Development and validation of an instrument for measuring the burden of medicine on functioning and well-being: the Medication-Related Burden Quality of Life (MRB-QoL) tool.
ABSTRACT: OBJECTIVE:Medication-related burden (MRB) is a negative experience with medicine, which may impact on psychological, social, physical and financial well-being of an individual. This study describes the development and initial validation of an instrument specifically designed to measure MRB on functioning and well-being-the Medication-Related Burden Quality of Life (MRB-QoL) tool. METHODS:An initial pool of 76-items for MRB-QoL was generated. The link to MRB-QoL survey was sent to a sample of consumers living with at least one chronic medical condition and taking ?3?prescription medicines on a regular basis. Exploratory factor analysis (EFA) was used to determine the underlining factor structure. Internal consistency (Cronbach's ?) and construct validity were examined. The latter was examined through correlation with Medication Regimen Complexity Index (MRCI), Drug Burden Index (DBI) and Charlson's Comorbidity Index (CCI). RESULTS:367 consumers completed the survey (51.2% male). EFA resulted in a 31-item, five-factor solution explaining 72% of the total variance. The five subscales were labelled as 'Routine and Regimen Complexity' (11 items), 'Psychological Burden' (six items), 'Functional and Role Limitation' (seven items), 'Therapeutic Relationship' (three items) and 'Social Burden' (four items). All subscales showed good internal consistency (Cronbach's ? 0.87 to 0.95). Discriminant validity of MRB-QoL was demonstrated via its correlations with MRCI (Spearman's r -0.16 to 0.08), DBI (r 0.12 to 0.28) and CCI (r -0.23 to -0.15). Correlation between DBI and 'Functional and Role Limitation' subscale (r 0.36) indicated some evidence of convergent validity. Patients with polypharmacy, multiple morbidity and DBI >0 had higher median scores of MRB-QoL providing evidence for known group validity. CONCLUSIONS:The MRB-QoL V.1 has good construct validity and internal consistency. The MRB-QoL may be a useful humanistic measure for evaluating the impact of pharmaceutical care interventions on patients' quality of life. Future research is warranted to further examine additional psychometric properties of MRB-QoL V.1 and its utility in patient care.
Project description:The Adult Carer Quality of Life questionnaire (AC-QoL) is a reliable and valid instrument used to assess the quality of life (QoL) of adult family caregivers. We explored the psychometric properties and tested the reliability and validity of a Chinese version of the AC-QoL with reliability and validity testing in 409 Chinese stroke caregivers. We used item-total correlation and extreme group comparison to do item analysis. To evaluate its reliability, we used a test-retest reliability approach, intraclass correlation coefficient (ICC), together with Cronbach's alpha and model-based internal consistency index; to evaluate its validity, we used scale content validity, confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) via principal component analysis with varimax rotation. We found that the CFA did not in fact confirm the original factor model and our EFA yielded a 31-item measure with a five-factor model. In conclusions, although some items performed differently in our analysis of the original English language version and our Chinese language version, our translated AC-QoL is a reliable and valid tool which can be used to assess the quality of life of stroke caregivers in mainland China. Chinese version AC-QoL is a comprehensive and good measurement to understand caregivers and has the potential to be a screening tool to assess QoL of caregiver.
Project description:The 15-item University of Washington Quality of Life questionnaire-Radiation Therapy Oncology Group (RTOG) modification (UW-QOL-RTOG modification) has been used in several trials of head and neck cancer conducted by NRG Oncology such as RTOG 9709, RTOG 9901, RTOG 0244, and RTOG 0537.This study is an exploratory factor analysis (EFA) to establish validity and reliability of the instrument subscales.EFA on the UW-QOL-RTOG modification was conducted using baseline data from NRG Oncology's RTOG 0537, a trial of acupuncture-like transcutaneous electrical nerve stimulation in treating radiation-induced xerostomia. Cronbach ? coefficient was calculated to measure reliability; correlation with the University of Michigan Xerostomia Related Quality of Life Scale was used to evaluate concurrent validity; and correlations between consecutive time points were used to assess test-retest reliability.The 15-item EFA of the modified tool resulted in 11 items split into four factors: mucus, eating, pain, and activities. Cronbach ? ranged from 0.71 to 0.93 for the factors and total score, consisting of all 11 items. There were strong correlations (? ? 0.60) between consecutive time points and between total score and the Xerostomia Related Quality of Life Scale total score (? > 0.65).The UW-QOL-RTOG modification is a valid tool that can be used to assess symptom burden of head and neck cancer patients receiving radiation therapy or those who have recently completed radiation. The modified tool has acceptable reliability, concurrent validity, and test-retest reliability in this patient population, as well as the advantage of having being shortened from 15 to 11 items.
