The Loss Inventory: preliminary reliability and validity data for a new measure of emotional and cognitive responses to disability

Purpose:?To examine the utility, reliability and validity of a new scale, The Loss Inventory (LI) for measuring symptoms unique to grief following disablement.

Methods:?Prospective survey study in which two self-report measures, the LI and Zung Self-Rating Depression Scale, were administered to 103 hospitalized rehabilitation patients. Correlational analyses, t tests, t score conversions of raw data, and analysis of variance used to determine reliability (internal consistency) of the LI and compare means of scores across several variables.

Results:?Cronbach's Alpha?=?0.90 for the LI. The Zung and the LI correlated 0.59 but study subjects were significantly (p?<?0.001) more likely to score higher on the LI than on the Zung. Certain LI items were significantly more frequently endorsed by depressed patients. Significant gender and ethnic differences were found.

Conclusions:?Rehabilitation patients sampled in this study were no more likely to be depressed than most people. Grief symptoms reported following functional losses are similar to those reported by persons who have experienced the death of someone close. The Loss Inventory reliably measures these grief symptoms. Gender and ethnicity affect the manner in which grief symptoms are reported. The LI may improve mental health clinicians' diagnostic accuracy in rehabilitation and medical settings.     

The Children's Cognitive Triad Inventory: reliability, validity, and congruence with Beck's cognitive triad theory of depression

Depression, once thought rare in children, is now more widely recognized and believed to arise from negative views of self, world, and future, according to Beck's cognitive theory of depression. The Cognitive Triad Inventory for children measures the three negative views, and although reported as psychometrically adequate, this study extended previous analyses with confirmatory factor analysis in a sample of 122 school-aged children. Internal consistency was .82 (total scale) but ranged from .54 to .76 for subscales reflecting the views of self, world, and future. Confirmatory factor analysis revealed factors reflecting three aspects of the self rather than the three negative views. The findings suggest that Beck's theory about the negative cognitive triad may be less suitable for children than adults.     

A spiritually-based measure of holistic health for those with disabilities: Development,preliminary reliability and validity assessment

Purpose. To develop and test a spiritually-based measure of holistic health for those with chronic physical conditions.

Method. Two studies are reported. Study One used 69 ex-patients with chronic physical conditions to develop a spiritually-based holistic measure of health. An open-ended questionnaire, the Participant Health Questionnaire used the echo technique to obtain statements about the nature of health. These were assembled to form the Rating of Health Statements Questionnaire, which was completed by 59 participants. Reliability and validity analysis yielded a 38-item Health Attitude Scale, the HAS:1, to which the responses of 48 participants produced the 40-item HAS:2, which included an Intent subscale. Wording the HAS:2 in the past tense then created a behavioural measure, the QE Health Scale (QEHS). Study Two used 233 participants from the same population with chronic conditions to assess the reliability of the HAS:2 and QEHS, and their validity against the STAI and the SOC-13.

Results. The QEHS proved reliable (Cronbach's alpha = 0.92) and valid in that it correlated with the SOC-13 (r = 0.32, p < 0.01), the STAI (State) (r = 0. – 39, p < 0.01), the STAI (Trait) (r = 0.35, p < 0.01), the HAS:2 (Importance) (r = 0.61, p < 0.01) and the HAS:2 (Intent) (r = 0.61, p < 0.01).

Conclusion. The QEHS possessed sufficient reliability and validity as a spiritually-based holistic measure of health to warrant further investigation.     

