舒适状况量表的信效度测试研究

目的检测美国舒适护理专家Kolcaba研制的简化的舒适状况量表(GCQ)在中国文化背景下的适用性。方法研究分两个阶段进行,第一阶段将量表翻译成中文后由5位护理专家对其进行内容效度的检验。第二阶段进行问卷调查,测试不同患者对各个项目用词的理解,强化 GCQ量表的信效度,并应用简化GCQ检测胸外科术后48 h患者的舒适度。问卷分2期进行,首轮20例胸外科术后48 h的患者参与问卷测试,次轮123例。结果简化GCQ的内容效度CVI= 0．86,Cronbach's α值为0．92,各维度α值波动在0．53～0．85。胸外科术后48 h患者的舒适状况得分为(91．27±8．63)分(为中高度舒适),生理维度平均单项得分最低为(2．50±0．47)分,心理精神维度平均单项得分最高为(3．26±0．35)分。结论Kolcaba简化的GCQ量表适合在我国使用,但其信度和效度有待进一步研究给予全面肯定。     

School phobia and childhood chronic fatigue syndrome (CCFS)

Chronic fatigue occurring in previously healthy children and adolescents is a vexing problem encountered by pediatric practitioners and the impact of fatigue in youngsters should not be underestimated. In its severe form, it is often associated with mood disorders. Findings in children and adolescent cases suggest that severe unexplained fatigue might precede the development of fatigue-related illness, such as childhood chronic fatigue syndrome (CCFS). This is a disabling condition characterized by severe disabling fatigue and a combination of symptoms, the prominent features being self-reported impairments in concentration and short-term memory, sleep disturbances and autonomic symptoms that cannot be explained by medical or psychiatric illness. We have encountered such patients with these complaints; their major symptoms include: general fatigue, fever, headache (not migraine), and memory disturbance. From our clinical experience, we have inferred that patients with CCFS might experience changes in brain function levels, which induce an autonomic imbalance and engender symptoms such as general fatigue, higher-order level cognitive dysfunction, and memory disturbance.     

Knowledge about childhood autism among health workers (KCAHW) questionnaire: description,reliability and internal consistency

Background

Knowledge and awareness about childhood autism is low among health workers and the general community in Nigeria and other Sub-Saharan African countries. Poor knowledge and awareness about childhood autism, especially among health workers can compromise early recognition and interventions which had been known to improve prognosis in children with autism. In formulating policy and designing interventions for these children, there is need to develop a reliable tool that can be used in assessing baseline knowledge about childhood autism among health workers and the impact that future continued education and awareness campaign may have on such baseline knowledge. Knowledge about childhood autism among health workers (KCAHW) questionnaire was designed for this purpose.

Methods

The KCAHW questionnaire is a nineteen (19) item self-administered questionnaire that is divided into four domains. KCAHW questionnaires were distributed to fifty (50) psychiatric nurses involved in community mental health services in South-Eastern Nigeria to complete. After two weeks period, the KCAHW questionnaires were re-administered to the same fifty (50) psychiatric nurses to assess their knowledge about childhood autism and to assess the test-retest reliability and internal consistency of this questionnaire.

Results

KCAHW questionnaire showed good test-retest reliability when the mean domain and total scores at first and second time administration were compared. The four mean domain scores and the mean total scores at first and second time administration were significantly correlated. The questionnaire also had a good overall internal consistency when the mean scores of the four domains were correlated with mean total scores (Cronbach's alpha = 0.97).

Conclusion

The KCAHW questionnaire is a reliable tool for assessing knowledge of health workers about childhood autism. It would be a useful tool in improving early recognition of features of autism among affected children in Sub-Saharan African and other developing countries of the world where knowledge and awareness about childhood autism is low.

     

Construct validity of the stroke-specific quality of life questionnaire in ischemic stroke patients

Hsueh I-P, Jeng J-S, Lee Y, Sheu C-F, Hsieh C-L. Construct validity of the Stroke-Specific Quality of Life questionnaire in ischemic stroke patients.

Objectives

To investigate the construct validity of the commonly used 8- and 12-domain versions of the Stroke-Specific Quality of Life (SS-QOL) with a first-order factor model. The better-fitted version was further evaluated by a second-order factor structure model in order to determine whether a summary score is justified.

