基于高血压患者报告的临床结局评价量表的计量心理学特征测评

目的为考察用于新药临床试验或临床疗效评价的基于高血压患者报告的临床结局评价量表(Hyper-PRO)的科学性,对其计量心理学特征进行评价。方法用Hyper-PRO量表对620例样本(536例高血压患者和84名健康人)进行自评量表式调查,对其信度、效度、反应度和临床可行性等计量心理学特征进行考评。结果分半信度系数:生理领域0.882,心理领域0.924,社会领域0.834,治疗领域0.950,整个量表0.950。克朗巴赫系数:生理领域0.839,心理领域0.905,社会领域0.770,治疗领域0.859,整个量表0.948。内容效度满意。因子分析显示量表的结构效度良好。高血压患者与健康人在每个方面的测评结果比较,除外焦虑和抑郁,其余各方面分量表及总量表得分差异均有统计学意义。结论 Hyper-PRO量表具有较好的信度(分半信度、克朗巴赫系数)、效度(内容效度、结构效度)、反应度和临床可行性,可以作为高血压临床疗效评价研究的工具。     

Validation of the Depression and Somatic Symptoms Scale by comparison with the Short Form 36 scale among psychiatric outpatients with major depressive disorder

Background: The Depression and Somatic Symptoms Scale (DSSS) is a self‐administered scale developed for monitoring both depression and somatic symptoms. The aims of this study were to establish the criterion‐related validity of the DSSS by testing the correlation between the DSSS and the Short Form 36 (SF‐36) scale and to compare the ability of the DSSS and two other scales in predicting the outcome of the SF‐36. Methods: The study enrolled 135 outpatients with a major depressive episode, 95 of whom received treatment for 1 month. Four scales were administered and evaluated: the DSSS, the SF‐36, the Hospital Anxiety and Depression Scale, and the Hamilton Depression Rating Scale. Pearson correlation was used to test correlations among scales. Multiple linear regressions were used to find the scales most effective in predicting the SF‐36. Results: The three scales were significantly correlated with most of the SF‐36 subscales. The depression and somatic subscales of the DSSS significantly correlated with the mental and physical subscales of the SF‐36, respectively. The DSSS and the Hospital Anxiety and Depression Scale were better able to predict physical and mental subscales of the SF‐36, respectively. The Hamilton Depression Rating Scale had a good ability to predict functional impairment. Conclusions: Psychometric scales with appropriate somatic symptoms might be more compatible with both physical and mental dimensions of the SF‐36. DSSS proved to be a valid scale for monitoring both depression and somatic symptoms in patients with depression. Future studies should test whether the DSSS is better at predicting the treatment and prognosis of depression than conventional scales for depression. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

The performance of the Edinburgh Postnatal Depression Scale in English speaking and non-English speaking populations in Australia

Background The Edinburgh Postnatal Depression Scale (EPDS) has been widely used to assess maternal depression following childbirth in a range of English speaking countries, and increasingly also in translation in non-English speaking ones. It has performed satisfactorily in most validation studies, has proved easy to administer, is acceptable to women, and rates of depression in the range of 10–20% have been consistently found. Methods The performance of the EPDS was compared across different population samples in Australia: (i) Women born in Australia or in another English speaking country who completed the EPDS in English as part of the 1994 postal Survey of Recent Mothers (SRM) 6–7 months after birth (n = 1166); (ii) Women born in non-English speaking countries who also completed the EPDS in English in the same survey (n = 142); and (iii) Women born in Vietnam (n = 103), Turkey (n = 104) and the Philippines (n = 106) who completed the EPDS 6–9 months after birth in translation in the Mothers in a New Country Study (MINC) study (total n = 313). The pattern of item responses on the EPDS was assessed in various ways across the samples and internal reliability co-efficients were calculated. Exploratory factor analyses were also conducted to assess the similarity in the factor solutions across the samples. Results The EPDS had good construct validity and item endorsement by women was similar across the samples. Internal reliability of the scale was also very satisfactory with Cronbach’s alpha for each sample being ≥8. Between 39 and 46% of the variance in each of the three main samples was accounted for by one principal factor ‘depression’ (6–7 items loading), with two supplementary factors ‘loss of enjoyment’ (2 items loading) and ‘despair/self-harm’ (2–3 items loading) accounting for a further 20–25% of the variance. Alternative one and two factor solutions also showed a great deal of consistency between the samples. Conclusions The good item consistency of the EPDS and the relative stability of the factor patterns across the samples are indicative that the scale is understood and completed in similar ways by women in these different English speaking and non-English speaking population groups. With the proviso that careful translation processes and extensive piloting of translations are always needed, these findings lend further support to the use of the EPDS in cross-cultural research on depression following childbirth.     