A spiritually-based measure of holistic health for those with disabilities: development, preliminary reliability and validity assessment

PURPOSE: To develop and test a spiritually-based measure of holistic health for those with chronic physical conditions. METHOD: Two studies are reported. Study One used 69 ex-patients with chronic physical conditions to develop a spiritually-based holistic measure of health. An open-ended questionnaire, the Participant Health Questionnaire used the echo technique to obtain statements about the nature of health. These were assembled to form the Rating of Health Statements Questionnaire, which was completed by 59 participants. Reliability and validity analysis yielded a 38-item Health Attitude Scale, the HAS:1, to which the responses of 48 participants produced the 40-item HAS:2, which included an Intent subscale. Wording the HAS:2 in the past tense then created a behavioural measure, the QE Health Scale (QEHS). Study Two used 233 participants from the same population with chronic conditions to assess the reliability of the HAS:2 and QEHS, and their validity against the STAI and the SOC-13. RESULTS: The QEHS proved reliable (Cronbach's alpha = 0.92) and valid in that it correlated with the SOC-13 (r = 0.32, p < 0.01), the STAI (State) (r = 0. - 39, p < 0.01), the STAI (Trait) (r = 0.35, p < 0.01), the HAS:2 (Importance) (r = 0.61, p < 0.01) and the HAS:2 (Intent) (r = 0.61, p < 0.01). CONCLUSION: The QEHS possessed sufficient reliability and validity as a spiritually-based holistic measure of health to warrant further investigation.     

The neck pain and disability scale: test-retest reliability and construct validity

OBJECTIVE: This research established test-retest reliability and construct validity for the Neck Pain and Disability Scale (NPAD). METHODS: Two groups of patients with neck pain completed the NPAD. The first group filled out the scale twice before treatment, whereas the second completed it with a number of other outcome measures once a month for 4 months, for evaluation of treatment with injections. RESULTS: The reliability coefficient (r2 = 0.93) calculated from the data for the first group of patients indicated high test-retest reliability. Construct validity was demonstrated with the second group when the NPAD was compared with a number of other pain measures and found to have a larger treatment effect. The Neck Pain and Disability Scale factor scores also indicated that treatment effects varied across the four factors. CONCLUSIONS: The NPAD is a stable and responsive measure for patients with neck pain. The Neck Pain and Disability Scale factor scores are useful in identifying treatment effects on the specific dimensions involved in the pain experience.     

中文版造口患者适应量表的信效度测评

目的研究中文版造口患者适应量表(Ostomy Adjustment Inventory,OAI)的信效度。方法 应用英文版OAI-23,经过翻译、回译和文化调适后,对176例造口患者进行问卷调查,评定该工具的信、效度。结果中文版OAI共20个条目,其Cron-bach'sα系数在0.704～0.855,整个量表的Cronbach'sα系数为0.886,Guttman折半系数为0.888,共析出3个公因子,分别是持续担忧、接受和积极的生活态度,2周重测信度分别是0.836,0.764,0.807。累积方差贡献率为52.72%。结论中文版的OAI具有较好的信、效度,适合中国文化背景下造口患者适应水平的测量。     

Unique aspects of women's emotional responses to disability

Purpose. To improve rehabilitation clinicians' awareness of gender differences in emotional responses to disability as a means of enhancing accuracy and sensitivity in diagnosis and treatment of persons in their care.

Method. A prospective survey study using a new grief measure, the Loss Inventory (LI), with a diverse convenience sample of persons undergoing inpatient rehabilitation in the USA. Focused review of the bereavement, depression, and disability literatures related to observed gender differences.

Results. Study participants reported grief symptoms in varying intensities. Consistent with all literature reviewed, significant gender differences were found in kind and intensity of grief and depression symptoms reported. Ethnicity also significantly affected responses to disability by LI study participant responses.

Conclusions. While persons with disabilities as a whole may not necessarily develop depression, gender is a risk factor for onset of mood problems after illness or injury-related losses. As compared with study sample disabled men, disabled women reported more intense and different symptoms of grief and depression. Women with disabilities in the LI sample were twice as likely as disabled men to be depressed. Rehabilitation clinicians may wish to incorporate consideration of these differences in their mental health assessments, diagnoses, and treatment plans.     

