The construct validity of brief continence self-assessment awareness questionnaires

The aim of this study was to develop brief versions of the continence self-assessment awareness questionnaire (CSAAQ), sensitive to gender-specific experiences of incontinence, and to evaluate their construct validity. Recruitment took place at four Victorian healthcare settings during 2001 and 2002. A total of 431 participants completed the CSAAQ following an appointment or hospital discharge. Factor analyses performed on CSAAQ items demonstrated there were three factors (urinary incontinence symptoms, faecal incontinence symptoms, lifestyle adjustment behaviours) for both women and men. The urinary and faecal items that loaded on their respective factors were different for women and men. Consequently two versions of the CSAAQ were developed; one for males and one for females. Analyses supported the construct validity and internal consistency reliability of the gender specific questionnaires. The brief gender specific CSAAQs could be produced as a single questionnaire with separate sections for female and male specific items. The brief CSAAQs are suitable for use as an incontinence self-assessment questionnaire to increase awareness of individual incontinence issues and to encourage health-seeking behaviours.

Pretend play and parents' view of social competence: the construct validity of the Child-Initiated Pretend Play Assessment.

Background and Aims: Play is the primary means through which children develop skills and socially interact with other children. The aim of this study was to investigate the relationship between pretend play and social competence in 4–5-year-old typically developing children, thereby adding further knowledge to the construct validity of the Child-Initiated Pretend Play Assessment (ChIPPA). Procedure: The pretend play ability of 35 preschool children aged 4–5 years was assessed using the ChIPPA. Parent/guardians of the children were interviewed regarding their child's social competence using the Vineland Social–Emotional Early Childhood Scales (Vineland SEEC Scales). Main Findings: No significant correlations were found between the children's play scores and their Vineland SEEC Scales scores. A significant and negative relationship was found between cooperation and sharing and elaborate play scores, suggesting that children who scored poorly on the play assessment were rated as cooperative by parents. Principal Conclusions: Parent report of social competence cannot be inferred from play scores. Reasons for the negative and significant finding are put forward and clinical implications of the findings are discussed. Additional investigations are necessary to further explore the construct validity of inferring social competence using the ChIPPA.

Construct validity of the Chinese version of the disability of the arm, shoulder and hand questionnaire (DASH-HKPWH)

The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages

Construct validity and reliability of the single checking administration of medications scale

Research indicates that single checking of medications is as safe as double checking; however, many nurses are averse to independently checking medications. To assist with the introduction and use of single checking, a measure of nurses' attitudes, the thirteen-item Single Checking Administration of Medications Scale (SCAMS) was developed. We examined the psychometric properties of the SCAMS. Secondary analyses were conducted on data collected from 503 nurses across a large Australian health-care service. Analyses using exploratory and confirmatory factor analyses supported by structural equation modelling resulted in a valid twelve-item SCAMS containing two reliable subscales, the nine-item Attitudes towards single checking and three-item Advantages of single checking subscales. The SCAMS is recommended as a valid and reliable measure for monitoring nurses' attitudes to single checking prior to introducing single checking medications and after its implementation.

Construct validity of the Experiences of Therapy Questionnaire (ETQ)

ObjectiveThe Experiences of Therapy Questionnaire (ETQ) is a reliable measure of adverse effects associated with psychotherapy. The measure has not been subject to validity analyses. This study sought to examine the validity of the ETQ by comparison against a measure of therapist satisfaction.MethodsParticipants were recruited from the Black Dog Institute¿s website and completed all measures online, at two time points (two weeks apart). Correlational analyses compared scale scores on the ETQ with related constructs of the Therapist Satisfaction Scale (TSS). To exclude any impact of current depression on ratings, we examined correlations between salient ETQ and TSS scales after controlling for depression severity.ResultsForty-six participants completed all the measures at both time points. Hypothesised associations between the ETQ and TSS scales were supported, irrespective of current depression severity.ConclusionsThe validity of the ETQ is supported; however limitations of the study are noted, including generalizability due to sample characteristics.

