Validity and Reliability of the Modified Manchester Health Questionnaire in Assessing Patients With Fecal Incontinence

PURPOSE To date, no measures of fecal incontinence severity or its impact on quality of life have been validated for telephone interview. This study was designed to 1) compare responses of a self-administered and a telephone-administered Fecal Incontinence Severity Index; 2) compare a self-administered Fecal Incontinence Quality of Life Scale to the Manchester Health Questionnaire after modifying the latter for telephone administration and American English (Modified Manchester Health Questionnaire); 3) assess test-retest reliability of the telephone-administered Modified Manchester Health Questionnaire; and 4) assess the internal consistency of the Modified Manchester Health Questionnaire subscales.METHODS Consecutive, English-speaking, nonpregnant females known to have fecal incontinence were invited to participate. Two validated paper questionnaires accompanied the letter informing them of the study: Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life Scale. Consenting patients were contacted for the initial telephone administration of the Modified Manchester Health Questionnaire, and patients who agreed to continue the study were contacted for a repeat telephone administration of the Modified Manchester Health Questionnaire two to four weeks after completing the first interview.RESULTS Fifty-one females were invited to participate in the study; however, 13 declined or were ineligible. Thirty females, aged 49.3 ± 10.3 years, returned self-administered questionnaires and completed the first telephone interview, and 21 completed a second telephone interview after an average interval of 23 days. The telephone-administered Fecal Incontinence Severity Index scores were significantly lower than those yielded by the self-administered Fecal Incontinence Severity Index, (6.19 vs. 9.85; P < 0.001), but the telephone and written administrations were significantly correlated (r = 0.5; P < 0.02). Correlations between the Modified Manchester Health Questionnaire quality of life subscales and the paper Fecal Incontinence Quality of Life subscales ranged from 0.6 to 0.9 (median, r = 0.81). The correlation between the total score for the Fecal Incontinence Quality of Life and the total score for the Modified Manchester Health Questionnaire quality of life scales was 0.93 (P < 0.001). Test-retest reliability for the eight Modified Manchester Health Questionnaire subscales ranged from 0.55 to 0.98 (median, r = 0.83), and test-retest reliability for the two telephone administrations of the Fecal Incontinence Severity Index was r = 0.75. Cronbachs alpha for the eight Modified Manchester Health Questionnaire subscales ranged from 0.79 to 0.92 (median, alpha = 0.85).CONCLUSIONS Telephone-administered versions of the Modified Manchester Health Questionnaire showed good-to-excellent validity, internal consistency, and test-retest reliability. The telephone-administered Fecal Incontinence Severity Index yielded lower severity scores than the written Fecal Incontinence Severity Index; however, the difference (3.66 units) was not clinically significant.Supported by Pelvic Floor Disorders Network.Supported by NICHD grants U10 HD41249, U10 HD41268, U10 HD41248, U10 HD41250, U10 HD41261, U10 HD41263, U10 HD41269, U10 HD41267.Presented at the American Urogynecologic Society, Hollywood, Florida, September 11 to 13, 2003.Reprints are not available.     

药品有效期管理的实践与思考

目的 基层医院病区药房药品有效期精细化管理的实践探讨。方法 通过6年实践,采取药品有效期精细化管理的三统一实践方式。结果 实践过程精细流畅,保障患者用药安全有效,过期药品报损率控制在较低范围。结论 药品有效期精细化管理很有必要。     

A comparison of the validity of two indirect utility instruments as measures of postoperative recovery

Background

Cost-effectiveness analyses of surgical interventions require valid measures of postoperative recovery. The objective of this study was to compare the validity of two indirect utility instruments, the Short Form 6D (SF-6D) and EuroQol 5D (EQ-5D), as measures of postoperative recovery.

Materials and methods

A prospective cohort of patients undergoing elective colorectal resection at two university-affiliated institutions from October 2012–October 2013 completed the SF-6D and EQ-5D (including the EQ-visual analog scale [EQ-VAS]) at baseline (before surgery), and at 4 and 8 wk after surgery. Responsiveness and construct validity were assessed through a priori hypotheses.