Design

Cohort study.

Setting

Outpatient stroke clinic.

Participants

Patients (N=388) with ischemic stroke.

Intervention

Not applicable.

Main Outcome Measures

The SS-QOL. We first conducted confirmatory factor analysis (CFA) to evaluate the construct validity of the first-order 8- or 12-domain versions of the SS-QOL. The better-fitted version was then validated by investigating the second-order health-related quality of life (HRQOL) factor.

Results

The 12-domain version, but not the 8-domain version, had sufficient goodness of fit (χ²=2041.7, df=1061, χ²/df=1.9, comparative fit index [CFI]=0.98, Tucker-Lewis index [TLI]=0.98, and root mean square error of approximation=0.05). All items of the 12-domain version showed acceptable factor loadings (>0.40) and were retained. Furthermore, the second-order CFA fit indices of the 12 domains were acceptable (χ²=2630.3, df=1115, χ²/df=2.4, CFI=0.97, TLI=0.97, root mean square error of approximation=0.06), indicating that a summary score was justified for representing the overall status of HRQOL.

Conclusions

Our results show that the construct validity of the 12-domain SS-QOL is well supported for measuring HRQOL in ischemic stroke patients. Thus, we recommend the 12-domain version of the SS-QOL for use in capturing the multiple impacts of stroke as well as overall HRQOL status on the basis of patients' perspectives.     

Construct validity and test-retest reliability of the questionnaire rising and sitting down in lower-limb amputees

de Laat FA, Rommers GM, Geertzen JH, Roorda LD. Construct validity and test-retest reliability of the Questionnaire Rising and Sitting Down in lower-limb amputees.

Objective

To investigate the construct validity and test-retest reliability of the Questionnaire Rising and Sitting Down (QR&S), a patient-reported measure of activity limitations in rising and sitting down, in lower-limb amputees.

Design

Cross-sectional study.

Setting

Outpatient department of a rehabilitation center.

Participants

Lower-limb amputees (N=171; mean age ± SD, 65±12y; 71% men; 83% vascular cause) participated in the study, 33 of whom also participated in the reliability study.

Interventions

Not applicable.

Main Outcome Measures

Construct validity was investigated by testing 8 hypotheses: limitations in rising and sitting down according to the QR&S would be: (1) greater in lower-limb amputees who are older, (2) independent of level of amputation, (3) greater in lower-limb amputees with a bilateral amputation, and (4) greater in lower-limb amputees who had rehabilitation treatment in a nursing home. Furthermore, limitations in rising and sitting down will be positively related to activity limitations according to (5) the Locomotor Capabilities Index (LCI), (6) the questions about rising and sitting down in the LCI, (7) the Climbing Stairs Questionnaire, and (8) the Walking Questionnaire. Construct validity was quantified with an independent t test and Pearson correlation coefficient. Test-retest reliability was assessed with a 3-week interval and quantified with the intraclass correlation coefficient (ICC), standard error of measurement, and smallest detectable difference (SDD).

Results

Construct validity (7 of 8 null hypotheses not rejected) and test-retest reliability were good (ICC=.84; 95% confidence interval, .65–.93; standard error of the measurement=6.7%; SDD=18.6%).

Conclusions

The QR&S has good construct validity and good test-retest reliability in lower-limb amputees.     

中文版多维疲劳量表在2型糖尿病患者中的信效度验证

目的：验证多维疲劳量表（MFI-20）在2型糖尿病（T2DM）患者中的信度和效度。方法：将MFI-20量表中文版应用于211例T2DM患者,以验证量表的信度和效度。结果：因子分析显示修订后的量表维持原量表20个条目不变,包含躯体疲劳、心理疲劳和脑力疲劳3个维度,可累计解释方差的56.9%。MFI-20量表得分与健康状况调查简表-活力维度（SF-36-VT）得分显著相关（r=-0.803,P<0.01)。量表总的Cronbach’s α系数为0.91,各维度的Cronbach’s α系数均达0.85以上。结论：中文修订版MFI-20量表在T2DM人群中具有较好的信度和效度,可作为2型糖尿病相关疲劳的可靠性测评工具。     

Mobility-related participation and user satisfaction: Construct validity in the context of powered wheelchair use

Purpose.?The aim of this study was to investigate the constructs of mobility-related participation and user satisfaction, two important outcome dimensions within praxis and research on mobility device interventions.