Joint position sense in elderly fallers: a preliminary investigation of the validity and reliability of the SENSERite measure

OBJECTIVES: To establish the validity and reliability of the SENSERite system and to determine and compare proprioceptive acuity thresholds (PATs) among 3 groups. DESIGN: Between groups, repeated measures, with randomized sequence. SETTING: University research laboratory. PARTICIPANTS: Forty-six adults recruited into 1 of 3 groups: group 1, 10 healthy young adults (mean age, 22.20y); group 2, 22 healthy older adults (mean age, 73.12y); and group 3, 14 older adults with a history of falls (mean age, 73.21y). INTERVENTIONS: The validity of SENSERite's joint position measure was determined by comparing the system's performance with a validated goniometer measure. The test-retest reliability was determined by repeatedly measuring the established joint positions for the neutral, inversion, eversion, plantarflexion, and dorsiflexion on 2 separate occasions, approximately 24 hours apart. In addition, PATs were measured to determine group differences. Data were analyzed by means of a univariate analysis of variance (ANOVA), intraclass correlation coefficient (ICC(2,k)), and paired t tests. MAIN OUTCOME MEASURES: Error in active reproduction of position and PAT derived from the 5 respective joint position sense tests. RESULTS: Excellent clinical goniometer and SENSERite correlation (ICC(2,k)=1.0, P<.05) was found. The test-retest reliability for the 5 respective position sense tests were excellent (ICC(2,k) range, .88-.99; P<.05). ANOVA revealed a significant difference in PATs among the 3 groups. Post hoc analysis indicated that PAT was greater in groups 2 and 3 than in group 1. No significant difference in PAT was observed between groups 2 and 3. CONCLUSIONS: The ability of the SENSERite to measure joint angular position was as good as that of a clinical goniometer; it had an adequate reliability when tested on 2 separate occasions. The device detected differences between elderly and young subjects, but it did not discriminate differences between fallers and nonfallers. This finding indicates that there is no significant difference between the fallers and nonfallers in proprioceptive acuity.     

Questionnaire for Persons with a Transfemoral Amputation (Q-TFA): initial validity and reliability of a new outcome measure

The Questionnaire for Persons with a Transfemoral Amputation (Q-TFA) is a new self-report measure developed for nonelderly transfemoral amputees using a socket- or osseointegrated prosthesis to reflect use, mobility, problems, and global health, each in a separate score (0-100). This paper describes the initial measurement properties of the Q-TFA as completed by 156 persons with a transfemoral amputation using a socket prosthesis (67% male, 92% nonvascular cases, mean age 51 years). Criterion validity was determined by associations between scores of the Q-TFA and the Short-Form 36 (SF-36)-Item Health Survey. Reliability was assessed by retest (n = 48) and by determination of the internal consistency. Correlations between Q-TFA and SF-36-Item Health Survey scales matched hypothesized patterns. Intraclass correlations were between 0.89 and 0.97, and measurement error ranged from 10 to 19 points. Cronbach's alpha revealed good internal consistency, with no values less than 0.7. This study shows that the Q-TFA, applied to persons using a transfemoral socket prosthesis, has adequate initial validity and reliability.     

The validity and intra-tester reliability of a clinical measure of humeral head position

The purpose of this study was to determine the degree of criterion validity and intra-tester reliability of humeral head palpation in subjects with shoulder pathology. The study also sought to determine whether there was any effect of arm position on humeral head position in subjects with shoulder pathology. In a same day repeated measures design, 27 subjects had the distance between the most anterior portion of the humeral head and the anterior edge of the acromion measured by a radiologist using MRI (supine), and by a physiotherapist using palpation and photography (supine, sit with arm in neutral and in abduction). The Standard Error of Measurement (SEM) for the difference between MRI and palpation ranged from 3.4 to 4.4mm and correlated significantly with palpation measures in sit (r=0.57-0.64, p相似文献   

埃森创伤问卷中文版的信度和效度研究

目的对埃森大学医院心身科编制的埃森创伤问卷（ETI）进行初步的修订和信度效度检验。 方法收集1120名受试者,分为心理患者组、躯体患者组、地震受灾组以及健康对照组,分别使用ETI进行测试,分析ETI中文版的信度、结构效度及效标效度。 结果ETI共23个项目的总体信度克隆巴赫系数为0.94,各维度的相关性系数为0.69~0.80,提示有较好的内部一致性。因子分析得到3个因子结构（包括闯入、回避、分离）;效标关联效度理想。 结论修订的ETI具有较高的信度和效度。     