Results

A total of 165 patients were included. The SF-6D was the most responsive to the expected postoperative changes at 4 and 8 wk compared with the EQ-5D and the EQ-VAS. The 4-wk SF-6D, EQ-5D, and EQ-VAS discriminated between patients with and without complications after controlling for confounders with adjusted mean differences of −0.070 (95% confidence interval [CI] −0.126 to −0.015), −0.133 (95% CI −0.231, −0.030), and −7.91 (95% CI −14.77, −1.04), respectively. Mean SF-6D and EQ-5D values were significantly different from the US population norms at all time points, but the magnitude of change was highest for the SF-6D. The strength of correlation between all three instruments was moderate at all time points (r = 0.550–0.684, all P < 0.05).

Conclusions

The SF-6D preference-based health index appears to be a more valid measure of postoperative recovery than the EQ-5D and EQ-VAS in surgical cost-effectiveness analyses.     

Cross-Cultural Adaptation,Reliability, and Validity of the Revised Korean Version of Ruminative Response Scale

Objective

Rumination is a negative coping strategy defined as repetitive and passive focusing on negative feelings such as depression. The Ruminative Response Scale (RRS) is a widely-used instrument to measure rumination, but there is continuing argument about the construct validity of the RRS, because of probable overlap between the measurement of depression and that of rumination. The RRS-Revised (RRS-R), which removed 12 items of the RRS, is suggested as a more valid instrument for measuring rumination. Therefore, we translated RRS-R into Korean and explored the reliability, validity and factor structure in patients with major depressive disorders.

Methods

Seventy-nine patients with major depressive disorder took the Korean version of RRS, RRS-R, State Trait Anxiety Inventory, Beck Depression Inventory and Penn State Worry Questionnaire. We performed exploratory factor analysis of RRS-R, and tested construct validity, internal reliability and test-retest reliability.

Results

The internal and test-retest reliability of RRS-R was high. Factor analysis revealed that RRS-R is composed of two factors. ''Brooding'' factor explained 56.6% and ''Reflection'' factor explained 12.5%. RRS-R, especially ''Brooding factor'', was highly correlated with other clinical symptoms such as depression, anxiety and worry.

Conclusion

In this study, we find out the RRS-R is more reliable and valid than the original RRS in Korean patients with depression because the RRS-R is free from the debate about the overlap of item with BDI. We also revealed that ''Brooding'' is highly correlated with depressive symptoms. RRS-R may be a useful instrument to explore the implication of ''Brooding'' in depression.     

常用精神健康筛查量表简介及其信度、效度比较

在物质生活日益丰盈的时代,精神健康逐渐成为人们关注的焦点。为了准确有效地筛查出存在精神障碍的人群,介绍了几种常用精神健康筛查量表,并对其信度、效度、灵敏度、特异度、优缺点等进行比较。     

Comparing patient generated blood glucose diary records with meter memory in type 2 diabetes

Aim

To assess agreement between meter and diary self monitoring of blood glucose (SMBG) records, over a year, in a sample of patients with type 2 diabetes.

Methods

Meter and diary records were available, for 95 individuals, who took part in the Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes study.Pearson's correlation coefficient was used to explore the relationships between the types of error. Maximum likelihood estimation was used to explore changes over time through a structural equation modelling approach. Paired samples t-tests were used to determine if the presence of errors led to a significant difference between the mean diary and meter SMBG concentrations or coefficients of variation. Multiple regression was used to explore possible predictors of the error indices.

Results

Mean over-reporting, under-reporting, concordance and overall reliability were 8.4%, 10.0%, 83.5% and 71.3%, respectively. The first week of monitoring had significantly more under-reporting, over-reporting and less concordance and overall reliability than subsequent weeks. The majority of concordance errors were not clinically significant. Those that were, tended to occur during the first three months of monitoring. Participants’ at one trial site were significantly more likely to have recording errors than those at the largest site.

Conclusions

Error levels were similar to those described previously in type 1 diabetes and there was a suggestion of an initial learning curve for record keeping. For some individuals diary records would not be considered acceptable if held to the same standards as blood glucose meters.     