Method.?To fulfill this aim, validity and reliability of a 12-item scale on mobility-related participation and a 10-item scale on user satisfaction were examined in the context of older people's powered wheelchair use (n?=?111). Rasch analysis and correlation analysis were applied.

Results.?Construct validity of both scales was confirmed. The reliability of the user satisfaction scale was good, while the mobility-related participation scale was not optimal in discriminating between persons with a high degree of mobility-related participation. It was demonstrated that mobility-related participation and user satisfaction are separate, not related constructs.

Conclusions.?It can be concluded that the investigated mobility-related participation and user satisfaction constructs appear to be valid. Since the two constructs are not related and both yield important information, both dimensions should be evaluated in outcomes research and praxis targeting powered wheelchair interventions. Reliability problems of the mobility-related participation scale indicate the complexity of this construct. The results have been instrumental in the development of a new scale for measuring mobility-related participation ‘The NOMO 1.0’.     

Impact on participation and autonomy questionnaire: internal scale validity of the Swedish version for use in people with spinal cord injury.

OBJECTIVE: To evaluate aspects of internal scale validity and reliability of the Swedish version of the Impact on Participation and Autonomy questionnaire (IPA-S) for use in people with spinal cord injury. SUBJECTS: A total of 161 persons with spinal cord injury. Method: IPA-S psychometric properties were evaluated using Rasch rating scale analysis. RESULTS: The results show that the IPA-S has 27 items for perceived participation and 6 items for perceived problems with participation, indicating 2 underlying unidimensional constructs for use in people with spinal cord injury, after removal of misfitting items. The established hierarchical order of the item calibration values in both scales appeared logical and the distances between the items, with a few exceptions in the problem scale, were appropriate. Both scales demonstrated good separation reliability. The range of item calibration values in both scales did not fully cover the range of measures of persons' perceived participation and problems thereof. CONCLUSION: The psychometric properties of IPA-S are promising and indicate that IPA-S has potential to be developed further.     

The stroke impairment assessment set: its internal consistency and predictive validity

OBJECTIVE: To study the scale quality and predictive validity of the Stroke Impairment Assessment Set (SIAS) developed for stroke outcome research. DESIGN: Rasch analysis of the SIAS; stepwise multiple regression analysis to predict discharge functional independence measure (FIM) raw scores from demographic data, the SIAS scores, and the admission FIM scores; cross-validation of the prediction rule. SETTING: Tertiary rehabilitation center in Japan. PATIENTS: One hundred ninety stroke inpatients for the study of the scale quality and the predictive validity; a second sample of 116 stroke inpatients for the cross-validation study. MAIN OUTCOME MEASURES: Mean square fit statistics to study the degree of fit to the unidimensional model; logits to express item difficulties; discharge FIM scores for the study of predictive validity. RESULTS: The degree of misfit was acceptable except for the shoulder range of motion (ROM), pain, visuospatial function, and speech items; and the SIAS items could be arranged on a common unidimensional scale. The difficulty patterns were identical at admission and at discharge except for the deep tendon reflexes, ROM, and pain items. They were also similar for the right- and left-sided brain lesion groups except for the speech and visuospatial items. For the prediction of the discharge FIM scores, the independent variables selected were age, the SIAS total scores, and the admission FIM scores; and the adjusted R2 was .64 (p < .0001). Stability of the predictive equation was confirmed in the cross-validation sample (R2 = .68, p < .001). CONCLUSIONS: The unidimensionality of the SIAS was confirmed, and the SIAS total scores proved useful for stroke outcome prediction.     