The validity and reliability of the GAITRite system's measurements: A preliminary evaluation

OBJECTIVE: To compare the concurrent validity and reliability of the GAITRite computerized gait analysis system with validated paper-and-pencil and video-based methods. DESIGN: Within-groups, repeated-measures design. SETTING: Research laboratory in a physical therapy education program. PARTICIPANT: One healthy woman, age 27 years. INTERVENTIONS: A subject walked across the walkway of the GAITRite system at various walking rates and degrees of step symmetry for 2 of the 3 analyses. Paper placed over the walkway enabled concurrent paper-and-pencil analysis. The subject was concurrently videotaped from the side. For the other analysis, a stride simulator with known step and stride lengths was applied to the walkway to simulate 2 steps and 1 stride. MAIN OUTCOME MEASURES: Cadence, walking speed, right and left step and stride lengths, and right and left step times. RESULTS: Excellent paper-and-pencil and GAITRite correlations (intraclass correlation coefficient [ICC] > 95) for spatial measures and excellent video-based and GAITRite correlations (ICC > 93) for temporal measures were found. GAITRite measures of step lengths and times were reliable in both walkway center and left-of-center measurements. CONCLUSIONS: Based on this data, GAITRite is a valid and reliable tool for measuring selected spatial and temporal parameters of gait.     

Assessing data adequacy for clinical research: reliability and validity of a surgical database

As clinical databases are utilized more frequently for clinical research, it is essential that researchers assess the quality of databased information. While researchers have begun to report strategies to measure accuracy of databased information, knowledge remains limited. The purpose of this study was to assess the reliability and validity of databased information among selected study variables contained within a computerized coronary artery surgery clinical database using the written patient medical record as an external standard. Both reliability (N = 400) and validity (N = 100) samples were randomly selected from a databased sampling frame of 548 Medicare subjects who underwent coronary artery bypass grafting surgery in 1998. Reliability assessed by consistency rates were age (95%), race (94%), gender (99%), congestive heart failure (CHF) (60.5%), angina (91.5%), renal insufficiency (82%), hypertension (91.7%), diabetes mellitus (93.7%), chronic obstructive pulmonary disease (COPD) (75.5%), clinical status (97%), American Society of Anesthesiologists classification (99%), prior peripheral vascular surgery (15.5%), prior CABGS (99%), and duration of mechanical ventilation (87.5%). These percentages reflected a large portion of missing data for CHF, COPD, and prior peripheral vascular surgery. Validity assessed by sensitivity and specificity analyses were all greater than 80%. The majority of computerized databased information among selected study variables was the same information recorded in the written patient medical record. Using the same external standard to assess both reliability and validity was a significant limitation of this study, which resulted in the same measure of data adequacy by utilizing differing statistical methods.     

The capabilities of upper extremity instrument: reliability and validity of a measure of functional limitation in tetraplegia

Objective: To evaluate the reliability and validity of the Capabilities of Upper Extremity (CUE) instrument, designed to measure upper extremity functional limitations in individuals with tetraplegia. Functional limitations are actions such as reaching or grasping and are a link between the domains of impairment and disability.Design: Survey of people with chronic spinal cord injury.Setting: Regional spinal cord injury center.Subjects: One hundred fifty-four individuals (140 male) with tetraplegia at least 1 year after injury and followed by the center. Mean age was 36.7 years (SD = 11.1). Sixty-eight percent were motor complete.Methods: The 32-item CUE was administered by telephone interview twice about 2 weeks apart. The motor portion of the Functional Independence Measure (FIM^sm) was collected during the first interview. Upper extremity motor scores and motor levels were obtained from the most recent assessment in the outpatient chart. The instrument was evaluated for internal consistency, reliability, and validity. Exploratory factor analysis was performed to examine scale structure.Results: Homogeneity of the scale was excellent. Cronbach's α was .96, and item-total correlations ranged from .49 to .78. Test-retest reliability was high (ICC = .94). All but three items had desired levels of agreement (κ > .60). Analysis of variance indicated that the CUE distinguished between motor levels of tetraplegia more than one level apart. The CUE was correlated highly with both motor scores and FIM. Regression analysis indicated that the CUE was better than upper extremity motor scores for predicting FIM scores. The model containing the CUE explained 73% of the variance in FIM and was not enhanced by the addition of motor scores. Factor analysis suggested four potential subscales: arm function (bilateral), right hand function, left hand function, and reaching down.Conclusion: The CUE exhibits good homogeneity, reliability, and validity; further work is needed to determine its sensitivity to change in function.     