Project description:Background and objective Quality of life (QoL) is a multi-dimensional concept and its assessment is one of important themes of care for older people. Assessing QoL in older people needs specific scales. The aim of this study was to culturally adapt and investigate the psychometric properties of the Persian version of brief Older People’s Quality of Life questionnaire (OPQOL-brief) in an Iranian older population. Methods This methodological cross-sectional study was conducted among 525 Persian-speaking older people (aged 60 and over), living in Isfahan, Iran. Translation of the OPQOL-brief questionnaire was performed using forward–backward method. Test–retest reliability was evaluated through Intra Class Correlation (ICC) coefficient and internal consistency by using Cronbach’s ?. Construct validity was investigated by using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Latent class analysis (LCA). Criterion, convergent and discriminant validities were also assessed. Results Persian version of the OPQOL-brief showed good test–retest reliability (ICC?=?0.842, 95% CI?=?0.73–0.91; P?<?0.001). Persian OPQOL-brief scale demonstrated high internal consistency (Cronbach’s ??=?0.83). It showed good discriminant validity and differentiated old patients from healthy older individuals (P?<?0.001). Construct validity based on EFA led to extraction of three dimensions (“socioeconomic”, “emotional”, and “physical” well-being) and the CFA confirmed the adequacy of extracted construct from EFA (CFI?=?0.909, PCFI?=?0.52, PNFI?=?0.5, CMIN/DF?=?3.012, and RMSEA?=?0.08). LCA classified participants into three classes in terms of QoL level (low (16%), middle (67%), and high (17%)). Criterion validity and convergent validity revealed significant positive correlations between OPQOL-brief and physical and psychological dimensions of the SF-36. Conclusion The Persian version of the OPQOL-brief is a reliable and valid instrument for assessing QoL with applicability in a broad range of older Persian language population.
Project description:<h4>Background</h4>No specific scale to measure Quality of Life in Alzheimer's Disease in Nursing Homes (QoL-AD NH) exists in French. We aimed to translate and culturally adapt the QoL-AD NH participant scale into a French version and evaluate its psychometric properties with residents in French nursing homes (EHPAD).<h4>Methods</h4>First, the QoL-AD NH was cross-culturally adapted into French according to guidelines. Secondly, a convenience group of residents with mild to moderate dementia answered the Folstein's test and the QoL-AD NH. They also answered the Dementia Quality of Life and the Geriatric Depression Scale to test convergent and divergent validity. Known-group validity was tested with a comparison group of residents without dementia. Exploratory Structural Equation Modeling (ESEM) was used after Exploratory Factor Analysis (EFA) to identify factors and measure invariance across age and mental state groups. Reliability (internal consistency, McDonald's omega and test-retest) were also measured.<h4>Results</h4>Following successful adaptation of the QoL-AD NH, 174 residents (mean age 86.6) from 7 nursing homes with mild to moderate dementia participated in the validation study. We retained a 3-factor model of the scale after ESEM identifying: "Intra & interpersonal environment-related QoL", "Self-functioning-related QoL" and "Perceived current health-related QoL" that were invariant across age and mental state groups. The QoL-AD NH had acceptable convergent (ρ range 0.24-0.53) and divergent validity (ρ range - 0.43 to - 0.57) and good known-group validity with 33 residents without dementia (t(205) = 2.70, p = .007). For reliability, the results revealed very good and adequate internal consistency (α = 0.86 for total scale and ≥ 0.71 for subscales). All total omega values exceeded the threshold 0.70. The hierarchical omega was 0.50, supporting the multidimensionality of the scale. Hierarchical omega subscale values exceeded the minimal level 0.50 except for the third factor, although reliable, would deserve more items. Test-retest was good with ICC (3,1) = 0.76.<h4>Conclusions</h4>The QoL-AD NH French participant version has globally good reliability and validity for evaluating residents' quality of life. However, further studies must rework and confirm the factor structure, test sensitivity to change and responsiveness.
