Development and construct validation of a parent-proxy quality of life instrument in children with bronchopulmonary dysplasia aged 4-8 years old.
ABSTRACT: PURPOSE:Children with bronchopulmonary dysplasia often develop complications that affect them well into adult life. Very little is known about how this affects their quality of life, since no sensitive instrument is available to measure health-related quality of life in this population. In this study, a Dutch parent-proxy instrument was developed for this purpose. METHODS:A list of items was generated after literature search and interviews with both parents of patients and clinical experts. Clinically relevant items were selected with the clinical impact method and item analysis. Results of clinical tests to measure complications in children with bronchopulmonary dysplasia were correlated with these items to select the items that show construct validity. Cronbach's alpha was calculated to estimate internal consistency of the items in the final questionnaire. RESULTS:In total, 92 children and their parents and 7 clinicians participated. Of 130 identified items, 47 showed clinical relevance. Spirometry, the Child Behavior Checklist, mean arterial pressure, and body mass index were used to determine construct validity of 33 items. These items were structured within five domains: pulmonary complaints, school functioning, growth and nutrition, exercise and locomotion, emotional functioning and health care concerns. The questionnaire showed excellent internal consistency with Cronbach's alpha of 0.919. CONCLUSION:This study developed a disease-specific parent-proxy instrument to measure health-related quality of life in children with bronchopulmonary dysplasia aged 4-8 years old, the BPD-QoL. All included items show construct validity and internal consistency reliability. Future research should focus on further validation and analysis of responsiveness and reliability.
Project description:BACKGROUND:The Scaling Integrated Care in Context (SCIROCCO) tool has been developed to facilitate knowledge transfer and learning about the implementation and scaling-up of integrated care in European regions. To adequately test the functionality of the tool in assessing the maturity for integrated care within regions, this study evaluated its structural validity, internal consistency and convergent validity. METHODS:Exploratory factor analysis was used to investigate the structural validity of the 12-items of the SCIROCCO tool. Hereafter, the internal consistency was assessed by calculating Cronbach's and ordinal alpha. The convergent validity was explored by testing 23 pre-hypothesized relationships between items of the SCIROCCO tool and items of an instrument measuring a similar construct. RESULTS:Factor analysis revealed a one-factor structure. Cronbach's alpha of the overall instrument was 0.92, ordinal alpha was 0.94. Only 30.34% of the hypotheses for testing the convergent validity were met. CONCLUSION:The one-factor structure is considered relevant in representing the structural validity of the SCIROCCO tool. The scale of the SCIROCCO tool shows good internal consistency. The tool (DMIC Quickscan) used to assess the convergent validity might measure a different aspect of integrated care than the SCIROCCO tool. Further research is needed to continue investigating the validity and reliability of the tool.
Project description: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:Rosacea is a common chronic facial disorder that affects patients' health-related quality of life; the only questionnaire designed specifically for rosacea is the Rosacea-specific Quality-of-Life instrument (RosQol). However, the questionnaire has not been validated among Chinese patients. This study aimed to validate the Chinese version of the RosQol. First, we translated the questionnaire into Chinese. Then, rosacea patients completed the RosQol and Dermatology Life Quality Index, indicating the disease's impact on their lives. We also collected patients' demographic and clinical data, including symptom self-evaluation scores and rosacea severity scores. Internal consistency was determined by using Cronbach's alpha, test-retest reliability, and Spearman's correlation. Criterion-related validity and internal construct validity were also determined. Most RosQol items showed good internal consistency. However, items 13 and 19 were not sufficiently sensitive for use in the Chinese population; we deleted them and constructed the adjusted Chinese-version RosQol, which had good reliability and validity. When patients' clinical symptoms changed, the scores on the relevant dimensions of the adjusted RosQol also changed. Some RosQol items were not suitable for use in the Chinese sample. The adjusted Chinese-version RosQol was easy to complete, well received by patients, and demonstrated acceptable validity and reliability.
