Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ‐C30?

HINZ A., EINENKEL J., BRIEST S., STOLZENBURG J.‐U., PAPSDORF K. & SINGER S. (2012) European Journal of Cancer Care 21 , 677–683 Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ‐C30? The aim of this paper is to test the psychometric properties of sum scores of the quality of life questionnaire EORTC QLQ‐C30. A sample of cancer patients (n= 1529) and a sample of the general population (n= 1185) were tested with the EORTC QLQ‐C30, the Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory. Three sum scores of the EORTC QLQ‐C30 are defined: a score concerning functioning, a score concerning symptoms and a total score. Compared with the two‐item quality of life scale of the EORTC QLQ‐C30, the psychometric quality of the total score and the functioning score is superior with respect to reliability, convergent validity and discriminant validity. Cronbach's alpha of the total score is 0.94 (cancer patients) and 0.95 (general population). The effect size discriminating between patients and controls is d= 0.83 for the total score, compared to only 0.50 obtained with the two‐item quality of life scale. The results prove that the calculation of sum scores provides useful information for clinicians who are interested in one generalising score of quality of life.     

Working in health access programme (WHAP): initial results

Context  Academic achievement and social class are positively related and applications to medical schools reflect a class-based bias favouring middle-class candidates. Applying a measure that is class-free could be useful as an indicator of a potential good health professional may widen the pool of applicants. In the Working in Health Access Programme (WHAP), we report on the potential usefulness of such a measure. In addition, we describe a programme for raising awareness of higher education (HE) and careers in health care.
Methods  Pupils attending schools with low HE participation rates sat a battery of psychometric tests assessing both cognitive and non-cognitive skills. A total of 2349 pupils sat the tests and 1000 of them took part in the subsequent activities. These pupils are being followed up and have obtained their Standard Grade (Year 11) examination results.
Results  Although social class influenced cognitive skills, it had no influence on non-cognitive abilities. Pupils with high levels of cognitive ability were found in all classes, including the most deprived. Both the testing and the awareness-raising programme were successful. Additional information was obtained on factors influencing the participants' choices of career.
Conclusions  Psychometric assessment could act as an early indicator for identifying potential in young people. For pupils with both cognitive and non-cognitive attributes that might indicate they would be successful in veterinary or human medicine, appropriate advice regarding subject choices for school examinations and future careers could be provided.     

Talking the talk on walking the walk

Background The Multiple Sclerosis Walking Scale (MSWS-12) was developed to measure the impact of multiple sclerosis on walking. Many other disabling neurological conditions affect patients’ ability to walk, and a generic measure of walking could provide valuable insights into patients’ perceptions in clinical trials and epidemiological studies as well as routine clinical practice. Objective To evaluate the clinical usefulness and psychometric properties of the Walking Impact Scale (Walk-12), a modified version of the MSWS-12, in patients with neurological conditions. Design A prospective, observational study of 120 consecutive patients admitted for rehabilitation. The Walk-12 was used to measure the impact of neurological disability on walking. Traditional psychometric methods (data quality, scaling assumptions, targeting, reliability, validity and responsiveness) were used to assess the Walk-12. Transition questions were used on discharge to measure perception of change. Outcome was also measured using the timed walk test (TWT), Barthel Index (BI) and Functional Independence Measure (FIM). Results For the total group, missing data were few, scaling assumptions were satisfied, and internal consistency was 0.94. Correlations between the Walk-12 and TWT, BI and FIM motor score were moderate (r = −0.58, −0.26, −0.31). Responsiveness of the Walk-12 was high (effect size = 1.12). Relationships between effect size and patients’ and physiotherapists’ opinion of change in walking demonstrated good concordance. Preliminary subgroup analyses indicate satisfactory psychometric properties across different neurological conditions; however, sample numbers in these analyses are small. Conclusions In this sample of neurologically disabled patients the Walk-12 was clinically useful and satisfied standard psychometric criteria. This provides preliminary evidence that it may be suitable as a generic measure of walking ability. Received in revised form: 9 February 2006     

High-Tech Home Health Care

This study examines staff perspectives and personnel issues related to the delivery of high-tech home health care services to older adults. Data were collected from a national sample of 154 agency directors and 92 local agency staff. Agency staff and directors consistently report an increase in high-tech service delivery over the past five years. Both agency directors and local staff agree that a variety of staff may be involved in the delivery of high-tech services, including both professional and paraprofessional staff. Although agency directors report providing training to at least one or more type of direct care staff, agency staff are less likely to report being required to participate in training programs. The provision of high-tech services impacts the agency, the staff, and the patient in various ways. Most staff feel that high-tech care enhances the quality of life of older patients, although high-tech care may be somewhat difficult to define and even more difficult to deliver. Challenges related to the provision of high-tech care, including providing adequate staff training, and developing appropriate quality assurance measures, are discussed.     