Development of a Short Version of the New Brief Job Stress Questionnaire

This study was aimed to investigate the test-retest reliability and validity of a short version of the New Brief Job Stress Questionnaire (New BJSQ) whose scales have one item selected from a standard version. Based on the results from an anonymous web-based questionnaire of occupational health staffs and personnel/labor staffs, we selected higher-priority scales from the standard version. After selecting one item with highest item-total correlation coefficient from each scale, a 23-item questionnaire was developed. A nationally representative survey was administered to Japanese employees (n=1,633) to examine test-retest reliability and validity. Most scales (or items) showed modest but adequate levels of test-retest reliability (r>0.50). Furthermore, job demands and job resources scales (or items) were associated with mental and physical stress reactions while job resources scales (or items) were also associated with positive outcomes. These findings provided a piece of evidence that the short version of the New BJSQ is reliable and valid.     

Validity and reliability of the Mastication Observation and Evaluation (MOE) instrument

The Mastication Observation and Evaluation (MOE) instrument was developed to allow objective assessment of a child's mastication process. It contains 14 items and was developed over three Delphi rounds. The present study concerns the further development of the MOE using the COSMIN (Consensus based Standard for the Selection of Measurement Instruments) and investigated the instrument's internal consistency, inter-observer reliability, construct validity and floor and ceiling effects. Consumption of three bites of bread and biscuit was evaluated using the MOE. Data of 59 healthy children (6–48 mths) and 38 children (bread) and 37 children (biscuit) with cerebral palsy (24–72 mths) were used.Four items were excluded before analysis due to zero variance. Principal Components Analysis showed one factor with 8 items. Internal consistency was >0.70 (Chronbach's alpha) for both food consistencies and for both groups of children. Inter-observer reliability varied from 0.51 to 0.98 (weighted Gwet's agreement coefficient). The total MOE scores for both groups showed normal distribution for the population. There were no floor or ceiling effects.The revised MOE now contains 8 items that (a) have a consistent concept for mastication and can be scored on a 4-point scale with sufficient reliability and (b) are sensitive to stages of chewing development in young children. The removed items are retained as part of a criterion referenced list within the MOE.     

Development and validation of the computerized bilateral motor coordination test

The purpose of this study was to explore the validity of computerized scaling of bilateral, motor coordination in children 4–6 years of age. There were 623 children with an average age of 5, years and 2 months (standard deviation = 6 months) that participated. The 290 girls (46.5%) and 333, boys (53.5%) were from a purposive sample taken from public and private kindergartens in Taiwan. The computerized bilateral motor coordination test included two subtests, bilateral coordination, movements and projected actions. The motion analysis, with mark position and contour motion, was, used to collect important variables from the subtests. Using the judgments of the experts as the, criterion standards, the accuracy, sensitivity, and specificity of the tool were calculated to evaluate the, validity of the computerized bilateral motor coordination test. The accuracy, sensitivity, and, specificity of the bilateral coordination movement subtests were on average 83.9%, 86.4%, and 83.1%, respectively. The accuracy, sensitivity, and specificity of the projected action subtests were on average, 90.5%, 88.1%, and 90.4%, respectively. The computerized bilateral motor coordination tests showed, an average accuracy of 86.3%, a sensitivity of 87.0%, and a specificity of 85.8%. The computerized, bilateral motor coordination test could be a valuable tool when used to identify problems of bilateral, motor coordination and in permitting early intervention to remedy these problems.     

职业院校教师心理素质量表的编制和信效度检验

目的 编制职业院校教师心理素质量表,并检验其信效度。方法 通过对630例职业院校教师的调研和访谈,编制了职业院校教师心理素质量表,间隔两周后对其中的87例教师重新施测,考察问卷的重测信度、同质性信度;选用大学优秀教师心理素质量表（DTPA）、中学教师心理素质量表（MTCA）作为效标问卷,对其中64例进行效标效度检验。结果 探索性因子分析形成6个因子,分别为表达与交流性、创新性、操作演示性、稳定性、聪慧性、职业认同感。量表重测信度为0.654,6个因子的Cronbach＇sα系数均大于0.7;总的分半信度系数为0.871,90.6%的条目的 CVR在0.6以上。效标效度检验除操作演示性与两个量表的相关没有达到显著性水平外,其他均具有统计学意义（P〈0.05）。结论该量表具有较好的信度效度,可以作为职业院校教师心理素质的测量工具。