Project description:<h4>Background</h4>Oral health related quality of life (OHRQoL) research among children and adolescents in Lithuania is just starting and no measures have been validated to date. Therefore, this study aimed to validate a Lithuanian version of the full (37 items) Child Perceptions Questionnaire (CPQ<sub>11-14</sub>) within a random sample of children aged 11 to 14.<h4>Methods</h4>A cross-sectional survey among a randomly selected sample of schoolchildren (N =?307) aged 11 to14 was conducted. An anonymous questionnaire included the full CPQ<sub>11-14</sub> and items on global life satisfaction, oral health and oral life quality self-rating. The questionnaire was translated into Lithuanian using translation guidelines. In addition, an item on the oral pain was modified identifying the pain location. Standard tests (Cronbach's ?, construct validity and discriminant validity), supplemented with both exploratory and confirmatory factor analyses, were employed for psychometric evaluation of the instrument. The questionnaire was also tested by comparison students' and their parents' (N =?255) responses about oral symptoms and functional limitations.<h4>Results</h4>The modified Lithuanian version of CPQ<sub>11-14</sub> revealed good internal consistency reliability (Cronbach's alpha for the total scale was 0.88). The measure showed significant associations with perceived oral health status and oral well-being, as well as with global life satisfaction (p <?0.01). Discriminant validity of the instrument was approved by comparison of children's groups defined by self-reported caries experience and malocclusion. Factor analysis revealed a complex structure with two or three factors in each of four domains of the CPQ<sub>11-14</sub>. Excellent or acceptable levels of indices of model fitting with the given data were obtained for oral symptoms, functional limitations and emotional well-being domains, but not for the social well-being domain. A significant association between child and parental responses was found (intraclass correlation coefficient was 0.56 and 0.43, correspondingly in domains of oral symptoms and functional limitations).<h4>Conclusion</h4>The Lithuanian version of the CPQ<sub>11-14</sub> (with a modified item that identifies location of oral pain) appears to be a valid instrument to be used in further studies for measuring OHRQoL among 11 to 14?year old children in Lithuania.
Project description:Quality of life (QL) assessments of children with incapacitating diseases, such as cerebral palsy (CP), have often been conducted with the help of the representatives of a child, making QL assessment more subjective. The Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI) is a QL assessment designed for children to self-report-it uses images to facilitate the reporting process.evaluate the psychometric properties of AUQEI when responses are given by children with CP.Children aged 4 to 12 years (45 with CP and 45 healthy children) gave responses to the questionnaire. The data quality, reliability and validity were assessed. The data loss rate ranged from 8.8% to 46.7%, and was highest for the "autonomy" factor. No floor or ceiling effect was detected. The success rate for reliability of the internal consistency of the items was less than 80% for the "autonomy" factor. Cronbach's alpha coefficient was 0.71 for the instrument and less than 0.5 for the factors. All the factors had a success rate of greater than 80% for the discriminating validity of the items. The factors did not have correlations between each other, thus indicating adequate discriminating validity. Convergent validity was tested and a significant correlation was demonstrated only between the AUQEI "functioning" factor and the Child Health Questionnaire--50-Item (CHQ-PF50) physical summary score (r = 0.31, p = 0.042). The AUQEI scores did not have correlations with the gross motor function scores (p>0.05) as expected for divergent validity. Regarding construct validity, the total AUQEI score obtained by the CP group was lower (median: 47.3) than that of the healthy group (median: 51.0) (p<0.01).The AUQEI was shown to be a reliable and valid instrument for assessing children with CP when the total score was used. Convergent validity should continue to be tested in future studies.
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:Objectives: Oral pain is underrecognized and undertreated in small animal practice. This study aimed to develop and perform a preliminary validation of an instrument to evaluate oral and maxillofacial pain in dogs and cats. Methods: Indicators potentially associated with oral pain in dogs and cats were identified and selected. The Composite Oral Pain Scale-Canine/Feline (COPS-C/F) in the Italian language was developed using a two-part questionnaire (owner and veterinary specific questionnaires). The instrument was used to score the intensity of oral and maxillofacial pain in patients with oral disease. Content validity was performed and the COPS-C/F was applied to 20 dogs and 16 cats with oral disease at baseline and 15 days after dental treatment for construct validity. Criterion validity was assessed by comparing the COPS-C/F with a visual analog scale (VAS), a numeric rating scale (NRS), and a simple descriptive scale (SDS). Construct validity/responsiveness and criterion validity were assessed with Wilcoxon and Spearman Pearson tests, respectively (p ? 0.05). The Cronbach's alpha coefficient was used to calculate internal consistency. Thereafter, the instrument was refined and translated to English and back-translated for semantic equivalence. Results: Construct validity was confirmed with a significant reduction of pain scores after treatment (p < 0.05) for most items. Criterion validity was confirmed by a significant correlation among the COPS-C/F total pain scores and those from VAS, NRS, and SDS (p < 0.05). Cronbach's alpha coefficient was 0.876 and 0.860 for the owner and the veterinary specific questionnaires, respectively, indicating good internal consistency. The items that did not present significant differences between time-points and the VAS, NRS, and SDS were removed prior to translation to English (COPS-C/F ENG). Conclusions and Clinical Relevance: The study described the development and preliminary validation of the COPS-C/F as an instrument for pain assessment in dogs and cats. Refinement and back-translation of COPS-C/F with semantic equivalency resulted in the COPS-C/F ENG consisting of six and four items for the owner and veterinary specific questionnaires, respectively. The English version requires further validation and testing using a larger number of patients in the clinical setting.
