Cross-cultural adaptation, reliability and validity of the Spanish version of the upper limb functional index

Background The Upper Limb Functional Index (ULFI) is an internationally widely used outcome measure with robust, valid psychometric properties. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp). Methods A two stage observational study was conducted. The ULFI was cross-culturally adapted to Spanish through double forward and backward translations, the psychometric properties were then validated. Participants (n = 126) with various upper limb conditions of >12 weeks duration completed the ULFI-Sp, QuickDASH and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample determined internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n = 35) determined reliability at seven days. Results The ULFI-Sp demonstrated high internal consistency (α = 0.94) and reliability (r = 0.93). Factor structure was one-dimensional and supported construct validity. Criterion validity with the EQ-5D-3 L was fair and inversely correlated (r = −0.59). The QuickDASH data was unavailable for analysis due to excessive missing responses. Conclusions The ULFI-Sp is a valid upper limb outcome measure with similar psychometric properties to the English language version.

Extending the validity of the Feeding Practices and Structure Questionnaire

Background Feeding practices are commonly examined as potentially modifiable determinants of children’s eating behaviours and weight status. Although a variety of questionnaires exist to assess different feeding aspects, many lack thorough reliability and validity testing. The Feeding Practices and Structure Questionnaire (FPSQ) is a tool designed to measure early feeding practices related to non-responsive feeding and structure of the meal environment. Face validity, factorial validity, internal reliability and cross-sectional correlations with children’s eating behaviours have been established in mothers with 2-year-old children. The aim of the present study was to further extend the validity of the FPSQ by examining factorial, construct and predictive validity, and stability. Methods Participants were from the NOURISH randomised controlled trial which evaluated an intervention with first-time mothers designed to promote protective feeding practices. Maternal feeding practices (FP) and child eating behaviours were assessed when children were aged 2 years and 3.7 years (n=388). Confirmatory Factor analysis, group differences, predictive relationships, and stability were tested. Results The original 9-factor structure was confirmed when children were aged 3.7±0.3 years. Cronbach’s alpha was above the recommended 0.70 cut-off for all factors except Structured Meal Timing, Over Restriction and Distrust in Appetite which were 0.58, 0.67 and 0.66 respectively. Allocated group differences reflected behaviour consistent with intervention content and all feeding practices were stable across both time points (range of r= 0.45-0.70). There was some evidence for the predictive validity of factors with 2 FP showing expected relationships, 2 FP showing expected and unexpected relationships and 5 FP showing no relationship. Conclusions Reliability and validity was demonstrated for most subscales of the FPSQ. Future validation is warranted with culturally diverse samples and with fathers and other caregivers. The use of additional outcomes to further explore predictive validity is recommended as well as testing construct validity and test-retest reliability of the questionnaire.

Development, reliability and validity of the queensland evaluation of wheelchair skills (QEWS)

- Objectives To develop and test a valid and reliable assessment of wheelchair skills for individuals with spinal cord injuries (SCI); the Queensland Evaluation of Wheelchair Skills (QEWS). - Setting Hospital, Australia. - Methods Phase 1: Four Delphi panel rounds with clinical experts were used to develop the QEWS. Phase 2: Intra-rater and inter-rater reliability of the QEWS items were examined in 100 people with SCI. Phase 3a: Concurrent validity was investigated by examining the association between QEWS total scores and physiotherapists’ global ratings of wheelchair skill performance. Phase 3b: Construct validity was tested in 20 people with recent SCI by examining change in QEWS total scores between when they first mobilised in a wheelchair and scores obtained 10 weeks later. - Results Phase 1: The QEWS was developed. Phase 2: The intra-class correlation coefficients reflecting the intra-rater reliability and the inter-rater reliability for the QEWS total score were 1.00 and 0.98, with scores being within one point of each other 96 and 91% of the time, respectively. Phase 3a: The QEWS total scores were comparable with the global rating of wheelchair skill performance (r2=0.93). Phase 3b: The QEWS scores changed by a median (interquartile range (IQR)) of 4 (1 to 6) points over the 10-week period following first wheelchair mobilisation. - Conclusion The QEWS is a valid and reliable tool for measuring wheelchair skills in individuals with SCI. The QEWS is efficient and practical to administer and does not require specialised equipment.

Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

Background A 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users’ experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items. Objectives Establish the construct and concurrent validity of GPPS items evaluating service users’ experience of GP out-of-hours care. Methods Cross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the ‘entry access’ (four items) and ‘consultation satisfaction’ (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions. Results The modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the ‘entry access’ scores (r=0.63) and 44.0% of variation in the ‘consultation satisfaction’ scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ. Conclusions Minor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users’ overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.

A psychometric analysis of reliability and validity of the index of learning styles (ILS)

Prior literature showed that Felder and Silverman learning styles model (FSLSM) was widely adopted to cater to individual styles of learners whether in traditional or Technology Enhanced Learning (TEL). In order to infer this model, the Index of Learning Styles (ILS) instrument was proposed. This research aims to analyse the soundness of this instrument in an Arabic sample. Data were integrated from different courses and years. A total of 259 engineering students participated voluntarily in the study. The reliability was analysed by applying internal construct reliability, inter-scale correlation, and total item correlation. The construct validity was also considered by running factor analysis. The overall results indicated that the reliability and validity of perception and input dimensions were moderately supported, whereas processing and understanding dimensions showed low internal-construct consistency and their items were weakly loaded in the associated constructs. Generally, the instrument needs further effort to improve its soundness. However, considering the consistency of the produced results of engineering students irrespective of cross-cultural differences, it can be adopted to diagnose learning styles.

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.

Evaluation of cervial range of motion and isometric nech muscle strngth: reliability and validity

Objective: To examine the test–retest reliability and construct validity of cervical active range of motion and isometric neck muscle strength as measured by the Multi Cervical Rehabilitation Unit (Hanoun Medical Inc., Ontario).
Design: A cross-sectional study.
Setting: Institutional practice.
Subjects: Twenty-one patients with neck pain and 25 healthy volunteers.
Methods: After a trial-run session, active range of motion (AROM) was measured in the subsequent two sessions, with 2–3 days in between. During each session, three measurements were taken for each direction (flexion, extension, lateral flexions and rotations). The measurement of isometric strength was after a 15-minute break following completion of the measurement of AROM. Three measurements were made for each of the six directions (flexion, extension, lateral flexions, protraction and retraction). The software of the Multi Cervical Rehabilitation Unit automatically recorded and calculated the maximum AROM and isometric strength.
Results: There was a good to high level of reliability in the measurement of AROM for both groups of subjects, with intraclass correlation coefficients (ICCs) ranging from 0.81 to 0.96. Results also demonstrated very good to excellent reliability in isometric strength measurement (ICCs ranged from 0.92 to 0.99). Moreover, there was a significant difference in isometric neck muscle strength (p = 0.001) and in AROM (p = 0.034) between the two groups.
Conclusions: The Multi Cervical Rehabilitation Unit was found to be reliable and valid for testing the cervical active range of motion and isometric neck muscle strength for both normal and patient subjects.

Examination of the validity and usefulness of the video suggestibility scale for children

