Psychometric properties of the SF-36 in the early post-stroke phase

BACKGROUND: Patients who have had a stroke are a large group in whom long-term disability is common and therefore impaired general health is likely. The Short Form 36 (SF-36) is a popular measure of general health that has been used with this patient group, but not all aspects of its psychometric properties have been established for use in this context, and its use in the early post-stroke phase has been neglected. AIMS: To examine the reliability, validity and sensitivity to change of the SF-36 (UK version I) in patients in the early post-stroke period. DESIGN: A prospective, observational study of stroke outcomes was carried out. RESEARCH METHODS: From May 1996 to April 1997, patients who had had a stroke were identified by 24 general practices in Scotland and were recruited within 1 month of their stroke, whether in hospital or at home. Outcome measures including the SF-36 were administered at one, 3 and 6 months after onset. RESULTS: The internal consistency of the eight subscales at all three time-points was good except for 1 month Vitality (alpha = 0.6824) and 3 month General Health (alpha = 0.6650), which were borderline in comparison with the criterion value of 0.7. Construct validity was adequate overall, although correlations between Role Physical and General Health and the Barthel Index and Canadian Neurological Scale were lower than hypothesized. Most SF-36 subscales were sensitive to change between 1 and 3 months post-stroke, but none detected change between 3 and 6 months. CONCLUSIONS: There were some practical problems in using the SF-36 in an acutely unwell stroke population. However, analysis of psychometric properties suggested that most of the subscales were adequately reliable and valid. Sensitivity to change was poorer in the later stages of the study.     

Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care

PTSD affects a substantial number of women in medical settings and is associated with significant distress and impairment. There are effective methods of treating trauma-related distress, but a minority seek such care. Thus, primary care is an important setting in which to identify individuals with PTSD. We sent questionnaires, including the PTSD Checklist—Civilian Version (PCL-C), to 419 female veterans who were seen in our primary care clinic in 1998; 56% (N = 221) returned the measures. A random subset (n = 49) was interviewed to establish psychiatric diagnoses. The results provide qualified support for the use of the PCL-C total score with a lowered cutoff score as a screening measure for PTSD in female veterans in primary care.     

Reliability,validity and standardization of the Japanese version of the Social Adjustment Scale-Self Report

The purpose of the present paper was to examine the reliability and validity of the Japanese version of the Social Adjustment Scale-Self Report (SAS-SR) and to present its normative data. The SAS-SR was administered to a random sample of all the employees of a large general hospital, together with the General Health Questionnaire (n = 363). It was also administered to a representative subset of first-visit patients at 33 psychiatric hospitals and clinics from all over Japan, along with the semistructured psychiatric interview to ascertain the patients' diagnoses (n = 1581). For the internal consistency reliability of the subscales and the overall scale of the SAS-SR, Cronbach's alpha was between 0.61 and 0.73. The Pearson product-moment correlations between the subscale and overall scale scores with the GHQ score were mostly >0.3. The scores were statistically significantly and substantively different between the normal sample and the patient samples, and were also meaningful, differentiating between various diagnostic subgroups. The reference ranges of the SAS-SR scores for mentally healthy subjects were calculated as 95% prediction intervals; for example, 1.22-2.22 for the overall score. The Japanese version of the SAS-SR has good reliability and satisfactory validity. The present study provided reference ranges for its scores in order to increase their interpretability. With its ease of administration and its rich subscales, the scale promises to offer a psychometrically sound measure with which to assess social adjustment in people with various psychiatric disorders.     

护理学专业学生心理健康状况调查

[目的]了解护理学专业学生的心理健康状况,为学校开展健康教育工作提供参考资料.[方法]采用症状自评量表(SCL-90)对护理学专业1 049名在校生进行问卷式调查.[结果]不同年级学生在躯体化、强迫、人际敏感、抑郁、焦虑、恐怖、偏执及精神病性等9个因素得分及总分间均有显著性差异,而不同学历层次学生仅在人际关系的得分间有显著性差异.护理学专业学生轻度的心理问题检出率为48.2%,1、2、3、4年级学生分别为40.0%,55.6%,44.9%,50.5%,各年级组相比较均有显著性差异.不同学历层次学生轻度的心理问题检出率间差异不明显,中等水平的心理问题检出率为8.9%,各年级及不同学历层次学生间均无显著性差异.护理学专业学生的主要心理问题为强迫症状,其次为人际敏感、抑郁及敌对等.[结论]大学生心理问题不容忽视,尤其是2年级学生应引起关注.     