Hyperventilation and chronic fatigue syndrome

We studied the link between chronic fatigue syndrome (CFS) andhyperventilation in 31 consecutive attenders at a chronic fatigueclinic (19 females, 12 males) who fulfilled criteria for CFSbased on both Oxford and Joint CDC/NIH criteria. All experiencedprofound fatigue and fatigability associated with minimal exertion,in 66% developing after an infective episode. Alternative causesof fatigue were excluded. Hyperventilation was studied duringa 43-min protocol in which end-tidal PCO₂ (P_ETCO2 was measurednon-invasively by capnograph or mass spectrometer via a finecatheter taped in a nostril at rest, during and after exercise(10–50 W) and for 10 min during recovery from voluntaryover-breathing to approximately 2.7 kPa (20 mmHg). P_ETCO2 <4kPa (30 mmHg) at rest, during or after exercise, or at 5 minafter the end of voluntary overbreathing, suggested either hyperventilationor a tendency to hyperventilate. Most patients were able voluntarilyto overbreathe, but not all were able to exercise. Twenty-twopatients (71%) had no evidence of hyperventilation during anyaspect of the test. Only four patients had unequivocal hyperventilation,in one associated with asthma and in three with panic. Onlyone patient with severe functional disability and agoraphobiahad hyperventilation with no other obvious cause. A furtherfive patients had borderline hyperventilation, in which P_ETCO2was <4 kPa (30 mmHg) for no more than 2 min, when we wouldhave expected it to be normal. There was no association betweenlevel of functional impairment and degree of hyperventilation.There is only a weak association between hyperventilation andchronic fatigue syndrome. When present, hyperventilation isusually related to known causes of respiratory stimulation suchas asthma or panic.     

Construct validity and test-retest reliability of the walking questionnaire in people with a lower limb amputation

de Laat FA, Rommers GM, Geertzen JH, Roorda LD. Construct validity and test-retest reliability of the Walking Questionnaire in people with a lower limb amputation.ObjectiveTo investigate the construct validity and test-retest reliability of the Walking Questionnaire, a patient-reported measure of activity limitations in walking in people with a lower limb amputation.DesignCross-sectional study.SettingOutpatient department of a rehabilitation center.ParticipantsPeople with a lower limb amputation (N=172; mean age ± SD, 65±12y; 71% men; 82% vascular cause) participated in the study, 33 of whom also participated in the reliability study.InterventionsNot applicable.Main Outcome MeasuresConstruct validity was investigated by testing 11 hypotheses: limitations in walking according to the Walking Questionnaire will be greater in people with a lower limb amputation who (1) are older, (2) have a bilateral amputation, (3) have a higher level of amputation, (4) underwent their rehabilitation treatment in a nursing home, (5) walk less (in terms of time), and (6) walk shorter distances. Furthermore, limitations in walking will be positively related to activity limitations according to the (7) Locomotor Capabilities Index, (8) “distance walked” question on the Prosthetic Profile of the Amputee Questionnaire, (9) Questionnaire Rising and Sitting Down, (10) Climbing Stairs Questionnaire, and (11) Special Interest Group on Amputation Medicine/Dutch Working Group on Amputations and Prosthetics mobility scale. Construct validity was quantified by using the Mann-Whitney U test and Spearman correlation coefficient. Test-retest reliability was assessed with a 3-week interval and quantified using the intraclass correlation coefficient.ResultsConstruct validity (10 of 11 hypotheses not rejected) and test-retest reliability were good (intraclass correlation coefficient =.73; 95% confidence interval, .43–.88).ConclusionsThe Walking Questionnaire has good construct validity and test-retest reliability in people with a lower limb amputation.     

Reliability, internal consistency, and validity of data obtained with the functional gait assessment

BACKGROUND AND PURPOSE: The Functional Gait Assessment (FGA) is a 10-item gait assessment based on the Dynamic Gait Index. The purpose of this study was to evaluate the reliability, internal consistency, and validity of data obtained with the FGA when used with people with vestibular disorders. SUBJECTS: Seven physical therapists from various practice settings, 3 physical therapist students, and 6 patients with vestibular disorders volunteered to participate. METHODS: All raters were given 10 minutes to review the instructions, the test items, and the grading criteria for the FGA. The 10 raters concurrently rated the performance of the 6 patients on the FGA. Patients completed the FGA twice, with an hour's rest between sessions. Reliability of total FGA scores was assessed using intraclass correlation coefficients (2,1). Internal consistency of the FGA was assessed using the Cronbach alpha and confirmatory factor analysis. Concurrent validity was assessed using the correlation of the FGA scores with balance and gait measurements. RESULTS: Intraclass correlation coefficients of.86 and.74 were found for interrater and intrarater reliability of the total FGA scores. Internal consistency of the FGA scores was.79. Spearman rank order correlation coefficients of the FGA scores with balance measurements ranged from.11 to.67. DISCUSSION AND CONCLUSION: The FGA demonstrates what we believe is acceptable reliability, internal consistency, and concurrent validity with other balance measures used for patients with vestibular disorders.     