Evaluation of the psychometric properties of the BCPT Symptom Checklist with a sample of breast cancer patients before and after adjuvant therapy

Objective: The purpose of this analysis was to provide psychometric information related to the Breast Cancer Prevention Trial (BCPT) Symptom Checklist in women with breast cancer prior to the initiation of adjuvant therapy and 6 months post‐initiation of therapy. Methods: This investigation was a secondary analysis of baseline data from the Anastrozole Use in Menopausal Women (AIM) Study (R01 CA 107408). The data used in this study were obtained from women diagnosed with Stage I, II, and IIIa breast cancer and who received adjuvant therapy that included chemotherapy alone, anastrozole alone, and chemotherapy plus anastrozole. Data were examined before adjuvant therapy (n=278), and at 6 months post‐adjuvant therapy (n=195). Construct validity was examined through exploratory and confirmatory factor analysis (CFA), and the internal consistency of each resulting subscale was computed. Discriminant validity evidence was obtained by correlating BCPT subscales with subscales from the MOS SF‐36. Results: A seven‐factor structure was extracted from the 42 items at baseline; an eight‐factor structure was found using 6‐month data. CFA was performed to compare the baseline and 6‐month models as well as an eight‐factor model recommended by Cella et al. Findings revealed that the two eight‐factor models best represented the data. Low negative correlations with the subscales of the MOS SF‐36 provided discriminant validity evidence. Conclusion: This analysis provides evidence for the reliability, discriminant validity, and factor structure of the BCPT Symptom Checklist. Further testing of this instrument is needed to confirm the factor structure of this measure. Copyright © 2010 John Wiley & Sons, Ltd.     

Use of a screening questionnaire for post-traumatic stress disorder (PTSD) on a sample of UK ICU patients

Background: Although rates vary across studies, research in recent years shows that prevalence of post-traumatic stress disorder (PTSD) following intensive care unit (ICU) can be high. Presently no screening tool assessing all three PTSD symptom categories has been validated in ICU patients. The aim of the study was to conduct a preliminary validation of such a measure, the UK- Post-Traumatic Stress Syndrome 14-Questions Inventory (UK-PTSS-14).
Methods: A case series cohort study performed at two ICUs in two UK district general hospitals. The UK-PTSS-14 was administered at three time-points (4–14 days, 2 months and 3 months post-ICU discharge). At time-point three participants also completed the Post-traumatic Stress Diagnostic Scale (PDS) and the Impact of Events Scale (IES).
Results: Forty-four patients completed the 3-month follow up. The UK-PTSS-14 was internally reliable at all three time-points (Cronbach's α=0.89, 0.86 and 0.84, respectively). Test–retest reliability was highest between time-points two and three (ICC=0.90). Concurrent validity at time-point three was high against the PDS ( r =0.86) and the IES ( r =0.71). Predictive validity was highest at time-point two ( r =0.85 with the PDS and r =0.71 with the IES). Receiver operator characteristic curve analysis suggested the highest levels of sensitivity (86%) and specificity (97%) for diagnosis of PTSD were at time-point two, with an optimum decision threshold of 45 points.
Conclusion: This preliminary validation study suggests that the UK-PTSS-14 could be reliably used as a screening instrument at 2 months post-discharge from the ICU to identify those patients in need of referral to specialist psychological services.     

The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors' Unmet Needs measure)

BACKGROUND: Many cancer survivors experience ongoing morbidity over the survivorship continuum and their supportive care needs have yet to be comprehensively assessed. METHODS: This study aimed to develop and empirically evaluate a self-report measure of cancer survivors' supportive care needs. In Phase I, questionnaire items were generated based upon previous qualitative research that identified both unique and shared needs in survivors and their partners; items were constructed into the Cancer Survivors' Unmet Needs measure (CaSUN). In Phase 2, the CaSUN was completed by 353 cancer survivors who had been diagnosed with cancer between 1 and 15 years earlier and were currently disease-free. RESULTS: After modification, the CaSUN included 35 unmet need items, 6 positive change items and an open-ended question. Good acceptability, internal consistency and validity were demonstrated, although test-retest reliability was low. Maximum likelihood factor analysis identified five discrete factors: Existential Survivorship, Comprehensive Care, Information, Quality of Life and Relationships. CONCLUSIONS: Preliminary data indicates that the CaSUN meets the majority of psychometric criteria for assessment measures, although its low test-retest reliability awaits further investigation. The CaSUN will facilitate the evaluation of supportive care services and generation of service delivery recommendations for cancer survivors.     