The Video Suggestibility Scale for Children (VSSC) was developed by Scullin and colleagues (Scullin & Ceci, 2000; Scullin & Hembrooke, 1998) as a tool for discriminating between children who have different levels of suggestibility. The scale requires children to view a 5-minute video about a birthday party, and to subsequently participate in an interview consisting of 18 yes/no questions. The VSSC consists of two main subscales; Yield (a measure of children's willingness to respond affirmatively to misleading questions about the video) and Shift (a measure of the children's tendency to change their responses after negative feedback from the interviewer). Preliminary research by Scullin and colleagues suggested that the scale possesses satisfactory internal consistency and that children's scores on the VSSC can predict their performance in another suggestibility paradigm. This thesis presents two studies, which further examine the validity and usefulness of the VSSC in an Australian sample of 3- to-5-year-old children. In Study One, children's performance on the VSSC (N = 77) was compared to their performance using other measures of suggestibility. These measures included children's willingness to assent to a false event as well as the number of false interviewer suggestions and new false details that the children provided in their accounts about an independent true-biased and an independent false (non-experienced) event. An independent samples t-test revealed that those children who assented to the false activity generated higher scores on the Yield measure. This pattern was also observed for the Shift subscale although it was not significant. Hierarchical regression analyses revealed that Yield was a significant predictor of the number of false details reported about the false activity, but not the true-biased activity. There was no significant relationship between the Shift Vlll subscale and any of the dependent variables. Overall this study provided partial support for the construct validity of the VSSC. However, it indicated that children's performance on this scale may not be generalisable across different contexts and interview paradigms, and that the Yield subscale is more generalisable than the Shift subscale. Study Two examined whether various group and individual factors that have previously been shown to relate suggestibility (i.e., age, IQ, memory, socio-economic status, gender, temperament) could predict suggestibility as measured by the VSSC. Two hundred and twenty children were recruited from kindergartens, and were divided into two broad socio-economic categories (based predominantly on income). Hierarchical regression analyses revealed that age, intelligence and memory inversely predicted children's Yield suggestibility. Further, children of low socio-economic backgrounds were more suggestible than children of high socio-economic background, and boys were more suggestible than girls on the Yield measure. Although shyness and other internalised and externalised characteristics were explored, no reliable significant relationships were found with Yield. With regard to the Shift subscale, no reliable relationships were found for any of the independent variables except for SES. Overall, results of Study 2 indicated that the VSSC is a potentially useful measure for discriminating between children's suggestibility on the basis on their individual characteristics, although benefits were observed mainly in relation to the Yield subscale. With reference to the findings of these two studies, the potential contribution of the VSSC for research and applied forensic contexts was discussed.

The quality-of-relationship construct in IT outsourcing

This paper reports on the conceptualization and measurement of an important management controllable factor affecting the success of an information technology outsourcing (ITO) arrangement, namely Quality of Relationship (QoR). Attributes of the construct were identified from an analysis of the literature, and key attributes selected based on interviews with 29 managers in four pairs of client and supplier organizations. Construct validity of the resultant measure is assessed through comparison with qualitative interview data, and through tests of association between our measure and perceived overall ITO success. The results suggest that the ten indicators identified in the paper provide a valid measure of the quality of relationship that can be used by both client and supplier managers, and researchers, in assessing the health of an ITO relationship.

Reliability and validity of a reactive agility test for Australian football

Purpose: The aim of this study was to test the reliability and construct validity of a reactive agility test (RAT), designed for Australian Football (AF).

Methods: Study I tested the reliability of the RAT, with 20 elite junior AF players (17.44 ± 0.55 y) completing the test on two occasions separated by 1 wk. Study II tested its construct validity by comparing the performance of 60 participants (16.60 ± 0.50 y) spread over three aged-matched population groups: 20 athletes participating in a State Under-18 AF league who had represented their state at national competitions (elite), 20 athletes participating in the same league who had not represented their state (subelite), and 20 healthy males who did not play AF (controls).

Results: Test-retest reliability reported a strong correlation (0.91), with no significant difference (P = .22) between the mean results (1.74 ± 0.07 s and 1.76 ± 0.07 s) obtained (split 2+3). Nonparametric tests (Kruskal-Wallis and Mann-Whitney) revealed both AF groups performed significantly faster on all measures than the control group (ranging from P = .001 to .005), with significant differences also reported between the two AF groups (ranging from P = .001 to .046). Stepwise discriminant analyses found total time discriminated between the groups, correctly classifying 75% of the participants.

Conclusions: The RAT used within this study demonstrates evidence of reliability and construct validity. It further suggests the ability of a reactive component within agility test designs to discriminate among athletes of different competition levels, highlighting its importance within training activities.

Competency measurements : testing convergent validity for two measures

Aim.  This paper is a report of a study to investigate whether the Australian National Competency Standards for Registered Nurses demonstrate correlations with the Finnish Nurse Competency Scale. Background.  Competency assessment has become popular as a key regulatory requirement and performance indicator. The term competency, however, does not have a globally accepted definition and this has the potential to create controversy, ambiguity and confusion. Variations in meaning and definitions adopted in workplaces and educational settings will affect the interpretation of research findings and have implications for the nursing profession. Method.  A non-experimental cross-sectional survey design was used with a convenience sample of 116 new graduate nurses in 2005. The second version of the Australian National Competency Standards and the Nurse Competency Scale was used to elicit responses to self-assessed competency in the transitional year (first year as a Registered Nurse). Findings.  Correlational analysis of self-assessed levels of competence revealed a relationship between the Australian National Competency Standards (ANCI) and the Nurse Competency Scale (NCS). The correlational relation between ANCI domains and NCS factors suggests that these scales are indeed used to measure related dimensions. A statistically significant relationship (r = 0·75) was found between the two competency measures. Conclusion.  Although the finding of convergent validity is insufficient to establish construct validity for competency as used in both measures in this study, it is an important step towards this goal. Future studies on relationships between competencies must take into account the validity and reliability of the tools.

Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities osteoarthritis index for elderly patients with a femoral neck fracture

Background: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture.

Methods: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older.

Results: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%).

Conclusions: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations.

Validity and reliability of field-based measures for assessing movement skill competency in lifelong physical activities: a systematic review

Background: It has been suggested that young people should develop competence in a variety of ‘lifelong physical activities’ to ensure that they can be active across the lifespan. Objective: The primary aim of this systematic review is to report the methodological properties, validity, reliability, and test duration of field-based measures that assess movement skill competency in lifelong physical activities. A secondary aim was to clearly define those characteristics unique to lifelong physical activities. Data Sources: A search of four electronic databases (Scopus, SPORTDiscus, ProQuest, and PubMed) was conducted between June 2014 and April 2015 with no date restrictions. Study Selection: Studies addressing the validity and/or reliability of lifelong physical activity tests were reviewed. Included articles were required to assess lifelong physical activities using process-oriented measures, as well as report either one type of validity or reliability. Study Appraisal and Synthesis Methods: Assessment criteria for methodological quality were adapted from a checklist used in a previous review of sport skill outcome assessments. Results: Movement skill assessments for eight different lifelong physical activities (badminton, cycling, dance, golf, racquetball, resistance training, swimming, and tennis) in 17 studies were identified for inclusion. Methodological quality, validity, reliability, and test duration (time to assess a single participant), for each article were assessed. Moderate to excellent reliability results were found in 16 of 17 studies, with 71 % reporting inter-rater reliability and 41 % reporting intra-rater reliability. Only four studies in this review reported test–retest reliability. Ten studies reported validity results; content validity was cited in 41 % of these studies. Construct validity was reported in 24 % of studies, while criterion validity was only reported in 12 % of studies. Limitations: Numerous assessments for lifelong physical activities may exist, yet only assessments for eight lifelong physical activities were included in this review. Generalizability of results may be more applicable if more heterogeneous samples are used in future research. Conclusion: Moderate to excellent levels of inter- and intra-rater reliability were reported in the majority of studies. However, future work should look to establish test–retest reliability. Validity was less commonly reported than reliability, and further types of validity other than content validity need to be established in future research. Specifically, predictive validity of ‘lifelong physical activity’ movement skill competency is needed to support the assertion that such activities provide the foundation for a lifetime of activity.

Reliability, Validity and Classification Accuracy of the South Oaks Gambling Screen in a Brazilian Sample

The purpose of this study was to examine the reliability, validity and classification accuracy of the South Oaks Gambling Screen (SOGS) in a sample of the Brazilian population. Participants in this study were drawn from three sources: 71 men and women from the general population interviewed at a metropolitan train station; 116 men and women encountered at a bingo venue; and 54 men and women undergoing treatment for gambling. The SOGS and a DSM-IV-based instrument were applied by trained researchers. The internal consistency of the SOGS was 0.75 according to the Cronbach`s alpha model, and construct validity was good. A significant difference among groups was demonstrated by ANOVA (F ((2.238)) = 221.3, P < 0.001). The SOGS items and DSM-IV symptoms were highly correlated (r = 0.854, P < 0.01). The SOGS also presented satisfactory psychometric properties: sensitivity (100), specificity (74.7), positive predictive rate (60.7), negative predictive rate (100) and misclassification rate (0.18). However, a cut-off score of eight improved classification accuracy and reduced the rate of false positives: sensitivity (95.4), specificity (89.8), positive predictive rate (78.5), negative predictive rate (98) and misclassification rate (0.09). Thus, the SOGS was found to be reliable and valid in the Brazilian population.