The Pittsburgh Rehabilitation Participation Scale: reliability and validity of a clinician-rated measure of participation in acute rehabilitation

OBJECTIVE: To demonstrate interrater reliability and predictive validity of the Pittsburgh Rehabilitation Participation Scale (PRPS), a clinician-rated 6-point Likert-type item measuring patient participation in inpatient rehabilitation sessions. DESIGN: Prospective measurement of patient participation in physical and occupational therapy sessions during inpatient rehabilitation. SETTING: University-based, freestanding acute rehabilitation hospital. PARTICIPANTS: Two hundred forty-two inpatients, primarily elderly, with a variety of impairment diagnoses (eg, stroke), who were admitted for inpatient rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Change in the 13 motor items from the FIM trade mark instrument, from admission to discharge. RESULTS: The PRPS had high interrater reliability (intraclass correlation coefficient [ICC]=.91 for occupational therapists; ICC=.96 for physical therapists). The subjects had mean PRPS scores +/- standard deviation of 4.73+/-0.76. Mean PRPS scores predicted rehabilitation outcome (N=242, r=.32, P<.0001), as measured by change in motor FIM. The strength of this association did not change in a multivariate model that controlled for age, gender, race, impairment group, medical comorbidity count, length of stay, and admission FIM. CONCLUSIONS: Patient participation during acute inpatient rehabilitation can be easily and reliably measured, and PRPS scores predict functional outcome. The PRPS may have applicability in clinical and research outcome measurement.     

Measurement of fatigue: Comparison of the reliability and validity of single-item and short measures to a comprehensive measure

BackgroundEvidence is needed on the clinicometric properties of single-item or short measures as alternatives to comprehensive measures.ObjectivesWe examined whether two single-item fatigue measures (i.e., Likert scale, numeric rating scale) or a short fatigue measure were comparable to a comprehensive measure in reliability (i.e., internal consistency and test–retest reliability) and validity (i.e., convergent, concurrent, and predictive validity) in Korean young adults.MethodsFor this quantitative study, we selected the Functional Assessment of Chronic Illness Therapy–Fatigue for the comprehensive measure and the Profile of Mood States–Brief, Fatigue subscale for the short measure; and constructed two single-item measures. A total of 368 students from four nursing colleges in South Korea participated. We used Cronbach’s alpha and item-total correlation for internal consistency reliability and intraclass correlation coefficient for test–retest reliability. We assessed Pearson’s correlation with a comprehensive measure for convergent validity, with perceived stress level and sleep quality for concurrent validity and the receiver operating characteristic curve for predictive validity.ResultsThe short measure was comparable to the comprehensive measure in internal consistency reliability (Cronbach’s alpha = 0.81 vs. 0.88); test–retest reliability (intraclass correlation coefficient = 0.66 vs. 0.61); convergent validity (r with comprehensive measure = 0.79); concurrent validity (r with perceived stress = 0.55, r with sleep quality = 0.39) and predictive validity (area under curve = 0.88). Single-item measures were not comparable to the comprehensive measure.ConclusionsA short fatigue measure exhibited similar levels of reliability and validity to the comprehensive measure in Korean young adults.