Psychometric Properties of the Cervical Smear Belief Inventory for Chinese Women

This study examines the reliability and validity of the scores of Cervical Smear Belief Inventory (CSBI) among Chinese women in Taiwan. Women who were nonadherent to cervical screening guidelines were recruited (N = 424). Reliabilities showed good internal consistency for the perceived Pros, Cons, and Susceptibility scales (α ranged from .78 to .87). Factor analysis showed good construct validity of the scores of CSBI that revealed concordant patterns with existing social and behavioral theories, except that the Norms scale was loaded with the Pros scale. Moreover, two items in the Cons scale appeared to be “cultural belief toward virginity.” Item-discrimination analysis showed that all items in the CSBI successfully discriminated women with favorable cervical smear beliefs from those with unfavorable beliefs (p < .001). In summary, many psychometric properties of the CSBI showed that the scores of the inventory were reliable and valid to assess belief toward cervical smear among Chinese women.     

Normal variation and abnormality: an empirical study of the liability distributions underlying depression and delinquency

BACKGROUND: Scale scores in studies of emotional and behavioural problems often possess highly skewed distributions. The long upper tails of these distributions place a small proportion of the population at some distance from the main body of the distribution. This invites an interpretation of their forming an abnormal group, one that may be qualitatively distinct. METHODS: Item-response models were fitted to data on parent and self-rated depression and delinquency from four large samples of children or adolescents. RESULTS: We found that underlying liability distributions show very little or no evidence of non-normality. CONCLUSIONS: The results suggest that (i) the skewed nature of the scale scores may be largely measurement artefacts, (ii) the distributions provide no evidence of a qualitatively distinct process generating abnormality as compared to normal variation and (iii) for characterising the whole distribution, including normality and abnormality, the selection of items in typical current assessments of emotional and behavioural problems is not optimal.     

Considerations for Measuring Functioning of the Elderly: IRM Dimensionality and Scaling Analysis

Modern measurement methods were applied in this study to examine the properties of a measure of functioning of the elderly. Measures of functioning form an essential element in health services and outcomes research. Several implications for scale development and improved score precision are presented in this case study. This study examined the structure of responses to the Older Americans Resources and Services (OARS) Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales using item response model (IRM) analysis methods. The analysis illustrates the extension of IRM dimensionality and item analysis to health scales in general. Attention is given to the underlying theory and appropriate interpretation of these methods for health measurement.Data were taken from 1364 elderly Canadians participating in the caregiver component of the Canadian Study of Health and Aging (CSHA). The fit of a two-parameter logistic IRM was compared with a one-parameter (Rasch) model for these data. The dimensionality of responses to the scale was evaluated with an approximate ² test of residuals after fitting an IRM based on non-linear factor analysis. Results confirm that ADL and IADL item sets differ in the degree of disability they measure and are well represented as separate dimensions using a two-parameter IRM. Implications are drawn concerning the adequacy of the OARS disability measure for health surveys, while more general conclusions cover the precision of IRM based optimal scoring for functional disability measures.     

单项筛选在病案终末质量控制中的作用

目的检查病历终末质量，探讨单项筛选的重要性，提高病历书写质量。方法参照国家、省、市有关病历书写规定，采用单项筛选法，对所有出院病案进行逐份检查。结果在71，319份病案中，发现9285份有不同程度的缺陷，其中乙级病历650份，丙级病历120份，病案完整率为86．98％。结论单项筛选法可以保证病案的完整性，减少由于病历资料的缺陷而造成的医疗纠纷。     

我国医院成本核算研究方法比较分析

医院经济管理带动了医院成本核算研究的发展，综合比较了不同时期不同研究者同类研究成果．试图以此揭示不同研究者在科室成本核算、项目成本核算和病种成本核算方面各自的特点与细微差别。     

军队中主要精神疾病筛查量表修订后在精神科门诊中的初步应用

目的 探讨台湾学者根据MMPI构建的29条目自评量表在精神科门诊中的应用价值。方法 翻译并对台湾学者构建的29条目自评量表进行适当修订，进而在精神科门诊中加以应用，将自评结果同最终诊断结果进行比较，应用尤登指数确定最佳截断点，进一步评价该自评量表在初步诊断中的应用价值。结果 136人按要求完成了量表填写，结果发现该自评量表灵敏度，特异度均较理想，可为精神疾病的诊断提供有用线索，有效的缩短就诊时间，记分方法简单，填表时间短，便于在门诊中应用，具有较大的实用价值。本研究应用尤登指数确定了新的最佳截断点，精神分裂症，抑郁症，噪狂症各自的最佳截断点分别是2分，2分，3分。结论 经过修订的29条目自评量表简便，快捷，实用，成本低，可用于在精神科门诊中初步诊断病人，有效的节约就诊时间，更充分的利用现有的医疗资源。     

Assessment of medication adherence and treatment satisfaction in Japanese patients with psoriasis of various severities

Psoriasis is a chronic, relapsing, inflammatory keratotic skin disease. To elucidate the medication adherence and treatment satisfaction, we performed a questionnaire survey using the eight‐item Morisky Medication Adherence Scale (MMAS‐8) and nine‐item Treatment Satisfaction Questionnaire for Medication (TSQM‐9) of 163 psoriatic patients who regularly visited hospitals or clinics. To assess the relationship between the MMAS‐8/TSQM‐9 outcomes and severity of psoriasis, two different clinical severity indices were used: the Psoriasis Area and the Severity Index (PASI) for disease severity and the Psoriasis Disability Index (PDI) for quality of life (QOL) impairment. The MMAS‐8 score for oral medication was significantly higher than that for topical medication. The oral and topical MMAS‐8 scores were significantly correlated with the PDI score, but not with the PASI score, indicating that QOL impairment lowered treatment motivation. All of the TSQM‐9 domain scores (effectiveness, convenience and global satisfaction) were significantly correlated with both the PASI and PDI scores, suggesting that patients whose skin and QOL conditions were under good control had high satisfaction with treatment. Patients treated with biologics had higher satisfaction than those treated with non‐biologics.     

Rasch Measurement Properties of the KIDSCREEN Quality of Life Instrument in Children with Cerebral Palsy and Differential Item Functioning between Children with and without Cerebral Palsy

Objective:  To assess if the Rasch-scaled KIDSCREEN-52 generic health-related quality of life measure was valid in children with cerebral palsy (CP).
Methods:  The Rasch measurement properties and differential item functioning (DIF) of the KIDSCREEN-52 were examined in children with CP. Data were available from the KIDSCREEN project from 3219 children aged 8 to 12 years and 2126 parents in the general population; and from the SPARCLE project from 501 children aged 8 to 12 years with CP and 823 parents. Analysis used Zumbo's logistic regression DIF approach. Partial credit model analyses were conducted.
Results:  All items of the KIDSCREEN self-report version fitted the partial credit model (smallest P -value: 0.256). Only one item of the parent version did not fit the data well (smallest P -value 0.001). Statistically significant DIF was observed in some items, but was of substantial magnitude (Δ R ² = 0.046, 0.049) for only two items in two dimensions of the parent version. The practical impact of DIF was small. DIF-adjusted standardized mean differences between children with and without CP being 1.07 and 0.34 for the physical and school dimensions, respectively (unadjusted: 1.09 and 0.16).
Conclusion:  The KIDSCREEN-52 functions in a similar way in children with CP and in the general population. Comparisons of quality of life between such children are therefore likely to be valid.