Apathy and anhedonia rating scales in Parkinson's disease: Critique and recommendations

Apathy is a common condition in Parkinson's disease (PD) and is generally defined as a lack of motivation. It is associated with more severe cognitive dysfunction and a decrease in activities of daily living (ADL) performance. Anhedonia, the inability to experience pleasure, can be a symptom of both depressive and apathetic syndromes. The Movement Disorder Society (MDS) commissioned a task force to assess the clinimetric properties of apathy and anhedonia scales in PD patients. A systematic literature review was conducted to identify scales that have either been validated or used in PD patients. Apathy scales identified for review include the Apathy Evaluation Scale (AES), the Apathy Scale (AS), the Apathy Inventory (AI), and the Lille Apathy Rating Scale (LARS). In addition, item 4 (motivation/initiative) of the Unified Parkinson's Disease Rating Scale (UPDRS) and item 7 (apathy) of the Neuropsychiatric Inventory (NPI) were included. Anhedonia scales identified for review were the Snaith‐Hamilton Pleasure Scale (SHAPS) and the Chapman scales for physical and social anhedonia. Only the AS is classified as “recommended” to assess apathy in PD. Although item 4 of the UPDRS also meets the criteria to be classified as recommended, it should be considered for screening only because of the obvious limitations of a single item construct. For the assessment of anhedonia, only the SHAPS meets the criteria of “Suggested.” Information on the validity of apathy and anhedonia scales is limited because of the lack of consensus on diagnostic criteria for these conditions. © 2008 Movement Disorder Society     

Book Reviews

Books Reviewed:
M. Radke-Yarrow, Children of Depressed Mothers: From Early Childhood to Maturity
A. Klin, F. Volkmar, & S. Sparrow, Asperger Syndrome
J. Triseliotis, M. Borland, & M. Hill, Delivering Foster Care     

The dialectical behavior therapy ways of coping checklist: development and psychometric properties

Skills training is a crucial mode of treatment in dialectical behavioral therapy (DBT; Linehan, 1993b ), yet a psychometrically sound measure of DBT skills use does not exist. We adapted the Revised Ways of Coping Checklist (RWCCL; Vitaliano, Russo, Carr, Maiuro, & Becker, 1985 ) to create the DBT Ways of Coping Checklist (DBT‐WCCL). Using factor analysis procedures, two subscales emerged: one assessing coping via DBT skills, the DBT Skills Subscale (DSS), and one assessing coping via dysfunctional means, the Dysfunctional Coping Subscale (DCS). Principal component, internal consistency, test‐retest reliability, and content validity analyses suggested that the scale has good to excellent psychometric properties. In addition, the DSS successfully discriminated patients who received skills training during 4 months of treatment from patients who did not. Moderators of skills use are also discussed. The DBT‐WCCL appears to be a promising new measure of DBT skills use. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1–20, 2010.     

Reliability and clinical usefulness of psychometric measures in a self-referred population of odontophobics

Questionnaire responses of 155 self-referred subjects with extreme dental fear were used to evaluate the reliability and clinical usefulness of some psychometric tests used in diagnosis and treatment. The Corah Dental Anxiety Scale (DAS), State-Trait Anxiety Inventory (STAI), and a general Geer Fear Scale (GFS) were filled out by all subjects, while 80 patients with highest dental fear scores were also tested before and after dental fear treatment with the following scales; a Getz Dental Belief Survey (DBS), Dental Fear Survey (DFS), and a Mood Adjective Checklist (MACL). Cronbach's alpha measured internal consistency reliability. SPSS data analyses calculated item-remainder and test-retest correlations. Clinical usefulness of scales was judged by Spearman correlations of initial scores and test score changes after dental fear treatment. All total test scores showed high internal consistency and test-retest reliability. DFS was judged the preferred clinical measure of threatening perceptions of pain or unpleasantness specific to dental procedures. DBS and STAI-State measured confidence in relating with the dentist and situational fear associated with that relationship. GFS, STAI-Trait, and MACL discriminated levels of general fearfulness, anxiety and mood fluctuations that can impact on dental fear.     

Development of an instrument to measure strategic and clinical quality indicators in postoperative pain management

AIM OF THE STUDY: To develop and evaluate psychometric properties, that is reliability and validity, of an instrument to measure strategic and clinical quality indicators in postoperative pain management. BACKGROUND: Strategic and clinical quality indicators in postoperative pain management were previously developed from a tentative model of important aspects of surgical nursing care and assessed to have content validity, that is to be essential for the quality of care, realistic to carry out and possible for nurses to use to influence management. METHODS: The quality indicators were converted to items suitable for a patient questionnaire and were scored on a 5-point scale, with higher scores indicating higher quality of care. Inpatients from five surgical wards took part in this study on their second postoperative day. The response rate was 96% and the average ages of the female (n=120) and the male (n=78) respondents were 62 and 63 years, respectively. RESULTS: Items in the total scale had an average inter-item correlation >0.20 and an item-total correlation >0.30. Cronbach's coefficient alpha was 0.84 for the total scale. Four factors entitled 'communication', 'action', 'trust' and 'environment' emerged from an orthogonal factor analysis, with a cumulative variance of 61.4%. Patients who received epidural analgesia had higher scores on the total scale compared with those who did not receive epidural analgesia. Patients who reported more pain than expected had lower scores on the total scale compared with those who did not report more pain than expected. Correlation between the total scale and an overall pain relief satisfaction question was 0.53. CONCLUSION: The results suggest initial support for the new instrument as a measure of strategic and clinical quality indicators in postoperative pain management, but it must be further refined, tested and evaluated.