Development and psychometric evaluation of workplace psychologically violent behaviours instrument

Aim. To develop an instrument to determine nurses’ perceptions of psychologically violent behaviours that they are exposed to in the workplace. Background. According to Leymann, psychological terror or mobbing in work life involves hostile and unethical communication, which is directed in a systematic way towards one individual who, due to mobbing, is pushed into a helpless and defenceless position, and being held there by means of continuing mobbing activities. Design. Survey. Methods. Because nurses who work in hospitals are generally the principle victims of physical, emotional and verbal violence due to the nature of their work environment, the research sample comprised 476 hospital nurses. Data were collected via self‐administered questionnaires. Results. The instrument to determine the perception of workplace psychologically violent behaviours contains 33 items and four factors (individual’s isolation from work, attack on professional status, attack on personality and direct attack). All items have shown statistically significant correlation (p < 0·01); the instrument’s total Cronbach’s α internal consistency coefficient was found to be 0·93. Conclusions. The findings show that the instrument’s validity and reliability are within the limits of an acceptable level and that it is an instrument that will encourage more studies on this subject. Relevance to practice. Defining the psychological pressure that nurses are exposed to in the workplace and determining its negative effects on the victim of workplace psychological pressure and on the institution will make it possible to protect individuals and the institution from psychological violence with both individual and institutional practices.     

A psychometric evaluation of the Chinese version of the Cardiovascular Limitations and Symptoms Profile in patients with coronary heart disease

Aims and objectives. The aim of this study was to translate from English and evaluate the validity, reliability and cultural relevance of the Cardiovascular Limitations and Symptoms Profile (CLASP) as a health‐related quality‐of‐life (HRQL) measure in Chinese patients with coronary heart disease. Background. Improvement in HRQL is increasingly used as a primary outcome in determining the treatment benefit using a generic instrument. However, disease‐specific instruments are being cited as more responsive and sensitive in detecting even the smallest changes in health status. Therefore, valid and reliable disease‐specific measures for patients with coronary heart disease are now being developed and evaluated. Design. Questionnaire design. Methods. The translation equivalence and content validity of the Chinese version of CLASP were evaluated by an expert panel. Measurement performance was tested on a convenience sample of 369 Chinese coronary heart disease patients. Results. The instrument demonstrated good content validity (content validity index 0·94), acceptable internal consistency (>0·70), except for two subscales of angina and tiredness and significant positive correlations among the subscales of CLASP, Hospital Anxiety Depression Scale and the Short Form 36 Health Survey. Principal components analysis revealed nine factors that together explained 69% of the variance. Conclusions. The results of this study support that CLASP is a valid and reliable disease‐specific health status measure for Chinese patients with coronary heart disease. However, further item modifications and testings are needed when considering the cross‐cultural context. Relevance to clinical practice. The use of disease‐specific HRQL measures could effectively evaluate nursing interventions in clinical practice. Further validations of CLASP among different diagnostic groups, such as patients with heart failure and those who have survived an acute myocardial infarction, would provide further empirical support for its use with all patients with heart disorders.     

Use of the LIFE-H in stroke rehabilitation: A structured review of its psychometric properties

Purpose.?To perform a structured review of the psychometric properties specific to the stroke population of the Assessment of Life Habits (LIFE-H). This tool measures quality of social participation, an important but under-evaluated aspect of stroke recovery.

Method.?A structured review of publications at MEDLINE; Embase, CINAHL, and the Cochrane Library using the following terms: LIFE-H, life habits, psychometric properties, measurement properties, reliability, repeatability, validity, responsiveness, appropriateness, ceiling effects, and floor effects.

Results.?Eleven studies were identified specific to stroke. Test–retest reliability was excellent (Intraclass correlation coefficients [ICCs] ranging from 0.80 to 0.95). Inter-rater reliability ranged from adequate to excellent (r?=?0.64–0.91) as well as agreement between responses of clients with stroke and their proxies (ICC ranging from 0.73 to 0.82). Convergent validity was adequate to excellent (r?=?0.57–0.91) between the LIFE-H and two measures of functional independence. Two studies, one using patients and one using caregivers, suggest the LIFE-H is able to detect change over time.

Conclusions.?The LIFE-H is a psychometrically sound measure of quality of social participation for use in post-stroke assessment and is responsive to change.     

Translation of the Manchester Clinical Supervision Scale (MCSS) into Danish and a preliminary psychometric validation

A central challenge for empirical research of clinical supervision is how to measure the effectiveness of clinical supervision. The Manchester Clinical Supervision Scale (MCSS) measures supervisees' perception of the effectiveness of clinical supervision. The aims of this paper were to account for the translation of the MCSS from English into Danish and to present a preliminary psychometric validation of the Danish version of the scale. Methods included a formal translation/back‐translation procedure and statistical analyses. The sample consisted of MCSS scores from 139 Danish mental health nursing staff members. The total MCSS score had good internal consistency, but the analyses identified a number of reliability and consistency issues. The results were compared with other translations of the MCSS and with the reduced version of the MCSS, the MCSS‐26. The discussion indicated that MCSS theoretically refers to a broad conception of supervision, which includes supervision practices ranging from highly formalized events to more frequent ad hoc sessions. The MCSS's intention to measure perceptions of supervisees from this variety of practices may be problematic, and it is suggested that a further reduction of the type of practices MCSS currently aims at measuring could be beneficial.