out using principal component analysis with varimax rotation and Kaiser Normalization to test its construct validity. Results. The Cronbach’s alpha was found to be reliability for the total scale was 0·88 and subscale alpha coefficients ranged from 0·73–0·83. Confirmatory factor analysis resulted in four factor structure: burden, distruptiveness, positive adaptation and financial concerns. Conclusion. The effects of providing care for patients with cancer on caregiver quality of life have not yet been adequately explored in Turkey. The results of this study suggest that the Turkish version of the Caregiver Quality of Life Index‐Cancer is a reliable and valid supplementary measure of the quality of life in cancer caregivers in Turkey. Relevance of clinical practice. In research and practice, valid measurement instruments are needed to assess Quality of Life in Turkish cancer caregivers. The Caregiver Quality of Life Index‐Cancer scale is simple to administer and nurses by using this equipment in routine appointments will be able to better identify caregiver at risk for developing cancer related distress and worse Quality of Life.     

The Management of Aggression and Violence Attitude Scale (MAVAS): a cross-national comparative study

Title.  The Management of Aggression and Violence Attitude Scale (MAVAS): a cross-national comparative study.
Aim.  This paper is a report of a study to determine the transferability of the Management of Aggression and Violence Attitude Scale to European mental health inpatient settings.
Background.  Incidents of patient aggression and violence are common in psychiatric in-patient facilities, and nurses' attitudes may play a part in how they are managed.
Methods.  Nursing staff from acute psychiatric in-patient units in Switzerland and the United Kingdom completed the Management of Aggression and Violence Attitude Scale. Data were collected in the UK in 2001 and Switzerland in 2003. The Swiss sample comprised 75 respondents: 45 female, mean age 36·24, mean experience 7·35 years, 60 Registered Nurses. The United Kingdom sample was 75 respondents: 58 female, mean age 32, mean experience 5·25 years, 48 Registered Nurses. T -tests identified differences between the groups in their responses to each Management of Aggression and Violence Attitude Scale statement.
Results.  There was 66% concordance of views between the groups. Swiss nurses were, however, more likely to regard factors internal to the patient as contributory to aggression while United Kingdom nurses perceived environmental factors to be more important. Both groups endorsed physical means of aggression management, Swiss nurses more so.
Conclusion.  There are both commonalities and differences between the attitudes of Swiss and United Kingdom nursing staff regarding patient aggression. Differences may relate to rates of aggression, variations in management approaches, training and policy. The Management of Aggression and Violence Attitude Scale is a potentially effective tool for making comparisons about perspectives on patient aggression.     

Reynolds Adolescent Depression Scale – Second Edition: initial validation of the Korean version

Title.  Reynolds Adolescent Depression Scale – Second Edition: initial validation of the Korean version.
Aim.  This paper is a report of a study conducted to test the validity and reliability of the Reynolds Adolescent Depression Scale – Second Edition in Korean culture.
Background.  Depression is a significant mental health problem in adolescents. The Reynolds Adolescent Depression Scale – Second Edition has been shown to be a useful tool to assess depression in adolescents, with extensive research on this measure having been conducted in western cultures. Measures developed in western cultures need to be tested and validated before being used in Asian cultures.
Method.  The participants were a convenience sample of 440 Korean adolescents with a mean age of 13·78 years ( sd  = 0·95) from grades 7 to 9 in three public middle schools in South Korea. A cross-sectional design was used. Back-translation was used to create the Korean version, with additional testing for cultural meaning and comprehension. The data were collected at the end of 2004.
Results.  Internal consistency reliability for the Korean version of the Reynolds Adolescent Depression Scale – Second Edition was 0·89, with subscale reliability ranging from 0·66 to 0·81. Evidence for criterion-related, convergent and discriminant validity for the Korean version of the Reynolds Adolescent Depression Scale – Second Edition was found. Confirmatory factor analysis supported the 4-factor structure of Reynolds Adolescent Depression Scale – Second Edition.
Conclusion.  Our results support the validity and reliability for the Korean version of the Reynolds Adolescent Depression Scale – Second Edition as a measure of depression and suggest that it can be used to screen students and to evaluate the effectiveness of preventive interventions in school settings.     