Project description:Introduction:The wide variety of symptoms in patients with cardiac arrhythmias can affect daily living activities. The evaluation of symptoms with patient-reported outcome measures (PROMs), with validated instruments, can provide information that contributes to clinical decisions and treatment. In Brazil, however, there is no available scale that evaluates symptoms in different types of arrhythmias. Purpose:This study aimed to translate the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia symptom scale (ASTA-symptom scale) and then validate the questionnaire in terms of Brazilian culture. Method:The methodological process of cultural adaptation used was based on international literature guidelines consisting of forward translation, synthesis, back translation, review by an expert committee, and pretest. Psychometric analyses were conducted with 140 patients. These included measuring internal consistency (Cronbach's alpha), construct validity with item-total correlations, and convergent construct validity with correlations with the quality of life questionnaire for patients with atrial fibrillation-version 2 (QVFA-v2). Usability and understandability were evaluated through the usability evaluation of instruments. Results:The translation and adaptation processes were performed by obtaining the Brazilian Portuguese version of the original Swedish instrument. This version presented the internal consistency of items, evaluated through Cronbach's ? (0.79). Construct validity was demonstrated by item-total correlations for the nine items, all except one reached the level of >0.30 (0.24). Convergent validity showed a high correlation with QVFA-v2 (0.89). As for the evaluation of usability and understanding, after two small suggested changes, no additional alterations were necessary. Conclusion:The psychometric properties of the Brazilian version of ASTA-symptom scale evaluated in this study were satisfactory, and the scale was proved to be a valid and reliable tool to assess the symptom burden in patients with different forms of tachyarrhythmia. The ASTA-Br-symptom scale questionnaire can be an important addition to PROMs for patients with arrhythmias and could help healthcare professionals in decision-making.
Project description:Enabling patients with asthma to obtain the knowledge, confidence and skills they need in order to assume a major role in the management of their disease is cost effective. It should be an integral part of any plan for long-term control of asthma. The modified Patient Enablement Instrument (mPEI) is an easily administered questionnaire that was adapted in the United Kingdom to measure patient enablement in asthma, but its applicability in Portugal is not known. Validity and reliability of questionnaires should be tested before use in settings different from those of the original version. The purpose of this study was to test the applicability of the mPEI to Portuguese asthma patients after translation and cross-cultural adaptation, and to verify the structural validity, internal consistency and reproducibility of the instrument. The mPEI was translated to Portuguese and back translated to English. Its content validity was assessed by a debriefing interview with 10 asthma patients. The translated instrument was then administered to a random sample of 142 patients with persistent asthma. Structural validity and internal consistency were assessed. For reproducibility analysis, 86 patients completed the instrument again 7 days later. Item-scale correlations and exploratory factor analysis were used to assess structural validity. Cronbach's alpha was used to test internal consistency, and the intra-class correlation coefficient was used for the analysis of reproducibility. All items of the Portuguese version of the mPEI were found to be equivalent to the original English version. There were strong item-scale correlations that confirmed construct validity, with a one component structure and good internal consistency (Cronbach's alpha >0.8) as well as high test-retest reliability (ICC=0.85). The mPEI showed sound psychometric properties for the evaluation of enablement in patients with asthma making it a reliable instrument for use in research and clinical practice in Portugal. Further studies are needed to confirm its responsiveness.
Project description:<h4>Objective</h4>The current study aimed to develop iWorkHealth, a valid and reliable self-administered instrument which identifies workplace psychosocial risk factors in Singapore.<h4>Methods</h4>The survey was conducted among 2718 employees who were primarily salaried workers and working in five companies from the healthcare, banking and finance, and legal sectors in Singapore. Factor extraction and item reduction were conducted using exploratory factor analysis (EFA) and Mokken scale analysis (MSA). Construct validity, internal consistency and convergent validity of the final scale were confirmed using confirmatory factor analysis (CFA), Cronbach's alpha and Pearson correlation coefficients, respectively. Multiple Indicators Multiple Causes model was used to detect Differential Item Functioning (DIF).<h4>Results</h4>EFA and MSA identified a five-factor solution (job demand, job control, employee and management engagement, supervisor support and colleague support) for the 27 items iWorkHealth instrument. CFA demonstrated that the five-factor model fitted the data with high internal consistency (Cronbach's alpha ranged from 0.79 to 0.92). The convergent validity was shown through significant association with existing scales-high job demand was significantly associated with high burnout and depression, while high job control, employee and management engagement, supervisor support and coworker support were significantly associated with low burnout and depression. Ten items were detected with significant DIF, but impact was minimal on the associations between socio-demographics factors and iWorkHealth subscales.<h4>Conclusions</h4>The findings provided evidence that the iWorkHealth instrument which comprises 27 items in five domains of psychosocial risk at the workplace is a reliable and valid instrument that could be used to measure and compare the level of psychosocial risk factors across companies and industries in Singapore.