中文版糖尿病自护行为量表的信度和效度研究

目的 考察中文版糖尿病自护行为量表(SDSCA)的信度和效度,为我国2型糖尿病患者,自护行为评估提供有效、简便的工具.方法 翻译国外的糖尿病自护行为量表(SDSCA),形成中文版SDSCA,采用随机抽样方法,从内分泌门诊中选取20例2型糖尿病患者,进行中文版糖尿病自护行为量表的重测信度、量表内部一致性和结构效度研究.结果 中文版SDSCA各维度重测信度在0.763～1.000;量表各维度条目间相关系数,具体饮食最低(0.104),其余各维度条目间呈中度至高度相关0.555～0.933;主成分分析共抽取4个因子,解释变异量的67.483%.结论 中文版SDSCA的信效度理想,适合于2型糖尿病患者自护行为评价.

Abstract：

Objective To test the reliability and validity of the Chinese version Diabetea Self-Care Behavior(SDSCA)Questionnaire,and thus to provide an effective and convenient way of self-care behavior assessment for patients with type 2 diabetes.Methods The questionnaire based on the translation of SDSCA wag used in 20 cases of type 2 diabetes patients,in order to analyze the retest rehability,internal consistency and scale construct validity. Results The retest reliability of each dimension wag between 0.763 to 1.000;the scale correlation coeflicients between items in specific diet dimension Wag lowest(0.104),and the others were moderate to high degree of correlation between 0.555～0.933;exploratory factor analysis extracted 4 components,and the percentage of variance explained was 67.483% .Conclusions Chinese version SDSCA has a good reliability and validity,and is good for evaluating the self-care activities in type 2 diabetes patients.     

中文版参与和自主性测评问卷的修订及信度、效度分析

目的:修订中文版参与和自主性测评问卷(IPA)并对其进行信度和效度评价,为评估脑卒中患者社会水平的康复结局提供简单、有效的工具。方法:对英文IPA问卷进行系统的翻译和文化调适,并应用中文版IPA对150例脑卒中患者进行测量,对测定结果进行信度和效度分析。结果:中文版IPA-Ⅰ问卷总的Cronbach α系数为0.959,各维度的Cronbach α系数为0.782—0.965;IPA-Ⅱ问卷Cronbach α系数为0.905。内容效度分析得出:IPA问卷各条目的CVI值为0.8以上,除一个条目(与配偶间亲密关系)外,其余各条目得分与总分相关性系数为0.406—0.901(P<0.01);平行效度分析得出:IPA-Ⅰ问卷与伦敦残障量表(LHS)得分的相关系数为0.807(P<0.01),IPA-Ⅱ问卷与LHS得分的相关系数为0.657(P<0.01);对中文版IPA-Ⅰ问卷进行因子分析,IPA-Ⅰ得到4个公因子,各条目载荷大于0.4,共解释了78.824%的方差。结论:中文版IPA问卷是一份具有较好信度和效度的测评工具,可用于我国脑卒中患者的相关研究中。     

History of chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is not a new disease. Similar morbidities have been known as different names since past several centuries. For example, neurasthenia, epidemic neuromyasthenia, myalgic encephalomyelitis, Akureyri disease, Royal Free disease, chronic EBV disease, post-viral fatigue syndrome etc. Much of the recent interest in CFS was generated by incidence of infection-like outbreak at Lake Tahoe in Nevada. The Center for Disease Control (USA) realized that correlation was poor between those patients who had virologic evidence of EBV infection and those who had the symptoms of chronic fatigue. This is a review of the history of CFS. (1) Historical perspectives in chronic fatigue cases in past old period, (2) Post-viral infectious fatigue and chronic fatigue (myalgic encephalomyelitis), (3) Recent trend of CFS studies and its clinical similar situation. Finally, I would like to state that we intend to draw up a new diagnostic guideline for CFS in Japan.