Wisdom as the mediator in the relationships between religious meaning system and attitude toward death among older adults

Abstract

The objective of the present research was to investigate whether wisdom is a mediator in the association between the religious meaning system and the attitude toward death in the period of late adulthood. The study included 315 persons aged 60–75. Three measures were used: Religious Meaning System Scale (RMSS), Three-Dimensional Wisdom Scale (3D-WS), Death Attitude Profile-Revised (DAP-R). The analyses allowed for a partial verification of the hypothesis that wisdom is a mediator in the relationship between the explicit religious meaning system and the multidimensional attitude toward death in late adulthood. It was confirmed that the relationship of the religious meaning system with fear of death, death avoidance, neutral acceptance, escape acceptance and approach acceptance is mediated by at least one (cognitive, reflective and/or affective) of the dimensions considered in the study.     

Factors associated with lower quality of life among patients receiving palliative care

Title.  Factors associated with lower quality of life among patients receiving palliative care.
Aim.  This paper is a report of a study conducted to (1) assess the quality of life (QoL) and physical functioning status of patients diagnosed with advanced cancer and receiving palliative care; (2) determine if there was a statistically significant relationship between their physical functioning and QoL and (3) identify the demographic and disease-related variables related to their QoL.
Background.  Achieving the best possible QoL is a major goal in palliative care. However, research findings about the relationship between QoL and demographic variables have been inconsistent.
Method.  Three hundred patients with advanced cancer were recruited from four district hospitals in Hong Kong between February 2005 and July 2006. Their QoL and physical functioning status were assessed by face-to-face interview, using the McGill Quality of Life Questionnaire (Hong Kong version) and the Palliative Performance Scale respectively.
Results.  Participants reported reduced ambulation, inability to perform hobbies or housework, and the need for occasional assistance in self-care (mean: 64·6 out of 100, sd : 19·3, range: 20–100). QoL was fair (mean: 6·2 out of 10, sd : 1·5, range: 0·9–10). There was a weak positive association between physical functioning and QoL scores. Multiple regression analysis showed that patients who were older, female, had ever been married, or had higher physical functioning tended to have better QoL.
Conclusion.  More could be done in symptom and psychosocial management to improve patients' QoL, in particular for those who are younger, male or single, or who have lower physical functioning.     

The construction and evaluation of the reliability and validity of a life attitude scale for elderly with chronic disease

The elderly with chronic diseases face numerous impacts which influence their life attitudes. The purpose of this study was to construct, and evaluate the reliability and validity of a life attitude scale for elderly with chronic disease. Initially, the 27 items of the Life Attitude Scale were constructed by in depth interview of 48 elderly with chronic diseases. Then, the construct validity was established by factor analysis with 663 samples. Six factors: Congeniality of Family Life, Life Meaning, Dignity of Life, Struggle with Adversities, Hollow Existence, and Destiny to Life, which included 20 items, explained 59.7% of total variances. Content validity was found to be well established by 6 experts. Correlation of inter-rater reliability among 6 data collectors was 0.96. Cronbach's alpha of internal consistency was above 0.89 for 148 samples. Correlation of test-retest reliability was above 0.87 for 37 samples with 2-week interval. This study presents what the Taiwan elderly with chronic diseases are undergoing and their views on life and its value. There are highly culture-based and philosophy-based knowing about life attitude of elderly with chronic disease in Taiwan, and it is imperative to inspire nurses to promote the quality of spiritual care for elderly with chronic disease.     

The Danish version of the Medication Adherence Report Scale: Preliminary Validation in Cancer Pain Patients

Objective:   To examine the psychometric properties of the Danish version of the Medication Adherence Report Scale (DMARS-4) adapted to measure adherence to analgesic regimen among cancer patients.
Methods:   The validated English version of the Medication Adherence Report Scale was translated into Danish following the repeated back-translation procedure. Cancer patients for the study were recruited from specialized pain management facilities. Thirty-three patients responded to the DMARS-4, the Danish Barriers Questionnaire II, The Danish version of Patient Perceived Involvement in Care Scale measuring the quality of patient-physician pain communication, and the Danish Brief Pain Inventory pain severity scale.
Results:   A factor analysis of the DMARS-4 resulted in one factor. Mean (SD) score on the cumulative scale ranging from 4 to 20, with higher scores indicating better medication adherence, was 17.8 (0.42). The DMARS-4 scores were related to the measures of patients' concerns about pain management and patients' pain communication. The internal consistency of the DMARS-4 was 0.70.
Conclusions:   The DMARS-4 seems to be a valid and reliable measure of self-reported adherence to analgesic regimen in the context of cancer pain.     