Project description:To assess the factorial structure, internal consistency, construct validity and reproducibility of the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS).An Exploratory Factor Analysis (EFA) was performed on QWLQ-CS data from a sample of employed cancer survivors to establish the final number of items and factorial structure of the QWLQ-CS. Internal consistency was assessed using Cronbach's alpha. In a second sample of (self-)employed cancer survivors, construct validity was tested by convergent validity (correlations of QWLQ-CS with construct-related questionnaires), and discriminative validity (difference in QWLQ-CS scores between cancer survivors and employed people without cancer). In a subgroup of stable cancer survivors subtracted from the second sample, reproducibility was evaluated by Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM).EFA on QWLQ-CS data of 302 cancer survivors resulted in 23 items and five factors. The internal consistency of the QWLQ-CS was Cronbach's ??=?0.91. Convergent validity on data of 130 cancer survivors resulted in r?=?0.61-0.70. QWLQ-CS scores of these cancer survivors statistically differed (p?=?0.04) from employed people without cancer (N?=?45). Reproducibility of QWLQ-CS data from 87 cancer survivors demonstrated an ICC of 0.84 and a SEM of 9.59.The five-factor QWLQ-CS with 23 items and adequate internal consistency, construct validity, and reproducibility at group level can be used in clinical and occupational healthcare, and research settings.
Project description:RATIONALE:Having developed the first disease-specific, health-related quality of life (HRQoL) instruments for children with primary ciliary dyskinesia (PCD), we aimed to assess the psychometric performance of quality of life (QOL)-PCD child, adolescent, and parent-proxy versions in terms of reliability and validity across cross-cultural settings and caring for patients with this rare disease. METHODS:Children (n?=?71), adolescents (n?=?85), and parents (n?=?68) from multiple centers in the UK and North America completed age-appropriate QOL-PCD and generic QOL measures: pediatric QOL inventory, COPD assessment test (CAT), and Sino-Nasal Outcome Test 20. Total of 13 children, 13 parents, and 17 adolescents repeated QOL-PCD 10 to 14 days later to assess test-retest reliability. Multitrait analysis evaluated how the items loaded to hypothesized scales: physical, emotional & social functioning, treatment burden, role, vitality, upper and lower respiratory symptoms, and ears and hearing symptoms. Examination of item-to-total correlations led to removal of three, five, and six items, respectively in the prototype child, adolescent and parent-proxy versions; the validated measures now comprise between 34 and 38 items. RESULTS:The QOL-PCD scales had good internal consistency; Cronbach's ? for QOL-PCD parent-proxy ranged 0.62 to 0.86. Test-retest reliability demonstrated stability across all scales; for example QOL-PCD adolescent intraclass correlation coefficients ranged 0.71 to 0.89. Significant relationships were found between QOL-PCD scales and similar constructs on generic questionnaires, for example, QOL-PCD adolescent lower respiratory symptoms and the CAT score (r?=?.64, P?<?.01); weaker correlations were found between different constructs. CONCLUSION:Age-specific QOL-PCD demonstrated good internal consistency, test-retest reliability, and validity. QOL-PCD offers promising outcome measures for multicenter clinical trials, as well as monitoring symptoms, functioning, and QOL during routine care.
Project description:Responsiveness of physicians is the social actions that physicians do to meet the legitimate expectations of service seekers. Since there is no such scale, this study aimed at developing one for measuring responsiveness of physicians in rural Bangladesh, by structured observation method.Data were collected from Khulna division of Bangladesh, through structured observation of 393 patient-consultations with physicians. The structured observation tool consisted of 64 items, with four Likert type response categories, each anchored with a defined scenario. Inter-rater reliability was assessed by same three raters observing 30 consultations. Data were analyzed by exploratory factor analysis (EFA), followed by assessment of internal consistency by ordinal alpha coefficient, inter-rater reliability by intra-class correlation coefficient (ICC), concurrent validity by correlating responsiveness score with waiting time, and known group validity by comparing public and private sector physicians.After removing items with more than 50% missing values, 45 items were considered for EFA. Parallel analysis suggested a 5-factor model. Nine items were removed from the list owing to?<?0.50 communality, <0.32 loading in un-rotated matrix, and <0.30 on any factor in rotated matrix. Since 34 items (i.e., the number of remaining items after removing nine items by EFA) were loaded neatly under five factors, explained 61.38% of common variance, and demonstrated high internal consistency with coefficient of 0.91, this was adopted as the Responsiveness of Physicians Scale (ROP-Scale). The five factors were named as 1) Friendliness, 2) Respecting, 3) Informing and guiding, 4) Gaining trust, and 5) Financial sensitivity. Inter-rater reliability was high, with an ICC of 0.64 for individual rater's reliability and 0.84 for average reliability scores. Positive correlation with waiting time (0.51), and higher score of private sector by 0.18 point denote concurrent, and known group validity, respectively.The ROP-Scale consists of 34 items grouped under five factors. One can apply this with confidence in comparable settings, as this scale demonstrated high internal consistency and inter-rater reliability. More research is needed to test this scale in other settings and with other types of providers.