The construct validity of the work-related flow inventory in a sample of Australian workers

The purpose of this study was to examine the construct validity of the WOrk-reLated Flow inventory (WOLF; Bakker, 2008). This instrument was administered to 711 men and women who were working in Queensland, Australia. The results from the confirmatory factor analysis showed that the WOLF has moderately acceptable construct validity, with the three-factor model being a borderline fit to the data. Tests of the convergent validity of the WOLF yielded satisfactory results. However, the analysis of the discriminant validity of the WOLF showed that the instrument poorly discriminated between work enjoyment and intrinsic work motivation. Follow-up exploratory factor analysis, using recommended procedures for determining the number of factors to extract, revealed a two-factor solution, with the work enjoyment and intrinsic work motivation items loading on the same factor. Drawing on literature on psychological flow and motivation, as well as the findings of the present study, questions are raised over the adequacy of the conceptual basis of the three-factor model of work-related flow, the discriminant validity of the WOLF subscales, and the appropriateness of the wording of several of this measure's items. Using alternative methods and measures to investigate flow in work settings is recommended.

Construct validity of the pictorial scale of perceived movement skill competence

Objectives: The Pictorial Scale of Perceived Movement Skill Competence (PMSC) assesses young children's perceptions of movement skill competence: 12 perceived Fundamental Movement skills (FMS; based on the Test of Gross Motor Development 2nd edition TGMD-2) and six Active Play activities (e.g. cycling). The main study purpose was to assess whether children's movement perception scores fit within the imposed constructs of Active Play and FMS by testing the latent structure and construct validity of the PMSC.

Design: Construct validation study.

Methods: Participants were part of the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT). The latent structure of the PMSC responses was tested through confirmatory factor analysis (CFA) and Bayesian Structural Equation Modeling (BSEM). Internal consistency was conducted using polychoric correlation-based alphas.

Results: The 303 children (boys 53.1%, n = 161) were aged 4-5 years (M = 4.7, SD = 0.46). The final model had an 18 item 3-factor solution with good fit indices (using CFA and BSEM). Factors were: Active Play (Bike, Board Paddle, Climb, Skate/Blade, Scooter, and Swim), Object Control - Hand Skills (Bounce, Catch, Hit, Throw), and FMS skills with a leg action (Gallop, Hop, Jump, Leap, Run, Step Slide, Kick, Roll). Alpha reliability values were: Active Play (0.78), Object Control-Hand Skills (0.76) and FMS-Dynamic Leg (0.84).

Conclusion: Young children can distinguish between movement perceptions. The factors reflect the hypothesized structure in terms of FMS being distinguished from Active Play. Further research should investigate how and if these constructs change in children over time.

A preliminary adaptation of the Problem Gambling Severity Index for Indigenous Australians: internal reliability and construct validity

Objective: This paper describes the process employed to adapt the Problem Gambling Severity Index (PGSI) for use with Indigenous Australian populations.Methods: This study comprised a two-stage process: an initial consultation with Indigenous health workers, informing the textual and conceptual adaptation of items, followed by trial of the adjusted instrument with Indigenous community members (n=301).Results: Internal reliability was demonstrated: Australian Indigenous Problem Gambling Index (AIPGI) Cronbach's alpha α = 0.92 (Original PGSI, α = 0.84). Item-rest correlations confirmed that responses to items were consistent and related to the total score of remaining items. The AIPGI could predict gambling severity based on gambling frequency, when controlling for age and gender (OR=1.28, 95%CI 1.17–1.40).Conclusions: The adapted instrument is accessible to a cross-section of Indigenous Australians and has demonstrated properties of reliability and validity. An extended trial is needed to test the application of the instrument to a broader Indigenous audience and to further explore and confirm psychometric properties of the adapted instrument.Implications: This study introduces a culturally adapted tool for measuring rates of disordered gambling among Indigenous Australians.

The internal consistency and construct validity of the partners in health scale : validation of a patient rated chronic condition self-management measure

PURPOSE: The purpose of this study was to test the internal consistency and construct validity of the revised 12-item self-rated Partners in Health (PIH) scale used to assess patients' chronic condition self-management knowledge and behaviours. METHODS: Baseline PIH data were collected for a total of 294 patients with a range of co-morbid chronic conditions including diabetes, cardiovascular disease and arthritis. Scale data for the initial sample of 176 patients were analysed for internal consistency and construct validity using Reliability Analysis and Factor Analysis. Construct validity was tested in a separate sample of 118 patients using confirmatory factor analysis and a structural equation model. RESULTS: Good internal consistency was indicated with a Cronbach's alpha coefficient of 0.82 in the initial sample. Factor analysis for this sample revealed four key factors (knowledge, coping, management of condition and adherence to treatment) across the twelve items of the scale. These four key factors were then confirmed by applying the exploratory structural equation model to the separate sample. CONCLUSION: The PIH scale exhibits construct validity and internal consistency. It therefore is both a generic self-rated clinical tool for assessing self-management in a range of chronic conditions as well as an outcome measure to compare populations and change in patient self-management knowledge and behaviour over time. The four domains of self-management provide a valid measure of patient competency in relation to the self-management of their chronic condition(s).