The Danish Barriers Questionnaire-II: Preliminary Validation in Cancer Pain Patients

Objective:   The objective of this study was to examine the psychometric properties of the Danish version of the Barriers Questionnaire-II (DBQ-II).
Methods:   The validated Norwegian version of the DBQ-II was translated into Danish. Cancer patients for the study were recruited from specialized pain management facilities. Thirty-three patients responded to the DBQ-II, Hospital Anxiety and Depression Scale, and Brief Pain Inventory pain severity scale.
Results:   A factor analysis of the DBQ-II resulted in six scales. Scale one, Fatalism, consisted of three items addressing fatalistic beliefs regarding cancer pain management. Scale two, Immune System, consisted of three items addressing the belief that pain medications harm the immune system. Scale three, Monitor, consisted of three items addressing the fear that pain medicine masks changes in one's body. Scale four, Communication, consisted of five items addressing the concern that reports of pain distract the physician from treating the cancer, and the belief that "good" patients do not complain. Scale five, Addiction, consisted of two items addressing the fear of becoming addicted to pain medication. Finally, scale six, Tolerance, consisted of three items addressing the fear of getting tolerant to analgesic effect of pain medicine. Items related to medication side effects were analyzed as separate units. The DBQ-II total had an internal consistency of 0.87. The DBQ-II total score was related to measures of pain relief and anxiety.
Conclusions:   The DBQ-II seems to be a reliable and valid measure of the barriers to pain management among Danish cancer patients.     

TEMPtEd: development and psychometric properties of a tool to evaluate material used in patient education

Title.  TEMPtEd: development and psychometric properties of a tool to evaluate material used in patient education.
Aim.  This paper describes the development and psychometric properties of a Tool to Evaluate Materials Used in Patient Education (TEMPtEd), which was designed to assist healthcare professionals to evaluate and select printed patient educational materials for their clients.
Background.  Previously-developed instruments include attribute checklists, readability formulae and rating scales, but they have not been shown to be valid or reliable. The TEMPtEd is an attempt to overcome the limitations of previously developed instruments.
Method. The instrument was developed using Strickland's framework, with pilot testing conducted from 2004 to 2007.
Results.  The overall ratings of a heart failure educational brochure between the TEMPtEd and the Suitability Assessment of Materials, a previously developed instrument, were not statistically significantly different. Statistically significant correlations were noted between the two instruments in the overall scale and four of the five subscales. The internal consistency of the TEMPtEd was 0·68; however, a reduction in the number of rating scale options resulted in an internal consistency of 0·83–0·84. Exploratory factor analysis identified a six-factor solution and accounted for 74% of the variance. Study participants preferred the TEMPtEd.
Conclusion.  As a result of psychometric testing, the TEMPtEd appears to be a promising instrument for the evaluation of patient educational material.     

Quality of life instruments for caregivers of patients with cancer: a review of their psychometric properties

The quality of life of caregivers of patients with cancer is an important construct given the substantial impact of caring on the physical, psychological, social, and financial well-being of caregivers. Moreover, caring for patients with cancer also affects family functioning and places burdens on caregivers. The reliability and validity of instruments used to assess the quality of life of caregivers of patients with cancer were reviewed to aid in the selection of the most appropriate measures for research and practice. (1980-2000) and (1982-2000) searches located relevant quality of life instruments using the keywords "cancer and quality of life" and "caregiver or spouse or partner." The search identified the following instruments: the Caregiver Quality of Life Index-Cancer Scale, the Caregiver Quality of Life Index, the Quality of Life Tool, and the Quality of Life Index-Cancer Version. Quality of life instruments developed specifically to measure the quality of life of caregivers of patients with cancer had the best psychometric properties. The Caregiver Quality of Life Index-Cancer Scale, in particular, met or exceeded minimum psychometric criteria for reliability and validity. The development of reliable and valid caregiver quality of life measures is an important factor in developing interventions to enhance quality of life of caregivers of patients with cancer.     