Project description:OBJECTIVES:The aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff. METHODS:The 22-items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross-sectional survey. The internal consistency reliability was estimated using Cronbach's ?. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work. RESULTS:In total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's ? values demonstrated acceptable internal consistency in two scales (supervisor support ? = .87; coworker support ? = .86), while Cronbach's ? was below the acceptable threshold of 0.70 for job control (? = .45) and job demand (? = .50). EFA assuming a four-factor structure showed a factor structure that was almost identical to the original JCQ, with two items loading on other scales. The subscales of depression, anxiety, and stress response of DASS 21 and the subscales of JCQ were significantly correlated, as expected. CONCLUSION:The results suggest that the JCQ in Vietnamese can be used with some reliability and validity for examining psychosocial work environment among nurses. Further studies should be done to confirm and expand our findings in a variety of occupational groups and in other Asian low- and middle-income countries.
Project description:Objectives:This study aims to develop the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes (DNSS-T2DM) to measure diabetes-specific support and patients' preference as well as evaluate the construct validity and reliability of the DNSS-T2DM. Methods:A cross-sectional study was conducted in Tongzhou District, Beijing, China from July to September 2015. A total of 474 participants who had been diagnosed as type 2 diabetes by physicians and completed the DNSS-T2DM were included. The original 11-item DNSS-T2DM contains five items on nondirective support (Items 1-5) and six items on directive support (Items 6-11). There were two parallel questions for each item with one to measure the preference for support (Preference part) and the other to measure the perception of support in reality (Reality part). The final DNSS-T2DM was determined based on the results of the exploratory factor analysis (EFA). The construct validity of the final DNSS-T2DM was evaluated by the confirmatory factor analysis (CFA). The reliability was evaluated by internal consistency with Cronbach's ? coefficients. Results:A final 7-item DNSS-T2DM loaded on 2 factors with four items representing nondirective support and three items representing directive support was determined based on the EFA. The CFA indicated a satisfactory construct validity. The internal consistency of the 7-item DNSS-T2DM as well as the nondirective support items was satisfactory with Cronbach's ? ? 0.70. Conclusions:Our study supported the validity and reliability of the 7-item DNSS-T2DM. Further studies on the application of the DNSS-T2DM in different settings and population are needed.
Project description:<h4>Background</h4>The Prolapse Quality of Life (P-QoL) is a disease-specific instrument designed to measure the health-related quality of life in women with prolapse; however, there is no Amharic version of the instrument. The aim of this study were to translate the P-QoL into Amharic and evaluate its psychometric properties among adult women.<h4>Methods</h4>We followed an intercultural adaptation procedure to translate and adapt the P-QoL. A forward-backward translation, face validity interviews with experts and cognitive debriefing of the translated version with ten adults from the target group were performed. The Amharic version was then completed by 230 adult women with and without POP symptoms. All women were examined using a simplified Pelvic Organ Prolapse Quantification (SPOP-Q) system. We examined internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficient?=?ICC). Confirmatory factor analysis (CFA) was conducted and model fit was discussed. We extracted a new factor structure by exploratory factor analysis (EFA). Criterion validity was also assessed against the SPOP-Q stage.<h4>Results</h4>The translated measure was found acceptable by the experts and target group, with only minor adaptations required for the Amharic context. It had high internal consistency (??=?0.96) and test-retest reliability (ICC?=?0.87; p?<? 0.001). In CFA results, the model fit indices were unacceptable (CFI?=?0.69, RMSEA?=?0.17, SRMR?=?0.43, TLI?=?0.65, and PCLOSE?=?0.00). EFA extracted three-factor with satisfactory convergent and discriminant validity. The P-QoL median scores were significantly higher in symptomatic women (Mann-Whitney U Test; p?<? 0.001). The score was also significantly correlated with stage of prolapse (Spearman's correlation coefficient?=?0.42 to 0.64, p?<? 0.001).<h4>Conclusions</h4>The P-QoL scale was successfully translated to Amharic and appears feasible, reliable and valid for Amharic-speaking women. Factor analysis confirmed a three-factor structure, inconsistent with the original English version. Further studies are needed to evaluate responsiveness of the Amharic P-QoL score.