The Quality of Life in Care questionnaire: An assessment of feasibility,test–retest reliability and responsiveness in a clinical sample

This study determined the feasibility, test–retest reliability and responsiveness of the Quality of Life in Care (QOLIC), a measure of health-related quality of life (HRQoL) developed specifically for children in public care. Based on the Pediatric Quality of Life Inventory? (PedsQL?) model, this questionnaire has previously demonstrated good validity and internal reliability. Two forms of the questionnaire are available, a self-completed report for children and a parallel proxy report for completion by carers. Thirty-five children aged between 8 and 17 years, and their carers, completed the PedsQL generic module and QOLIC on two separate occasions. At the second completion, carers and children were asked to rate whether the child's physical and emotional health had changed (improved, got worse or stayed the same) since the first questionnaire was completed to enable test–retest reliability and responsiveness to a change in health to be calculated. Both measures demonstrated good feasibility with missing responses of less than 1%. No floor effects and minimal to moderate ceiling effects were found. Test–retest reliability could not be established due to the small numbers reporting no change in their health status. However, it can be argued that responsiveness is more important, when looking at a changeable population such as this one. Good responsiveness was established for self-reported PedsQL and QOLIC measures, and for the proxy version of QOLIC. Therefore, this study provides further evidence that QOLIC provides a valid and reliable measure of HRQoL. QOLIC is easy to use and therefore has the potential to have a major impact on clinical practice with children in public care. It is recommended that future studies focus on assessing the ability of the measure to differentiate between groups of “looked-after” children.     

学员用军校理科大学教员评价量表的编制及信效度检验

目的编制学员用军校理科大学教员评价量表,为今后选拔、评估军校理科大学教员提供量化评价工具。方法基于前期构建的"军校教员胜任特征模型",根据军校学员评价教员的侧重点,采用问卷调查法和专家论证法,对"同行用军校理科大学教员评价指标体系及权重体系"进行必要修改,最后构建起适应学员的军校理科大学教员评价指标权重体系,再依据权重体系把评价指标体系转化为评价量表。初步编制的量表经预测后形成实测量表,用实测量表正式施测,以某军校优秀教员为效标,检验量表的效标效度。又针对同一批评价对象进行了重测。结果各分量表和总量表的Cronbach’sα系数和重测系数分别在0.769~0.878、0.805~0.895。对学员用评价量表42个题项和自评量表得分进行因素分析,接着又对学员用评价量表的分量表德、勤、体、能、绩得分进行因素分析,结果 2次得到了同样的三因素模型(课堂质量、教师能力、综合素质)可解释总方差60%以上的变异量。优秀教员组在勤、能、绩的课堂质量、总绩得分及量表总分均显著高于普通组(P0.05,P0.01)。结论编制的学员用军校理科大学教员评价量表具有良好的信度和效度,可以作为学员量化评价教员的工具。     

Prevalence of dental anxiety in an adult population in a major urban area in Sweden

The aims of the study were to describe the level of dental anxiety in a representative sample of an adult population, to evaluate different demographic variables in relation to dental anxiety, and to compare two measurement scales of dental anxiety. A random sample of residents (n = 830) of the city of Gothenburg (population 432,000) was selected for a telephone survey. The survey comprised different questions concerning demographic variables, dental care habits, and the level of dental anxiety. The methods of measurement of dental anxiety were a 10-point dental Fear Scale (FS) and the Corah Dental Anxiety Scale (DAS). A total of 620 interviews were completed giving a response rate of 74.7%. 41.4% of the respondents were males, 58.6% females. Females were significantly more likely to report a high dental anxiety compared with males. The prevalence of high dental anxiety in the sample as measured by the FS and DAS was 6.7% and 5.4% respectively. The correlation between the FS and DAS was 0.81. The distribution of high dental anxiety and age showed a clearly and significantly higher portion of dental anxiety in the age group 20-39 yr compared to both younger and older groups. The effect of dental anxiety on regularity of dental visits revealed a significant difference as measured by the FS. No significant correlation was found between dental anxiety and educational level or income. A majority of the respondents (82-95%) expressed a desire for establishment of a special dental fear treatment clinic without need for referral.