Validation and test–retest reliability of the Risser patient satisfaction scale in Cyprus

charalambous a. (2010) Journal of Nursing Management   18 ,61–69
Validation and test–retest reliability of the Risser patient satisfaction scale in Cyprus
Aim  To describe the translation, adaptation and validation of the Risser Patient Satisfaction Scale (RPSS) questionnaire into Greek language and discuss possibilities of its use in cancer care settings.
Background  The translation and cultural adaptation of a widely accepted, psychometrically tested tool is regarded as an essential component of effective human resource management or quality monitoring and improvement in the healthcare arena.
Methods  The original version of the English self-administered questionnaire consisting of 25 items was translated and validated using the internationally accepted and recommended methodology. The validation process included: assessment of the item internal consistency, using the alpha coefficient of Cronbach. Reproducibility (test–retest reliability) was tested by the Kappa correlation coefficient.
Results  The psychometric properties of the Greek version of the PSS were good. The internal consistency of the instrument was very good, Cronbach's alpha was found to be 0.89 ( P  < 0.001) and Kappa coefficient for reproducibility was found to be 0.84 (95% CI: 0.83–0.85, P  < 0.0001).
Conclusions  The translated and adapted Greek version is comparable with the original instrument in terms of validity and reliability.
Implications for nursing management  Managers should use validated patient satisfaction scales such as the RPSS in order to evaluate the quality of care in cancer care departments. The findings should be also compared using a bench mark on national and international levels.     

Validation evidence for the French Canadian adaptation of the Multidimensional Fatigue Inventory as a measure of cancer-related fatigue

Cancer-related fatigue is the most reported symptom among patients with cancer. Researchers in the field of psychooncology have encouraged the development of short instruments, which allow for easier completion by clinical populations while still maintaining solid psychometric properties. The current study examined the validity and reliability of the French Canadian adaptation of the Multidimensional Fatigue Inventory (MFI) among women (n = 277) and men (n = 327) undergoing therapy for breast or prostate cancer, respectively. An exploratory factor analysis of the selected 15-item MFI yielded the following four factors: general/physical, mental, reduced motivation, and reduced activity. This was supported by a confirmatory factor analysis. The reliability, as evaluated by test-retest and Cronbach alpha internal consistency reliability coefficients of the French Canadian shortened MFI, was acceptable. In addition, the four factor-based scores correlated in a theoretically meaningful manner with existing measures of mood disturbance (Profile of Mood States and Hospital Anxiety and Depression Scale), cancer-related stressors (Inventory of Recent Life Experiences), coping with illness (Coping with Health Injuries and Problems Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire), and insomnia (Insomnia Severity Index), suggesting good construct, convergent, and concurrent criterion validity. Although further validation is recommended, the results for the French Canadian MFI in assessing cancer-related fatigue in both women and men undergoing cancer treatments showed good psychometric qualities.     

Jordanian nurses' knowledge and practice of breast self-examination

Title.  Jordanian nurses' knowledge and practice of breast self-examination.
Aim.  This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self-examination.
Background.  Studies have shown that women who have learned about breast self-examination have positive attitudes toward breast cancer and practise breast self-examination more frequently, and that nurses who teach their clients about methods of early detection and breast self-examination are more knowledgeable about breast cancer screening and breast self-examination techniques than those who do not. Therefore, it is important to understand nurses' knowledge about breast cancer and its early detection.
Methods.  A cross-sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self-administrated questionnaire with three parts and based on the American Cancer Society's guidelines: demographics, knowledge, and practice of breast self-examination.
Results.  Nurses reported high levels of knowledge of breast self-examination (M = 7·6, sd . 2·7). A high proportion of nurses reported doing breast self-examination in the past 12 months (85%), but only 17·7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self-examination.
Conclusion.  More health education about monthly breast self-examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women.