Construct validity of the Dutch version of the 12-item Partners in Health scale : measuring self-management behaviour and knowledge in COPD patients

The 12-item Partner in Health (PIH) scale was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases. The scale has undergone several changes since first published. Our study aim was to validate the latest PIH in Dutch COPD patients.The 12 items of the PIH are scored on a self-rated 9-point Likert scale (range: 0-8; higher scores indicate better self-management), providing total and subscale scores (knowledge, coping, recognition and management of functions, adherence to treatment).We used forward-backward translation of the latest version of the Australian PIH. Dimensionality and reliability analyses were performed to investigate the psychometric properties, and to determine whether the Dutch PIH replicated the same four subscales of self-management as the original PIH.Reanalysis of the original PIH validation study (186 Australian patients with chronic diseases) showed a single scale. Two scales (1. knowledge and coping; 2. recognition and management of symptoms, adherence to treatment) were found for the Dutch PIH (118 Dutch COPD patients). The correlation between the two Dutch scales was 0.43. The lower-bound of the reliability of the total scale was 0.81 (Australian PIH) and 0.84 (Dutch PIH).Different scale structures were found for the original Australian and the Dutch PIH. Our results did not support the 4-scale structure reported previously. To increase comparability and generalisability of our findings, the scale structure of the revised Australian PIH needs to be investigated further. Meanwhile, we advise using the PIH total score or two subscale scores when assessing COPD patients.

Construct validity of the Dutch version of the 12-item Partners in Health scale: measuring patient self-management behaviour and knowledge in patients with Chronic Obstructive Pulmonary Disease

Objective The 12-item Partners in Health scale (PIH) was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases, and has undergone several changes. Our aim was to assess the construct validity and reliability of the latest PIH version in Dutch COPD patients.

Methods The 12 items of the PIH, scored on a self-rated 9-point Likert scale, are used to calculate total and subscale scores (knowledge; coping; recognition and management of symptoms; and adherence to treatment). We used forward-backward translation of the latest version of the Australian PIH to define a Dutch PIH (PIH(Du)). Mokken Scale Analysis and common Factor Analysis were performed on data from a Dutch COPD sample to investigate the psychometric properties of the Dutch PIH; and to determine whether the four-subscale solution previously found for the original Australian PIH could be replicated for the Dutch PIH.

Results Two subscales were found for the Dutch PIH data (n = 118); 1) knowledge and coping; 2) recognition and management of symptoms, adherence to treatment. The correlation between the two Dutch subscales was 0.43. The lower-bound of the reliability of the total scale equalled 0.84. Factor analysis indicated that the first two factors explained a larger percentage of common variance (39.4% and 19.9%) than could be expected when using random data (17.5% and 15.1%).

Conclusion We recommend using two PIH subscale scores when assessing self-management in Dutch COPD patients. Our results did not support the four-subscale structure as previously reported for the original Australian PIH.

Design, format, validity and reliability of mutiple choice questions for use in nursing research and education

Multiple choice questions are used extensively in nursing research and education and play a fundamental role in the design of research studies or educational programs. Despite their widespread use, there is a lack of evidence-based guidelines relating to design and use of multiple choice questions. Little is written about their format, structure, validity and reliability of in the context of nursing research and/or education and most of the current literature in this area is based on opinion or consensus. Systematic multiple choice question design and use of valid and reliable multiple choice questions are vital if the results of research or educational testing are to be considered valid. Content and face validity schould be established by expert panel review and construct validity should be established using ‘key check’, item discrimination and item difficulty analyses. Reliability measures include internal consistency and equivalence. Internal consistency should be established by determination of internal consistency using reliability coefficients while equivalence should be established using alternate form correlation. This paper reviews literature related to the use of multiple choice questions, current design recommendations and processes to establish reliability and validity, and discusses implications for their use in nursing research and education.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.